Minority Stress Research Articles

Centering the margins: Reimagining resilience and resistance for transgender and nonbinary people of color

AbstractBy centering the margins through intersectional and cross‐cultural perspectives, this article offers a reimagining of resilience by exploring individual versus collective (i.e., group‐level) approaches and strategies adopted by transgender and nonbinary people of color (TPOC) to resist oppression. We address the dynamics of multiple group membership and recognize the profound effects of culture on how TPOC communities navigate resilience and resistance. Utilizing an international perspective, we examine risk and resilience by considering proximal and distal minority stressors such as discrimination and internalized stigma. We also address the utility of current models used to address TPOC resilience (i.e., minority stress and resilience theory, transgender resilience intervention model). Finally, we address tensions associated with the characterization of resilience and resistance for TPOC within the social sciences and across cultures. This article thus serves as a critical foundation for reimagining research with TPOC by presenting potential avenues for further research, theory, and community action globally.

A systematic review and Bayesian meta-analysis of 30 years of stress generation research: Clinical, psychological, and sociodemographic risk and protective factors for prospective negative life events.

Stress generation posits that (a) individuals at-risk for psychopathology may inadvertently experience higher rates of prospective dependent stress (i.e., stressors that are in part influenced by their thoughts and behaviors) but not independent stress (i.e., stressors occurring outside their influence), and (b) this elevated dependent stress, in some measure, is what places these individuals at-risk for future psychopathology. In recognition of 30 years of stress generation research, we conducted a systematic review and meta-analysis using frequentist and Bayesian approaches (102 articles with 104 eligible studies, N = 31,541). Generally strong support was found for psychopathology predicting dependent stress (e.g., dsOverall psychopathology = 0.36-0.52, BF₁₀ = 946.00 to 4.65 × 10¹⁸). Moderator analyses for dependent stress revealed larger effects for briefer assessments periods, shorter follow-ups, and self-report measures than for interviews. Among risk factors, depressogenic cognitive styles (ds = .26-.50, BF₁₀ = 47.50 to 1.00 × 10⁵) and general interpersonal vulnerability (ds = .26-.44, BF₁₀ = 2.72 to 2708.00) received the strongest support as stress generation mechanisms, and current evidence is modest for protective factors predicting dependent stress. Overall, larger effects were generally found for prospective prediction of dependent stress than independent stress. Evaluations of mediation in the research literature were relatively few, limiting the current review to qualitative analysis of the mediation component of stress generation. General support was found, however, for dependent stress as a mediator for psychopathology and associated risk factors in relation to subsequent psychopathology. The current review ends with recommendations for future research and integration of stress generation within minority stress frameworks. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Therapy and counselling experiences of queer adults in Germany

AbstractBackgroundMental health professionals play a crucial role in either alleviating or exacerbating stress among queer clients.AimsDrawing on minority stress theory, we conducted a study to examine the experiences of lesbian, gay, bisexual and/or consensually non‐monogamous clients with current or recent psychotherapy or counselling experiences in Germany.MethodA convenience sample of 492 queer individuals participated in an online survey, providing insights into their most recent experiences with psychotherapy or counselling and evaluating the success of these processes. Among the participants, 92% identified as lesbian, gay, bisexual, or another non‐heterosexual identity, while 8% identified as heterosexual. Additionally, 54% reported being in consensually non‐monogamous relationships, and 23% identified as gender‐diverse.ResultsThe majority (92%) had prior experience with psychotherapy, with over half reporting their last session within the last month. The remaining 8% reported counselling experience. Most participants rated their recent psychotherapy or counselling process as successful. Exemplary practices were more common than inappropriate ones. While overt discrimination by mental health professionals was rare, subtle inappropriate behaviours were still prevalent. Affirmative and actively reassuring practices were strongly linked to subjective therapy success.ConclusionThe study's findings warrant cautious optimism regarding a non‐discriminative stance in German mental health professionals while highlighting the need for further research, training and guidelines for therapists and counsellors.

