Sexual And Gender Minority Status Research Articles

Recommendations for the assessment of sexual and gender minority status in serious mental illness research and clinical care.

Sexual and gender minority (SGM) groups experience exposure to minority stress, including discrimination, prejudice, microaggressions, and internalized stigma. Despite the sizable portion of the United States' population that identifies as SGM, relatively little research has been done to comprehensively understand the mental health consequences of SGM stress-particularly as they relate to serious mental illnesses (SMIs)-and SGM status is rarely reported in published studies. This article provides an overview of SGM research among people with SMIs as well as other relevant disorders. Findings show that sizable gaps remain in our knowledge of whether SGM groups experience higher rates or greater severity of SMIs, including schizophrenia-spectrum and bipolar disorders, though findings related to depressive and trauma-related disorders may be able to inform research and treatment for those with SMIs. To increase our understanding of potential mental health disparities for those with SMIs, researchers are encouraged to include measures to assess SGM identity, report upon this demographic information within their manuscripts, and examine differences in rates and severity of SMIs between these groups. Clinicians are encouraged to incorporate demographic questions into their standard intake batteries and initiate discussion of SGM status and minority stressors early on in treatment to promote more positive outcomes for this group. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An Examination of Pregaming Behavior and Motives among Sexual and Gender Minority College Students

Introduction: Pregaming is a popular but high-risk drinking behavior common among college students. Although sexual and gender minority (SGM) college students are a vulnerable population with regards to hazardous alcohol use and alcohol consequences, there is currently limited research investigating the pregaming behavior of this group. The present study aimed to (1) examine mean level differences in pregaming behaviors and motives between SGM and non-SGM college students and (2) explore how SGM status was associated with pregaming behaviors and if SGM status moderated the association between motives and pregaming behaviors. Methods: The sample consisted of 485 college student drinkers in the US, with 19% (n = 93) identifying as SGM. All participants completed measures of past 30-day pregaming frequency and quantity (yielding a total pregaming drinks outcome) and drinking consequences experienced on pregaming days. Results: SGM participants consumed significantly fewer pregaming drinks than non-SGM participants, but did not significantly differ on alcohol-related consequences or drinking motives. The pregaming motive of intimate pursuit moderated the association between SGM status and total pregaming drinks, such that non-SGM participants with high intimate pursuit motives drank the heaviest. Conclusions: Our findings suggest that SGM students consume significantly fewer pregaming drinks than their non-SGM counterparts. However, they may be at a similar risk of experiencing pregaming consequences as non-SGM students. SGM students were less susceptible to the effect of intimate pursuit motives on pregaming drink consumption. This study offers support for past research regarding the effects of certain pregaming motives on pregaming drink consumption and consequences.

Health disparities in one of the world’s most progressive countries: a scoping review of mental health and substance use among sexual and gender minority people in the Netherlands

BackgroundEvidence from many parts of the world shows that sexual and gender minority (SGM) people have poorer health than their cisgender heterosexual counterparts. Minority stressors, particularly stigma and discrimination, have been identified as major contributors to sexual orientation- and gender identity-related health disparities, particularly negative mental health and behavioral health outcomes. To better understand factors that contribute to these disparities, we conducted a scoping review of SGM mental health and substance use research in the Netherlands—a country with a long-standing reputation as a pioneer in SGM equality.MethodsUsing Joanna Briggs Institute guidelines and the PRISMA-ScR protocol, we searched seven databases to identify studies published between 2010 and 2022 that focused on substance use and/or mental health of SGM youth and adults in the Netherlands.ResultsAlthough there was some evidence that SGM people in the Netherlands report fewer substance use and mental health concerns than those in less progressive countries, with very few exceptions studies found poorer outcomes among SGM participants than cisgender, heterosexual participants. However, this observation must be considered cautiously given major gaps in the literature. For example, only one study focused exclusively on adult sexual minority women, two focused on older SGM adults, and very little attention was given to nonbinary individuals. Most studies used non-probability samples that were quite homogenous. Many studies, especially those with youth, assessed sexual orientation based on sexual attraction; some studies of adults operationalized SGM status as having a same-sex partner. Importantly, we found no studies that directly assessed associations between structural-level stigma and health outcomes. Studies were mostly focused at the individual level and on health problems; very little attention was given to strengths or resilience.ConclusionsFindings of persistent health disparities—despite the relatively long history of SGM supportive policies in the Netherlands—highlight the need for more research and greater attention to population groups that have been underrepresented. Such research would not only provide guidance on strategies to improve the health of SGM people in the Netherlands, but also in other countries that are seeking to reduce health inequities. Addressing SGM health disparities in the Netherlands and elsewhere is complex and requires a multifaceted approach that addresses individual, interpersonal and structural factors.

