Contemporary heterosexism on campus and psychological distress among LGBQ students: the mediating role of self-acceptance

Microaggressions Toward Sexual and Gender Minority Emerging Adults: An Updated Systematic Review of Psychological Correlates and Outcomes and the Role of Intersectionality

Purpose: Quantitative data on the psychological effects of microaggressions toward sexual and gender minority individuals have grown substantially. Sexual orientation-based and transgender and gender-diverse (trans+) identity-based microaggressions have been thematically identified in prior research. In addition, combined lesbian, gay, bisexual, transgender and gender-diverse, queer/questioning, and other non-heterosexual (LGBTQ) microaggressions can be examined intersectionally with other marginalized identities. This systematic review synthesizes research on the relationships among these microaggressions and psychological correlates and outcomes. Methods: Forty-five quantitative studies examining sexual orientation-, trans+ identity-, or intersectional identity-based microaggressions and various psychological outcomes were identified from systematic searches of PsycINFO, PsycARTICLES, MEDLINE, and PubMed databases. Data regarding microaggressions were extracted, synthesized, and grouped by mental health outcome or correlate. Results: Sexual orientation-based microaggressions were risk factors for depression, anxiety, and internalized stigma and were positively associated with psychological distress, traumatic stress symptoms, alcohol use and abuse, cannabis use and problems, suicidal ideation, and suicide attempt. Trans+ identity-based microaggressions were positively associated with depression, suicide attempt, and cannabis use. LGBTQ intersectional identity-based microaggressions concerning race/ethnicity were associated with depression, anxiety, and suicidal ideation. Research on other intersectional identity-based microaggressions is scarce. Conclusion: These findings emphasize the psychological harm inflicted by various microaggressions on LGBTQ late adolescents and early adults. Future work should focus on microaggressions toward individuals with trans+ and intersectional identities and protective factors for these experiences. This review also highlights the distinct need for community-based research on implementing microintervention strategies in family, school, and work environments to mitigate the harmful effects of these microaggressions.

Sexual orientation-based microaggressions and cannabis use outcomes among sexual minority individuals: The impact of negative affect and coping-motivated cannabis use

INTRODUCTION

Sexual minority individuals report significantly more cannabis use and problems than their heterosexual peers, possibly due to their frequent experiences with sexual orientation-based microaggressions. As a result, sexual minority individuals may turn to cannabis use to cope with the negative affect associated with these experiences. No known studies have tested this hypothesis; therefore, the current study tested if sexual orientation microaggressions are positively associated with negative affect (anxiety and depression), cannabis coping motives, and cannabis-related outcomes (frequency, problems); if coping motives are positively associated with cannabis-related outcomes; and if negative affect and cannabis use to cope with negative affect serially mediate the relation between sexual orientation microaggressions and cannabis-related outcomes.

METHODS

Sexual minority undergraduate students who reported cannabis use in the past three months (N = 328; 71.3 % cis-female) completed an online survey.

RESULTS

Microaggressions were significantly positively correlated with anxiety, depression, coping-motivated cannabis use, cannabis-related problems, non-sexual orientation-related stress, and overt sexual orientation-based discrimination. Additionally, after controlling for non-sexual orientation-related stress and overt sexual orientation-based discrimination, microaggressions were indirectly positively related to cannabis use frequency and problems via the sequential effects of negative affect and coping motives. This relation remained significant when examining negative affect specific to sexual orientation microaggressions and cannabis use to cope with this microaggressions-specific negative affect.

CONCLUSIONS

Results highlight the adverse impact of sexual orientation microaggressions in terms of negative affect and negative cannabis-related outcomes.

Elements of Minority Stress and Resilience in LGBTQ+ Students' Experience of Education

This study investigates the experiences of minority stress and resilience among LGBTQ+ students in educational settings and identifies critical contributors to their well-being. To highlight the unique educational experiences of LGBTQ+ participants a qualitative research strategy was employed. We conducted narrative interviews with 27 LGBTQ+ people aged 17 to 41 who are or have been enrolled in primary, secondary or tertiary education in Slovenia. The results indicate that minority stress is a significant in their educational experiences, with various deleterious effects. The testimonies of our respondents indicate, albeit to a lesser extent, that the education system can enhance the resilience of LGBTQ+ youth and mitigate the negative impacts of minority stress. This study confirms prior research on minority stress effects on LGBTQ+ individuals. It asserts that LGBTQ+ youth experience minority stress within the education system, while emphasizing that certain aspects of resilience can significantly mitigate these negative effects. As social support emerged as a significant factor in our study, it would be reasonable to investigate how school personnel can enhance LGBT youths' resilience in the future. Additionally, it would be beneficial to investigate how the support of peers and (chosen) families influences the school experiences of LGBTQ+ students.

A Conditional Process Analysis of Microaffirmations, Microaggressions, and Mental Health Among Thai Sexual Minorities

Sexual orientation (SO) microaggressions contribute to mental health issues among sexual minorities. Microaffirmations may mitigate these effects, with internalized heterosexism and SO concealment proposed as mediators. A community sample of 307 Thai sexual minorities completed measures assessing SO microaggressions, microaffirmations, internalized heterosexism, SO concealment, and mental health concerns. Serial mediation analysis using Hayes' PROCESS macro model 6 tested indirect effects through proposed mediators. Conditional process analysis using PROCESS model 85 examined the moderating role of microaffirmations. These models tested hypothesized moderated serial mediation relationships among study variables. SO microaggressions had a total effect on mental health concerns, directly and indirectly through increased SO concealment. The internalized heterosexism → SO concealment sequence mediated this relationship. Microaffirmations moderated the direct microaggressions-mental health link, reducing this association at higher levels of microaffirmations. The full model accounted for 31.6% of the variance (R2 = 0.316) in mental health concerns. The Johnson-Neyman technique identified 0.613 as the microaffirmations value above which the effect of SO microaggressions on mental health was no longer significant. Findings elucidate mechanisms linking SO microaggressions to mental health issues and microaffirmations' protective role among Thai sexual minorities. These results could inform efforts to mitigate minority stress impacts.

