Psychology › Social Psychology

LGBTQ Health, Identity, and Policy

Works Count: 64885

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Description

This cluster of papers explores the intersectionality of LGBTQ+ identities and its impact on mental health, stigma, discrimination, and health disparities. It delves into the complexities of gender identity, social stress, and minority stress within the LGBTQ+ community, providing a comprehensive understanding of the unique challenges faced by individuals with diverse sexual orientations and gender identities.

Keywords

Intersectionality; LGBTQ+; Mental Health; Stigma; Discrimination; Gender Identity; Social Stress; Minority Stress; Health Disparities; Sexual Orientation

The Health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding

2012-01-01

Robert J. Graham

Attempted Suicide Among Transgender Persons

2006-10-11

Kristen Clements‐Nolle , Rani Marx , Mitchell H. Katz

Abstract To determine the independent predictors of attempted suicide among transgender persons we interviewed 392 male-to-female (MTF) and 123 female-to-male (FTM) individuals. Participants were recruited through targeted sampling, respondent-driven sampling, … Abstract To determine the independent predictors of attempted suicide among transgender persons we interviewed 392 male-to-female (MTF) and 123 female-to-male (FTM) individuals. Participants were recruited through targeted sampling, respondent-driven sampling, and agency referrals in San Francisco. The prevalence of attempted suicide was 32% (95% CI = 28% to 36%). In multivariate logistic regression analysis younger age (<25 years), depression, a history of substance abuse treatment, a history of forced sex, gender-based discrimination, and gender-based victimization were independently associated with attempted suicide. Suicide prevention interventions for transgender persons are urgently needed, particularly for young people. Medical, mental health, and social service providers should address depression, substance abuse, and forced sex in an attempt to reduce suicidal behaviors among transgender persons. In addition, increasing societal acceptance of the transgender community and decreasing gender-based prejudice may help prevent suicide in this highly stigmatized population.

Handbook of counseling psychology

1992-01-01

Steven D. Brown , Robert W. Lent

PROFESSIONAL AND SCIENTIFIC ISSUES. The Maturation of Counseling Psychology: Multifaceted Perspectives, 1978-1998 (P. Heppner, et al.). Ethical Issues in Counseling Psychology: Old Themes--New Problems (K. Kitchener & S. Anderson). Psychotherapy … PROFESSIONAL AND SCIENTIFIC ISSUES. The Maturation of Counseling Psychology: Multifaceted Perspectives, 1978-1998 (P. Heppner, et al.). Ethical Issues in Counseling Psychology: Old Themes--New Problems (K. Kitchener & S. Anderson). Psychotherapy Supervision and Training (R. Goodyear & C. Guzzardo). Scientific Training and Scholarly Productivity: The Person, the Training Environment, and Their Interaction (C. Gelso & R. Lent). Advances in Psychometric Theory and Methods (D. Bolt & J. Rounds). Issues in the Analysis and Interpretation of Quantitative Data: Deinstitutionalization of the Null Hypothesis Test (T. Tracey). Qualitative Research in Counseling Psychology (S. Morrow & M. Smith). CAREER, EDUCATIONAL, AND PSYCHOLOGICAL DEVELOPMENT. Advances in Vocational Psychology Theory and Research (J. Swanson & P. Gore). The Development of Academic Achievement in School Aged Children: Precursors to Career Development (C. Arbona). Advances in Theory and Research on Subjective Well-Being (S. Robbins & W. Kliewer). Gender and Sexuality in Human Development: Implications for Prevention and Advocacy in Counseling Psychology (R. Fassinger). Role of Race and Social Class in Development: Implications for Counseling Psychology (N. Fouad & M. Brown). PREVENTIVE AND DEVELOPMENTAL INTERVENTIONS. Preventive Interventions with School-Age Youth (E. Vera & L. Reese). The School-to-Work Transition: Adjustment Challenges of the Forgotten Half (D. Blustein, et al.). Prevention and Development in the Workplace (B. Hesketh). Counseling Older Adults: Theoretical and Empirical Issues in Prevention and Intervention (R. Hill, et al.). Health Promotion and Disease Prevention: A Concentric Biopsychosocial Model of Health Status (M. Hoffman & J. Driscoll). COUNSELING INTERVENTIONS. Advances in Theories of Change and Counseling (S. Warwar & L. Greenberg). Gender Issues in Counseling (C. Enns). Models of Multicultural Counseling (J. Ponterotto, et al.). The Process of Individual Therapy (C. Hill & E. Williams). Outcomes of Individual Counseling and Psychotherapy: Empirical Evidence Addressing Two Fundamental Questions (B. Wampold). Four (or Five) Sessions and a Cloud of Dust: Old Assumptions and New Observations about Career Counseling (S. Brown & N. Krane). Process, Outcome, and Methodology in Group Counseling Research (D. Kivlighan, et al.). Processes and Outcomes in Couples and Family Therapy (M. Friedlander & Ma. Tuason). Indexes.

The impact of homophobia, poverty, and racism on the mental health of gay and bisexual Latino men: findings from 3 US cities

2001-06-01

Rafael M. Díaz , George Ayala , Edward Bein +2 more

OBJECTIVES: This study assessed the relation between experiences of social discrimination (homophobia, racism, and financial hardship) and symptoms of psychologic distress (anxiety, depression, and suicidal ideation) among self-identified gay and … OBJECTIVES: This study assessed the relation between experiences of social discrimination (homophobia, racism, and financial hardship) and symptoms of psychologic distress (anxiety, depression, and suicidal ideation) among self-identified gay and bisexual Latino men in the United States. METHODS: Data were collected from a probability sample of 912 men (self-identified as both Latino and nonheterosexual) recruited from the venues and public social spaces identified as both Latino and gay in the cities of Miami, Los Angeles, and New York. RESULTS: The study showed high prevalence rates of psychologic symptoms of distress in the population of gay Latino men during the 6 months before the interview, including suicidal ideation (17% prevalence), anxiety (44%), and depressed mood (80%). In both univariate and multivariate analyses, experiences of social discrimination were strong predictors of psychologic symptoms. CONCLUSIONS: The mental health difficulties experienced by many gay and bisexual Latino men in the United States are directly related to a social context of oppression that leads to social alienation, low self-esteem, and symptoms of psychologic distress.

A critical introduction to queer theory

2004-04-01

Nikki Sullivan

Contents Introduction 1 The Social Construction of Same-Sex Desire: Sin, Crime, Sickness 2 Assimilation or Liberation, Sexuality or Gender? 3 Queer: A Question of Being, or A Question of Doing? … Contents Introduction 1 The Social Construction of Same-Sex Desire: Sin, Crime, Sickness 2 Assimilation or Liberation, Sexuality or Gender? 3 Queer: A Question of Being, or A Question of Doing? 4 Queer Race 5 Performance, Performativity, Parody and Politics 6 Transsexual Empires and Transgender Warriors 7 Queering 'Straight' Sex 8 Community and Its Discontents 9 Sadomasochism as Resistance? 10 Fetishism(s) and Political Perversion 11 Queering Popular Culture Bibliography.

The Invention of Heterosexuality

1996-11-01

Mary Kay DeGenova , Jonathan N. Katz

Heterosexuality, assumed to denote a universal sexual and cultural norm, has been largely exempt from critical scrutiny. In this boldly original work, Jonathan Ned Katz challenges the common notion that … Heterosexuality, assumed to denote a universal sexual and cultural norm, has been largely exempt from critical scrutiny. In this boldly original work, Jonathan Ned Katz challenges the common notion that the distinction between and homosexuality has been a timeless one. Building on the history of medical terminology, he reveals that as late as 1923 the term heterosexuality referred to a morbid sexual passion and that its current usage emerged to legitimate men and women having sex for pleasure. Drawing on the works of Sigmund Freud, James Baldwin, Betty Friedan, and Michel Foucault, The Invention of Heterosexuality considers the effects of heterosexuality's recently forged primacy on both scientific literature and popular culture.

Homosexual Identity Formation:

1979-04-24

Vivienne C. Cass

A six-stage model of homosexual identity formation is outlined within the framework of interpersonal congruency theory. Stages are differentiated on the basis of the person's perceptions of his/her own behavior … A six-stage model of homosexual identity formation is outlined within the framework of interpersonal congruency theory. Stages are differentiated on the basis of the person's perceptions of his/her own behavior and the actions that arise as a consequence of this perception. The person is seen to have an active role in the acquisition of a homosexual identity. Alternative paths of development are proposed within each stage. The notion that people can accept homosexuality as a positively valued status is assumed. Several factors believed to be influential in determining whether a person takes one line of development or another are discussed. The model is intended to be applies to both female and male homosexuals.

Heterosexuals' attitudes toward lesbians and gay men: Correlates and gender differences

1988-11-01

Gregory M. Herek

This paper discusses the basis for differences among heterosexuals in their reactions to gay people, with special emphasis on the issue of gender differences. Three studies conducted with students at … This paper discusses the basis for differences among heterosexuals in their reactions to gay people, with special emphasis on the issue of gender differences. Three studies conducted with students at six different universities revealed a consistent tendency for heterosexual males to express more hostile attitudes than heterosexual females, especially toward gay men. The same social psychological variables appear to underlie both males' and females' attitudes toward both gay men and lesbians: religiosity, adherence to traditional ideologies of family and gender, perception of friends' agreement with one's own attitudes, and past interactions with lesbians and gay men. The role of these variables in shaping attitudes is discussed and areas for future research are proposed. Construction and validation of the Attitudes Toward Lesbians and Gay Men (ATLG) scale are also described.

Prevalence of mental disorders, psychological distress, and mental services use among lesbian, gay, and bisexual adults in the United States.