Social Determinants of Message Exposure and Health Anxiety Among Young Sexual Minority Men in the United States During the 2022 Mpox Outbreak

ABSTRACT This study tested the structural influence model of communication in the context of the 2022 global outbreak of the Mpox virus among young sexual minority men. The primary objective was to understand how distinct social determinants, including education, race/ethnicity, and interpersonal discrimination, influenced exposure to Mpox messages in daily life and affected health anxiety concerning the Mpox virus in the United States. We also explored the significance of LGBTQ+ community connectedness as a crucial form of social capital during the outbreak. We collected a three-wave longitudinal dataset and examined within-person and between-person associations using a random-intercept cross-lagged panel model. Participants (N = 254) reported that internet sources and social media were their primary information sources for Mpox messages during the outbreak. Educational attainment, racial minority status, and LGBTQ+ community connectedness were significantly associated with message exposure. Young sexual minority men who faced greater interpersonal discrimination in their daily lives also reported higher rates of Mpox-related health anxiety. Longitudinal analysis indicated that (at the within-person level) Mpox anxiety was significantly associated with greater Mpox message exposure in the month following the outbreak, but that relationship waned in the subsequent month. The theoretical implications highlight the relevance of minority stress variables in the structural influence model of communication framework and suggest the importance of community connectedness as a distinct form of social capital shaping message exposure and health anxiety during the Mpox outbreak in the United States.

Stress testing the minority stress model: It's not just neuroticism.

Stress testing the minority stress model: It's not just neuroticism.

The mediating effects of minority stress experiences on cannabis consumption among 2SLGBTQ+ youth

Introduction Data suggest there are within-group variations in cannabis consumption among sexually diverse individuals. However, less is known about specific sexual orientations, such as Two-Spirit, asexual, pansexual, and queer (2SAPQ+), when compared with lesbian, gay, and bisexual people, as they often are not given an option to indicate their identities on surveys, leading them to be grouped with bisexuals. This study aimed to compare the relationship between LG and 2SAPBQ+ (including bisexual) identification and routine cannabis use, and whether it was mediated by minority stress. Methods Data were collected across two time points from 851 Two-Spirit, lesbian, gay, bisexual, queer, and questioning (2SLGBTQ+) youth participants. Structural equation modeling (SEM) was employed to analyze whether latent constructs within the minority stress framework mediated the relationship between sexual identity and cannabis use longitudinally. Results A preliminary logistic regression confirmed that 2SAPBQ + individuals were more likely to consume cannabis than LG individuals. The results suggest that the minority stress constructs accounted for a significant portion of the variance within the relationship between sexual orientation and cannabis use. Conclusion The pathway between sexual orientation and routine cannabis use was complex. Findings signal that not all sexual minority individuals should be grouped into one category and call for attention to careful measurement practices.

Including Sexually and Gender Diverse Populations in 3,4-Methylenedioxymethamphetamine-Assisted Psychotherapy Trial Research.

Sexually and gender diverse (SGD) populations experience an increased prevalence and severity of posttraumatic stress disorder (PTSD) compared with the general population. Minority stress theory contextualizes this increased disease burden by outlining how stigma and discrimination (e.g., homophobia and transphobia) contribute to worse mental health outcomes. The standard-of-care pharmacotherapy for PTSD is associated with significant treatment resistance. 3,4-Methylenedioxymethamphetamine (MDMA)-assisted psychotherapy (MDMA-AP) has emerged as an investigational treatment for PTSD but has lacked consideration for SGD populations. This article explores next steps in clinical trial design and implementation for the study of MDMA-AP with SGD populations who have PTSD.

"Society Isn't Designed for Us to Win": Trauma and Sexual Healthcare Experiences Among Transgender Women in the Southeastern United States.

Transgender women (TGW) are disproportionately affected by sexually transmitted infections (STIs). Experienced trauma threatens TGW's commitment to sexual healthcare. Trauma-informed approaches to sexual healthcare can improve engagement. This study aimed to characterize the trauma experienced by TGW in the Southeastern US, especially related to sexual health. TGW completed in-depth individual interviews guided by the Modified Social Ecological Model (MSEM) and Minority Stress framework. Interviews explored the nature of trauma, sexual health, and their intersection in TGW's lives, and a thematic analysis was performed. Between August 2022 and January 2023, 13 TGW enrolled (69% Black, 31% White). Mental illness was common (77%). Five participants (38%) were HIV+, and seven (54%) reported lifetime STI history. Themes reflected societal (barriers to healthcare, anti-transgender legislation), community (misgendering/deadnaming), network (limited support), and individual (dysphoria, sex work, fear for physical safety, stigma, mental health conditions, race) stressors. The physical/sexual violence and resilience themes pervaded all stressor levels. Medical mistrust was exacerbated by past traumatic experiences within sexual healthcare settings. Resilience and transgender representation in healthcare settings were protective. Various experienced traumas and their cumulative effects were pervasive in the daily lives of TGW. Development of targeted interventions to improve sexual health engagement of TGW must optimize personal strengths and provide holistic support.