A 4-year prospective investigation of predictive effects of prepandemic sexual stigma, affective symptoms, and family support on fear of COVID-19 among lesbian, gay, and bisexual individuals

Aim

This prospective study examined whether prepandemic sexual stigma, affective symptoms, and family support can predict fear of coronavirus disease 2019 (COVID-19) among lesbian, gay, and bisexual (LGB) individuals.

Methods

Data of 1,000 LGB individual on prepandemic sociodemographic characteristics, sexual stigma (familial sexual stigma [FSS] measured by the Homosexuality-Related Stigma Scale, internalized sexual stigma [ISS] measured by the Measure of Internalized Sexual Stigma for Lesbians and Gay Men, and sexual orientation microaggression [SOM] measured by the Sexual Orientation Microaggression Inventory), affective symptoms (i.e., depression measured by the Center for Epidemiologic Studies-Depression Scale and anxiety measured by the State-Trait Anxiety Inventory-State version), and family support measured by the Adaptability, Partnership, Growth, Affection, and Resolve Index were collected. Four years later, the fear of COVID-19 was assessed using the Fear of COVID-19 Scale and the associations of prepandemic sexual stigma, affective symptoms, and perceived family support on fear of COVID-19 4 years later were analyzed using multiple linear regression analysis.

Results

In total, 670 (67.3%) participants agreed and completed the follow-up assessment. Greater prepandemic FSS, ISS, SOM, affective symptoms, and perceived family support were significantly associated with a greater fear of COVID-19 at follow-up.

Conclusion

The identified predictors should be considered when designing interventions aimed at preventing and reducing the fear of COVID-19 in LGB individuals.

Developing and Validating Thai Sexual Orientation Microaggression and Microaffirmation Scales

Mental health disparities exist for sexual minority populations globally. Microaggressions and microaffirmations related to sexual orientation may negatively or positively impact well-being. Culturally validated tools are needed to assess these constructs among LGBQ+ (lesbian, gay, bisexual, queer/questioning) individuals in Thailand's high-context culture. This study aimed to develop and validate the Thai Sexual Orientation Microaggressions Scale (T-SOMG) and the Thai Sexual Orientation Microaffirmations Scale (T-SOMF) to quantify experiences among LGBQ+ Thais. A mixed-methods approach was utilized. Initial scale items were derived from a literature review, expert consultation, and interviews with LGBQ+ Thais. Exploratory factor analysis (n = 164) refined the item pools. Confirmatory factor analysis (n = 200) confirmed the factor structures. Reliability and validity were examined. The final 18-item T-SOMG contained two subscales-Interpersonal and Environmental Microaggressions. The 13-item T-SOMF contained Interpersonal and Environmental Microaffirmations subscales. All scales demonstrated good model fit, reliability, convergent validity, and discriminant validity. The T-SOMG and T-SOMF are culturally valid tools for assessing microaggressions and microaffirmations among LGBQ+ Thais. These localized scales can enable research on factors impacting LGBQ+ well-being. Further validation in diverse samples is warranted.

Predicting the Influences of Depression and Sexual Stigma on Motivation to Get Vaccinated against COVID-19 in Lesbian, Gay, and Bisexual Young Adults: A 4-Year Follow-Up Study

Vaccination is a crucial preventive measure against COVID-19. However, limited research has focused on identifying the factors predicting motivation to get vaccinated against COVID-19 (MoVAC-19) among lesbian, gay, and bisexual (LGB) individuals. This study examined the predictive effects of depression and sexual stigma (i.e., perceived sexual stigma from family members, perceived sexual orientation microaggression, and internalized sexual stigma) before the COVID-19 pandemic on MoVAC-19 among LGB individuals 4 years later during the COVID-19 pandemic in Taiwan. Baseline data related to depression and sexual stigma were collected in 2018 and 2019. Depression was assessed using the 20-item Mandarin Chinese version of the Center for Epidemiologic Studies Depression Scale. Perceived sexual stigma from family members was assessed using the Homosexuality-Related Stigma Scale. Internalized sexual stigma was assessed using the Measure of Internalized Sexual Stigma for Lesbians and Gay Men. Perceived sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory. Participant MoVAC-19 during the pandemic was assessed using the nine-item Motors of COVID-19 Vaccination Acceptance Scale. The associations of depression and sexual stigma at baseline with MoVAC-19 at follow-up were examined through multivariate linear regression analysis. Internalized sexual stigma was negatively associated with MoVAC-19, whereas perceived sexual orientation microaggression was positively associated with MoVAC-19. Depression and perceived sexual stigma from family members were not significantly associated with MoVAC-19. Although male sex and older age were positively associated with increased MoVAC-19, sex and age did not moderate the relationship between sexual stigma and motivation to get vaccinated. Among LGB individuals, sexual stigma experiences should be considered when developing intervention strategies aimed at enhancing MoVAC-19.