2003-01-01

Susan D. Cochran , J. Greer Sullivan , Vickie M. Mays

Recent estimates of mental health morbidity among adults reporting same-gender sexual partners suggest that lesbians, gay men, and bisexual individuals may experience excess risk for some mental disorders as compared … Recent estimates of mental health morbidity among adults reporting same-gender sexual partners suggest that lesbians, gay men, and bisexual individuals may experience excess risk for some mental disorders as compared with heterosexual individuals. However, sexual orientation has not been measured directly. Using data from a nationally representative survey of 2,917 midlife adults, the authors examined possible sexual orientation-related differences in morbidity, distress, and mental health services use. Results indicate that gay-bisexual men evidenced higher prevalence of depression, panic attacks, and psychological distress than heterosexual men. Lesbian-bisexual women showed greater prevalence of generalized anxiety disorder than heterosexual women. Services use was more frequent among those of minority sexual orientation. Findings support the existence of sexual orientation differences in patterns of morbidity and treatment use.

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Suicide and Suicide Risk in Lesbian, Gay, Bisexual, and Transgender Populations: Review and Recommendations

2010-12-30

Ann Pollinger Haas , Michèle J. Eliason , Vickie M. Mays +7 more

Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these … Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these populations. This article is a culmination of a three-year effort by an expert panel to address the need for better understanding of suicidal behavior and suicide risk in sexual minority populations, and stimulate the development of needed prevention strategies, interventions and policy changes. This article summarizes existing research findings, and makes recommendations for addressing knowledge gaps and applying current knowledge to relevant areas of suicide prevention practice.

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Gender: An Intersectionality Perspective

2008-07-17

Stephanie A. Shields

Minority Stress and Mental Health in Gay Men

1995-03-01

Ilan H. Meyer

This study describes stress as derived from minority status and explores its effect on psychological distress in gay men. The concept of minority stress is based on the premise that … This study describes stress as derived from minority status and explores its effect on psychological distress in gay men. The concept of minority stress is based on the premise that gay people in a heterosexist society are subjected to chronic stress related to their stigmatization. Minority stressors were conceptualized as: internalized homophobia, which relates to gay men's direction of societal negative attitudes toward the self; stigma, which relates to expectations of rejection and discrimination; and actual experiences of discrimination and violence. The mental health effects of the three minority stressors were tested in a community sample of 741 New York City gay men. The results supported minority stress hypotheses: each of the stressors had a significant independent association with a variety of mental health measures. Odds ratios suggested that men who had high levels of minority stress were twice to three times as likely to suffer also from high levels of distress.

How does sexual minority stigma “get under the skin”? A psychological mediation framework.

2009-08-24

Mark L. Hatzenbuehler

Sexual minorities are at increased risk for multiple mental health burdens compared with heterosexuals. The field has identified 2 distinct determinants of this risk, including group-specific minority stressors and general … Sexual minorities are at increased risk for multiple mental health burdens compared with heterosexuals. The field has identified 2 distinct determinants of this risk, including group-specific minority stressors and general psychological processes that are common across sexual orientations. The goal of the present article is to develop a theoretical framework that integrates the important insights from these literatures. The framework postulates that (a) sexual minorities confront increased stress exposure resulting from stigma; (b) this stigma-related stress creates elevations in general emotion dysregulation, social/interpersonal problems, and cognitive processes conferring risk for psychopathology; and (c) these processes in turn mediate the relationship between stigma-related stress and psychopathology. It is argued that this framework can, theoretically, illuminate how stigma adversely affects mental health and, practically, inform clinical interventions. Evidence for the predictive validity of this framework is reviewed, with particular attention paid to illustrative examples from research on depression, anxiety, and alcohol-use disorders.

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When Black + Lesbian + Woman ≠ Black Lesbian Woman: The Methodological Challenges of Qualitative and Quantitative Intersectionality Research

2008-03-20

Lisa Bowleg

Lesbian, Gay, Bisexual, and Transgender–Related Content in Undergraduate Medical Education

2011-09-06

Juno Obedin‐Maliver , Elizabeth S. Goldsmith , Leslie Stewart +7 more

Lesbian, gay, bisexual, and transgender (LGBT) individuals experience health and health care disparities and have specific health care needs. Medical education organizations have called for LGBT-sensitive training, but how and … Lesbian, gay, bisexual, and transgender (LGBT) individuals experience health and health care disparities and have specific health care needs. Medical education organizations have called for LGBT-sensitive training, but how and to what extent schools educate students to deliver comprehensive LGBT patient care is unknown.To characterize LGBT-related medical curricula and associated curricular development practices and to determine deans' assessments of their institutions' LGBT-related curricular content.Deans of medical education (or equivalent) at 176 allopathic or osteopathic medical schools in Canada and the United States were surveyed to complete a 13-question, Web-based questionnaire between May 2009 and March 2010.Reported hours of LGBT-related curricular content.Of 176 schools, 150 (85.2%) responded, and 132 (75.0%) fully completed the questionnaire. The median reported time dedicated to teaching LGBT-related content in the entire curriculum was 5 hours (interquartile range [IQR], 3-8 hours). Of the 132 respondents, 9 (6.8%; 95% CI, 2.5%-11.1%) reported 0 hours taught during preclinical years and 44 (33.3%; 95% CI, 25.3%-41.4%) reported 0 hours during clinical years. Median US allopathic clinical hours were significantly different from US osteopathic clinical hours (2 hours [IQR, 0-4 hours] vs 0 hours [IQR, 0-2 hours]; P = .008). Although 128 of the schools (97.0%; 95% CI, 94.0%-99.9%) taught students to ask patients if they "have sex with men, women, or both" when obtaining a sexual history, the reported teaching frequency of 16 LGBT-specific topic areas in the required curriculum was lower: at least 8 topics at 83 schools (62.9%; 95% CI, 54.6%-71.1%) and all topics at 11 schools (8.3%; 95% CI, 3.6%-13.0%). The institutions' LGBT content was rated as "fair" at 58 schools (43.9%; 95% CI, 35.5%-52.4%). Suggested successful strategies to increase content included curricular material focusing on LGBT-related health and health disparities at 77 schools (58.3%, 95% CI, 49.9%-66.7%) and faculty willing and able to teach LGBT-related curricular content at 67 schools (50.8%, 95% CI, 42.2%-59.3%).The median reported time dedicated to LGBT-related topics in 2009-2010 was small across US and Canadian medical schools, but the quantity, content covered, and perceived quality of instruction varied substantially.

Estimating HIV Prevalence and Risk Behaviors of Transgender Persons in the United States: A Systematic Review

2007-08-12

Jeffrey H. Herbst , Elizabeth D. Jacobs , Teresa Finlayson +3 more

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Suicidality and Depression Disparities Between Sexual Minority and Heterosexual Youth: A Meta-Analytic Review

2011-06-08

Michael P. Marshal , Laura J. Dietz , Mark Friedman +7 more

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Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults

2008-12-29

Caitlin Ryan , David M. Huebner , Rafael M. Díaz +1 more

We examined specific family rejecting reactions to sexual orientation and gender expression during adolescence as predictors of current health problems in a sample of lesbian, gay, and bisexual young adults.On … We examined specific family rejecting reactions to sexual orientation and gender expression during adolescence as predictors of current health problems in a sample of lesbian, gay, and bisexual young adults.On the basis of previously collected in-depth interviews, we developed quantitative scales to assess retrospectively in young adults the frequency of parental and caregiver reactions to a lesbian, gay, or bisexual sexual orientation during adolescence. Our survey instrument also included measures of 9 negative health indicators, including mental health, substance abuse, and sexual risk. The survey was administered to a sample of 224 white and Latino self-identified lesbian, gay, and bisexual young adults, aged 21 to 25, recruited through diverse venues and organizations. Participants completed self-report questionnaires by using either computer-assisted or pencil-and-paper surveys.Higher rates of family rejection were significantly associated with poorer health outcomes. On the basis of odds ratios, lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were 8.4 times more likely to report having attempted suicide, 5.9 times more likely to report high levels of depression, 3.4 times more likely to use illegal drugs, and 3.4 times more likely to report having engaged in unprotected sexual intercourse compared with peers from families that reported no or low levels of family rejection. Latino men reported the highest number of negative family reactions to their sexual orientation in adolescence.This study establishes a clear link between specific parental and caregiver rejecting behaviors and negative health problems in young lesbian, gay, and bisexual adults. Providers who serve this population should assess and help educate families about the impact of rejecting behaviors. Counseling families, providing anticipatory guidance, and referring families for counseling and support can help make a critical difference in helping decrease risk and increasing well-being for lesbian, gay, and bisexual youth.

Re-Thinking Intersectionality

2008-06-01

Jennifer C. Nash

Intersectionality has become the primary analytic tool that feminist and anti-racist scholars deploy for theorizing identity and oppression. This paper exposes and critically interrogates the assumptions underpinning intersectionality by focusing … Intersectionality has become the primary analytic tool that feminist and anti-racist scholars deploy for theorizing identity and oppression. This paper exposes and critically interrogates the assumptions underpinning intersectionality by focusing on four tensions within intersectionality scholarship: the lack of a defined intersectional methodology; the use of black women as quintessential intersectional subjects; the vague definition of intersectionality; and the empirical validity of intersectionality. Ultimately, my project does not seek to undermine intersectionality; instead, I encourage both feminist and anti-racist scholars to grapple with intersectionality's theoretical, political, and methodological murkiness to construct a more complex way of theorizing identity and oppression.