Exploring the Health Impact of Intersectional Minority Identity Stressors on Arab Sexual Minority Women Migrants to the United States.

Using an intersectionality lens and the minority stress theory as our theoretical grounding, this qualitative study is the first to examine the mental health of Arab sexual minority women (SMW) migrants to the United States. The study aimed to (1) explore the perceptions and experiences of intersectional minority identity-related life stressors and (2) discern their impact on the mental health of first-generation Arab SMW migrants. From December 2022 to March 2023, we conducted 20 semi-structured interviews with Arab SMW migrants. Guided by principles of community engagement in research, four community advisors, including three Arab SMW migrants and a mental health service provider, assisted in mock interviews, recruitment, and data analysis. This enriched our thematic analysis providing a nuanced understanding of Arab SMW migrant experiences. Participants reflected diverse nationalities, socioeconomic statuses, and religions and identified as lesbian, bisexual, or queer. Our sample included asylum seekers, documented migrants, and non-binary individuals (assigned female at birth). Findings revealed three major themes: (1) Community- and Interpersonal-Level Stressors, (2) Strategies for Coping with Stressors, and (3) Impact of Intersectional Life Stressors on Mental Health. Community- and interpersonal-level stressors included challenges navigating migration-related stressors, rejection and discrimination from the Arab, queer, and dominant-group (i.e., non-Arab, non-White) communities, and experiences of invalidation of their intersectional identities. Coping mechanisms included avoidance, identity concealment, and seeking social support. Participants reported various mental health impacts, from anxiety, depression to suicidal thoughts, emphasizing the urgency for tailored interventions. Participants called for the development of support groups specifically for Arab SMW migrants.

“It changed me for the better”: Feasibility, acceptability, and safety of an online program for sexual and gender minority youth to prevent alcohol use and teen dating violence

ObjectiveThe purpose of the current study was to describe and present implementation outcome data from an open pilot trial of the Promoting Resilient Youth with Strong Hearts and Mind (PRYSHM) Program, an online, live-facilitated, nine-session group program for dating sexual and gender minority youth (SGMY) ages 15 to 18. The program, co-facilitated by two LGBTQIA2S+ adults, focuses on reducing proximal forms of minority stress and building LGBTQIA2S+ community in addition to providing evidence-based teen dating violence (TDV) and alcohol use (AU) prevention components. MethodParticipants (recruited via social media) included 18 SGMY (ages 15 to 17) from across the U.S. who completed a baseline survey and immediate post-test, as well as post-session surveys following each of the nine sessions. Sessions were recorded to monitor fidelity and facilitation skills. ResultsThe intervention was highly acceptable, and the program was perceived to be relevant and impactful, as evidenced by SGMY agreeing or strongly agreeing to items assessing these domains. Further, fidelity was 82.4% (average) across sessions, and the average attendance was 6.50 out of 9 sessions. SGMY also provided open-ended feedback used to revise the PRYSHM program for future implementation and evaluation research. ConclusionThese data provide preliminary support for PRYSHM as a feasible, acceptable, and safe prevention program and suggest that further evaluation of the program using larger samples and rigorous outcome evaluation methods is warranted.

Gender Identity and Its Influence on Social Support Networks among LGBTQ+ youth in New Zealand

Purpose: The aim of the study was to analyze the gender identity and its influence on social support networks among LGBTQ+ youth in New Zealand. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Research on gender identity and its influence on social support networks among LGBTQ+ youth in New Zealand highlights that individuals with diverse gender identities often face unique challenges in accessing and maintaining supportive relationships. Findings indicate that LGBTQ+ youth experience varying levels of support based on their gender identity, with those who identify as non-binary or transgender sometimes facing more barriers compared to their cisgender or gay/lesbian peers. Social support networks play a crucial role in providing emotional and practical assistance, but the quality and availability of these network Unique Contribution to Theory, Practice and Policy: Social identity theory, minority stress theory & ecological systems theory may be used to anchor future studies on gender identity and its influence on social support networks among LGBTQ+ youth in New Zealand. Implement educational programs for families to foster understanding, acceptance, and support for transgender and non-binary youth. Advocate for and implement comprehensive anti-bullying and inclusivity policies in schools that protect LGBTQ+ students. Policies should mandate the creation of safe spaces and support groups within educational institutions.