Cannabis and Nicotine Dual Use among Sexual Minority Individuals: Relations to Cannabis Use and Negative Affect

Background: Sexual minority individuals report significantly more cannabis use and use-related problems than their heterosexual peers, and emerging data indicate sexual minority individuals who use cannabis are at greater risk for dual use of nicotine products (combustible smoking, e-cigarette use) than heterosexual individuals. Although cannabis-nicotine dual use is related to worse cannabis outcomes and negative affect, little work has identified factors related to dual use among sexual minority individuals or tested if sexual orientation-based discrimination (microaggressions, overt discrimination) is related to dual use. Objectives: The current study tested if cannabis-nicotine dual use is related to more frequent cannabis use, more cannabis-related problems, negative affect, and discrimination among sexual minority undergraduate students who endorsed current (past three-month) cannabis use (N = 328), 43.6% of whom endorsed dual nicotine use. Cannabis-nicotine dual use was related to more frequent cannabis use, more cannabis-related problems, more anxiety (but not depression), and more sexual orientation-based microaggressions and microaggressions-related negative affect (but not overt discrimination or non-sexual orientation-based daily stressors). Conclusions/Importance: Overall, this is the first known study to identify that sexual orientation-based discrimination is related to cannabis-nicotine dual use and that dual use is related to more frequent cannabis use, use-related problems, and negative affect (especially anxiety) among this underrepresented group.

Effects of gender nonconformity and biological sex on the relationship between sexual orientation microaggressions and anxiety and depressive symptoms among lesbian, gay, and bisexual Taiwanese young adults: A moderated-moderation study

BACKGROUND

Sexual orientation microaggressions (SOMs) may negatively affect lesbian, gay, and bisexual (LGB) individuals' mental health. However, the moderating effects of gender nonconformity and biological sex on the relationship between SOMs and anxiety and depressive symptoms has never been examined. We evaluated the moderating effect of gender nonconformity on the association of SOMs with anxiety and depressive symptoms among LGB young male and female adults. We hypothesized that the associations of SOMs with anxiety and depressive symptoms weakened with increasing gender nonconformity among gay and bisexual men but strengthened with increasing gender nonconformity among lesbian and bisexual women.

METHODS

In total, 1000 self-identified LGB young adult individuals participated in the study. The experience of sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory, anxiety was assessed using the State subscale on the State-Trait Anxiety Inventory, and depression was assessed using the Center for Epidemiological Studies-Depression Scale. The two-way moderation models stratified by sex examined the moderating effects of gender nonconformity on the association between SOMs and anxiety symptoms in the male and female participants. The three-way moderated moderation models were used to determine whether gender nonconformity and sex jointly moderated the associations between SOMs and anxiety and depressive symptoms.

RESULTS

In the two-way moderation models stratified by sex, gender nonconformity exerted opposite moderating effects on the association between SOMs and anxiety and depressive symptoms in the male and female participants. For the male participants, the association between SOMs and anxiety (β = -0.08) and depressive symptoms (β = -0.09) weakened with increasing gender nonconformity. For the female participants, the association between SOMs and anxiety (β = 0.08) and depressive symptoms (β = 0.13) strengthened with increasing gender nonconformity. The three-way moderated moderation models further confirmed that sex moderated the moderating effects of gender nonconformity on the associations between SOM and anxiety (β = -0.16, p = .047) and depressive symptoms (β = -0.22, p < .001).

LIMITATION

The cross-sectional study design limited the inferences that could be made concerning the temporal relationship between SOMs and mental health problems.

CONCLUSIONS

The association between SOMs and anxiety and depressive symptoms weakened with increasing gender nonconformity in gay and bisexual men, whereas the association between SOMs and anxiety and depressive symptoms strengthened with increasing gender nonconformity in lesbian and bisexual women.

Psychological Adjustment Profiles of LGBTQ+ Young Adults Residing with Their Parents during the COVID-19 Pandemic: An International Study

The COVID-19 pandemic has been associated with poor mental health symptoms, particularly among vulnerable populations such as LGBTQ+ individuals. In the present study, we aimed to (i) identify different psychological adjustment profiles among LGBTQ+ young adults during the COVID-19 pandemic and compare LGBTQ+ young adults in relation to (ii) sociodemographic characteristics and COVID-19-related experiences and (iii) the internal and external protective resources associated with each adjustment profile. An online questionnaire was administered to 1699 LGBTQ+ young adults from six countries (Brazil, Chile, Italy, Portugal, Sweden, and the UK). A cluster analysis was conducted, and four profiles of psychological adjustment were identified: unchallenged, resilient, distressed, and at-risk. The at-risk cluster scored lowest in social support (particularly from family). The profiles of participants who experienced the highest levels of pandemic adversity (at-risk and resilient) comprised mostly South American participants, those under lockdown at the time of survey completion, those who self-identified as transgender and non-binary, and those with a plurisexual sexual orientation. Interventions should consider strategies to help young adults maintain support systems and reinforce the value of positive family relationships. Specific groups within the LGBTQ+ community that seem to be in a particularly vulnerable situation may need additional tailored support.

Sexual Orientation Microaggression Experiences and Coping Responses of Lesbian, Gay, and Bisexual Individuals in Taiwan: A Qualitative Study

This qualitative study explored the sexual orientation microaggression (SOM) experiences and coping strategies of lesbian, gay, and bisexual (LGB) individuals in Taiwan. In total, 30 LGB individuals (17 women and 13 men; 17 homosexual and 13 bisexual individuals) who experienced SOMs participated in qualitative, semistructured interviews, during which their SOM experiences were assessed. Through the interviews, several types of SOMs were identified, corresponding to three main types of microaggression (microassaults, microinsults, and microinvalidations) previously identified in Western studies. The participants reported various coping responses to SOMs, ranging from active responses to choosing not to respond, to protecting themselves or to minimizing the negative consequences of confrontation. The results provide mental health professionals with insight regarding the contexts of and coping responses to the SOMs experienced by LGB individuals.

