Rates of nonsuicidal self-injury (NSSI) among lesbian, gay, bisexual, transgender, and other sexual or gender minority (LGBTQ+) young adults are high. Research is needed to elucidate potential mechanisms underpinning this elevated risk. In 2021, young adults in the United Kingdom and United States (n=1475, aged 18-30) reported their NSSI history and psychological distress (Kessler Psychological Distress Scale) in an online survey. Participants were cisgender heterosexual (CH; n=1100), cisgender sexual minority (CSM; lesbian, gay, bisexual, asexual) (n=272), or gender minority (GM; transgender, non-binary) (n=103). Rates of lifetime NSSI and psychological distress were significantly higher for GM participants than CSM participants (NSSI: OR=2.68, p<0.001 | Distress: Coef. = 5.22, p<0.001), and significantly higher for CSM participants than CH participants (NSSI: OR=3.39, p<0.001, | Distress: Coef. = 3.08, p<0.001). Cross-sectional mediational models (i.e., associational variable analysis) revealed that psychological distress partially accounted for the relationship between identity group and lifetime NSSI in a stepwise fashion, contributing to higher NSSI in the GM group compared to the CSM group, and higher NSSI in the CSM group compared to the CH group. Findings suggest GM young people are at elevated risk of NSSI and psychological distress relative to both CSM and CH peers, and disparities in distress levels may be a key driver of disparities in NSSI rates. While longitudinal mediation models are needed to verify this mechanism, findings support interventions aimed at reducing psychological distress and NSSI among LGBTQ+ young people.

Objectives. To investigate if anticipated survey context (e.g., national government health survey, local community health survey, health care provider form) would affect participants' likelihood of (1) responding to sexual orientation, gender identity, sex assigned at birth, and intersex status (SOGISI) questions or (2) changing their responses to SOGISI questions. Methods. We performed an online study of people across sexual orientations and gender identities in the United States (n = 851) testing the hypotheses that individuals with minoritized identity would be less likely to respond and more likely to change their responses to questions about their SOGISI identity. Results. Overall, results were significant and in the expected direction, indicating that there was a dependent relation between identities and type of question being asked. Conclusions. Within this sample, participants with minoritized sexual and gender identities were more likely to change their answer on the basis of the context of data collection, highlighting important considerations for individuals who utilize surveys to collect SOGISI data. Public Health Implications. Results from this study can be used to provide recommendations for questions to use in surveys for collection of SOGISI data and important considerations when collecting data from sexual and gender minorities. (Am J Public Health. 2026;116(4):533-543. https://doi.org/10.2105/AJPH.2025.308376).

Social participation and memory of aging sexual minority people: the Canadian Longitudinal Study on Aging.

ABSTRACT Sexual and gender minority (SGM) individuals experience disproportionately high rates of depression, anxiety, trauma, and discrimination, yet remain underrepresented in psychedelic research. This prospective, naturalistic study explored the impact of an ayahuasca retreat experience on mental health, quality of life, and spiritual well-being among SGM participants. Participants attended a seven-day ayahuasca retreat and completed assessments across six time points from 2–4 weeks pre-ceremony to 2–3 months post-ceremony. Findings revealed significant reductions in depression and anxiety scores, alongside increases in spiritual well-being and quality of life, particularly within the first month following the retreat. Participants consistently described the experience as highly meaningful and spiritually significant, with many identifying the ceremony as among the most meaningful of their lives. Benefits were further supported by reports of positive behavioral changes, including improved interpersonal relationships and reduced substance use. Adverse effects were minimal and transient. Importantly, this study addresses the historical gap in the literature and highlights the need to reconceptualize psychedelic spaces as inclusive and reparative for queer communities. Given the historical misuse of psychedelics in conversion therapy, these findings mark a critical step in reclaiming psychedelics for SGM healing, empowerment, and identity affirmation.