Assessment of Sexual Violence Risk Perception in Men Who Have Sex With Men: Proposal for the Development and Validation of "G-Date".

Sexual violence (SV) is a significant problem for sexual minorities, including men who have sex with men (MSM). The limited research suggests SV is associated with a host of syndemic conditions. These factors tend to cluster and interact to worsen one another. Unfortunately, while much work has been conducted to examine these factors in heterosexual women, there is a lack of research examining MSM, especially their SV risk perception. Further, MSM are active users of dating and sexual networking (DSN) mobile apps, and this technology has demonstrated usefulness for creating safe spaces for MSM to meet and engage partners. However, mounting data demonstrate that DSN app use is associated with an increased risk for SV, especially given the higher likelihood of using alcohol and other drugs before sex. By contrast, some researchers have demonstrated that DSN technology can be harnessed as a prevention tool for HIV; unfortunately, no such work has progressed regarding SV. This study aims to (1) use qualitative and quantitative methods to tailor an existing laboratory paradigm of SV risk perception in women for MSM using a DSN mobile app framework and (2) subject this novel paradigm to a rigorous validation study to confirm its usefulness in predicting SV, with the potential for use in future prevention endeavors. To tailor the paradigm for MSM, a team of computer scientists created an initial DSN app (G-Date) and incorporated ongoing feedback about the usability, feasibility, and realism of this tool from a representative sample of MSM. We used focus groups and interviews to assist in the development of G-Date, including by identifying relevant stimuli, developing the cover story, and establishing the appropriate study language. To confirm the paradigm's usefulness, we are conducting an experimental study with web-based and face-to-face participants to determine the content, concurrent, and predictive validities of G-Date. We will evaluate whether certain correlates of SV informed by syndemics and minority stress theories (eg, history of SV and alcohol and drug use) affect the ability of MSM to detect SV risk within G-Date and how paradigm engagement influences behavior in actual DSN app use contexts. This study received funding from the National Institute on Alcohol Abuse and Alcoholism on September 10, 2020, and ethics approval on October 19, 2020, and we began app development for aim 1 immediately thereafter. We began data collection for the aim 2 validation study in December 2022. Initial results from the validation study are expected to be available after December 2025. We hope that G-Date will enhance our understanding of factors associated with SV risk and serve as a useful step in creating prevention programs for this susceptible population.

'The Lost Peace': Evidencing the Syndemic Relationship between Neglected Tropical Diseases and Mental Distress in Liberia.

Neglected Tropical Diseases (NTDs) are a group of chronic infectious diseases of poverty affecting over one billion people globally. Intersections of NTDs, disability, and mental ill-health are increasingly evidenced but are rarely studied from a mixed-methods perspective. Here, we advance syndemic understandings by further assessing and contextualising the syndemic relationship between NTDs (particularly their associated disability) and mental distress in Liberia. Participatory qualitative methods, including body mapping (56 participants), social mapping (28 participants), and in-depth interviews (12) provided space for persons affected by NTDs to narrate their experiences. Simultaneously, 201 surveys explored experiences of common mental health conditions among persons affected by skin NTDs. An intersectionality approach was applied within the analysis for both qualitative and quantitative methods informed by Meyer's minority stress model, adapted for NTDs. Qualitative data was analysed thematically and gender-disaggregated, univariable and multivariable analyses were applied to survey data for the outcome measures depression (PHQ-9) and anxiety (GAD-7). Disability was associated with higher levels of depression and anxiety (p < 0.001). An interaction between disability and being a women increased incidence risk ratio of depression (p < 0.001). In alignment with qualitative findings, persons affected experienced additional generalised (financial concerns), external (experience of stigma) and internal (experience of pain and physical symptoms) minority stressors, to varying degrees, which contributed towards their mental distress, and mental health conditions. These findings were used to co-develop a syndemic-informed person-centred health system response to address the suffering associated with NTDs and mental distress, including a focus on strengthening relationships between formal and informal community health actors and the broader health system.

How Do Intimate Partner Violence, Outness, and Community Connection Relate to Minority Stressors for Men Who Have Sex with Men?

