Anxiety Disorders among Sexual and Gender Minority Populations

Rates of anxiety disorders are significantly elevated among sexual and gender minorities. In this chapter, the minority stress model is discussed as a framework for conceptualizing anxiety among sexual and gender minorities, and the authors review the literature on the relationships between specific minority stressors and symptoms. The authors examine prevalence rates of anxiety disorders among sexual minorities and gender minorities, separately and in comparison to heterosexual and cisgender individuals. Also reviewed is the literature on anxiety disorders among sexual and gender minorities with a racial or ethnic minority status. Current assessment and treatment approaches are identified and reviewed. Finally, limitations to the current literature base are discussed and recommendations are provided for future studies.

The Role of Resilience in Sexual and Gender Minority Mental Health

Many lesbian, gay, bisexual, transgender, and queer (LGBTQ) persons are able to persevere and flourish despite pervasive social stigma and minority stress based on their sexual orientation and gender identity. This chapter reviews the research on LGBTQ resilience that can occur at individual, interpersonal/family, community, and contextual/structural levels. The authors describe qualitative research that has examined pathways to resilience and positive LGBTQ identity. The authors also review quantitative research on LGBTQ resilience via mediator, moderator, and moderated mediation models. Variables are described that have been found to explain or buffer the links between external and internalized minority stressors and mental health outcomes. The authors review the small but growing body of research that has begun to examine the efficacy of therapeutic interventions aimed at promoting LGBTQ resilience. Limitations are discussed and directions for future research are suggested.

Gender Nonbinary Mental Health

In this chapter the author explores the mental health of those with nonbinary gender identities and focuses on the issues they face. The author defines nonbinary identities and discusses how these identities are different than people who have binary identities. There is a summary of the extant psychological literature focusing on people with nonbinary identities. Attention is also brought to how racial and ethnic minority individuals, including Native American people, conceptualize nonbinary identities. The chapter ends with information about the lack of attention to the Global South and the need for additional research and training in the mental health of those with nonbinary identities.

Sexual and Gender Minority Mental Health among Children and Youth

Sexual and gender minority (SGM) young people are coming of age at a time of dynamic social and political changes with regard to LGBTQ rights and visibility around the world. And yet, contemporary cohorts of SGM youth continue to evidence the same degree of compromised mental health demonstrated by SGM youth of past decades. The authors review the current research on SGM youth mental health, with careful attention to the developmental and contextual characteristics that complicate, support, and thwart mental health for SGM young people. Given a large and rapidly growing body of science in this area, the authors strategically review research that reflects the prevalence of these issues in countries around the world but also concentrate on how mental health concerns among SGM children and youth are shaped by experiences with schools, families, and communities. Promising mental health treatment strategies for this population are reviewed. The chapter ends with a focus on understudied areas in the SGM youth mental health literature, which may offer promising solutions to combat SGM population health disparities and promote mental health among SGM young people during adolescence and as they age across the life course.

History of Sexual Orientation and Mental Health

Psychology’s understanding of lesbian, gay, and bisexual (LGB) people has evolved, become more refined, and impacted the lives of LGB people in profound ways. This chapter traces the history of LGB psychology from the nineteenth century to the present and focuses on major events and the intersections of theory, psychological science, politics, and activism in the history of this field. It explores various facets of cultural and psychological history that include the pathologizing of homosexuality, the rise of psychological science and the political movements in the mid-twentieth century, and the major shifts in policy that ensued. The toll of the AIDS epidemic on the field is discussed as is the impact of psychological research on national and international policy and legislation.