Objective Suicidal ideation and planning affect ∼10.6 million and 3.1 million adults in the United States annually, respectively, with sexual minority individuals experiencing disproportionately higher rates. Despite greater mental health service utilization, sexual minority individuals experience greater unmet need due to additional barriers to care, including stigma and a lack of practitioner cultural competency, compared to heterosexual individuals. Unmet need for mental health services is a known risk factor for suicidal ideation, planning, and attempts, and may contribute to disparities in suicidality between heterosexual and sexual minority individuals. The current study aims to explore how unmet need and service utilization interact with sexual orientation in relation to past-year suicidal ideation and planning. Method Using a cross-sectional nationally representative sample of 41,806 respondents, the current study used logistic regression to examine past-year suicidal ideation and planning in relation to sexual orientation, unmet need, reasons for unmet need, service utilization, and the interactions between sexual orientation and both unmet need and service utilization. Results Results indicated that sexual minority status, unmet need, and service utilization were independently associated with higher odds of suicidal ideation and planning. Interaction analyses revealed that sexual minority individuals were more likely than heterosexual individuals to report suicidal ideation and planning among those with unmet need or service utilization. Conclusions These findings suggest that factors beyond service access, such as stigma, may contribute to suicidal outcomes among sexual minority individuals, highlighting the need for tailored interventions addressing their specific barriers.

Increasing diversity in the physician associate (PA) profession is important for enhancing patient care. Recognizing barriers such as bias in the PA program admissions process is essential for programs seeking to enroll more diverse students. This study investigates whether pre-PA students are concerned about bias in the admissions process and whether underrepresented minorities in medicine (URM-Med), sexual or gender minority (SGM), or low socioeconomic status (SES) groups express greater concern. It also explores the impact of various support types on perceptions of bias. Between February and March 2023, pre-PA students and PA students completed a 55-item online survey, the "2023 AAPA Student Survey," which included demographic questions and concerns about bias in the admissions process measured on a 5-point Likert scale. Out of 675 pre-PA students, 606 completed the survey. A majority (61.1%) expressed concern about bias, with a mean score of 3.65 ± 1.05. URM-Med (67.0% vs. 58.1%, P = .04), SGM (77.8% vs. 59.4%, P = .01), and low SES students (75.2% vs. 57.4%, P < .01) were more concerned than their counterparts. SGM (OR 2.37, 95% CI 1.18-4.73) and low SES (OR 1.68, 95% CI 1.04-2.73) students were more likely to be concerned about bias. Having an academic mentor was a protective factor against concern about bias (OR 0.64, 95% CI 0.41-0.99). The majority of pre-PA students are concerned about admissions bias, particularly SGM and low SES students. Academic mentorship appears to reduce these concerns, suggesting PA programs should enhance mentorship to support diverse applicants and mitigate bias.

Trends and Disparities in Mental Health and Suicidality by Sexual Orientation Among East Asian Adolescents in Canada, 1998-2023.

Dyadic coping among sexual minority men (SMM) has been a focus of HIV prevention research for decades, but few studies have examined relationship quality as a covariate of HIV care cascade outcomes (ART adherence and an undetectable viral load (VL)). This study utilized a 5-category relationship status variable (single; non-monogamous, sero-discordant; non-monogamous, sero-concordant; monogamous, sero-discordant; monogamous, sero-concordant) to test the hypothesis that relationship quality would moderate associations between relationship status and HIV care outcomes. Adult SMM living with HIV (LWHIV) (n = 1389), recruited via social networking applications between January and December 2021, completed a cross-sectional, online survey. At average levels of relationship quality, only non-monogamous SMM with sero-discordant partners were more likely to be adherent to ART (OR = 3.064, p<.001) and have an undetectable VL (OR = 2.595, p<.001) compared to single SMM. Among non-monogamous SMM with sero-discordant partners, relationship quality was positively associated with ART adherence (OR = 1.065, p<.001) and having an undetectable VL (OR = 1.046, p=.003). Among monogamous SMM with sero-concordant partners, the effect of relationship quality on ART adherence (OR=0.855, p=.007) and having an undetectable VL (OR=0.909, p=.011) was significantly smaller compared to non-monogamous SMM with sero-discordant partners. Among non-monogamous SMM with sero-concordant partners, the effect of relationship quality on ART adherence (OR=0.956, p=.039) was also significantly smaller compared to non-monogamous SMM with sero-discordant partners. Results suggest non-monogamous SMM with sero-discordant partners in high-quality relationships may experience the greatest motivation to engage in HIV care. Messages enhancing motivation for care engagement to improve individual health for SMM LWHIV may augment treatment as prevention.