Intimate partner violence (IPV) is a pervasive issue among men who have sex with men (MSM). However, IPV has long been conceptualized as abuse between a male perpetrator and a female victim, leaving gaps in the literature on the unique impacts IPV victimization has for both male victims and victims in same-sex relationships. This study examines relationships between IPV and negative minority stress experiences specific to LGBTQ individuals: overt experiences of homophobia, sexual orientation microaggressions, and internalized homophobia. Participants (N = 168) were recruited through three popular MSM networking applications (i.e., Grindr, Jack'd, and Scruff. Most were recruited from one state in the southeastern United States. Ordinary Least Squares regressions were used to examine IPV as a predictive factor in three separate models, all of which controlled for age, race, outness, and gay community connection (GCC). IPV victimization is associated with increased levels of experiences of overt homophobia, homophobic microaggressions, and internalized homophobia for MSM. Outness, or being open with the people in one's life about one's MSM identity, is associated with lower levels of both sexual orientation microaggressions and internalized homophobia. GCC is also associated with lower levels of internalized homophobia. Results from this study show that IPV victimization is related to minority stressors for MSM. These findings support the existence of unique elements of IPV for LGBTQ victims, specifically MSM. Implications for IPV researchers and service providers are discussed, including the importance of the protective role of outness and GCC against some minority stressors.

Surveying Psychological Wellbeing in a Post-Pandemic World: The Role of Family and Social Support for LGBTQ+ and Cisgender Heterosexual Adults in the UK.

Studies have emphasized the importance of social support in mitigating the relationship between psychological distress and mental health effects, with family of origin and family of formation providing key sources of social support over the life course. However, LGBTQ+ people may experience family of origin relationships as a source of distress, while partners and friends may buffer the relationship between minority stress and psychological wellbeing. Through our online survey (March-June 2022), which was conducted when the social restrictions of the COVID-19 pandemic were lifted in the UK, we considered the association between psychological wellbeing and sources of social support by sampling n = 1330 LGBTQ+ and cisgender heterosexual adults. LGBTQ+ adults generally experienced poorer psychological wellbeing outcomes than did cisgender heterosexual people. For LGBTQ+ adults, social support from family of origin, a special person, or friends was not associated with depression, anxiety, or stress levels, but social support from family or a special person was positively associated with higher levels of life satisfaction. Our findings indicate the importance of considering negative as well as positive wellbeing.

The integration of queer-related curriculum in psychology training in Aotearoa/New Zealand: a survey with programme directors

ABSTRACT As a key profession within the mental health workforce, psychologists can offer affirmative services that lead to positive therapeutic outcomes for queer clients. This study examined how training programmes to become a registered psychologist in Aotearoa New Zealand currently provide content on working with queer clients. In 2022, all (N = 17) programme directors of psychology training were invited to participate in a survey that assessed the cultural responsiveness of their training programmes and 15 responded. One-fifth (19%) classified their programme as containing at least ‘a moderate amount’ of queer content. Four-fifths (79%) reported that knowledge of caring for queer clients would be ‘very’ or ‘extremely’ important in psychology practice and/or thought more time should be dedicated to such content. Over half (57%) adopted an ‘add on’ approach to deliver queer content (e.g. guest lectures). During a time when queer communities experience drastically high rates of mental health issues and high exposure to minority stressors, there is a critical gap in the meaningful threading of queer content across the psychology curriculum. We have outlined ten points for reflection on developing this aspect.

The Influence of Gender Dysphoria in Social Aspects

Gender dysphoria(GD) is a mental illness that causes distress when the gender identity(GI) of people differs with their physical gender. This article gives a review of GD in social aspects which discusses the internal process and external process as the source of stress and associates the social interactions of individuals with GD in the social context. The social function of people with GD could be affected by misgendering, gendered assumptions and intrusive thoughts about preoccupation with how others perceive them. Discrimination and exclusion was confronted by people with GD and linked to the minority stress model to describe different sources of stress. That will trigger negative mental health outcomes while social support connects to positive mental consequences in individuals with GD. The result of this research provides an understanding of people with GD through the analysis of the interaction in social context and the problems of their situations in society have been described through the data and studies, such as discrimination and stigma. The further research can focus on the solutions that can change their situations and help them in various ways.

HIV-related knowledge, risk perception, and minority stressors among South Asian sexual minority men in the United States.