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Family Acceptance in Adolescence and the Health of LGBT Young Adults

2010-11-01

Caitlin Ryan , Stephen T. Russell , David M. Huebner +2 more

ISSUE: The role of family acceptance as a protective factor for lesbian, gay, bisexual, and transgender (LGBT) adolescents and young adults has not been established. METHODS: A quantitative measure with … ISSUE: The role of family acceptance as a protective factor for lesbian, gay, bisexual, and transgender (LGBT) adolescents and young adults has not been established. METHODS: A quantitative measure with items derived from prior qualitative work retrospectively assessed family accepting behaviors in response to LGBT adolescents' sexual orientation and gender expression and their relationship to mental health, substance abuse, and sexual risk in young adults ( N = 245). FINDINGS: Family acceptance predicts greater self‐esteem, social support, and general health status; it also protects against depression, substance abuse, and suicidal ideation and behaviors. CONCLUSIONS: Family acceptance of LGBT adolescents is associated with positive young adult mental and physical health. Interventions that promote parental and caregiver acceptance of LGBT adolescents are needed to reduce health disparities.

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Worldwide burden of HIV in transgender women: a systematic review and meta-analysis

2012-12-21

Stefan Baral , Tonia Poteat , Susanne Strömdahl +3 more

Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth

2016-01-16

Stephen T. Russell , Jessica N. Fish

Today's lesbian, gay, bisexual, and transgender (LGBT) youth come out at younger ages, and public support for LGBT issues has dramatically increased, so why do LGBT youth continue to be … Today's lesbian, gay, bisexual, and transgender (LGBT) youth come out at younger ages, and public support for LGBT issues has dramatically increased, so why do LGBT youth continue to be at high risk for compromised mental health? We provide an overview of the contemporary context for LGBT youth, followed by a review of current science on LGBT youth mental health. Research in the past decade has identified risk and protective factors for mental health, which point to promising directions for prevention, intervention, and treatment. Legal and policy successes have set the stage for advances in programs and practices that may foster LGBT youth mental health. Implications for clinical care are discussed, and important areas for new research and practice are identified.

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Mental Health Correlates of Perceived Discrimination Among Lesbian, Gay, and Bisexual Adults in the United States

2001-11-01

Vickie M. Mays , Susan D. Cochran

Objectives. Recent studies suggest that lesbians and gay men are at higher risk for stress-sensitive psychiatric disorders than are heterosexual persons. We examined the possible role of perceived discrimination in … Objectives. Recent studies suggest that lesbians and gay men are at higher risk for stress-sensitive psychiatric disorders than are heterosexual persons. We examined the possible role of perceived discrimination in generating that risk. Methods. The National Survey of Midlife Development in the United States, a nationally representative sample of adults aged 25 to 74 years, surveyed individuals self-identifying as homosexual or bisexual (n = 73) or heterosexual (n = 2844) about their lifetime and day-to-day experiences with discrimination. Also assessed were 1-year prevalence of depressive, anxiety, and substance dependence disorders; current psychologic distress; and self-rated mental health. Results. Homosexual and bisexual individuals more frequently than heterosexual persons reported both lifetime and day-to-day experiences with discrimination. Approximately 42% attributed this to their sexual orientation, in whole or part. Perceived discrimination was positively associated with both harmful effects on quality of life and indicators of psychiatric morbidity in the total sample. Controlling for differences in discrimination experiences attenuated observed associations between psychiatric morbidity and sexual orientation. Conclusions. Higher levels of discrimination may underlie recent observations of greater psychiatric morbidity risk among lesbian, gay, and bisexual individuals.

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Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence.

2003-09-01

Ilan H. Meyer

In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher … In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress--explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.

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A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people

2008-08-18

Michael King , Joanna Semlyen , Sharon See Tai +4 more

Lesbian, gay and bisexual (LGB) people may be at higher risk of mental disorders than heterosexual people. We conducted a systematic review and meta-analysis of the prevalence of mental disorder, … Lesbian, gay and bisexual (LGB) people may be at higher risk of mental disorders than heterosexual people. We conducted a systematic review and meta-analysis of the prevalence of mental disorder, substance misuse, suicide, suicidal ideation and deliberate self harm in LGB people. We searched Medline, Embase, PsycInfo, Cinahl, the Cochrane Library Database, the Web of Knowledge, the Applied Social Sciences Index and Abstracts, the International Bibliography of the Social Sciences, Sociological Abstracts, the Campbell Collaboration and grey literature databases for articles published January 1966 to April 2005. We also used Google and Google Scholar and contacted authors where necessary. We searched all terms related to homosexual, lesbian and bisexual people and all terms related to mental disorders, suicide, and deliberate self harm. We included papers on population based studies which contained concurrent heterosexual comparison groups and valid definition of sexual orientation and mental health outcomes. Of 13706 papers identified, 476 were initially selected and 28 (25 studies) met inclusion criteria. Only one study met all our four quality criteria and seven met three of these criteria. Data was extracted on 214,344 heterosexual and 11,971 non heterosexual people. Meta-analyses revealed a two fold excess in suicide attempts in lesbian, gay and bisexual people [pooled risk ratio for lifetime risk 2.47 (CI 1.87, 3.28)]. The risk for depression and anxiety disorders (over a period of 12 months or a lifetime) on meta-analyses were at least 1.5 times higher in lesbian, gay and bisexual people (RR range 1.54–2.58) and alcohol and other substance dependence over 12 months was also 1.5 times higher (RR range 1.51–4.00). Results were similar in both sexes but meta analyses revealed that lesbian and bisexual women were particularly at risk of substance dependence (alcohol 12 months: RR 4.00, CI 2.85, 5.61; drug dependence: RR 3.50, CI 1.87, 6.53; any substance use disorder RR 3.42, CI 1.97–5.92), while lifetime prevalence of suicide attempt was especially high in gay and bisexual men (RR 4.28, CI 2.32, 7.88). LGB people are at higher risk of mental disorder, suicidal ideation, substance misuse, and deliberate self harm than heterosexual people.

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Development of the Gender Minority Stress and Resilience Measure.

2014-12-29

Rylan J. Testa , Janice Habarth , Jayme Peta +2 more

Researchers currently lack a reliable and valid means of assessing minority stress and resilience factors in transgender and gender-nonconforming (TGNC) people. This study was conducted to develop and evaluate the … Researchers currently lack a reliable and valid means of assessing minority stress and resilience factors in transgender and gender-nonconforming (TGNC) people. This study was conducted to develop and evaluate the validity of a tool to better assess these constructs in TGNC populations. The Gender Minority Stress and Resilience (GMSR) measure was developed grounded on Meyer’s minority stress model, and adjusted to reflect the experiences of TGNC populations based on TGNC literature and archival data from TGNC focus groups. The final GMSR includes scales assessing 9 constructs: gender-related discrimination, gender-related rejection, gender-related victimization, nonaffirmation of gender identity, internalized transphobia, negative expectations for future events, nondisclosure, community connectedness, and pride. In the current study, 844 participants completed the GMSR measure as well as measures related to mental health, general life stress, and social support. Results indicated good model fit, criterion validity, convergent validity, and discriminant validity for the 9 hypothesized scales. Discriminant validity for the scales were also partially supported. Overall, the current study offers preliminary evidence of the reliability and validity of the GMSR Measure for use with TGNC populations. The GMSR Measure has several uses for both research and clinical purposes, including increasing understanding of the experiences and correlates of gender minority stress and resilience factors and assessing whether specific therapies or interventions are helpful in reducing risk and supporting resilience in TGNC populations.

Sexual orientation and adolescent substance use: a meta‐analysis and methodological review*

2008-03-13

Michael P. Marshal , Mark Friedman , Ron Stall +5 more

ABSTRACT Aims Several decades of research have shown that lesbian, gay and bisexual (LGB) adults are at high risk for substance use and substance use disorders (SUDs). These problems may … ABSTRACT Aims Several decades of research have shown that lesbian, gay and bisexual (LGB) adults are at high risk for substance use and substance use disorders (SUDs). These problems may often start prior to young adulthood; however, relatively little is known about risk for substance use in LGB adolescents. The primary aims of this paper were to conduct a meta‐analysis of the relationship between sexual orientation and adolescent substance use and a systematic review and critique of the methodological characteristics of this literature. Methods Medical and social science journals were searched using Medline and PsychInfo. Studies were included if they tested the relationship between sexual orientation and adolescent substance use. Eighteen published studies were identified. Data analysis procedures followed expert guidelines, and used National Institutes of Health (NIH)‐sponsored meta‐analysis software. Results LGB adolescents reported higher rates of substance use compared to heterosexual youth (overall odds ratio = 2.89, Cohen's d = 0.59). Effect sizes varied by gender, bisexuality status, sexual orientation definition and recruitment source. None of the studies tested mediation and only one tested moderation. One employed a matched comparison group design, one used a longitudinal design, and very few controlled for possible confounding variables. Conclusions The odds of substance use for LGB youth were, on average, 190% higher than for heterosexual youth and substantially higher within some subpopulations of LGB youth (340% higher for bisexual youth, 400% higher for females). Causal mechanisms, protective factors and alternative explanations for this effect, as well as long‐term substance use outcomes in LGB youth, remain largely unknown.

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Beyond “Homophobia”: Thinking about sexual prejudice and stigma in the twenty-first century

2004-04-01

Gregory M. Herek

Endocrine Treatment of Transsexual Persons:An Endocrine Society Clinical Practice Guideline

2009-06-10

Wylie C. Hembree , Peggy T. Cohen‐Kettenis , Henriëtte A. Delemarre‐van de Waal +5 more

Objective: The aim was to formulate practice guidelines for endocrine treatment oftranssexual persons. Objective: The aim was to formulate practice guidelines for endocrine treatment oftranssexual persons.

