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The chapter begins with a review of the historical and current socio-political context for sexual minority and gender diverse (SMGD) individuals living in Portugal, followed by relevant research on the associations between minority stress and well-being. A particular focus is devoted to presenting data collected as part of the SMGD-MN study. The chapter concludes with recommendations for future psychological research with SMGD communities in Portugal.
The chapter begins with a review of the historical and current socio-political context for sexual minority and gender diverse (SMGD) individuals living in Indonesia, followed by relevant research on the associations between minority stress and well-being. A particular focus is devoted to presenting data collected as part of the SMGD-MN study. The chapter concludes with recommendations for future psychological research with SMGD communities in Indonesia.
The chapter begins with a review of the historical and current socio-political context for sexual minority and gender diverse (SMGD) individuals living in Switzerland, followed by relevant research on the associations between minority stress and well-being. A particular focus is devoted to presenting data collected as part of the SMGD-MN study. The chapter concludes with recommendations for future psychological research with SMGD communities in Switzerland.
The chapter begins with a review of the historical and current socio-political context for sexual minority and gender diverse (SMGD) individuals living in Malaysia, followed by relevant research on the associations between minority stress and well-being. A particular focus is devoted to presenting data collected as part of the SMGD-MN study. The chapter concludes with recommendations for future psychological research with SMGD communities in Malaysia.
The chapter begins with a review of the historical and current socio-political context for sexual minority and gender diverse (SMGD) individuals living in the United States, followed by relevant research on the associations between minority stress and well-being. A particular focus is devoted to presenting data collected as part of the SMGD-MN study. The chapter concludes with recommendations for future psychological research with SMGD communities living in the United States.
The chapter begins with a review of the historical and current socio-political context for sexual minority and gender diverse (SMGD) individuals living in South Africa, followed by relevant research on the associations between minority stress and well-being. Given the dearth of research on this topic, a large portion of this chapter focuses on recommendations for future research and practice for those interested in working with SMGD individuals living in South Africa.
The chapter begins with a review of the historical and current socio-political context for sexual minority and gender diverse (SMGD) individuals living in Italy, followed by relevant research on the associations between minority stress and well-being. A particular focus is devoted to presenting data collected as part of the SMGD-MN study. The chapter concludes with recommendations for future psychological research with SMGD communities in Italy.
This chapter outlines future research directions to advance understanding of sexual minority and gender diverse (SMGD) individuals and their relationships by advocating for the examination of cultural and legal contexts that shape SMGD experiences across nations. Additionally, this chapter argues that future research should address minority stress processes and resilience factors, with attention to couple-level outcomes and mechanisms connecting stigma to health and incorporate intersectionality to elucidate how multiple marginalized identities interact. Methodological considerations for future research are also presented. Lastly, this chapter discusses translational priorities including community outreach, tailored interventions and programs, legal advocacy utilizing research evidence, educational initiatives, and technology-enabled solutions tailored for SMGD individuals. This chapter concludes with an integrated perspective on open questions, methods, and real-world applications to guide the next phase of research and practice aimed at promoting justice and well-being for SMGD individuals globally.
This chapter presents considerations when conducting multi-nation research, with a particular focus on research conducted with sexual minority and gender diverse (SMGD) communities. Specifically, this chapter provide a nonexhaustive list of best practices from idea development, including forming multi-nation research teams, to practical challenges of the research process, such as questions of cross-cultural reliability and validity of chosen methods, and challenges of recruitment and data collection. Additionally, reference is made to specific methodological aspects, including missing data analysis and common analytical procedures, such as multilevel modeling. Examples and aspects of reflective practices, such as reflections on positionality, the impact of cultural and ethical aspects on the research process, and sources of bias and how research teams may make efforts to overcome them, are also presented.
The chapter begins with a review of the historical and current socio-political context for sexual minority and gender diverse (SMGD) individuals living in Brazil, followed by relevant research on the associations between minority stress and well-being. A particular focus is devoted to presenting data collected as part of the SMGD-MN study. The chapter concludes with recommendations for future psychological research with SMGD communities in Brazil.
The chapter begins with a review of the historical and current socio-political context for sexual minority and gender diverse (SMGD) individuals living in Nigeria, followed by relevant research on the associations between minority stress and well-being. Given the dearth of research on this topic, a large portion of this chapter focuses on recommendations for future research and practice for those interested in working with SMGD individuals living in Nigeria.