Relations Between Interpersonal Microaggressions, Depressive Symptoms, and Pet Attachment in an LGBTQ+ Emerging Adult Sample

Exposure to microaggressions can have detrimental impacts on the mental health of LGBTQ+ emerging adults. Positive social relationships are a well-documented protective factor that help to buffer the impact of adversity on mental health in this population. However, the role of social relationships with pets has received minimal attention in research on LGBTQ+ mental health, despite the high prevalence of pets in U.S. households. This cross-sectional study examined whether the association between interpersonal microaggressions and depressive symptoms among LGBTQ+ emerging adults varied as a function of attachment to pets across three domains: love, emotion regulation, and personal growth. We recruited 163 LGBTQ+ emerging adults (18-21 years) who lived with a cat and/or dog within the past year (98.8% sexual minority, 47.2% gender minority, 37.4% racial/ethnic minority). We found that love and emotion regulation significantly moderated the positive association between interpersonal microaggressions and depressive symptoms. Specifically, this association was only significant when love and emotion regulation were at moderate or high levels. These findings have important implications for practice with LGBTQ+ pet owners, as it suggests that high levels of pet attachment may amplify the relation between interpersonal microaggressions and depressive symptoms.

Leisure Satisfaction, Personality, and Psychosexual Adjustment Among College Students: A Latent Profile Analysis

Although the factors influencing sexual health have been explored by researchers, the impact of leisure and personality on psychosexual adjustment and the interaction of these two factors remain unknown. This study investigated the relationship between leisure satisfaction and psychosexual adjustment based on the compensation theory and the social learning theory. The differences in psychosexual adjustment across different personality types were also explored. Finally, we examined the interaction between personality and leisure satisfaction based on the personal-environment fit models. The participants in this study were 1,161 college students. The results supported all the hypotheses proposed. There was a significant positive correlation between leisure satisfaction and psychosexual adjustment. Participants of four personality types (the overcontrolled, high-moderate, low-moderate, and resilient groups) had different performance in psychosexual adjustment. The resilient group had the highest scores, while the overcontrolled group had the lowest scores. The results suggest that there is an interaction between personality and leisure satisfaction. Our research could enrich the research contents of leisure and personality and provide a practical basis for the improvement of college students in psychosexual adjustment.

Problematic Smartphone Use and Its Associations with Sexual Minority Stressors, Gender Nonconformity, and Mental Health Problems among Young Adult Lesbian, Gay, and Bisexual Individuals in Taiwan

Smartphones are a necessity for many people; however, problematic smartphone use (PSU) may negatively influence people’s mental health. Using multivariate linear regression analysis, the study examined the associations of sexual minority stressors [namely perceived sexual stigma from family members, sexual orientation microaggressions (SOMs), and internalized sexual stigma] and gender nonconformity with PSU severity as well as the associations of PSU with depression and anxiety in young adult lesbian, gay, and bisexual (LGB) individuals. This cross-sectional survey study recruited 1000 young adult LGB individuals (500 men and 500 women). PSU severity was assessed using the Smartphone Addiction Inventory. The experiences of perceived sexual stigma from family members, SOMs, and internalized sexual stigma and the levels of gender nonconformity, depression, and anxiety were assessed. The results indicated that perceived sexual stigma from family members, SOMs, internalized sexual stigma in the dimensions of social discomfort and identity and gender nonconformity were significantly associated with PSU severity in LGB individuals. Moreover, PSU was significantly associated with depression and anxiety in LGB individuals. The findings highlight the significance of developing strategies for the prevention and early detection of PSU and sexual minority stress in LGB individuals.

Self-esteem in sexual minority young adults: a qualitative interview study exploring protective factors and helpful coping responses

Research on mental health inequalities between sexual minority and heterosexual young adults has historically focussed on the additional stress processes that might explain this disparity. However, more recently there has been a shift towards research focussed on resilience factors that might promote mental health in sexual minority young adults. Self-esteem is one such proposed resilience factor. This study aimed to explore the factors that promote or protect self-esteem itself in sexual minority young adults. A semi-structured interview study was conducted with 20 sexual minority young adults (aged 16-24) to explore their perspectives on the factors, responses and strategies that have helped to protect or promote their self-esteem. Six themes were identified from thematic analysis: helpful responses to minority stress; sexuality acceptance; positive LGBTQ + social connections and representations; positive social relationships and evaluation; successes and positive qualities and general coping strategies for low self-esteem. Findings are discussed in terms of their theoretical implications.

Violence and the Academic Lives of College Students at the Intersection of Race/Ethnicity and Sexual Orientation/Gender Identity

To ascertain whether sexual and/or gender minority (SGM) students at a Hispanic-serving institution who experience violence are more likely to experience interference with their academic lives when compared to heterosexual, cisgender students, and how this relationship differs by race/ethnicity. Data came from 736 undergraduate students at a university in the Southwestern United States responding to a 2017 Campus Climate Survey. Multivariable logistic regression was conducted on self-identified SGM students and reported interference with their academic lives. The model was also tested for effect modification by race/ethnicity. Two-thirds (67.65%) of SGM students reported four or more incidences of violence. Nearly one-fifth (18.83%) of SGM students reported being harassed, insulted, threatened, or intimidated, and 2.63% reported being physically hurt (including forced sex), because the perpetrator thought the individual might have been gay, lesbian, bisexual, or transgender. SGM students had 2.44 (95% CI: 1.29, 4.61) increased odds of interference with academic life as a result of violence victimization compared with non-SGM students. When the model was evaluated for effect modification by race/ethnicity, large effect sizes were observed, although the results were not significant. SGM undergraduate students are at significantly increased risk of violence and interference with their academic lives. This research emphasizes the need for institutions of higher education to ensure that their policies and practices support equal access to education by SGM students. Additionally, this study contributes insights into a potential protective effect of Hispanic ethnicity that warrants further research.