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Intersectionality's Definitional Dilemmas

2015-04-04

Patrícia Hill Collins

The term intersectionality references the critical insight that race, class, gender, sexuality, ethnicity, nation, ability, and age operate not as unitary, mutually exclusive entities, but rather as reciprocally constructing phenomena. … The term intersectionality references the critical insight that race, class, gender, sexuality, ethnicity, nation, ability, and age operate not as unitary, mutually exclusive entities, but rather as reciprocally constructing phenomena. Despite this general consensus, definitions of what counts as intersectionality are far from clear. In this article, I analyze intersectionality as a knowledge project whose raison d'être lies in its attentiveness to power relations and social inequalities. I examine three interdependent sets of concerns: (a) intersectionality as a field of study that is situated within the power relations that it studies; (b) intersectionality as an analytical strategy that provides new angles of vision on social phenomena; and (c) intersectionality as critical praxis that informs social justice projects.

Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7

2012-08-01

Eli Coleman , Walter O. Bockting , M. Botzer +7 more

ABSTRACT The Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People is a publication of the World Professional Association for Transgender Health (WPATH). The overall … ABSTRACT The Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People is a publication of the World Professional Association for Transgender Health (WPATH). The overall goal of the SOC is to provide clinical guidance for health professionals to assist transsexual, transgender, and gender nonconforming people with safe and effective pathways to achieving lasting personal comfort with their gendered selves, in order to maximize their overall health, psychological well-being, and self-fulfillment. This assistance may include primary care, gynecologic and urologic care, reproductive options, voice and communication therapy, mental health services (e.g., assessment, counseling, psychotherapy), and hormonal and surgical treatments. The SOC are based on the best available science and expert professional consensus. Because most of the research and experience in this field comes from a North American and Western European perspective, adaptations of the SOC to other parts of the world are necessary. The SOC articulate standards of care while acknowledging the role of making informed choices and the value of harm reduction approaches. In addition, this version of the SOC recognizes that treatment for gender dysphoria i.e., discomfort or distress that is caused by a discrepancy between persons gender identity and that persons sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics) has become more individualized. Some individuals who present for care will have made significant self-directed progress towards gender role changes or other resolutions regarding their gender identity or gender dysphoria. Other individuals will require more intensive services. Health professionals can use the SOC to help patients consider the full range of health services open to them, in accordance with their clinical needs and goals for gender expression.

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Stigma, Mental Health, and Resilience in an Online Sample of the US Transgender Population

2013-03-14

Walter O. Bockting , Michael H. Miner , Rebecca E. Swinburne Romine +2 more

We assessed the association between minority stress, mental health, and potential ameliorating factors in a large, community-based, geographically diverse sample of the US transgender population.In 2003, we recruited through the … We assessed the association between minority stress, mental health, and potential ameliorating factors in a large, community-based, geographically diverse sample of the US transgender population.In 2003, we recruited through the Internet a sample of 1093 male-to-female and female-to-male transgender persons, stratified by gender. Participants completed an online survey that included standardized measures of mental health. Guided by the minority stress model, we evaluated associations between stigma and mental health and tested whether indicators of resilience (family support, peer support, identity pride) moderated these associations.Respondents had a high prevalence of clinical depression (44.1%), anxiety (33.2%), and somatization (27.5%). Social stigma was positively associated with psychological distress. Peer support (from other transgender people) moderated this relationship. We found few differences by gender identity.Our findings support the minority stress model. Prevention needs to confront social structures, norms, and attitudes that produce minority stress for gender-variant people; enhance peer support; and improve access to mental health and social services that affirm transgender identity and promote resilience.

Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions

2015-11-11

Jaclyn M. W. Hughto , Sari L. Reisner , John E. Pachankis

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The Social Organization of Sexuality. Sexual Practices in the United States

1997-11-01

Alain Giami , Edward O. Laumann , John H. Gagnon +3 more

PSYCHIATRIC SERVIcES . February 1996 Vol.47 No.2 205 ture, doubting hen adequacy as a parent, and feeling isolated in what she at first believed to be a unique situation, Dew … PSYCHIATRIC SERVIcES . February 1996 Vol.47 No.2 205 ture, doubting hen adequacy as a parent, and feeling isolated in what she at first believed to be a unique situation, Dew describes an initial attempt to nun away from society and to hide in order to protect her son, her family, and herself. “Our house had taken on the dimensions ofa single closet, and a closet is no place like home.” The author gives exacting attention to her efforts to integrate her son’s newly disclosed identity into a redefined relationship. Mother and son’s ultimately successful attempts to help one another come to terms with Stephen s sexuality, starting from mitial faltering missteps, are chronicled with dialogues that read almost like process recordings, so vivid are they in their detail. Drawing on hen own initial reaction to her son s homosexuality, Dew confronts the homophobia imbued in our culture and the toll it takes on gay children who struggle to keep their stigmatized identity a secret to avoid

A conceptual framework for clinical work with transgender and gender nonconforming clients: An adaptation of the Minority Stress Model.

2012-08-13

Michael Hendricks , Rylan J. Testa

The Journal of Homosexuality

1980-11-01

William Simon , John P. De Cecco

Global health burden and needs of transgender populations: a review

2016-06-27

Sari L. Reisner , Tonia Poteat , JoAnne Keatley +6 more

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Transgender people: health at the margins of society

2016-06-27

Sam Winter , Milton Diamond , Jamison Green +4 more

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Inside/out: lesbian theories, gay theories

1992-05-01

Guidelines for psychological practice with transgender and gender nonconforming people.

2015-12-01

In 2015, the American Psychological Association adopted Guidelines for Psychological Practice with Transgender and Gender Nonconforming Clients in order to describe affirmative psychological practice with transgender and gender nonconforming (TGNC) … In 2015, the American Psychological Association adopted Guidelines for Psychological Practice with Transgender and Gender Nonconforming Clients in order to describe affirmative psychological practice with transgender and gender nonconforming (TGNC) clients. There are 16 guidelines in this document that guide TGNC-affirmative psychological practice across the lifespan, from TGNC children to older adults. The Guidelines are organized into five clusters: (a) foundational knowledge and awareness; (b) stigma, discrimination, and barriers to care; (c) lifespan development; (d) assessment, therapy, and intervention; and (e) research, education, and training. In addition, the guidelines provide attention to TGNC people across a range of gender and racial/ethnic identities. The psychological practice guidelines also attend to issues of research and how psychologists may address the many social inequities TGNC people experience.

Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States.

2003-01-01

Susan D. Cochran , J. Greer Sullivan , Vickie M. Mays

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

2022-08-19

Eli Coleman , Asa Radix , Walter Pierre Bouman +7 more

Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people … Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8.

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Terrorist assemblages: homonationalism in queer times

2008-07-01

People are now coming out of the closet on the word empire,'' said the conservative columnist Charles Krauthammer.''The fact is no country has been as dominant culturally, economically, technologically and … People are now coming out of the closet on the word empire,'' said the conservative columnist Charles Krauthammer.''The fact is no country has been as dominant culturally, economically, technologically and militarily in the history of the world since the Roman Empire.''The metaphor of coming out is striking, part of a broader trend of appropriating the language of progressive movements in the service of empire.How outrageous to apply the language of gay pride to a military power that demands that its soldiers stay in the closet.-AmyKaplan, ''Violent Belongings and the Question of Empire Today''

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The Transgender Studies Reader

2013-10-18

Susan Stryker , Stephen Whittle

Complications in transgender patients undergoing vaginoplasty procedure

2025-06-25

Francisco Delgado-Guerrero | Cirugía y Cirujanos (English Edition)

K. D. Acquaviva (2023) The Handbook of LGBTQIA-Inclusive Hospice and Spiritual Care

2025-06-25

Geoffrey Morgan | Health and Social Care Chaplaincy

K. D. Acquaviva (2023) The Handbook of LGBTQIA-Inclusive Hospice and Spiritual Care. New York and Chichester: Columbia University Press, 348 pp. (pbk). ISBN: 9780231206433 K. D. Acquaviva (2023) The Handbook of LGBTQIA-Inclusive Hospice and Spiritual Care. New York and Chichester: Columbia University Press, 348 pp. (pbk). ISBN: 9780231206433

Protecting transgender and gender-diverse health

2025-06-25

The Lancet Global Health | The Lancet Global Health

Whose urinal is it anyway?: Black nonbinary trans* femme resistance in public restrooms

2025-06-25

Miguel Wilson | Qualitative Research in Organizations and Management An International Journal

Purpose Trans* studies introduced concepts like situational docility and passing to explain how gender-expansive individuals find ways to safely navigate public spaces. I set out to better understand why, despite … Purpose Trans* studies introduced concepts like situational docility and passing to explain how gender-expansive individuals find ways to safely navigate public spaces. I set out to better understand why, despite presenting femininely, I find myself choosing not to “pass” and often frequent the men’s restroom. Design/methodology/approach This autoethnography centers around my embodied knowledge as a Black nonbinary trans* femme. From September to December of 2023, I collected field notes, reflexive journal entries and artifacts of my time navigating public restrooms. Integrating Black feminist thought and Black fugitivity, I explore how my embodiment and queer troublemaking inform my navigation of gender-segregated spaces. Findings I found the threat of gender policing, gender multiplicity (i.e. identifying and being perceived across the gender binary), along with intersectional (i.e.gender, race, and class) embodiment and a refusal to be erased shape how I navigate the bathroom. Originality/value This study extends the discussion of fugitivity and embodiment in organizations to public restrooms. I highlight the unspoken gendered and racialized dynamics of gender policing, how intersecting identities can inform fugitive efforts and the joy of resisting erasure. My narrative advocates for multi-stall all-gender restrooms, demonstrates the importance of further investigations of intersectional trans* embodiment, and the potential benefits of using visual methods in embodiment research.