South Asian gay, bisexual, and other men who have sex with men (GBM) in the United States have been persistently overlooked in HIV research and programming. To address this limitation, this article describes their HIV-related knowledge, risk perception, and minority stressors, with a focus on identifying variations between American-born individuals and immigrants. Participants were recruited from April-July 2022 through social media advertising and peer referral and surveyed about their sociodemographic and HIV-related behavioral characteristics. Previously validated scales were used to assess their HIV-related knowledge, risk perception, disclosure of sexual identity, experienced homophobia, and perceived racism within the sexual and gender minority community. Mann-Whitney-Wilcoxon tests were conducted to compare those born in the United States and those born abroad. Of the 112 participants, 26 (23.21%) were American-born individuals and 86 (76.79%) were immigrants. Despite similar levels of sexual risk behaviors, such as having multiple male sex partners, engaging in condomless anal sex, and using alcohol or drugs immediately before or during sex, immigrants had lower levels of HIV-related knowledge (p = .0480) and risk perception (p = .0114) compared to American-born individuals. Immigrants were also less likely to have disclosed their sexual identity to family, friends, and society compared to American-born individuals (p = .0004). No differences were identified with respect to experiences of homophobia (p = .2303) or perceptions of racism (p = .4011). Comprehensive HIV prevention efforts that address the social and cultural norms of South Asian GBM in the United States are needed.

“To smoke feels gender”: Exploring the transformative and emancipatory capacities of cannabis among transgender, non-binary and gender non-conforming (TGNC) youth

BackgroundTransgender, non-binary and gender non-conforming (herein, “TGNC”) youth (15–24 years old) face overlapping minority stressors (e.g., gender discrimination, lack of access to gender-affirming care, rejection, violence) that contribute to mental health inequities. TGNC youth also use substances at higher rates when compared to cisgender youth, including some of the highest rates of cannabis use in Canada. MethodsThis community-based participatory research study provides an in-depth qualitative, photovoice-based analysis examining how cannabis use features within the gender experiences of a sample of TGNC youth in British Columbia (BC). We conducted in-depth, semi-structured interviews with 27 TGNC youth (15–24 years old) from across British Columbia. Interviews were designed to elicit discussions about the photos youth had taken as well as various gender and mental health experiences related to their cannabis use. Analysis and identification of emergent themes was guided by social constructivist grounded theory as well as queer and trans theorizing and informed by community-based research approaches through regular meetings with our team's Substance Use Beyond the Binary Youth Action Committee comprised of TGNC youth who use substances. ResultsThree overarching themes pertaining to cannabis use and gender experiences amongst TGNC youth in our study were generated. First, participants used cannabis purposefully and strategically to enact diverse gender expressions and embodiments. Second, participants leveraged cannabis to support introspection whilst mobilizing identity discovery and development. Finally, participants mobilized cannabis as a vehicle for accessing moments of gender euphoria and affirmation. ConclusionsThese findings identify how some TGNC youth use cannabis to purposefully and strategically facilitate their mental health, well-being, identity development and self-expression. This research reveals critically important experiential and embodied dimensions of cannabis use that have not historically been considered in cannabis-related policy and the provision of care, including mental health and substance use-related care.

Differences in Thinness- and Muscularity-Oriented Eating and Body Image Disturbances and Psychosocial Well-Being in Chinese Sexual Minority Men Reporting Top, Bottom, and Versatile Sexual Self-Labels.

In addition to describing sexual partner preferences, sexual self-labels in gay and bisexual (henceforth, sexual minority) men, such as top, bottom, and versatile, are associated with psychological characteristics (e.g., gendered personality traits). No research has explored the association between sexual self-labels and eating and body image disturbances in sexual minority men. Research in sexual minority men from China is particularly valuable and needed due to recent rises in rates of eating and body image disturbances and unique, minority-specific stressors experienced by Chinese sexual minority populations. We adopted an online, cross-sectional study in a sample of sexual minority men from China (N = 403; tops, n = 256, bottoms, n = 95, versatiles, n = 52). Bottoms reported higher thinness internalization, lower muscularity internalization, higher body fat dissatisfaction, and higher psychological distress than tops. Bottoms' weight bias internalization was higher than tops' and versatiles' reports and, compared to versatiles, bottoms also reported higher psychosocial impairment related to eating disorder psychopathology. Compared to versatiles, tops reported higher drive for muscularity and muscularity-oriented disordered eating. Adjusting for age, psychological distress, and psychosocial impairment, tops reported higher muscularity internalization than bottoms and higher drive for muscularity and muscularity-oriented disordered eating than both bottoms and versatiles. Findings suggested unique relations between sexual self-labels and eating and body image disturbances in Chinese sexual minority men. Replication and validation of the temporal order between sexual self-labels and eating and body image disturbances is needed, including assessment of social factors (e.g., femmephobia, minority stress) that may help explain the links between sexual self-labels and eating pathology.