Transdiagnostic Approaches to Improve Sexual Minority Individuals’ Co-occurring Mental, Behavioral, and Sexual Health

Sexual and gender minority individuals are at elevated risk of many adverse psychosocial health outcomes, including mood, anxiety, and substance use disorders, as well as suicidality and sexually transmitted infections. Despite greater utilization of mental health services, there remain few evidence-based approaches specifically tailored for sexual minority individuals and even fewer that are designed to explicitly address the multiple co-occurring conditions that afflict this group. This chapter describes one such approach, rooted in minority stress theory, that has been shown to empirically address the multitude of problematic outcomes and behaviors among sexual minority men and is currently being developed for sexual minority women. The chapter begins by describing the theoretical underpinnings of this therapeutic approach, subsequently providing a description of the major principles underlying this intervention. This chapter ends with an illustrative case example taken from the current clinical trials of this treatment program.

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Venturing beyond the “Behavioural MSM”: Sex, Chems, & Satisfaction in their Syndemic Contexts

10.35198/01-2019-002-0003 ◽

2020 ◽

Keyword(s):

Hiv Testing ◽

Sexual Minority ◽

Sexual Behaviour ◽

Minority Stress ◽

Online Survey ◽

Well Being ◽

Steady Partner ◽

Sexual Minority Men ◽

Sexually Transmitted ◽

Minority Men

BACKGROUND: The health and well-being of those sexual-minority men who are often behaviourally defined as men who have sex with men (MSM) is affected by a system of interlinked factors that interact on the structural, interpersonal, and individual levels. Recently, two of the most common MSM health issues have been (a) the risks of acquiring sexually transmitted infections (STIs), mostly HIV, and (b) the sexualized use of addictive substances, known as chemsex. AIMS: On the basis of the first comprehensive Czech dataset to integrate several mutually interlinked factors on the behavioural, as well as the psychological and structural domains, we attempt to shed light on the barriers to HIV testing and adherence to safer sex practices, including the most thorough description of the chemsex phenomenon that is available. We aim to go beyond the behavioural perspective and draw links to the well-being and satisfaction of this sexual minority and their sex lives. METHODS: A series of descriptive statistical analyses was conducted on a sample of 547 respondents obtained within a self-administered online survey. RESULTS: More than half of our respondents (55%) and three-quarters (72%) of the men younger than 25 years have never been tested for HIV. One-third of the respondents considered testing services to be insufficiently friendly to gay, bisexual, or other men, and they also reported stigmatization and discrimination by healthcare workers as a problem that exists. 84% of the MSM have experience with anal sex; 43% of them always use condoms. Of all the respondents, nearly 6% have had at least one chemsex experience during their life. Only 46% of the MSM reported being satisfied with their sex lives; 52% of those who were dissatisfied attributed this to “not having a steady partner” and 49% to “not having any sex”. CONCLUSION: The sexual behaviour of MSM and their experience with HIV testing, chemsex, perceived stigma, and satisfaction with their sex lives are among the phenomena that deserve to be more regularly covered by relevant epidemiological examinations. Although our current analysis was more exploratory than in-depth, it may contribute to a better understanding of the syndemic and multifactorial conditions that influence the sexual behaviour of MSM, including the minority stress that may be rooted in deficiencies in our understanding of these populations.

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Minority Stress, Structural Stigma, and Physical Health Among Sexual and Gender Minority Individuals: Examining the Relative Strength of the Relationships

Annals of Behavioral Medicine ◽

10.1093/abm/kaab051 ◽

2021 ◽

Author(s):

Annesa Flentje ◽

Kristen D Clark ◽

Ethan Cicero ◽

Matthew R Capriotti ◽

Micah E Lubensky ◽

...

Keyword(s):

Physical Health ◽

Sexual Minority ◽

Minority Stress ◽

Relative Strength ◽

Sexual Minority Women ◽

Sexual Minority Men ◽

Gender Minority ◽

Sexual And Gender Minority ◽

Community Environments ◽

And Gender

Abstract Background Sexual and gender minority (SGM; i.e., non-heterosexual and transgender or gender-expansive, respectively) people experience physical health disparities attributed to greater exposure to minority stress (experiences of discrimination or victimization, anticipation of discrimination or victimization, concealment of SGM status, and internalization of stigma) and structural stigma. Purpose To examine which components of minority stress and structural stigma have the strongest relationships with physical health among SGM people. Methods Participants (5,299 SGM people, 1,902 gender minority individuals) were from The Population Research in Identity and Disparities for Equality (PRIDE) Study. Dominance analyses estimated effect sizes showing how important each component of minority stress and structural stigma was to physical health outcomes. Results Among cisgender sexual minority women, transmasculine individuals, American Indian or Alaskan Native SGM individuals, Asian SGM individuals, and White SGM individuals a safe current environment for SGM people had the strongest relationship with physical health. For gender-expansive individuals and Black, African American, or African SGM individuals, the safety of the environment for SGM people in which they were raised had the strongest relationship with physical health. Among transfeminine individuals, victimization experiences had the strongest relationship with physical health. Among Hispanic, Latino, or Spanish individuals, accepting current environments had the strongest relationship with physical health. Among cisgender sexual minority men prejudice/discrimination experiences had the strongest relationship with physical health. Conclusion Safe community environments had the strongest relationships with physical health among most groups of SGM people. Increasing safety and buffering the effects of unsafe communities are important for SGM health.