The Role of Social Networks on Depression and Anxiety Among a Sample of Urban American Indian/Alaska Native Emerging Adults

PurposeMental health inequalities continue to persist among American Indian/Alaska Native (AI/AN) people. However, few studies have examined the association of social networks and depression and anxiety among urban emerging AI/AN adults. MethodsThis study analyzes the association of social network characteristics with depression and anxiety among a sample of urban AI/AN emerging adults. A second set of regression models tested the same associations but controlling for respondent sexual and gender minority (SGM) status. Data were from a sample of 150 AI/AN emerging adults residing in urban areas from 20 different states (86% female; mean age 21.8; 48.0% SGM) who participated in a randomized controlled trial analyzing the effects of culturally grounded interventions on alcohol and other drug use and cultural connectedness. ResultsParticipants with a higher proportion of network members who were around the same age reported significantly less anxiety. Those who had a higher proportion of network members who they sometimes/often argue/fight with were more likely to report greater depression and anxiety. Participants with higher proportions of social network members who have ever lived on a reservation/Rancheria/tribal land/tribal village reported significantly less depression. However, participants with higher proportions of social network members who lived 50 miles away or more reported significantly more depression. Controlling for SGM status, results were largely similar. DiscussionResults highlight the role of social connections on the mental well-being of urban AI/AN emerging adults.

Barriers to Care Among Sexual and Gender Minority Individuals With Chronic Inflammatory Skin Diseases in the US

Research on the prevalence of barriers to care among sexual and gender minority (SGM) patients with chronic inflammatory skin diseases (CISDs) in the US is limited. To compare the prevalence of cost and noncost barriers to care among SGM and non-SGM patients with CISDs and to analyze the prevalence of barriers based on SGM status and race and ethnicity. A cross-sectional study of health care access and utilization survey data collected by the National Institutes of Health's All of Us Research Program between May 31, 2017, and July 1, 2022, was conducted. Participants were adults aged 18 years or older with CISDs who enrolled in All of Us directly online or through partner health care practitioner organizations located across the US. Chronic inflammatory skin diseases, sexual orientation and gender identity, and race and ethnicity. The main outcome was the experience of cost and noncost barriers to health care among SGM patients with CISDs. Multivariable logistic regression was used to examine the association of SGM status with experiencing barriers to care. This study included 19 743 patients with CISDs; 1877 were SGM patients (median age, 40.5 years [IQR, 28.7-57.9 years]; 1205 [64.2%] assigned female sex at birth) and 17 866 were non-SGM patients (median age, 57.1 years [IQR, 40.8-68.1 years]; 13 205 [73.9%] assigned female sex at birth). Compared with non-SGM patients, SGM patients with CISDs were significantly more likely to delay specialist care (adjusted odds ratio [AOR], 1.23; 95% CI, 1.03-1.47), mental health care (AOR, 1.62; 95% CI, 1.37-1.91), and filling a prescription (AOR, 1.30; 95% CI, 1.11-1.52) because of cost. In addition, SGM patients with CISDs were significantly more likely than non-SGM patients to delay care because of transportation issues (AOR, 1.49; 95% CI, 1.22-1.80) and not having a health care practitioner who shares the same background with regard to race and ethnicity, religion, native language, sexual orientation, and gender identity (AOR, 1.39; 95% CI, 1.19-1.62). Sexual and gender minority patients with CISDs were also significantly more likely than non-SGM patients to report not always being treated with respect by their health care practitioners (AOR, 1.47; 95% CI, 1.30-1.65). The findings of this cross-sectional study of survey data suggest that SGM patients with CISDs may be disproportionately affected by cost and noncost barriers to health care. Dermatologists and other health care practitioners caring for SGM patients with CISDs have an important role in helping to address these barriers and larger systemic issues for SGM patients at both the patient and system levels.