Development of the nonbinary gender microaggressions (NBGM) scale

Background: While research pertaining to nonbinary microaggressions has become increasingly comprehensive in recent years, a measure specifically assessing this construct does not yet exist.Aims: The purpose of the present research was to develop and validate the Nonbinary Gender Microaggressions (NBGM) scale, which will allow future researchers to quantitatively examine nonbinary individuals' experiences of microaggressions. Methods and Results: In Study 1 (n = 5), interviews with nonbinary individuals were conducted to explore their microaggressive experiences. The results of this study, as well as findings from previous qualitative research, were used to generate an initial pool of 92 items. In Study 2 (n = 158), a principal component analysis, which was used for item reduction, resulted in the retention of 41 items. In Studies 3 (n = 151) and 4 (n = 266), an exploratory factor analysis yielded a 23-item 5-factor solution (i.e., Negation of Identity [6 items], Inauthenticity [6 items], Deadnaming [4 items], Trans Exclusion [3 items], and Misuse of Gendered Terminology [4 items]), and a confirmatory factor analysis found that this solution demonstrates adequate model fit. Evidence of the measure's scale score reliability, convergent validity, and incremental validity also were provided. Discussion: These findings indicate that, overall, the NBGM scale is a psychometrically sound measure of nonbinary individuals' experiences of microaggressions. As such, this measure can be utilized by future researchers and clinicians to better understand nonbinary individuals' microaggressive experiences.

How do we measure gender discrimination? Proposing a construct of gender discrimination through a systematic scoping review

BACKGROUND

Gender discrimination (GD) has been frequently linked to mental health. The heterogeneity of how GD is defined has led to variation around the analysis of GD. This might affect the study of the association between GD and health outcomes. The main goal of this systematic scoping review is to operationalize the definition of the GD construct.

METHODS

Three search strategies were set in Pubmed, CINAHL and PsycINFO. The first strategy obtained results mainly about women, while the second focused on men. The third strategy focused on the identification of GD questionnaires. The prevalence of GD, factors and consequences associated with GD perception, and forms of discrimination were the principal variables collected. Risk of bias was assessed (PROSPERO:CRD42019120719).

RESULTS

Of the 925 studies obtained, 84 were finally included. 60 GD questionnaires were identified. GD prevalence varied between 3.4 and 67 %. Female gender and a younger age were the factors most frequently related to GD. Poorer mental health was the most frequent consequence. Two components of the GD construct were identified: undervaluation (different recognition, opportunities in access, evaluation standards and expectations) and different treatment (verbal abuse and behaviour).

CONCLUSIONS

Two-component GD definition can add order and precision to the measurement, increase response rates and reported GD.

Relationships of Sexual Orientation Microaggression with Anxiety and Depression among Lesbian, Gay, and Bisexual Taiwanese Youth: Self-Identity Disturbance Mediates but Gender Does Not Moderate the Relationships

The aims of this cross-sectional survey study were to examine the association between sexual orientation microaggression and anxiety and depression among young adult lesbian, gay, and bisexual (LGB) individuals in Taiwan, as well as to examine the mediating effect of self-identity disturbance and the moderating effect of gender. In total, 1000 self-identified LGB individuals participated in the study. The experience of sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory, self-identity disturbance was assessed using the Self-Concept and Identity Measure, anxiety was assessed using the State subscale on the Chinese version of the State-Trait Anxiety Inventory, and depression was assessed using the Center for Epidemiological Studies-Depression Scale. Structural equation modeling (SEM) was used to examine relationships between the variables. The SEM results demonstrated that sexual orientation microaggression was directly associated with increased anxiety and depression, as well as being indirectly associated with increased anxiety and depression via the mediation of self-identity disturbance among young adult LGB individuals. Gender did not moderate the relationships between any of the variables. Both sexual orientation microaggression and self-identity disturbance warrant program interventions for enhancing mental health among LGB individuals.

Advancing the conversation: A review of scholarly activity for curricular interventions for sexually- and gender-diverse patients in pharmacy education

BACKGROUND

Educational interventions are required to train pharmacists to provide culturally safe care to sexually- and gender-diverse patients. Programming must promote inclusivity and should also focus on systemwide change. The aim of this review was to identify, summarize, and map scholarly activity with respect to lesbian, gay, bisexual, transgender, queer, plus (LGBTQ+) health in entry-to-practice pharmacy curricula.

METHODS

An electronic search of Medline, EMBASE, and International Pharmaceutical Abstracts was conducted to search for relevant literature up to May 2021. This search was supplemented with a keyword search of three pharmacy education journals. Articles were included in the review if they described an educational intervention for entry-to-practice pharmacy students related to health for sexually- or gender-diverse patients.

RESULTS

Five articles met inclusion criteria. All articles reported interventions relating to gender-diverse patients. One reported interventions relating to sexually-diverse patients and another was deemed unclear. Four articles reported single teaching events or short modules, and one article reported a full course. Incorporating real patients into teaching events to share their experiences with the health system was consistently received positively by students.

IMPLICATIONS

Scholars involved in developing and implementing educational interventions related to health for sexually- and gender-diverse patients should be encouraged to contribute to the scholarly conversation by sharing successful experiences, as well as lessons learned. Future areas of expansion include integration of sexual and gender minority health across curricula and including content to prepare students for implementing and supporting systemwide change.

Experience of Sexual Orientation Microaggression among Young Adult Lesbian, Gay, and Bisexual Individuals in Taiwan: Its Related Factors and Association with Mental Health Problems

Experiences of sexual orientation microaggression (SOM) are prevalent in lesbian, gay, and bisexual (LGB) individuals. The aims of this quantitative cross-sectional survey study were to examine the factors, including demographics, sexual orientation characteristics, and perceived social support related to SOM, as well as the relationships of SOM with anxiety, depression, and suicidality among young adult LGB individuals in Taiwan. In total, 1000 self-identified young adult LGB individuals (500 men and 500 women) participated in this study. The experience of SOM was assessed using the Sexual Orientation Microaggression Inventory. We also collected demographic and sexual orientation characteristics; perceived general family support, using the Family APGAR Index; anxiety on the State-Trait Anxiety Inventory; depression on the Center for Epidemiological Studies-Depression Scale; and suicidality on the suicidality module of the Kiddie-SADS. The factors related to SOM and the associations of SOM with anxiety, depression, and suicidality were examined using multivariate linear regression analysis. The results indicated that males experienced greater SOM than females, and that younger age of identification of sexual orientation and perceived lower general family support were significantly associated with greater SOM. Greater SOM was significantly associated with greater anxiety, depression, and suicidality. The experiences of SOM in LGB individuals with mental health problems warrant assessment and intervention that take the related factors into account.