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LGBTQ Health and Well-Being in China: A Trend Analysis of English- and Chinese-Language Research, 2011–2018

10.31234/osf.io/cmxqu ◽

2021 ◽

Author(s):

Tao Lin ◽

Yijun Cheng ◽

Tonda L. Hughes ◽

Cindy Veldhuis

Keyword(s):

Sexual Minority ◽

Coming Out ◽

English Language ◽

Chinese Language ◽

Well Being ◽

Future Research ◽

Sexual Minority Women ◽

Sexual Minority Men ◽

Sexually Transmitted ◽

Minority Men

Purpose: Research on LGBTQ populations has dramatically increased in both Western and non-Western countries over the past several decades. Attempts to synthesize this research have largely focused on studies conducted in the West. We conducted a review of LGBTQ research in China to elucidate trends and gaps in the literature and to provide a foundation for future research. Methods: We searched the literature to identify studies that focused on LGBTQ people in China using PsycINFO and reviews of article titles and abstracts in 15 English-language LGBTQ-specific journals published between 2011–2018. We used the Wanfang database to identify Chinese-language LGBTQ research articles published in any journal between 2011–2018. Each article was coded by topic, study type, province, and sample. Results: These searches yielded 798 LGBTQ research studies conducted in China between 2011–2018. HIV/AIDS, sexuality, and LGBTQ-specific issues (e.g., coming out) have been most frequently studied. Most of the articles focused on sexual minority men (69.5%), with smaller proportions focused on sexual minority women (15.5%) or transgender individuals (2.6%). The disparity wasreduced after excluding studies on HIV or other sexually transmitted infections. The geographic distribution of studies was uneven; most were conducted in economically developed areas. Conclusion: This study identified gaps and trends in LGBTQ research in China and highlighted priority and under-researched topics to guide future LGBTQ research. More research on these understudied populations and topics will contribute to understanding of LGBTQ populations.

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"Multiple minority stress and LGBT community resilience among sexual minority men": Correction to McConnell et al. (2018).

Psychology of Sexual Orientation and Gender Diversity ◽

10.1037/sgd0000290 ◽

2018 ◽

Vol 5 (2) ◽

pp. 168-168 ◽

Cited By ~ 1

Keyword(s):

Sexual Minority ◽

Minority Stress ◽

Community Resilience ◽

Sexual Minority Men ◽

Lgbt Community ◽

Minority Men ◽

Multiple Minority

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Intersectional Invisibility: Race, Gender, Sexuality, and the Erasure of Sexual Minority Women in US Asylum Law

Law & Social Inquiry ◽

10.1017/lsi.2021.15 ◽

2021 ◽

pp. 1-30

Author(s):

Roxana Akbari ◽

Stefan Vogler

Keyword(s):

Sexual Minority ◽

Minority Women ◽

Social Difference ◽

Regulatory Structure ◽

Sexual Minority Women ◽

Empirical Examination ◽

Sexual Minority Men ◽

Asylum Law ◽

Quantitative Metrics ◽

Minority Men

Advocates have long observed that sexual minority women are treated less favorably than sexual minority men under US asylum law. However, there has been little empirical examination of these claims in a US context. We offer the first systematic comparative empirical analysis of 199 asylum decisions for cisgender sexual minorities. Using quantitative metrics to contextualize in-depth qualitative analysis, we show that even when cisgender sexual minority men and women face very similar types of violence, women’s claims are adjudicated differently. This is particularly stark in courts’ treatment of sexual violence but is also evident in determinations of generalized persecution and individuals’ sexualities. When women attempt to use laws that are structured around straight, white, Western male perspectives and experiences, their pathways are limited and sometimes nonexistent. Although the flexibility in this area of asylum law has allowed many types of new claims, these changes have mostly benefited those assigned male at birth, and this surface malleability has ultimately worked to maintain law as a regulatory structure. Even with seemingly progressive changes in asylum law, the law itself continues to uphold race, gender, and sexuality as durable social structures and does little to ameliorate inequalities along these axes of social difference.

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Minority stress, intra-minority stress and social anxiety: Examining an extended psychological mediation framework among sexual minority men

European Journal of Public Health ◽

10.1093/eurpub/ckz185.140 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

C Mahon ◽

G Kiernan ◽

P Gallagher

Keyword(s):

Sexual Orientation ◽

Social Anxiety ◽

Sense Of Coherence ◽

Sexual Minority ◽

Minority Stress ◽

Rejection Sensitivity ◽

Sexual Minority Men ◽

Lgbt Community ◽

Minority Men ◽

Everyday Discrimination

Abstract Background Compared to their heterosexual counterparts, sexual minority men (SMM) are at an increased risk of social anxiety disorder. Distal (i.e., everyday discrimination) and proximal (i.e., internalised homophobia, rejection sensitivity, concealment of sexual orientation) minority stress processes are associated with heightened social anxiety for SMM. Stressors emerging from within the sexual minority male community, termed intra-minority stress, and psychological processes that may foster resilience (i.e., a sense of coherence, connectedness to the LGBT community) are less explored in this area. This study examined potential pathways between everyday discrimination, intra-minority stress, proximal minority stressors, resilience and social anxiety. Methods Self-identified SMM (N = 255) residing in the Republic of Ireland completed an online survey containing measures of minority stress, intra-minority stress, resilience and social anxiety. Structural equation modelling was used to examine the model. Results The model yielded a good fit to the data, X2(16) = 26.61, CFI = .99, TLI = .97, RMSEA = .05, and SRMR = .03. Rejection sensitivity and a sense of coherence had a significant indirect effect in the relationships between both exogenous variables (i.e., discrimination and intra-minority stress) and social anxiety. There were no significant pathways to social anxiety involving concealment of sexual orientation, internalised homophobia or LGBT community connectedness. Conclusions For SMM, minority stress processes and intra-minority stress are important determinants of social anxiety. Our findings demonstrate that proximal minority stressors may operate differently in a social anxiety context for SMM in western European countries. A sense of coherence was an integral factor in the model and demonstrated the strongest association with social anxiety.

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