LGBTQ Utilization of a Statewide Tobacco Quitline: Engagement and Quitting Behavior, 2010-2022.

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) individuals use tobacco at disproportionately high rates but are as likely as straight tobacco users to want to quit and to use quitlines. Little is known about the demographics and geographic distribution of LGBTQ quitline participants, their engagement with services, or their long-term outcomes. Californians (N = 333 429) who enrolled in a statewide quitline 2010-2022 were asked about their sexual and gender minority (SGM) status and other baseline characteristics. All were offered telephone counseling. A subset (n = 19 431) was followed up at seven months. Data were analyzed in 2023 by SGM status (LGBTQ vs. straight) and county type (rural vs. urban). Overall, 7.0% of participants were LGBTQ, including 7.4% and 5.4% of urban and rural participants, respectively. LGBTQ participants were younger than straight participants but had similar cigarette consumption. Fewer LGBTQ participants reported a physical health condition (42.1% vs. 48.4%) but more reported a behavioral health condition (71.1% vs. 54.5%; both p's < .001). Among both LGBTQ and straight participants, nearly 9 in 10 chose counseling and both groups completed nearly three sessions on average. The groups had equivalent 30-day abstinence rates (24.5% vs. 23.2%; p = .263). Similar patterns were seen in urban and rural subgroups. LGBTQ tobacco users engaged with and appeared to benefit from a statewide quitline even though it was not LGBTQ community-based. A quitline with staff trained in LGBTQ cultural competence can help address the high prevalence of tobacco use in the LGBTQ community and reach members wherever they live. This study describes how participants of a statewide tobacco quitline broke down by sexual orientation and gender. It compares participants both by SGM status and by type of county to provide a more complete picture of quitline participation both in urban areas where LGBTQ community-based cessation programs may exist and in rural areas where they generally do not. To our knowledge, it is the first study to compare LGBTQ and straight participants on their use of quitline services and quitting aids, satisfaction with services received, and rates of attempting quitting and achieving prolonged abstinence from smoking.

Sexual orientation and gender identity inequities in cervical cancer screening by race and ethnicity.

In the United States, inequities in preventive health behaviors such as cervical cancer screening have been documented. Sexual orientation, gender identity, and race/ethnicity all individually contribute to such disparities. However, little work has investigated their joint impact on screening behavior. Using sampling weighted data from the 2016 and 2018 Behavioral Risk Factor Surveillance System, we assessed differences in two metrics via chi-square statistics: 1) lifetime uptake, and 2) up-to-date cervical cancer screening by sexual orientation and gender identity, within and across racial/ethnic classifications. Within all races, individuals who identify as members of sexual and gender minority (SGM) communities reported higher rates of never being screened (except for Black transgender men) than straight or cisgender individuals (p < 0.0001). [*START*Across all races, the Asian/Pacific Islander transgender population (32.4%; weighted n (w.n.) = 1,313) had the lowest proportion of lifetime screening, followed by the Asian/Pacific Islander gay/lesbian (53.0%, w.n. = 21,771), Hispanic transgender (58.7%; w.n. = 24,780), Asian/Pacific Islander bisexual (61.8%, w.n. = 54,524), and Hispanic gay/lesbian (69.6%, w.n. = 125,781) populations. *END*]Straight or cisgender Non-Hispanic White (w.n. = 40,664,476) individuals had the highest proportion of lifetime screening (97.7% and 97.5%, respectively). However, among individuals who had been screened at least once in their lifetime, identifying as SGM was not associated with a decreased proportion of up-to-date screening within or between races. Due to small sample sizes, especially among Asian/Pacific Islander and Hispanic populations, confidence intervals were wide. Heterogeneity in screening participation by SGM status within and across racial/ethnic groups were observed. These screening disparities reveal the need to disaggregate data to account for intersecting identities and for studies with larger sample sizes to increase estimate reliability.

Examining Measurement Invariance in the Personality Inventory for DSM-5 Brief Form Across Sexual and Gender Minority Status.

The Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Brief Form (PID-5-BF) was developed with an assumption of invariance across sexual and gender minority (SGM) individuals. This assumption has yet to be tested empirically. Using multigroup confirmatory factor analysis, we examined measurement invariance in the PID-5-BF across the SGM status in clinical (N = 1,174; n = 254 SGM) and nonclinical (N = 1,456; n = 151 SGM) samples. Measurement invariance was supported for the PID-5-BF structure, item thresholds, and factor loadings, but not at the item intercept level. SGM individuals endorsed higher negative affectivity, antagonism, disinhibition, and psychoticism domains in both samples. In the clinical sample, adjusting for partial invariance decreased detachment and antagonism levels for SGM persons. In the nonclinical sample, adjusting for partial invariance reduced antagonism disparities in the SGM group, even rendering original group differences null. Our results support the use of the PID-5-BF in SGM populations but indicate that some measurement bias may drive observed disparities in maladaptive trait domains and, in turn, personality disorder diagnosis.

A Systematic Review of Inflammatory Bowel Disease Epidemiology and Health Outcomes in Sexual and Gender Minority Individuals

A Systematic Review of Inflammatory Bowel Disease Epidemiology and Health Outcomes in Sexual and Gender Minority Individuals

Disparities in Cancer Screening in Sexual and Gender Minority Populations: A Secondary Analysis of Behavioral Risk Factor Surveillance System Data.

To describe cancer screening characteristics and better understand individual-, environmental-, and organizational-level barriers of sexual and gender minority (SGM) populations.&nbsp. This study was conducted using a combined sample from the Behavioral Risk Factor Surveillance System (BRFSS) national dataset from 2014 and 2016. Chi-square tests for independence and logistic regression analysis tests were performed to determine whether relationships existed between SGM status and demographics. Black respondents or those who reported their race as other, were female, had some college or technical school or more, and had healthcare coverage were less likely to present for cancer screening. SGM respondents who were in good or better health; were unmarried; were aged 18-44 years or 45-55 years; or were Asian, Native American, or Hawaiian, or reported their race as other, had higher odds of screening for cancer. Disparities in cancer screening among SGM populations are not well documented. These findings will inform structured education and preventative interventions to improve screening participation among SGM populations.

Violent victimization at the intersections of sexual orientation, gender identity, and race: National Crime Victimization Survey, 2017-2019.

Prior research has found that experiences with violence in the U.S. differ across individual demographic characteristics, including race, gender, and sexual orientation. However, peer reviewed studies have yet to examine the relationship between the intersections of race, gender, and sexual orientation, victimization risk, and characteristics of victimization. We use data from three years (2017-2019) of the National Crime Victimization Survey, the primary source of information on criminal victimization in the United States, to examine victimization at the intersection of sexual orientation, gender, and race/ethnicity. We test whether non-Hispanic Black, Hispanic, and non-Hispanic White sexual and gender minority (SGM) persons aged 16 or over are victimized at greater rates than their non-SGM counterparts and assess whether there are differences between sexual minority females and males of each racial group. We further document characteristics of victimization such as reporting to the police by SGM status and race or ethnicity. We find that SGMs are disproportionately more likely to be victims of violent crime than non-SGM people, and these disparities are present across the assessed racial and ethnic groups (non-Hispanic Black odds ratio [OR] = 3.3, 90% CI [CI] = 1.36, 5.16; Hispanic OR = 4.5, CI = 2.25, 6.71; non-Hispanic White OR = 4.8, CI = 2.25, 6.71). However, sexual orientation disparities are statistically distinguishable for lesbian or bisexual (LB) non-Hispanic White and Hispanic females but not for non-Hispanic Black LB females. Among LB females, the overall differences in victimization were primarily driven by bisexual respondents. We further find racial and ethnic differences among SGM victims in the likelihood of having the victimization reported to the police, in the utilization of community (non-police) resources, and in other aspects of victimization experiences, such as whether arrests occurred or in the suspicion that the violent incident was a hate crime. Our findings raise indicate a complex picture of how sexual orientation, gender identity, sex, and race and ethnicity interact in victimizations and their characteristics that should be further explored.

"I Don't Feel at Home in This World" Sexual and Gender Minority Emerging Adults' Self-Perceived Links Between Their Suicidal Thoughts and Sexual Orientation or Gender Identity.