Measurement Invariance of the Sexual Orientation Microaggression Inventory across LGB Males and Females in Taiwan: Bifactor Structure Fits the Best

The present study examined the factor structure and concurrent validity of the traditional Chinese version of the Sexual Orientation Microaggression Inventory (SOMI) among lesbian, gay, and bisexual (LGB) individuals in Taiwan. In total, 1000 self-identified LGB individuals completed the SOMI, HIV and Homosexuality Related Stigma Scale (HHRSS), and Acceptance and Action Questionnaire-II (AAQ). Different factor structures (including one-factor, four-factor, bifactor, and higher-order factor structures) were evaluated using confirmatory factor analysis. The bifactor structure significantly outperformed all others on the SOMI. The bifactor structure with one general factor and four trait factors was found to be measurement invariant across biological sex with satisfactory fit indices. The SOMI general factor was significantly associated with HHRSS-Homosexuality score and AAQ score. The findings indicate that the SOMI is a psychometrically sound instrument for Taiwan sexual minority groups. More specifically, SOMI can be used to accurately assess microaggression among LGB individuals. The measure on microaggression may also provide insights for healthcare providers about LGB individuals' sexuality-related stigma. Moreover, healthcare providers and relevant stakeholders can use the SOMI to understand how LGB individuals perceive and feel microaggression.

"It's Not in Your Head": Gaslighting, 'Splaining, Victim Blaming, and Other Harmful Reactions to Microaggressions

Secondary microaggressions refer to the ways in which people of historically dominant groups negate the realities of people of marginalized groups. Gaslighting describes the act of manipulating others to doubt themselves or question their own sanity; people confronted for committing microaggressions deny the existence of their biases, often convincing the targets of microaggressions to question their own perceptions. 'Splaining (derived from mansplaining/Whitesplaining) is an act in which a person of a dominant group speaks for or provides rationale to people of marginalized groups about topics related to oppression or inequity. Victim blaming refers to assigning fault to people who experience violence or wrongdoing and is used as a tool to discredit people of marginalized groups who speak out against microaggressions or any injustices. Finally, abandonment and neglect refer to a bystander's failure to address or acknowledge microaggressions. Although these terms are commonly known among marginalized communities (and frequently used in popular media), there is a dearth in academic literature that substantiates these phenomena and relates them to microaggressions. The purpose of this article is to review these concepts in the psychological literature and to demonstrate the psychological harm caused by these behaviors on interpersonal and systemic levels.

"School Shouldn't Be Something You Have to Survive": Queer Women's Experiences with Microaggressions at a Canadian University

The authors used an interpretative phenomenological analysis of focus-group data provided by eight research participants to investigate microaggressions that target queer women at an urban Canadian university. Four themes emerged from the data that support and extend prior sexual orientation microaggressions typologies research: (a) facing skepticism as response to sexual orientation, (b) living with surveillance as response to gender presentation, (c) encountering heteronormative assumptions, and (d) experiencing vulnerability. The authors discuss these findings in the context of previous research, outline future research directions, and provide implications for campus life.

Protester, Partygoer, or Simply Playing It Down? The Impact of Crowd Affiliations on LGBT Emerging Adults' Socioemotional and Academic Adjustment to College

Although peer crowd affiliations have been studied among emerging adults in college, this work has yet to focus in on LGBT-identifying students. Accordingly, the current study a) surveyed the peer crowd landscape using a sample of 234 LGBT students (M_age = 19.89, SD = 1.55; 70.51% female, 18.38% male, 11.11% other) at a small, private, liberal arts college in Southern California, and b) explored the relationships between self-reported peer crowd affiliations and LGBT students' adjustment (i.e., loneliness, belongingness, and academic-, alcohol-, drug-, and sex-risk behaviors). Results point to the existence of four underlying peer crowd dimensions among LGBT students: protester, nonvocal, social, and athletic. Furthermore, affiliation with these peer crowds was found to relate to students' self-reported loneliness and academic-, drug-, and sex-risk behaviors.

A Social Affective Neuroscience Model of Risk and Resilience in Adolescent Depression: Preliminary Evidence and Application to Sexual and Gender Minority Adolescents

Depression is a disorder of dysregulated affective and social functioning, with attenuated response to reward, heightened response to threat (perhaps especially social threat), excessive focus on negative aspects of the self, ineffective engagement with other people, and difficulty modulating all of these responses. Known risk factors provide a starting point for a model of developmental pathways to resilience, and we propose that the interplay of social threat experiences and neural social-affective systems is critical to those pathways. We describe a model of risk and resilience, review supporting evidence, and apply the model to sexual and gender minority adolescents, a population with high disparities in depression and unique social risk factors. This approach illustrates the fundamental role of a socially and developmentally informed clinical neuroscience model for understanding a population disproportionately affected by risk factors and psychopathology outcomes. We consider it a public health imperative to apply conceptual models to high-need populations to elucidate targets for effective interventions to promote healthy development and enhance resilience.