ObjectiveTo review literature on Community Health Workers' (CHW) role in providing tobacco cessation programming and offer recommendations for future research and programming based on findings.Data SourcesPubMed, Scopus, and Academic Search Complete.Study Inclusion and Exclusion CriteriaThe first author screened and selected articles that (1) were published after 2000; (2) used CHWs; (3) included tobacco cessation as a primary objective; and (4) were conducted in the United States. Twenty articles met the criteria and were analyzed.Data ExtractionData were extracted and organized in a table that included: author, title, publication year, study design, intervention characteristics (type, length, setting, and description), primary outcome, summary of outcomes, and strengths/limitations.Data SynthesisData were analyzed based on study characteristics and grouped thematically.ResultsTwenty studies demonstrated positive associations between CHW engagement and improved cessation outcomes across populations, including public housing residents and racial/ethnic minorities. CHWs contribute to successful cessation through four mechanisms: repetitive/consistent interactions, provision of medical therapies, wraparound services addressing the social determinants of health (SDOH), and psychosocial support to improve mental health and well-being.ConclusionThis study highlights the ability of CHWs to reach diverse populations and establish trust through shared experiences and understanding of barriers to cessation. Key recommendations include expanding research to engage underrepresented populations such as sexual and gender minorities, veterans, and unhoused people; prioritizing sustained CHW-patient engagement; incorporating medical therapies and culturally tailored cessation aids; and developing comprehensive programming that addresses the SDOH along with cessation.

Clinical trials involving sexual minority adolescents and young men in low- and middle-income countries have historically been limited due to a combination of structural, social, and scientific barriers that often hinder their participation. In addition, researchers lack the cultural competence or knowledge of inclusive recruitment strategies to effectively engage these populations. In this commentary, we describe the experiences, challenges, and opportunities in establishing youth advisory boards as a pathway to entry into the community, overcoming exclusion, building trust, and incorporating the voices of under-served sexual minority adolescents and young men in clinical trials and the development of community-informed interventions.Trial registration: ClinicalTrials.gov NCT06350682. Registered on February 10, 2026.

Social learning theory posits that experiencing negative substance use consequences contributes to reductions in subsequent use. However, relatively few studies have examined prospective effects of substance use consequences on subsequent use; those that have focus exclusively on alcohol and have produced mixed results. The current study aimed to advance our understanding of daily effects of consequences on subsequent use by examining these associations for cannabis, determining if consequences accumulate over time and how long they continue to influence use, and identifying moderators (i.e., cannabis use problems; motives for use) of these associations. We used EMA data (2 observations per day for 14 days) from 593 young adult females who regularly used cannabis. The sample included a majority sexual minority women and gender diverse individuals (77.6%) and a comparison group of heterosexual cisgender women (22.4%). Recent cannabis consequences were associated with a decreased likelihood of subsequent use among individuals with fewer cannabis use (CU) problems. Coping motives also moderated associations between consequences and subsequent CU, with consequences only associated with lighter next-day use when coping motives were not endorsed on the next day. Findings also suggest that consequences accumulate across days and cumulative consequences over the past five days continue to influence CU. These findings indicate that individuals with severe CU problems may not respond with behavioral change to consequences, while individuals with fewer CU problems reduce use following consequences. This may result from differences in perceptions of the aversiveness of consequences, which should be examined by future research.