The chapter begins with a review of the historical and current socio-political context for sexual minority and gender diverse (SMGD) individuals living in Türkiye followed by relevant research on the associations between minority stress and well-being. A particular focus is devoted to presenting data collected as part of the SMGD-MN study. The chapter concludes with recommendations for future psychological research with SMGD communities in Türkiye.
This introduction provides an overview of the SMGD-MN study, including information on the context to which it was developed and its theoretical underpinnings. Additionally, we provide key terminology and an overview of the chapters’ content.
The chapter begins with a review of the historical and current socio-political context for sexual minority and gender diverse (SMGD) individuals living in Austria, followed by relevant research on the associations between minority stress and well-being. A particular focus is devoted to presenting data collected as part of the SMGD-MN study. The chapter concludes with recommendations for future psychological research with SMGD communities in Austria.
The chapter begins with a review of the historical and current socio-political context for sexual minority and gender diverse (SMGD) individuals living in India, followed by relevant research on the associations between minority stress and well-being. A particular focus is devoted to presenting data collected as part of the SMGD-MN study. The chapter concludes with recommendations for future psychological research with SMGD communities in India.
This chapter will discuss information pertinent to understanding gender identity. We will discuss key terms and the importance of understanding language usage as a foundation for communicating respect, knowledge, and awareness. Counselors create safe and affirming spaces for the clients we serve. As such, counselors must understand the complex past and historical discrimination clients have experienced while examining their own understanding of these communities. Counselors will also seek to understand their ethical and legal responsibilities to marginalized and minoritized communities while understanding the importance of cultural considerations. Barriers to services and our collective responsibility to address these barriers rooted in discrimination will be addressed. While counselors maintain culture humility in an attempt to avoid ethnocentrism regarding their own beliefs around gender identity development, we seek to grow in knowledge and awareness. While antitrans legislation continues to increase, counselors must remain steadfast in their approach to advocacy and to providing ethical care.
The mental health of sexual minority (SM) individuals remains overlooked and understudied in Czechia. We aimed to estimate (1) the prevalence rate and (2) the relative risk of common mental disorders and (3) the mental distress severity among the Czech SM people compared with the heterosexual population. In addition, we aimed to investigate help-seeking for mental disorders in SM people.
Methods
We used data from a cross-sectional, nationally representative survey of Czech community-dwelling adults, consisting of 3063 respondents (response rate = 58.62%). We used the Mini-International Neuropsychiatric Interview to assess the presence of mental disorders. In individuals scoring positively, we established help-seeking in the past 12 months. We assessed symptom severity using the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scale. We computed the prevalence of mental disorders and the treatment gap with 95% confidence intervals. To assess the risk of having a mental disorder, we used binary logistic regression.
Results
We demonstrated that the prevalence of current mental disorders was 18.85% (17.43–20.28), 52.27% (36.91–67.63), 33.33% (19.5–47.17) and 25.93% (13.85–38) in heterosexual, gay or lesbian, bisexual and more sexually diverse individuals, respectively. Suicidal thoughts and behaviours were present in 5.73% (4.88–6.57), 25.00% (11.68–38.32), 22.92% (10.58–35.25) and 11.11% (2.45–19.77) of heterosexual, gay or lesbian, bisexual and more sexually diverse individuals, respectively. After confounder adjustment, gay or lesbian individuals were more likely to have at least one current mental disorder compared with heterosexual counterparts (odds ratio = 3.51; 1.83–6.76). For bisexual and sexually more diverse individuals, the results were consistent with a null effect (1.85; 0.96–3.45 and 0.89; 0.42–1.73). The mean depression symptom severity was 2.96 (2.81–3.11) in heterosexual people and 4.68 (2.95–6.42), 7.12 (5.07–9.18) and 5.17 (3.38–6.95) in gay or lesbian, bisexual and more sexually diverse individuals, respectively. The mean anxiety symptom severity was 1.97 (1.85–2.08) in heterosexual people and 3.5 (1.98–5.02), 4.63 (3.05–6.2) and 3.7 (2.29–5.11) in gay or lesbian, bisexual and more sexually diverse individuals, respectively. We demonstrated broadly consistent levels of treatment gap in heterosexual and SM individuals scoring positively for at least one current mental disorder (82.91%; 79.5–85.96 vs. 81.13%; 68.03–90.56).