The Moderating Effect of Comfort from Companion Animals and Social Support on the Relationship between Microaggressions and Mental Health in LGBTQ+ Emerging Adults

LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and other sexual/gender minority identities) individuals frequently report exposure to microaggressions, which are associated with deleterious mental health outcomes. Social support from humans has been found to be an important protective factor for LGBTQ+ emerging adults. However, an underexplored area of research is the protective role of interactions with companion animals for this population. We conducted simple and multiple moderation analyses to explore whether and to what extent emotional comfort from companion animals and human social support moderated the relationship between LGBTQ-related microaggressions and depressive and anxiety symptoms. Our sample included 134 LGBTQ+ emerging adults (mean age of 19.31). We found that social support moderated the relationship between microaggressions and depressive symptoms. The relationship between microaggressions and depressive symptoms was not significant at high levels of social support, indicating the protective nature of human social support. Comfort from companion animals also moderated the relationship between interpersonal microaggressions and depressive symptoms. For participants with high or medium levels of emotional comfort from companion animals, interpersonal microaggressions were positively associated with depressive symptoms. Our results highlight the need to further investigate the complex role of relationships with companion animals on mental health outcomes for LGBTQ+ emerging adults.

Sexual Minority Status, Anxiety-Depression, and Academic Outcomes: The Role of Campus Climate Perceptions among Italian Higher Education Students

Students from sexual minorities generally describe Higher Education contexts as unwelcoming and chilly environments. Based on the Minority Stress theory, these disparities in climate perceptions may lead sexual minority students to negative health and academic outcomes. To date, research documenting the experience of sexual minority students within European Higher Education Institutions is limited. Framed within campus climate literature, the current study aimed to expand on previous knowledge by investigating the associations between sexual minority status, students’ perceptions of campus climate and psychological (i.e., anxiety–depression), and academic outcomes (i.e., intellectual and academic success and considering leaving the university) using a self-selected sample of 868 Italian university students (17.9% sexual minority students). The results showed that sexual minority status was associated with negative perceptions of campus climate, which, in turn, were associated with higher levels of anxiety–depression symptoms, lowered academic success, and a high probability of considering leaving university. Further research is needed to investigate the experience of sexual minority students within European Higher Education contexts and to explore possible actions that could contribute to fostering a greater sense of belonging to the campus community for all students, and particularly for students from sexual minority groups.

LGBQ+ Self-Acceptance and Its Relationship with Minority Stressors and Mental Health: A Systematic Literature Review

Many individuals who identify as lesbian, gay, bisexual, queer, and with other non-heterosexual orientations (LGBQ+) experience stigma, prejudice, and/or discrimination because of their sexuality. According to minority stress and identity development theories, these experiences can contribute to difficulties with self-acceptance of sexuality. Lower self-acceptance is considered a risk factor for adverse mental health outcomes. The current review aims to investigate whether self-acceptance of sexuality is associated with minority stressors or difficulties with mental health in LGBQ+ individuals, as well as whether there are differences in self-acceptance between different sexual orientations. Five bibliographic databases were searched. Thirteen studies were identified which used quantitative methodology to investigate associations between self-acceptance, minority stressors, and/or mental health within LGBQ+ samples, or differences in self-acceptance between different sexual orientations. The results from these cross-sectional studies suggested that lower self-acceptance of sexuality was associated with higher levels of self-reported minority stressors, including a lack of acceptance from friends and family, a lack of disclosure to others, and internalized heterosexism. Lower self-acceptance of sexuality was associated with poorer mental health outcomes, including greater global distress, depression symptoms, and lower psychological well-being. There was no significant relationship with suicidality. Studies also found that LGBQ+ individuals had lower general self-acceptance compared to heterosexual participants, bisexual individuals had lower sexuality self-acceptance compared to lesbian/gay individuals, and lesbian women had lower sexuality self-acceptance compared to gay men. Given the potential importance of self-acceptance for LGBQ+ populations, further research is required with more robust methodology. Self-acceptance could be a potential target in clinical interventions for LGBQ+ individuals.

Implicit Association Task and Perception of Homosexuality: Differences between African American and Non-Hispanic Caucasian Homosexual Males

This study investigated the relationship between sexual orientation and minority group membership in a sample of African American and non-Hispanic Caucasian (NHC) homosexual men. Participants competed measures of pathology, sexual orientation, and ethnic identity. They completed two IATs, one using homosexual symbols and the other ethnically diverse homosexual images. Results indicated that African American participants reported more ethnic and sexual orientation discriminatory experiences than NHC. It was also found that both groups exhibited a positive association toward gay symbols. Both groups also demonstrated a bias toward NHC homosexual images, although the bias was stronger for NHC participants. Moderation analyses indicated that as internalized homophobia increased, preference for gay NHC images decreased, and that high ethnically discriminatory experiences resulted in stronger associations between NHC images and "good" attributes. Overall, the results partially support the minority stress theory and highlight some important differences between African American and NHC homosexual men.

Perceived Attitudes Toward Lesbian, Gay, and Bisexual (LGB) Issues and Mental Health Among Taiwanese LGB Adults: The Mediating Role of Self-Acceptance

Research on structural stigma has associated the poor mental health status among lesbian, gay, and bisexual (LGB) people with discriminatory institutions. Yet, less is known about the role of LGB adults' perceptions of social attitudes toward LGB issues. Moreover, the psychological mediation framework posits LGB people's self-acceptance as a mediator between a stigmatizing environment and individual mental health. This study investigated: (a) how perceived attitudes toward LGB issues from different social realms (society, heterosexual friends, and family members) were associated with LGB people's mental health; and (b) whether self-acceptance mediated the effects of perceived attitudes. In this cross-sectional study, 1527 Taiwanese LGB adults (812 men; 715 women) aged between 20 and 62 years were recruited via Facebook to complete an online survey. The majority of respondents self-identified as homosexual (1129) and 399 as bisexual. The survey consisted of assessment of respondents' mental health and questions to rate individual self-acceptance and perceptions of social attitudes. Path analysis showed that self-acceptance partially mediated the association between mental health and perceived societal acceptance of homosexuality and fully mediated the effect of perceptions of friends' acceptance of homosexuality on mental health. Self-acceptance fully mediated the effects of perceived support for same-sex marriage from friends and families. This research yielded evidence about the interplay between perceived social stigma, self-acceptance, and mental health, particularly in the context of public debate about same-sex marriage. The effects of public discourse about sexual diversity and marriage equality on LGB adults' mental health should be addressed by affirmative policies and practices.