Barriers to sexual and reproductive health care faced by transgender and gender diverse people: a systematic review

2025-06-25

Connor Allen , Luke Muschialli , Åsa Nihlén +2 more | Reproductive Health

Perceptions of bisexual identity, outness, and mental health among racially diverse bisexual women and men

2025-06-24

Ariel Smith , Sydney Hainsworth , H. Munro Chadwick +2 more | Self and Identity

Randomized Controlled Trial of a Couples-Based HIV Intervention for Transgender Women and Their Partners: Findings from the “It Takes Two” Project

2025-06-24

Kristi E. Gamarel , Don Operario , Ellen Stein +7 more | AIDS and Behavior

Collecting patient-reported outcomes data in transgender and gender diverse adults seeking surgery: barriers and facilitators from the patient perspective

2025-06-24

Sophia Hu , Amitai S. Miller , Michael N. Parisi +4 more | Quality of Life Research

Intimate Partner Violence Perpetration and PrEP Use Among Sexual Minority Men: The Mediating Roles of Internalized Homonegativity and PrEP Stigma

2025-06-24

Erik D. Storholm , Jessica Randazzo , Chenglin Hong +4 more | AIDS and Behavior

Cisgender sexual minority men (SMM) report intimate partner violence (IPV) at rates comparable to or higher than heterosexual cisgender women, often linked to increased HIV risk. This study explores the … Cisgender sexual minority men (SMM) report intimate partner violence (IPV) at rates comparable to or higher than heterosexual cisgender women, often linked to increased HIV risk. This study explores the relationship between IPV perpetration and pre-exposure prophylaxis (PrEP), considering the potential mediating effects of sexual orientation related minority stress and PrEP stigma. Utilizing baseline data from the Empowering Relationships and Opportunities for Safety (EROS) cohort, this cross-sectional study examined survey data from partnered cisgender SMM in the U.S. Through online and community recruitment, participants were assessed for IPV perpetration using a validated measure, while internalized homonegativity and related stigma were evaluated through standardized scales. Current PrEP use was assessed through self-report and confirmed through dried blood spot assays. Of the 500 participants, 125 (25%) reported IPV perpetration, with perpetration of identity-related IPV (e.g., threatening to out a partner to family or coworkers; telling partner to act straight) significantly higher among non-PrEP users; mean number of identity-related IPV perpetration items endorsed was 0.21 (SD = 0.53) among non-PrEP users compared to 0.02 (SD = 0.14) among PrEP users. Perpetration of identity-related IPV was positively correlated with internalized homonegativity (r =.19, p <.001), experienced sexual orientation discrimination (r =.15, p <.01), and PrEP stigma (r =.14, p <.001). A logistic regression mediation analysis found that, separately, internalized homonegativity (OR = 0.97, 95% CI [0.94-0.99]) and PrEP stigma (OR = 0.48, 95% CI [0.40, 0.57]) had significant associations with PrEP use, and that each mediated the relationship between perpetration of identity-related IPV and PrEP use as demonstrated by their significant indirect effects (OR = 0.88, 95% CI [0.78, 0.98] and (OR = 0.77, 95% CI [0.60, 0.98], respectively). The study underscores internalized homonegativity and PrEP stigma as critical mediators of the relationship between perpetration of identity-related IPV and PrEP use among SMM. Findings call for interventions aimed at reducing internalized homonegativity, PrEP stigma and enhancing PrEP access while addressing IPV dynamics. Future research should further delineate these pathways to inform culturally sensitive interventions promoting health equity among SMM.

Tacts, Mands, and Margins: Using Behavior Analysis to Affirm Trans Lives

2025-06-24

Mychal A. Machado | Behavior and Social Issues

A Critical Analysis of Intersectionality and Migration

2025-06-24

Gökçe Yurdakul , Tunay Altay , Gülay Çağlar | Oxford University Press eBooks

Abstract This chapter critically examines the application of intersectionality as a theoretical and empirical tool in migration research, emphasizing its potential to address the complexity of migration experiences. The text … Abstract This chapter critically examines the application of intersectionality as a theoretical and empirical tool in migration research, emphasizing its potential to address the complexity of migration experiences. The text highlights the limitations of conventional frameworks in migration research, such as the “native-citizen” versus “migrant-other” dichotomy and reductive models like “push and pull factors,” which fail to capture the realities of migration processes. Drawing on intersectionality’s origins in Black feminist thought, the authors argue for its use as an analytical framework to explore intersecting systems of oppression—such as race, gender, class, and sexuality—and their impact on migrants’ lives. The chapter identifies key challenges in operationalizing intersectionality within migration research, including Western-centric biases, methodological ambiguities, and the mainstreaming of intersectionality as a buzzword. Furthermore, the chapter addresses critical gaps, such as the neglect of queer migration studies and the lack of decolonial sensitivity. By integrating intersectionality into migration research as a field of study, an analytical strategy, and a critical praxis, the authors propose a paradigm shift that moves beyond incremental knowledge to foster a holistic understanding of migration experiences. This approach aims to address how to dismantle structural systems of oppression while advancing epistemological and methodological rigor in the combined field of migration, gender, and sexuality.

“Parents’ rights actually mean every parent, not just some”: Navigating parental rights in public schools under the pending threat of anti-LGBTQ+ legislation

2025-06-24

Hannah Knipp | Education Policy Analysis Archives

Conducted in a critical transitional period in 2023, this article explores how eight school professionals in New Orleans public charter schools perceived and responded to proposed state-level anti-LGBTQ+ educational legislation. … Conducted in a critical transitional period in 2023, this article explores how eight school professionals in New Orleans public charter schools perceived and responded to proposed state-level anti-LGBTQ+ educational legislation. During the liminal period following the proposal of two anti-LGBTQ+ bills in Louisiana, but prior to their eventual enactment in 2024, educators reflected on how parental rights impacted schools currently, their fears and worries about the new legislation, and plans to resist the new legislation. Refracted through the lenses of institutional theory and chilling effects theory, potential consequences and implications of the legislation are discussed, ultimately concluding that the current political environment has the potential to further ingratiate prevailing cisheteronormativity embedded within the school system.

Selective moral priorities: White evangelicals, <i>imago Dei</i> , and cultural engagement

2025-06-24

Betty Edwards | The Review of Education Pedagogy & Cultural Studies

A roundtable on lesbian generations

2025-06-24

Rachel Corbman , Ann Cvetkovich , Jen Jack Gieseking +5 more | Feminist Theory

The following written dialogue began as an intergenerational conversation, hosted by the lesbian feminist literary journal Sinister Wisdom , about Mairead Sullivan's book Lesbian Death: Desire and Danger between Feminist … The following written dialogue began as an intergenerational conversation, hosted by the lesbian feminist literary journal Sinister Wisdom , about Mairead Sullivan's book Lesbian Death: Desire and Danger between Feminist and Queer , and continued over a series of Zoom conversations in the spring of 2024. We discuss what the term lesbian means to us, teaching and intergenerational encounters, lesbian feminism in the archives, and lineages of lesbian in the present.

Transgender and other gender minoritised assigned female at birth young adults’ perceptions of and experiences with human papillomavirus vaccination

2025-06-24

Allison Rhodes , T. Ahmadi , Allegra R. Gordon +4 more | Culture Health & Sexuality

Transgender and other gender minoritised individuals have lower human papillomavirus (HPV) vaccine completion rates than the general population, and little is known about how gender minoritised young adults perceive and … Transgender and other gender minoritised individuals have lower human papillomavirus (HPV) vaccine completion rates than the general population, and little is known about how gender minoritised young adults perceive and experience HPV vaccination. The aim of this study was to characterise perceptions of, experiences with, and recommendations to facilitate access to HPV vaccination among transgender and other gender minoritised assigned female at birth (AFAB) young adults in the greater Boston area. In 2020, in-depth interviews were conducted in Boston with a purposive community sample of 34 transgender and other gender minoritised AFAB young adults aged 18-26. Thematic analysis was used to examine participants' HPV vaccine perceptions and experiences. Participants reported that gendered representations of the HPV vaccine, lack of relevant HPV vaccine education, and previous negative experiences with healthcare led to low prioritisation of, and at times avoidance of, HPV vaccination. Participants had inadequate and at times inaccurate understandings of the HPV vaccine and called for increased education of the public and healthcare providers on HPV vaccination for this vulnerable population. Targeted interventions providing transgender and other gender minoritised AFAB individuals with culturally responsive care and tailored information about the HPV vaccine are needed.

Having No Idea and Many Ideas at the Same Time: Emergence, Continuity, and Dissonance in Cultural Frames of Sexual Orientation and Gender Identity

2025-06-24

Nicole M. Warner | Psychoanalytic Inquiry

Reframing the National Institute on Minority Health and Health Disparities Research Framework: Strengthening the Behavioral Domain with the Inclusion of Psychological Factors

2025-06-24

Caleb Esteban , Normarie Torres‐Blasco , Alíxida Ramos-Pibernus | International Journal of Environmental Research and Public Health

The National Institute on Minority Health and Health Disparities Research Framework (NIMHD-RF) provides a multidimensional structure to examine health disparities across domains and levels of influence. While influential, its current … The National Institute on Minority Health and Health Disparities Research Framework (NIMHD-RF) provides a multidimensional structure to examine health disparities across domains and levels of influence. While influential, its current Behavioral Domain centers on observable behaviors and underrepresents key psychological factors and determinants that shape health outcomes among minoritized populations. This gap limits the framework’s capacity to account for complex factors such as internalized stigma, identity-related stress, and cultural processes that significantly contribute to mental health disparities. In this viewpoint, we propose an adaptation of the Behavioral Domain into a Psychological/Behavioral Domain to better reflect the interconnected psychological, biological, sociocultural, and environmental factors influencing health. The revised domain incorporates psychological vulnerabilities, coping strategies, and identity-based stressors across all levels of influence, from individual to societal, and acknowledges macro-level processes such as structural stigma and inequitable policies. This reframing emphasizes that behaviors are shaped by psychological experiences and systemic inequities, not merely individual choice. By explicitly integrating psychological factors and determinants, the framework becomes more robust in guiding culturally responsive, equity-driven research and interventions. This adaptation aims to enhance the framework’s utility in mental health disparities research and to support efforts to achieve health equity for historically underserved populations.