Conclusions
We provide evidence that SM people in Czechia have substantially worse mental health outcomes than their heterosexual counterparts. Systemic changes are imperative to provide not only better and more sensitive care to SM individuals but also to address structural stigma contributing to these health disparities.
Gender- and sexuality-minoritised (GSM) adolescents are at increased risk of self-harm and suicidal behaviours compared with their cisgender and heterosexual peers. This increased risk is thought to be explained in part by exposure to stigma and societal oppression. Dialectical behaviour therapy (DBT) is an evidence-based intervention for self-harm and suicidal behaviour that may have advantages for supporting GSM young people in distress. No study has yet sought to understand what GSM-associated difficulties may be important to consider in DBT for adolescents, or the experiences of GSM young people in a standard DBT programme. Therefore, this study aimed to understand the experiences of GSM young people in DBT and what difficulties and dilemmas associated with their gender and sexuality diversity were thought by them to be important to target in DBT. Qualitative interviews were conducted with 14 GSM young people in a comprehensive DBT programme and were analysed using reflexive thematic analysis. The analysis was supported by two further GSM young people who had finished DBT. The findings were split into three over-arching themes (Identity, Impact of Others, and Space for Sexual and Gender Identity in DBT), each with themes within. The identity-based theme included ‘identity confusion and acceptance’; the relationship-based themes included ‘cis-Heterosexism’ and ‘community connectedness’; and the space within DBT themes included ‘negotiating focus and targeting in DBT’ and ‘creating safety in DBT’. Findings are discussed in relation to implications and recommendations for therapists working with GSM young people within and outside of DBT.
Key learning aims
(1) To learn about what gender- and sexuality-minoritised (GSM) young people consider to be important GSM-associated contributors to distress and thus potential treatment targets in DBT.
(2) To learn about what GSM young people felt were barriers to negotiating GSM-associated difficulties as a focus in DBT and how safety was created in the therapeutic relationship.
(3) To consider potential implications and recommendations for improvements to practice when supporting GSM young people in therapy.
Lesbian, gay, bisexual and queer (LGBQ) women and men are increasingly utilizing fertility treatment services to build their families. This chapter provides an overview of topics to consider when providing fertility counseling to this population of prospective parents. It first explores the decisions that same-sex couples need to make with regard to family building and fertility treatment, including various routes to parenthood, whose gametes to use, or who will serve as the carrier. The chapter further explores many of the challenges couples often face during fertility treatment via the sexual minority stress framework. Particular attention is given to issues of homophobic discrimination, heteronormative bias and stigma, as well as to challenges related to social support, costs and legal rights. Finally, this chapter provides guidance to fertility counselors and treatment professionals on steps to take to provide culturally competent care to LGBQ patients and their partners. Such practices are crucial for offering an inclusive treatment environment to support same-sex couples in their family-building efforts.
There is growing evidence that sexual minority men (e.g., gay, bisexual) experience lower sleep quality when compared to their heterosexual peers. Minority stress (e.g., discrimination, victimization) may account for these differences, however little is known about these relationships and how generalized anxiety may play a role in sleep disturbance.
Objectives
Therefore, the aims of this study are to (a) understand the relationship between minority stress and sleep disturbance in a sample of sexual minority men, and (b) test whether these relationships are mediated by generalized anxiety.
Methods
In 2020, 241 sexual minority men were recruited across a south-eastern state in the USA. Participants were asked to respond to scales assessing perceived social stress, minority stress constructs (i.e., internalized homophobia, experiences of harassment, microaggressions), generalized anxiety, and sleep disturbance. Linear regressions were used to test the relationship between minority stress and sleep disturbance controlling for perceived social stress and to test mediation by generalized anxiety.
Results
Two minority stress constructs (experiences of harassment, and microaggressions) and perceived social stress were found to have a positive relationship with sleep disturbance. Generalized anxiety symptoms fully mediated the relationship between minority stress and sleep disturbance.
Conclusions
Because sleep quality has a profound impact on health, findings from this study suggest the need for psychological intervention to improve sleep for sexual minority men. Given that generalized anxiety fully mediates the relationship between minority stress and sleep, targeted anxiety-based interventions have the potential to reduce sleep disturbance disparities between heterosexual and sexual minority men.