Sexual minority men (SMM) living with HIV face an elevated risk of anal cancer, and SMM-affirming HIV clinics serve as vital entry points for cancer prevention. We evaluated human papillomavirus (HPV) knowledge, vaccine acceptability and whether time living with HIV was associated with anal cancer symptom awareness. A cross-sectional survey was conducted at an HIV clinic offering anal cancer prevention in Abuja, Nigeria. Descriptive statistics were used to summarize HPV knowledge and vaccine acceptability. Multivariable negative binomial regression evaluated the number of anal cancer symptoms correctly reported using adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs). Among 249 SMM living with HIV, 20.5% reported having heard of HPV. Fewer than 20% correctly identified key anal cancer symptoms, including anal bleeding (15.7%) and a lump or mass in the anus (16.9%). Time living with HIV was initially associated with anal cancer symptom awareness, but not after adjustment (aPR 1.02, 95% CI 0.98-1.07). Other independent predictors of anal cancer symptom awareness were anal cancer screening (aPR 1.51, 95% CI 1.15-1.97) and knowing HPV vaccine can prevent anal cancer (aPR 1.52, 95% CI 1.18-1.98). Despite low HPV awareness, 93.6% of participants reported willingness to receive HPV vaccine. Integrating cancer prevention services into SMM-affirming HIV care may offer an opportunity to strengthen HPV-related knowledge and reduce cancer disparities.

Sexual and gender minority (SGM) individuals can experience notable health disparities, including higher HIV prevalence, social isolation, substance abuse, lack of culturally competent providers, and poorer health outcomes compared to heterosexuals due to stigma and discrimination. This study aims to identify predictors of dental care utilization across sexual minorities using the 2023 TEXAS PRIDE Survey. We analyzed data from 517 SGM individuals, assessing sociodemographic characteristics, health behaviors, and recent medical and dental visits. Multivariable logistic regression identified predictors of dental care utilization (i.e., a dental visit in the past year). Among sexual orientation groups, reported dental care utilization was highest among gay (23.7%) and lesbian (21%) individuals, followed by bisexual (18.3%), pansexual (11.1%), queer (9.9%), and other sexual orientations (16.2%). Those with a college degree were significantly more likely to report dental utilization compared to those with less education. Individuals who did not have a medical visit in the past year were 0.27 times as likely to utilize dental care than those who did. No significant disparities in dental care utilization were found based on sexual orientation in the regression analysis. Higher education and recent medical visits are significant predictors of dental care utilization among SGM individuals. Efforts to reduce oral health disparities should focus on affordable dental care coverage, improving health literacy, fostering inclusive dental environments, and training providers in SGM cultural sensitivity. Future research should explore integrated healthcare approaches and provider cultural competence training to address these gaps.

Abstract Background and aims Psychedelic use among college students and young adults has been increasing, but there continues to be a shortage of research on usage among college students. The purpose of this study is to identify risk factors for psychedelics use and understand how they interact with attitudes towards psychedelic usage. Methods Data were collected on 466 liberal arts college students. Using exploratory and confirmatory factor analyses, we validated a new and brief instrument that assessed attitudes toward psychedelics called the Psychedelic Attitudes Scale (PAS). Results The PAS evidenced good psychometric properties and structural equation modeling was used to investigate factors associated with use. Demographic variables, lifetime substance use, and mental health status were used as predictors, and PAS was used as a mediator, explaining 85.6% of the variance in lifetime use. Males, sexual minorities, older students, those who were not religious, and those who used other substances evidenced more positive attitudes toward psychedelics, which in turn led to a higher likelihood of actual usage. Lifetime usage was also found to be directly associated with better mental health. Conclusions College is a time when many students experiment with psychedelics. Understanding risk and protective factors are important for identifying those at great risk and provides critical information for designing harm reduction programs. Moreover, the PAS fills a gap in the literature and provides a brief assessment tool that can be readily implemented with the general population and in future research studies to better understand how attitudes influence actual behaviors.