Estradiol Concentrations for Adequate Gender-Affirming Feminizing Therapy: A Systematic Review

2025-06-24

Gabrielle Winston‐McPherson , Tiffany Thomas , Matthew D. Krasowski +7 more | LGBT Health

Purpose: Guidelines recommend serum estradiol concentrations of 100-200 pg/mL for transgender women prescribed oral, subcutaneous, or transdermal estradiol with or without adjunct antiandrogen as gender-affirming feminizing hormone therapy (HT). The … Purpose: Guidelines recommend serum estradiol concentrations of 100-200 pg/mL for transgender women prescribed oral, subcutaneous, or transdermal estradiol with or without adjunct antiandrogen as gender-affirming feminizing hormone therapy (HT). The purpose of this systematic review was to evaluate if the guideline range of 100-200 pg/mL for estradiol concentration is associated with indicators of adequate gender-affirming feminizing HT, specifically feminizing sufficiency, insufficiency, testosterone suppression, or toxicity in transgender women. Methods: The Populations/Intervention/Comparator/Outcome model was applied to the study question, whereby the target population included transgender, gender-diverse, and nonbinary adults using gender-affirming feminizing HT by any route of administration, with or without adjunct antiandrogen use. The comparator was defined as estradiol concentrations within (100-200 pg/mL or 367-734 pM) versus outside (</>100-200 pg/mL) the guideline range; evaluated outcomes were listed by the same clinical guidelines that recommend using the 100-200 pg/mL range. Embase, MEDLINE, and Web of Science were queried over a 24-year time frame (January 1, 1999-April 20, 2023); the search was restricted to English. The extracted outcomes were categorized as indicators of therapeutic insufficiency, sufficiency, toxicity, or hormone concentration. Results: There were 49 studies that met the inclusion criteria, of which 9, 42, 25, and 5 studies included indicators of therapeutic insufficiency, sufficiency, toxicity, or hormone concentration, respectively. The search did not identify articles demonstrating that the 100-200 pg/mL guideline range provides optimal feminizing outcomes or reduces adverse events. Conclusions: Evidence does not support using the guideline range of 100-200 pg/mL to indicate sufficient feminization in transgender women using gender-affirming feminizing HT.

Gynecologic Care of the Transgender Patient

2025-06-23

Cecile A. Ferrando | Clinical Obstetrics & Gynecology

Loneliness and Intersectional Discrimination Among Aging LGBT People in Spain: A Qualitative Research Study of Gay Men

2025-06-23

Sacramento Pinazo Hernandis , Jose Miguel Cerezo , Celia Carrascosa-Sánchez | Behavioral Sciences

Background: Loneliness is both a social and a health-related problem, and among LGBT people, feelings of loneliness are often exacerbated. According to the minority stress theory, stress and loneliness can … Background: Loneliness is both a social and a health-related problem, and among LGBT people, feelings of loneliness are often exacerbated. According to the minority stress theory, stress and loneliness can be directly related to the discrimination and stigma that are experienced over time in a heteronormative society. Exposure to social stigma causes mental health problems, stress, and loneliness, coupled with increased social and economic vulnerability. Method: The aim of this study was to conduct an exploratory analysis of homosexual men’s feelings of loneliness and their relationship with experiences of discrimination throughout their life. A qualitative methodology involving focus groups and individual interviews was utilized. Results: The results show the double or overlapping discriminations that gay men experience as a result of their age and sexual orientation and, in some cases, their HIV status, and the relationship between said discrimination and the feeling of unwanted loneliness. Exposure to such intolerance is more common among those with a reduced social network, which limits their social participation and has a negative impact on their well-being. Conclusion. The aging process of LGBT people implies a new context of intervention and research that must be addressed to prevent episodes of unwanted loneliness that negatively affect the quality of life among this demographic.

Positive Emotional Memories, Stigma, and Mental Health in Sexual and Gender Minority Adults: The Mediating Role of Self-Compassion and Social Support

2025-06-23

Lara Palmeira , Joana Silva , Bruna Veloso +1 more | LGBTQ+ Family An Interdisciplinary Journal

Barriers experienced by and educational needs of clinicians who provide care for transgender, nonbinary, and gender-diverse young adults in the Mid-Atlantic and Southern United States

2025-06-23

Jessica Kremen , Meg Quint , Regina L. Tham +5 more | PLoS ONE

The purpose of this study is to identify and explore the educational needs of and broader barriers experienced by clinicians who provide care to transgender, nonbinary, and gender diverse (TGD) … The purpose of this study is to identify and explore the educational needs of and broader barriers experienced by clinicians who provide care to transgender, nonbinary, and gender diverse (TGD) young adults (aged 18-24), with a focus on unique healthcare needs and challenges. Between April 2022 - July 2022, we conducted qualitative interviews with 13 clinicians (n = 9 medical and n = 4 mental health) about perceived needs and barriers relating to the care of TGD young adults. Clinicians were recruited throughout the Southeastern and Mid-Atlantic United States and were a mix of general practitioners and specialists. Using a hybrid deductive and inductive thematic analysis approach, the interview transcripts were analyzed and key themes identified. Thematic analyses of these interviews identified three main themes: the need for knowledgeable clinicians, the need and desire for reliable training resources and mentorship, and concerns surrounding the impact of the sociopolitical environment. Many participants noted a lack of access to local educational opportunities and mentorship but expressed willingness to seek these out if centralized resources, such as national platforms or accessible training modules, were available. This study identifies both gaps in clinician education and broader barriers - such as local politics and access to mentorship - that hinder the ability to provide effective care to TGD young adults. These findings will help to inform the development of clinician education and support programs.

Moderating effects of self-defined sexual orientation on the relation between social factors and depressive symptoms or suicidal ideation among French young adults

2025-06-23

Junko Kose , Camille Davisse‐Paturet , Anne Pastorello +4 more | Social Psychiatry and Psychiatric Epidemiology

Disparities in mental health across sexual orientation groups and among young adults have long been discussed. The aim of this cross-sectional study was to investigate the moderating effects of sexual … Disparities in mental health across sexual orientation groups and among young adults have long been discussed. The aim of this cross-sectional study was to investigate the moderating effects of sexual orientation on the associations between social factors and depressive symptoms as well as suicidal ideation in young adults. The study included 6,337 participants aged 18-25y in 2022 from the French EpiCov cohort. The outcome variables were depressive symptoms and suicidal ideation. Poisson regressions with robust error variance were performed to investigate the associations between social factors and outcomes according to sexual orientation (lesbian, gay, bisexual, other, or not defining themselves according to their sexuality: sexual minority (SM); heterosexual or not wishing to answer: Not belonging to SM (NSM)). The prevalence of depressive symptoms and suicidal ideation was higher in the SM than in the NSM group. Regarding depressive symptoms, significant moderating effects of sexual orientation were observed for female vs male sex (NSM: adjusted Prevalence Ratio (aPR) 1.58[1.28-1.95], SM: aPR 1.03[0.78-1.36]) and age category 22-25y vs 18-21y (NSM: aPR 1.32[1.05-1.67], SM: aPR 0.78[0.59-1.03]). Regarding suicidal ideation, significant moderating effect was observed for not being vs being in a relationship (NSM: aPR 1.55[1.14-2.12], SM: aPR 0.82[0.59-1.13]). In this study conducted in 2022, well-known social risk factors of mental problems do not explain the higher prevalence of depressive symptoms and suicidal ideation among young SM group. Further studies are needed to understand the specific challenges faced by these young people.

Self-Concept Among Formerly Incarcerated Sexual Minority Women

2025-06-23

Al Stone , Amy B. Smoyer , Karen D’Angelo | Social Sciences

Sexual minority women (SMW) are a resilient yet vulnerable population who may experience poor psychosocial outcomes due to minority stress associated with their marginalized status and traumatic experiences resulting from … Sexual minority women (SMW) are a resilient yet vulnerable population who may experience poor psychosocial outcomes due to minority stress associated with their marginalized status and traumatic experiences resulting from interpersonal and structural violence. When SMW are incarcerated, the trauma of this experience can exacerbate existing mental health challenges. Self-concept is a key measure of mental health that is associated with increased self-efficacy and positive psychosocial outcomes. This analysis explores the ways in which incarceration impacts the self-concept of SMW. Secondary data analysis of three qualitative interviews with formerly incarcerated SMW was conducted. Specifically, Gilligan’s Listening Guide was used to create “I poems” that articulate the participants’ narratives and contrapuntal voices. These poems were then analyzed to build knowledge about participants’ self-concept. This analysis informs our understandings of self-concept among SMW, violence against women, the vulnerability of binary constructs, and the ways in which people negotiate past, present and future selves. The findings can inform interventions that seek to mitigate the psychosocial risks faced by SMW and formerly incarcerated people and improve outcomes for these populations.