Sexual Disorders among Sexual and Gender Minority Populations

Sexual disorders and dysfunction are common among people of all sexual orientations and gender identities. And while definitions and conceptions of sexual health are typically broad, the clinical and research perspectives on sexual function and dysfunction have traditionally relied on the four-phase model of sexual response and disorders are generally classified as “male” or “female.” This chapter reviews the diagnostic criteria for specific sexual dysfunctions and presents a summary of existing research among sexual and gender minority populations. Overall, research on sexual dysfunction among sexual and gender minority people is limited, and this is especially true for transgender and gender nonconforming individuals. Understanding these often complex disorders requires that individuals, clinicians, and researchers consider a range of biopsychosocial factors that can affect and be affected by one’s sexual health and sexuality.

Introduction

The Oxford Handbook of Sexual and Gender Minority Mental Health provides an overview of the current research on the mental health of sexual and gender minority (SGM) populations. It is aimed at researchers conducting studies on the mental health of SGM populations, clinicians and researchers interested in psychiatric disorders that affect SGM populations, clinicians using evidence-based practice in the treatment of SGM patients/clients, students in mental health programs (clinical psychology, psychiatry, clinical social work, and psychiatric nursing), and policymakers. This chapter defines some terms and provides an overview of current and past SGM research methods.

Over Depression and Mood Disorders among Sexual and Gender Minority Populations

Sexual and gender minority (SGM) adults have rates of depressive disorders that are higher than those of cisgender or heterosexual adults. These differences are likely due to the ways that SGMs are treated both on an individual and population basis. This chapter begins by discussing evolving conceptualizations of depressive disorders among SGMs with a focus on the dimensionality in symptomatology. Insights are provided into the ways that differences in risk for depressive disorders occur in SGMs by subpopulations with a focus on gender, developmental stages, and geographic context. The authors discuss social risks, examining the ways in which stigma, discrimination, and early life adversity can contribute to depressive disorders in SGMs. This provides a basis for researchers and clinicians to explore and include structural and societal change in addressing mental health disorders in SGMs. The authors also discuss the comorbidity of depressive disorders with several chronic health conditions with particular regard to the health inequities that some subpopulations of SGMs face. Adopting an intersectional approach is useful in studying depressive disorders among SGMs, and the authors suggest pairing this approach with the National Institute of Health’s Research Domain Criteria (RDoC) framework. Future directions are suggested to researchers and clinicians to reduce risks of depressive distress in SGM subpopulations.

Mental Health for Sexual and Gender Minority Polyamorous and Consensually Non-monogamous Individuals

This chapter covers four areas. First, the author introduces, defines, and briefly describes how sexual and gender minority (SGM) polyamorous and consensually non-monogamous (poly/CNM) individuals, families, and communities have been researched in mental health studies. Second, the author reviews the available evidence-based research on poly/CNM SGMs and mental health, and mental health service provision. Third, the author reviews absences and erasures in research pertaining to the mental health of poly/CNM SGMs, particularly in relation to whether an intersectional lens has been applied in service provision such as in relation to age and to racial and ethnic minorities. In the final section, the author identifies and proposes future directions in the content and methodologies of research on poly/CNM SGM mental health, and recommendations for more effective mental health service provision.

Mental Health for Men Who Have Sex with Men (MSM) and Women Who Have Sex with Women (WSW)

This chapter reviews mental health research of sexual minorities who are defined by their same-gender sexual behavior. Women who have sex with women (WSW) and men who have sex with men (MSM) encompass not only those who identify as LGBQ+ but also people who identify as heterosexual or are unsure of their sexual orientation. The authors discuss the implications of this broad categorization on the study of mental disorders and psychological distress and present the typical rates of risk for WSW and MSM overall and within subgroups (e.g., heterosexual-identified WSW, Black MSM). This area of research is often hindered by the multiple ways in which MSM and WSW groups can be defined and the vast heterogeneity of people who fall within these categories. Further, because of the origins of WSW/MSM-terminology in HIV/AIDS research, there is a gendered imbalance in allocation of research funding toward MSM over WSW. Future research should address the limitations of this categorization system in understanding mental health by including multiple measures of sexuality to create a fine-grained understanding of which experiences of WSW/MSM transfer risk and by addressing the paucity of research on WSW and their mental health.