Sexually minoritized men (SMM) experience sexual minority stress, a product of exposure to prejudice, discrimination, and heterosexism. This study sought to identify the latent profiles of sexual minority stress among SMM with HIV who use methamphetamine and to examine the correlates associated with profile membership. A cross-sectional examination of 104 participants in San Francisco self-reported their experiences with sexual minority stress. A latent profile analysis was used to characterize the underlying "profiles" or subgroups of participants. ANOVA and Chi-square analysis were used to examine sociodemographic characteristics, psychological health, substance use, and HIV-related health associated with each profile. Participants' mean age was 43 years old (SD = 9); most identified as Black, Hispanic, or Other racial and ethnic identities (57%), and had been diagnosed with HIV for 13 years (SD = 9) on average. Our findings revealed four distinct profiles: (1) High Concealment, Moderate Prejudice Events, (2) Low Concealment, High Prejudice Events, (3) Low Sexual Minority Stress, and (4) High Sexual Minority Stress. Members of the High Sexual Minority Stress profile had the highest mean addiction severity scores and the greatest endorsement of feelings of shame and guilt. Notably, each profile had clinically significant PTSD and depression scores, even among those who experienced stressful events to a lesser extent. Our findings suggest that sexual minority stress plays a critical role in substance use and mental health outcomes. Additional research is needed to elucidate the other facets of stress in SMM that use substances.

This study examines how bullying experiences are associated with retaliatory impulses among autistic university students, highlighting minority stress as a key mediating mechanism and sexual and gender minority (SGM) status as a moderating condition within an intersectional framework. Guided by Minority Stress Theory and Social Information Processing Theory, we surveyed 280 autistic undergraduates; 35% identified as SGM. Participants completed validated measures of bullying, minority stress, retaliatory impulse, and related psychosocial factors. Structural equation modeling and multi-group analyses were conducted to evaluate the proposed mediation and moderation patterns while adjusting for gender, grade level, social support, autistic traits, and internet use. The measurement model showed good reliability and convergent validity (Cronbach’s α = 0.84–0.89; AVE = 0.62–0.69). Bullying was positively associated with minority stress, which was in turn associated with retaliatory impulses, supporting partial mediation [indirect effect = 0.42, 95% CI (0.36, 0.50)]. Multi-group results indicated stronger path coefficients in the SGM group (bullying → stress β = 0.72; stress → retaliation β = 0.66) than among non-SGM (heterosexual and cisgender) peers, consistent with the possibility that compounded stigma heightens emotional reactivity and defensive processing. Minority stress remained the strongest correlate of retaliatory impulses after covariate adjustment, whereas social support showed a protective association. Taken together, the findings suggest that retaliatory impulses among autistic students are better understood in relation to sustained identity-based exclusion and structural stressors rather than as simple dispositional aggression. The results also imply that effective prevention may require institutional and relational strategies—alongside individual support—such as inclusive curricula, peer sensitization, and policies that strengthen belonging and psychological safety in higher education.