Impact of Online Discrimination on Mental Health Among Sexual Minorities

2025-06-23

Chiara Imperato , Tiziana Mancini | Oxford University Press eBooks

Abstract Sexual minorities, a term used to refer to individuals whose sexual identity, orientation, or practices differ from those of the heterosexual majority, often experience discrimination based on their sexual … Abstract Sexual minorities, a term used to refer to individuals whose sexual identity, orientation, or practices differ from those of the heterosexual majority, often experience discrimination based on their sexual orientation, which adversely affects their mental health. While this is well documented offline, the internet has emerged as a new context for both direct (i.e., perceived) and indirect (i.e., mediated and vicarious) discrimination. The present study specifically focuses on perceived, mediated, and vicarious forms of online discrimination and their relationship with sexual minorities’ mental health. Additionally, given that the internet also offers opportunities to reduce prejudice and discrimination through intergroup contact, this study examined the interplay between online discrimination, online intergroup contact, and sexual minorities’ mental health. This research employed a cross-sectional design using an online questionnaire distributed among LGBTQIA+ communities on popular social networks, yielding a final sample of 233 participants (males = 206, females = 25, nonbinary = 2; Mean age = 30.30, Standard Deviation = 8.87). Results from a general linear regression model used on data about homosexual men revealed that distress was significantly related to mediated online discrimination. Moreover, high-quality intergroup contact intensified the negative impact of mediated discrimination on distress. These findings underscore the harmful effects of online discrimination on sexual minorities’ mental health. Surprisingly, instead of mitigating distress, high-quality intergroup contact amplified it, suggesting controversial positive outcomes from such contact for sexual minorities.

Exploring the Role of Perceived Social Support on Mental Help-Seeking Behavior among LGBTQ Young Adults

2025-06-23

Sidhanth Ashok , T. S. Saranya | International Journal of Science and Research (IJSR)

Racial disparities in gender-affirming surgery in the United States: A systematic review and meta-analysis

2025-06-23

Antoinette T. Nguyen , Jonathan I. Leckenby , Clinton Morrison | International Journal of Transgender Health

Attitudes, Perceptions, and Knowledge of Greek Midwives Toward LGBT Individuals: Findings From the ATHENA Study and Validation of the Greek Version of the Perception and Knowledge of Sexual and Gender Minority Health (PKSGMH) Questionnaire

2025-06-23

Angeliki Antonakou , Vikentia Harizopoulou , Eleni Theodoridou +1 more | Cureus

Supplemental Material for Social Justice Awareness and Action and Ethnoracial Identity Moderates Caregiver Acceptance and Mental Health in BIPOC Caregivers of LGBTQ Youth: Implications for Family Therapy Interventions

2025-06-23

| Translational Issues in Psychological Science

From rejection by others to affirmation of self: Understanding the dynamics of cissexism-based stress, resilience factors, and suicidal ideation among bi+ transgender and gender diverse adults.

2025-06-23

Emily Herry , Christina Dyar , Emily Bettin +3 more | Psychology of Sexual Orientation and Gender Diversity

Trends in cannabis use among adults across sexual identities in the United States, 2015-2019

2025-06-22

Jie Yang , R. Andrew Yockey , Joseph G. L. Lee | Deleted Journal

Systematic review of PSA reference intervals in the gender diverse population with prostates

2025-06-22

Rose Hall , Devon Buchanan , Elizabeth Bancroft +2 more | BJU International

Objectives To determine mean/median serum total prostate‐specific antigen (PSA) levels in transgender women and non‐binary people with prostates (TWNBPP) who have received gender‐affirming hormone therapy (GAHT) or an orchidectomy. The … Objectives To determine mean/median serum total prostate‐specific antigen (PSA) levels in transgender women and non‐binary people with prostates (TWNBPP) who have received gender‐affirming hormone therapy (GAHT) or an orchidectomy. The secondary objective was to identify other quantitative information that influences PSA levels in this population. Methods Systematic review of existing publications from primary studies published in English, excluding case reports and guidelines. Included studies: TWNBPP who have received GAHT/post‐orchidectomy, without a diagnosis of prostate pathology, with recorded serum PSA levels. MEDLINE and Embase databases were searched, up to July 2024. Results Four papers met the inclusion criteria, with 290 participants. Two papers measured the mean PSA level after 4 and 12 months of GAHT (mean [range] age 30 [18–45] years). A third paper measured the mean PSA level after a median of 9 years of GAHT (mean [range] age 40.1 [19–67] years). The fourth study measured 852 PSA levels in 210 participants receiving oestradiol therapy, over a 23‐year period (mean [range] age 60 [40–79] years). The mean and median PSA levels ranged from 0.020 to 0.525 ng/mL. Meta‐analysis of these data was unfeasible, due to low quantity, comparability, and quality of the studies. Conclusions Existing data for serum PSA reference intervals for TWNBPP without prostate pathology were from four studies and cannot be used to make clinical recommendations. The evidence indicates that GAHT in TWNBPP lowers PSA levels from baseline, below expected levels for age‐matched cisgender controls. Not all TWNBPP over the age of 40 years should be offered PSA testing; however, those with a genetic predisposition, family history, or symptoms of prostate cancer, may request or be offered a PSA test. There are currently no clinical PSA thresholds to guide interpretation of PSA levels in TWNBPP when being evaluated for suspected prostate cancer or for those seeking PSA testing.

Examining Longitudinal Risk and Strengths-Based Factors Associated with Depression Symptoms Among Sexual Minority Men in Canada

2025-06-21

Yusuf Ghauri , Graham W. Berlin , Shayna Skakoon‐Sparling +4 more | Behavioral Sciences

Sexual minority men (SMM) experience anti-SMM stressors and have elevated rates of mental health issues compared to heterosexual men, such as depression. Importantly, strengths-based factors may directly increase wellbeing and … Sexual minority men (SMM) experience anti-SMM stressors and have elevated rates of mental health issues compared to heterosexual men, such as depression. Importantly, strengths-based factors may directly increase wellbeing and provide a buffer against the detrimental effects of such stressors. In the present study, we integrated risk and strengths-based models to examine predictors of depression symptoms in a sample of 465 Canadian SMM across three time points using multilevel modeling. Higher scores on a measure of childhood physical abuse at baseline, and greater within-person (i.e., deviation from individual’s average) and between-person (i.e., deviation from group average) internalized homonegativity and heterosexist discrimination were associated with higher depression scores. Higher within- and between-person scores on measures of self-esteem, social support, and hope were associated with lower depression scores. Social support buffered the effects of between-person heterosexist discrimination on depression symptoms: at mean and high levels of social support, heterosexist discrimination was not associated with depression symptoms. This is the first study to disaggregate between-person and within-person effects of both risk factors and strengths-based factors among SMM, which has critical importance for the development of tailored individual-level interventions that target internalized homonegativity, hope, social support, and self-esteem to alleviate symptoms of depression among SMM.

“Sonrisas y lágrimas”: limitaciones, apoyos y estilos de apego en la visibilización de personas gais y lesbianas

2025-06-21

Julio Rodríguez Rodríguez , Ainoa Mateos Inchaurrondo , Daniel Ortega Ortigoza | Acciones e Investigaciones Sociales

La aceptación pública de la homosexualidad continúa siendo cuestionada, existiendo actitudes negativas sutiles y manifiestas. Hacerse visible como gay o lesbiana conlleva algunas dificultades, porque socialmente se presupone la heterosexualidad … La aceptación pública de la homosexualidad continúa siendo cuestionada, existiendo actitudes negativas sutiles y manifiestas. Hacerse visible como gay o lesbiana conlleva algunas dificultades, porque socialmente se presupone la heterosexualidad en hombres y mujeres. Crecer en un entorno familiar con unos vínculos afectivos positivos funciona como una base segura que favorecería una visibilización positiva. Esta investigación tuvo como objetivo identificar los elementos de apoyo y las limitaciones en la visibilización de personas adultas cisgénero gais y lesbianas en Cataluña (España), y clasificar sus estilos de apego. Se realizó un estudio cuantitativo en el que participaron 241 hombres gais (n=121) y mujeres lesbianas (n=120). Se utilizaron como instrumentos una encuesta ad hoc y el cuestionario de apego adulto CaMir-R. Los resultados señalan que la visibilización es un proceso complejo. Los elementos facilitadores se agrupan en dos temáticas: las relaciones y el apoyo emocional, mientras que las limitaciones se organizan en tres: la diversidad y las relaciones, la identidad y la percepción social, la discriminación y la adversidad, y la falta de apoyo. Por otra parte, el estilo de apego seguro es el más frecuente (59.3%) frente al preocupado (26.1%) o el evitativo (14.5%). Las dificultades significativas están presentes en los apegos inseguros, mientras que los apoyos significativos están presentes en el apego seguro y el evitativo. En conclusión, conocer las experiencias de gais y lesbianas debe alentar a promocionar elementos protectores como los vínculos afectivos familiares y sociales que favorezcan un proceso de autoafirmación positivo.