To examine whether sexual and gender minority (SGM) emerging adults perceived their SGM status was linked to suicidal ideation, and to explore if their responses fell within tenets of the minority stress framework. Open text (survey) responses of Dutch and Flemish SGM emerging adults (n = 187) were thematically analysed using the constant comparative comparison method for qualitative analysis. We identified 8 themes in our qualitative analysis. Two themes fell within the scope of the minority stress framework that has received little attention: (1) concerns about relationships and family planning and (2) feeling different (internal stressor). Two additional themes emerged largely beyond the scope of existing minority stress framework studies on suicidality: (3) SGM-related questioning; (4) negativity in LGBT communities. Four established minority stress framework themes emerged: (5) gender identity stress; (6) victimization; (7) coming-out stress; (8) psychological difficulties linked to SGM status. Suicide prevention needs to focus on supporting SGM emerging adults who worry about feeling "different", or who have concerns over their romantic and family life, on reducing gender minority stress, as well as on caring for those who are victimized due to their sexual or gender identity.

Sexual and gender identity and note-leaving among adult suicide decedents in the USA

Suicide is one of the leading causes of preventable death in the USA, representing a critical public health threat. Suicide risks differ for different populations. In particular, the sexual and gender minority (SGM) population remains at increased risk for suicide. One of the circumstances that may differ for SGM and non-SGM individuals is the propensity to leave a suicide note. Information regarding note-leaving may be helpful in informing suicide prevention and intervention. This study documents the differences in note-leaving in SGM individuals compared with non-SGM individuals, using recent data from the National Violent Death Reporting System (N = 98 515) and accounting for important covariates. We fit a logistic regression model with SGM status and covariates predicting note-leaving in suicide. SGM decedents were 1.508 times more likely to leave a note than their non-SGM counterparts, controlling for demographic, mental health and substance use covariates. These findings highlight the importance of tailoring suicide prevention and intervention efforts to meet the needs of SGM populations.

Trajectories of Emerging Adults' Binge Drinking and Depressive Symptoms and Associations With Sexual Violence Victimization: Examining Differences by Sexual and Gender Minority Status.

We examined longitudinal associations between binge drinking (BD), depressive symptoms, and sexual violence (sexual harassment and sexual assault) among sexual and gender minority (SGM) and non-SGM emerging adults. Data were drawn from four annual web-based surveys of a diverse cohort of 2,553 emerging adults, spanning from approximately age 19 (2016) to age 22 (2020). About 18% were SGM individuals. We tested a multigroup parallel process latent growth curve model (recent depression symptoms; past-year BD) with time-varying covariates (past-year sexual harassment; sexual assault) to determine associations of sexual violence with BD and depression outcomes over time, and whether growth curves and associations differed by SGM status. For both SGM and non-SGM emerging adults, past-year sexual harassment was associated with depressive symptoms at each time point, but harassment was not associated with BD. For both groups, sexual assault was associated with both depressive symptoms and BD. To our knowledge, this is the first study to examine longitudinal, contemporaneous associations of sexual violence (including both harassment and assault as distinct constructs), with BD and depressive symptoms among racially and ethnically diverse emerging adults, comparing SGM and non-SGM groups. Although our models do not disentangle directionality or causality, the findings suggest the need to address sexual violence victimization (assault and harassment) in the context of depression screening and treatment, and vice versa. We discuss a number of intervention strategies currently in use for an implicitly non-SGM general population that could be adapted for greater inclusion of and relevance to SGM populations.

Cancer Risk Behaviors, Cancer Beliefs, and Health Information Seeking Among Under-Represented Populations in San Francisco: Differences by Sexual Orientation and Gender Identity.

Purpose:Sexual and gender minority (SGM) individuals in the United States are at increased risk of cancer compared to the non-SGM population. Understanding how SGM persons perceive cancer risk and their practices and preferences for accessing health information is key for improving the preventive and health care services they receive.Methods:In this cross-sectional study, we analyzed data from the San Francisco Health Information National Trends Survey. SGM individuals were identified by self-report. Differences in cancer risk factors, cancer beliefs, and health information seeking were evaluated by SGM status using multivariable logistic regression models.Results:Out of 1027 participants, 130 (13%) reported being SGM individuals. Current smoking (odds ratio [OR]=1.93, 95% confidence interval [CI]=1.24–3.01) and alcohol use (OR=1.69, 95% CI=1.10–2.59) were more common among SGM persons than among non-SGM persons. No differences by SGM status were observed in health information seeking behaviors, preferences, and cancer beliefs, but SGM participants reported significantly higher odds of feeling frustrated (OR=1.78, 95% CI=1.20–2.64) and having concerns about the quality of the information (OR=1.54, 95% CI=1.03–2.31) during their most recent health information search.Conclusions:Intervention efforts aimed at SGM individuals with current use of tobacco and/or alcohol should be expanded. SGM communities also need improved access to consistent, reliable, and accurate sources of health information. Their increased frustration when seeking health information and concerns about the quality of the information they find have important implications for SGM health and care, and the drivers of these differences merit further evaluation.