Transgender and gender-diverse (TGD) individuals experience elevated psychological distress and poorer quality of life (QoL) due to pervasive stigma and discrimination. Minority stress theory posits that distal (e.g., discrimination) and proximal stressors (e.g., internalized stigma) predict adverse mental health outcomes, whereas protective factors such as community connectedness foster resilience. However, empirical data from contexts in the global south, such as Chile, remain scarce. This study assessed the impact of minority stress and healthcare discrimination on psychological distress and QoL among TGD people in Chile. A cross-sectional online survey was administered to 224 TGD adults in Chile in 2024. Participants were recruited through sexual and gender minority organizations. Data were analyzed using descriptive statistics, Pearson correlations, and multiple linear regressions, and one-sample t-tests to compare sample scores to Chilean normative data. Measures included the LGBT Minority Stress Measure; the Patient Health Questionnaire-4 (PHQ-4) to assess overall psychological distress, with its anxiety (Generalized Anxiety Disorder-2; GAD-2) and depression (Patient Health Questionnaire-2; PHQ-2) subscales; and the four subscales, physical, psychological, social, and environmental, of the WHOQOL-BREF. Healthcare discrimination was measured with ad hoc items. Primary outcomes were levels of psychological distress, anxiety, depression, and QoL across four domains. Predictors included minority stress dimensions and healthcare discrimination. Nearly half of participants (50.1%) reported moderate to severe psychological distress; 42.9% screened positive for anxiety, and 32.1% for probable depression. QoL scores were significantly lower than population norms across all domains, particularly psychological (d = -1.46) and physical (d = -1.09). Discrimination events (β = 0.29), internalized stigma (β = 0.23), and victimization (β = -0.23) significantly predicted higher distress and lower QoL. Community connectedness was a protective factor (β = 0.19). Healthcare discrimination uniquely predicted higher psychological distress (β = 0.16) and poorer overall QoL (β = -0.23). Findings emphasize the urgent need for gender-affirmative healthcare, anti-discrimination training, and community-based interventions to mitigate the psychological burden associated with minority stress and promote resilience among TGD populations. This is one of the first quantitative studies on TGD minority stress and QoL in Latin America. Strengths include a robust sample size and validated measures. Limitations include non-probabilistic sampling, cross-sectional design, and reliance on self-report data, which preclude causal inference and limit generalizability. TGD individuals in Chile experience substantial inequities in psychological well-being and QoL, partially driven by minority stress and healthcare discrimination. Inclusive policies and affirming care practices are essential to reducing these disparities and improving TGD health.

Perceived Helpfulness and Affirmingness of Different Sources of Sex and Relationship Education among Sexual Minority Men

Self-rated health (SRH), as measured by a single item, is a well-established and remarkably robust predictor of morbidity and mortality, yet few studies have examined its biological correlates across diverse sexual orientation identities. Using data from the population-representative National Couples' Health and Time study (NCHAT) and its biospecimen substudy (NCHAT-BIO), this study explored the relationship between lesbian, gay, bisexual, queer, or other nonheterosexual identities (LGBQ+), SRH, and systemic inflammation. Among 3,477 partnered (married or cohabiting) cisgender adults, 42.6% identified as LGBQ+, and a subset of 652 (41.3% LGBQ+) provided dried blood spot samples analyzed for interleukin-6 (IL-6) and C-reactive protein (CRP). In the full NCHAT sample, LGBQ+ respondents reported significantly poorer SRH than their heterosexual peers (LGBQ+ vs. heterosexual: t = 3.3574, df = 3,466, p value < .001). In the NCHAT-BIO subsample, poorer SRH was significantly related to both higher IL-6 (β = -.23, SE = .042, p < .0001) and higher CRP (β = -.41, SE = .054, p < .0001), supporting the hypothesis that subjective health assessments may capture interoceptive awareness of inflammatory status. Importantly, the strength of the association between SRH and inflammation did not differ across groups based on sexual orientation and gender (Interaction p value for IL-6: .46, for CRP: .39). The associations between SRH and inflammatory markers were slightly attenuated after inclusion of key health and behavioral covariates, suggesting potential mediating factors warranting future investigation. These findings replicate prior research on SRH and inflammation and extend them to LGBQ+ plus adults, underscoring the importance of inclusive health measurement. Given SRH's robust predictive power for future morbidity and mortality, integrating assessments of sexual orientation and biological markers offers critical insight for understanding and addressing health disparities. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

In the United States, sexual and gender minorities (SGM) are incarcerated at three times the rate of the adult population, yet there is limited research on this population’s reentry into the community post-incarceration. Reentry into the community presents many challenges for SGM, who must contend with the stigma of not only being formerly incarcerated but also identifying as an SGM, all while navigating access to affirmative physical and mental health services, employment, stable housing, and repairing relationships with family and friends. Currently, there is limited research on the reentry experience of formerly incarcerated SGM, who have a long history of inequality, racism, and injustice. Through the lens of intersectionality theory, this narrative review aims to understand the barriers they face in accessing community services tailored to the specific needs of the SGM population and understand how sex and gender identity, along with race, class, socioeconomic status, and geographic location, impact their reentry to the community.