Presenting a strengths-based ecological model for promoting well-being among LGBTQ+ adults

2025-06-21

Alexandra Cowand , Konrad Bresin , Nathan R. Todd +1 more | New Ideas in Psychology

We are real: Sexuality, gender and the problem of ontology in US health education

2025-06-21

Matthew Thomas-Reid | Health Education Journal

Background: Far-right movements in the USA have increasingly opposed inclusive health education by deploying arguments that delegitimize LGBTQIA+ identities. These arguments often conflate ontological and epistemological claims, positioning gender and … Background: Far-right movements in the USA have increasingly opposed inclusive health education by deploying arguments that delegitimize LGBTQIA+ identities. These arguments often conflate ontological and epistemological claims, positioning gender and sexuality diversity as ideological rather than legitimate aspects of human experience. Objective: This article critically examines the ontological assumptions underlying far-right arguments against sexual and gender diversity in health education. It aims to expose the epistemic fallacies in these arguments and to provide health educators with philosophical tools to resist them. Methods: Drawing on critical theory and philosophical analysis, the author dissects far-right discourses, focusing on the rhetorical use of concepts like “gender ideology.” They employ Roy Bhaskar’s concept of epistemic fallacy to differentiate between ontology (the nature of being) and epistemology (ways of knowing). Results: The analysis reveals that far-right arguments rely on a conflation of epistemology and ontology to invalidate LGBTQIA+ identities. These arguments often rest on Christian theological assumptions disguised as objective science, weaponsising bodily materiality to maintain heteronormative power structures. Conclusion: Health educators should recognise the difference between epistemological and ontological claims and resist far-right rhetorical tactics. Acknowledging that health education primarily concerns epistemological work, educators can foster inclusive and safe learning environments while navigating conflicts of belief and values.

The moderating role of sexual identity centrality in the association between gay community stress and social anxiety among sexual minority men

2025-06-21

Zachary A. Soulliard , Anthony J. Maiolatesi , Robert B. Manning +2 more | Journal of Affective Disorders

Gay community stress has been linked to social anxiety among sexual minority men; however, the moderating role of identity-related processes (e.g., sexual identity centrality) has yet to be examined in … Gay community stress has been linked to social anxiety among sexual minority men; however, the moderating role of identity-related processes (e.g., sexual identity centrality) has yet to be examined in this association. The present study investigated the association between gay community stress and two measures of social anxiety (i.e., self-reported social anxiety symptoms and interviewer-based diagnostic assessment of social anxiety disorder), as well as the moderating role of sexual identity centrality. Data come from the baseline assessment of a randomized controlled trial testing an LGBTQ-affirmative cognitive behavioral therapy intervention with 251 sexual minority men between the ages of 18-35. Results showed that gay community stress was significantly associated with social anxiety symptoms and social anxiety disorder diagnosis. Sexual identity centrality moderated these associations, such that the link between gay community stress and both social anxiety assessments was stronger among participants with higher levels of sexual identity centrality. These significant findings remained even after accounting for sexual orientation-based discrimination and general life stress. Future research can investigate how the interaction between gay community stress, sexual identity centrality, and social anxiety develops over time to inform interventions aimed at mitigating social distress among sexual minority men.

Through the Prism: Shining Light on LGBTQIA+ Applicant Identities and Influences

2025-06-21

Kayla Luliucci , Lea Moujaes , David L. Rudolph +7 more | Western Journal of Emergency Medicine

Unpacking Diversity: LGBTQIA+ Representation among Emergency Medicine Residents

2025-06-21

Lea Moujaes , Kayla Luliucci , David L. Rudolph +2 more | Western Journal of Emergency Medicine

For the Freedom to Marry… or Against It: A Qualitative Study of the Attitudes of Gays and Lesbians Toward Same-Sex Marriage in France

2025-06-21

M. Durand | International Journal of Politics Culture and Society

Heterosexual ‘situationships’ and HIV exposure for sexual and gender minority persons assigned female at birth in the Western Kenyan context

2025-06-20

Heather M. Tucker , Don Catherine Awuor , Anita Mbanda +3 more | Culture Health & Sexuality

Sexual and gender minority persons assigned female at birth (hereafter referred to as lesbian, bisexual, queer, transgender, intersex, gender non-conforming, non-binary and other sexual and gender minority persons, or LBQT+ … Sexual and gender minority persons assigned female at birth (hereafter referred to as lesbian, bisexual, queer, transgender, intersex, gender non-conforming, non-binary and other sexual and gender minority persons, or LBQT+ persons) experience extreme vulnerabilities to negative sexual health outcomes due to intersectional stigma in the Western Kenyan context. To navigate the structural violence created by this intersectional stigma, many LBQT+ persons manoeuvre heterosexual 'situationships', or relationships with cis-gender men. While such relationships help them to navigate economic inequalities and gendered expectations, they create vulnerability to intimate partner violence, and negative sexual and reproductive health outcomes, as well as the risk of acquiring HIV. Reflecting on the findings from a three month long feminist ethnographic study in Kisumu, Kenya, this paper explores the lived realities of LBQT+ persons, including those within heterosexual 'situationships', and the need to navigate compulsory heterosexual norms. The paper aims to challenge any conception that members of this group may not be vulnerable to HIV, highlighting the need to include the group and its specific needs in HIV and sexual and reproductive health interventions, research and programming, and calling for greater attention to the structural stigma its members experience as a barrier to health.

Social transition in young trans people accessing gender-affirming care

2025-06-20

Pip Buckingham , Michelle Tollit , Grace Wong +4 more | International Journal of Transgender Health

Recognizing Identity, Respecting Autonomy: The Role of Psychiatrists in Legal Gender Recognition

2025-06-20

Anitha Rayirala | Indian Journal of Psychological Medicine

The Legal Implications of Gender Identity and Sexual Orientation in Modern Laws

2025-06-20

Shraddha Chouhan - | International Journal of Leading Research Publication.

The legal implications of gender identity and sexual orientation in modern laws have become a crucial area of focus, as society evolves towards greater recognition of LGBTQ+ rights. The legal … The legal implications of gender identity and sexual orientation in modern laws have become a crucial area of focus, as society evolves towards greater recognition of LGBTQ+ rights. The legal framework surrounding gender identity and sexual orientation is often marked by tension between historical norms and progressive societal changes. Many jurisdictions have seen significant advancements in recognizing the rights of individuals, including the legalization of same-sex marriage, anti-discrimination laws, and the right to gender recognition. However, legal systems in many countries still face challenges related to the protection and acknowledgment of LGBTQ+ individuals, with issues such as employment discrimination, access to healthcare, and the legal recognition of non-binary and transgender individuals remaining contentious. Additionally, legal debates continue around the scope of religious freedom, parental rights, and military service in relation to gender identity and sexual orientation. This evolving legal landscape underscores the importance of reforming outdated laws to ensure equality and fairness. As societal attitudes towards gender and sexuality shift, the law must adapt to protect the rights of all individuals, irrespective of their gender identity or sexual orientation. This paper explores the current state of legal protections, challenges faced by LGBTQ+ individuals, and the implications of legal reforms in ensuring comprehensive human rights protections in a modern society.

Mental Health Outcomes Among Travestis and Transgender Women in Brazil: A Literature Review and a Call to Action for Public Health Policies

2025-06-20

David Richer Araujo Coelho , Ana Luiza N. Ferreira , Willians Fernando Vieira +2 more | International Journal of Environmental Research and Public Health

Travestis and transgender women in Brazil face a disproportionate burden of mental health conditions, exacerbated by structural discrimination, violence, and social exclusion. This narrative review synthesizes evidence on the prevalence … Travestis and transgender women in Brazil face a disproportionate burden of mental health conditions, exacerbated by structural discrimination, violence, and social exclusion. This narrative review synthesizes evidence on the prevalence of depression, anxiety, suicidality, and substance use among travestis and transgender women in Brazil, and examines intersecting social and health disparities. We searched PubMed, Embase, and PsycINFO in April 2025, identifying peer-reviewed studies in English or Portuguese reporting mental health outcomes or associated social determinants of health in this population. Thirty-one studies across twelve different cities (n = 7683) were included and grouped into two thematic domains. Reported prevalence ranged from 16–70.1% for depression, 24.8–26.5% for anxiety, and 25–47.3% for suicidality. Substance use was also highly prevalent, with studies reporting high rates of alcohol (21.5–72.7%), tobacco (56.6–61.6%), cannabis (19–68.9%), and cocaine/crack (6–59.8%) use. Discrimination, violence, economic hardship, and HIV were consistently associated with psychological distress and barriers to care. These findings underscore the urgent need to integrate mental health, gender-affirming care, and HIV services into Brazil’s Unified Health System (Sistema Único de Saúde–SUS), strengthen anti-discrimination and violence-prevention policies, and adopt inclusive public health strategies that prioritize the leadership and lived experiences of transgender, nonbinary, and gender diverse people, particularly amid rising political threats to gender-affirming care.

LGBTQ+ Women and Mental Health during the COVID-19 Pandemic

2025-06-20

Izaskun Zuazu , Yana van der Meulen Rodgers | Research Square (Research Square)

<title>Abstract</title> We analyze whether the pandemic and its containment policies affected the mental health of women differently by their sexual orientation and gender identity. Using a sample of 26 European … <title>Abstract</title> We analyze whether the pandemic and its containment policies affected the mental health of women differently by their sexual orientation and gender identity. Using a sample of 26 European Union countries, we find that LGBTQ+ women were 8 to 11 percentage points more likely than heterosexual, cisgender women to report anxiety, worries about mental well-being, and depression during the pandemic. We uncover a notable interaction between LGBTQ+ status and household composition, by which the presence of children below the age of 15 reduces the probability of anxiety for LGBTQ+ women. Causal mediation analysis shows that the presence of children partially mediates the link between LGBTQ+ and anxiety, explaining 10% of the total effect. LGBTQ+ women are unconditionally associated with a higher prevalence of worries about mental well-being and depression. Containment policies also mattered: LGBTQ+ women were more likely than heterosexual, cisgender women to have detrimental mental health effects from workplace and office closures. <italic><bold>JEL Codes: </bold></italic><italic>I14; I18; J16</italic>