Examining facilitators and barriers to sexual orientation and gender identity disclosure to healthcare providers among US college students

Sexual and gender minority (SGM) individuals generally experience health disparities. Frequent nondisclosure of SGM status to healthcare providers contributes to these disparities. We collaborated with an LGBTQIA+ student organization to conduct a virtual focus group exploring facilitators and barriers to SGM disclosure to healthcare providers. Five thematic clusters emerged from our group concept mapping procedure: (1) provider approach to SGM-specific care; (2) indicators of inclusive clinic culture; (3) interpersonal disclosure concerns; (4) harmful provider communication; and (5) persistent behavioral factors in patient-provider relationships. More broadly, participants indicated healthcare providers’ inclusive/exclusive behaviors and communication were generally important to SGM disclosure.

Alcohol use and cannabis use trajectories and sexual/gender minority disparities in young adulthood.

Sexual and gender minority (SGM) young people may use alcohol or cannabis (A/C) at higher rates that non-SGM peers, but little is known about whether SGM young adults experience poorer health, psychosocial, and other outcomes at similar levels of A/C use. We used longitudinal survey data from a community cohort recruited from California middle schools in 2008 (average age 11.5) and followed across 12 waves through 2020. Participants reported on past-month A/C use at each wave. Individuals also reported SGM status as well as outcomes in multiple domains in Wave 12. Sequelae of change models tested differences in intercept and slope for A/C use trajectories from Waves 1-12 across SGM groups, and simultaneously examined differences in outcomes by SGM status adjusting separately for A/C trajectories. SGM (n = 445) and non-SGM (n = 2,089) groups did not differ on baseline probability of A/C use. SGM individuals showed steeper increases in probability of cannabis but not alcohol use over time. Adjusting for trajectories of A/C use, SGM individuals had significant disparities relative to non-SGM peers with respect to: Employment and economic stability, criminal justice involvement, social functioning, subjective physical health, behavioral health, and perceived unmet mental health treatment need. At the same levels of A/C use from middle school through young adulthood, SGM individuals show disparities in multiple domains compared to non-SGM peers. Targeted efforts to reduce substance use in conjunction with other structural disadvantages experienced by SGM youths are needed to address the emergence of disparities in young adulthood. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Emotional changes following discrimination induction in gender- and sexuality-diverse adolescents.

Sexual and gender minority (SGM)-identifying adolescents are particularly vulnerable to negative psychological outcomes, including engagement in nonsuicidal self-injury (NSSI). However, little is known about why these relationships exist. We used experimental methods to test the psychological mediation framework in an online sample of 328 adolescents who reported female sex at birth and a range of sexual and gender identities. Participants reported on depressive symptoms, self-criticism (both self-report and implicit), NSSI, and discrimination. They also completed a discrimination-based mood induction to test emotional reactivity. At baseline, SGM participants reported higher levels of implicit and self-reported self-criticism, depressive symptoms, discrimination, and higher rates of NSSI compared with cisgender, heterosexual participants (ps < .03). Following the discrimination induction, SGM-identifying participants exhibited larger emotional reactivity compared with cisgender heterosexual participants, as measured by change in negative mood, F(1, 326) = 7.33, p = .01, ηp2 = .02, and state self-criticism, F(1, 326) = 4.67, p = .03, ηp2 = .014, but not implicit affect toward the self. This effect was associated with baseline depressive symptoms, self-criticism, NSSI history, and discrimination. Post hoc analyses revealed that participants who tended to reframe experiences of discrimination as opportunities for growth exhibited attenuated emotional reactivity to the induction; findings remained significant after adjusting for SGM status and event severity (ps < .001). Results indicate that adolescents identifying as SGM may experience elevated psychological distress compared with their cisgender heterosexual peers and that stigma-related stressors may increase emotion dysregulation and maladaptive cognitive styles, paralleling previously proposed psychological mediation models. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Abstract 22: Sexual and gender minority patients report psychosocial concerns and low quality of life entering cancer treatment

Abstract Background: Prior studies have suggested that underserved and minority populations experience psychosocial concerns and low quality of life (QoL) regarding their cancer care experience; however, presently there are limited data regarding psychosocial concerns and QoL among sexual and gender minority (SGM) populations (i.e., LGBTQ). Given the significantly higher emotional difficulties among SGM cancer patients and adverse impact of psychosocial vulnerabilities on patient outcomes, understanding of unique concerns related to physical/emotional health and QoL among SGM cancer patients is an unmet need. The current study analyzed the association between psychosocial concerns and QoL by SGM status. Methods: Participants (N=70,312) were cancer patients who completed a standard-of-care electronic patient questionnaire (EPQ) during their initial visits at the Moffitt Cancer Center. The EPQ captures patient-reported information on demographics (including sexual orientation and gender identity [SOGI]), medical history, family cancer history, lifestyle factors, use of complementary and alternative medicine, and QoL. The SOGI questions were used to identify SGM and non-SGM patients. The outcome variables were concerns in (1) having someone who can help the patient during treatment, (2) interference with ability to seek care (e.g., transportation, financial), (3) problems with work or other regular activities due to physical/emotional health and pain over the past 4 weeks, and (4) perceived general health. Pearson’s Chi-Square test and ANOVA were utilized; significance was determined by p&amp;lt;0.05. Results: Approximately 2.3% of the population self-identified as an SGM. SGM vs. non-SGM patients reported significantly greater concerns in having someone who can help the patient (4.4% vs 2.7%; p&amp;lt;.001), interference with ability to seek care (21.8% vs 16.6%; p&amp;lt;.001), and reported having accomplished less than one would like (36.6% vs 27.8%; p&amp;lt;.001), and engaged in activities less carefully than usual (23.1% vs 18.2%; p&amp;lt;.001) as a result of emotional problems. Further, SGM vs. non-SGM patients reported significantly greater interference due to pain and overall physical/emotional problems (p&amp;lt;.001) and marginally significant worse perceived general health (p=.060). Daily interference due to physical health did not differ between SGM and non-SGM patients. Discussion: These data suggest that SGM cancer patients compared to non-SGM cancer patients are reporting less psychosocial resources and lower QoL. These results add to the existing literature by elucidating potential difficulties in cancer treatment and preexisting interference due to emotional difficulties and pain among SGM cancer patients with heterogeneous cancer types. Further research is warranted in the short- and long-term impact of such concerns on cancer outcomes and potential need for early intervention. Citation Format: Min-Jeong Yang, Jaileene Pérez-Morales, Jarred D. Miller, Vani N. Simmons, Matthew B. Schabath. Sexual and gender minority patients report psychosocial concerns and low quality of life entering cancer treatment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 22.

Availability of Accessible Representative Health Data to Examine Sexual and Gender Minority Disparities in Incarceration and Its Health Implications in the United States, 2010-2020.

Purpose: To facilitate identification of the impact of incarceration on the health of sexual and gender minority (SGM) populations, we sought to identify publicly accessible, representative health datasets that assessed SGM status and incarceration history from 2010 to 2020 and to examine SGM disparities in lifetime incarceration experiences. Methods: Datasets were identified and analyzed through a multistep process: (1) content search of 76 health datasets; (2) consultation with 14 subject matter experts; (3) a systematic review; and (4) a data analysis stage. Utilizing the identified health datasets, we produced representative estimates of sexual minority (SM) incarceration disparities. Results: Five publicly accessible databases were identified that assessed SM status and incarceration history; none assessed gender minority status and incarceration history. Across datasets, the weighted prevalence of lifetime incarceration among SM populations was substantially higher (range = 17.5%-26.3%) than among non-SM populations (range = 4.6%-21.2%). Conclusion: Few publicly accessible, representative health datasets collect standardized information regarding SM status and incarceration history, and none assess diverse gender identities and incarceration history. These data suggest that a disproportionate proportion of SM individuals may experience incarceration compared with non-SM individuals. Research assessing the health effects of incarceration on SGM populations remains limited; publicly accessible, representative health data are needed to address this gap.