Heterosexist microaggressions, student academic experience and perception of campus climate: Findings from an Italian higher education context

While overt instances of harassment and violence towards LGBQ+ individuals have decreased in recent years, subtler forms of heterosexism still shape the social and academic experience of students in higher education contexts. Such forms, defined as microaggressions, frequently include environmental slights that communicate hostile and derogatory messages about one's sexual-minority status. However, there is some evidence suggesting that environmental microaggressions have deleterious effects on all students, regardless of their sexual orientation. The aim of the current study was to examine how heterosexist environmental microaggressions on campus contributed to heterosexual and non-heterosexual students' negative perceptions of campus climate. We also analyzed whether the effect of microaggressions on campus climate was mediated by student social integration on campus. Data were collected in 2018 through an anonymous web-based survey that involved students from a large university of Southern Italy. The sample consisted of 471 students from 18 to 33 years old. Thirty-eight (8.1%) students self-identified as non-heterosexual. Measures included self-reported experiences of environmental microaggressions on campus, student degree of satisfaction with peer-group and student-faculty interactions, perceptions of faculty concern for student development, and of the overall campus climate. The structural equation model showed that heterosexist environmental microaggressions on campus were associated with negative perceptions of campus climate through lowered satisfaction with peer-group interactions and perceptions of faculty concern for student development, for both heterosexual and non-heterosexual students. Overall, the findings of this study suggest that heterosexist microaggressions within campus environments are negatively associated with students' perceptions of campus climate, regardless of their sexual orientation. Both faculty and peers play an important role in creating an environment that supports the inclusivity of diversity and fosters a greater sense of belonging to the campus community.

Suicide risk among gender and sexual minority college students: The roles of victimization, discrimination, connectedness, and identity affirmation

BACKGROUND

Little is known about how victimization and discrimination relate to suicide risk among sexual and gender minority (SGM) college students, or what is protective for these students. The current study will: 1.) determine the extent to which interpersonal victimization, discrimination, identity affirmation, and social connectedness are associated with suicide risk characteristics, and if race and/or ethnicity moderates this association; 2.) examine whether identity affirmation and social connectedness are protective against associations between victimization or discrimination and suicide risk characteristics.

METHOD

Participants were 868 students (63.6% female) from four United States universities who completed an online screening survey and met the following study inclusion criteria: self-identification as gender and/or sexual minority, endorsement of at least one suicide risk characteristic and no current use of mental health services. Participants also completed measures that assessed demographics, non-suicidal self-injury (NSSI), victimization, discrimination, connectedness, and LGBTQ identity affirmation.

RESULTS

Victimization was positively associated with depression severity, suicidal ideation, alcohol misuse, suicide attempt history, and NSSI. Discrimination was positively associated with depression severity, suicide attempt history, and NSSI. Connectedness was inversely associated with depression severity, suicidal ideation severity, suicide attempt history, and NSSI, and moderated the association between victimization and suicide attempt history. LGBTQ identity affirmation moderated the link between victimization and depression.

CONCLUSIONS

Results suggest efforts to decrease victimization and discrimination and increase connectedness may decrease depressive morbidity and risks for self-harm among SGM college students. Further, increasing LGBTQ identity affirmation may buffer the impact of victimization on depression.

Sexual Orientation and Gender Identity in Patients: How to Navigate Terminology in Patient Care

OBJECTIVE

The purpose of this paper is to describe how health care providers can improve their practice environments to be more welcoming for patients on the spectrum of gender and sexual identity.

METHODS

Literature searches were performed in WorldCat, PubMed, and nongovernmental organizations and Gallup polls. The years searched were from 2005 to 2018. Key words used included sexual orientation, transgender, and health care. The PubMed MeSH termed searched included gender identity and sexuality, both in combination with patient care.

RESULTS

Terminology that patients use to identify their gender may vary. Understanding the terminology that patients use to self-identify is a first step to becoming more sensitive to the needs of gender and sexual minority patients. Minority patients on the spectrum of gender and sexual identity experience discrimination when accessing health care. Therefore, an accepting doctor-patient relationship especially benefits these patients. When communication competency and fluency is established, health care providers provide a more inclusive, accepting environment. Addressing patients based on their preferences and using inclusive forms and patient handouts are some recommendations that are made to create an open, patient-centered environment.

CONCLUSION

This article provides health care providers with terminology that facilitates communication and the healing environment for sexual and gender minority patients. Understanding and using this may create a more welcoming environment to all patients.

Sexual behaviors and seroprevalence of HIV, HBV, and HCV among hill tribe youths of Northern Thailand

Background

Sexual behaviors reflect the degree of exposure to human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV), especially in people in sexually active stages, such as youths. Hill tribe people have their own cultures, beliefs and lifestyles related to their behaviors, including sexual behaviors, which may lead to HIV, HBV, and HCV infections, especially among youths. The study aimed to examine sexual behaviors and assess the seroprevalence of HIV, HBV, and HCV among hill tribe youths.

Methods

A cross-sectional study was conducted. The participants were recruited from 60 randomly selected hill tribe villages in Chiang Rai Province, Thailand. A validated questionnaire and 5 mL blood specimens were used to collect data. Data were collected by a self-reporting method. Rapid immunochromatographic tests were used to detect hepatitis B surface antibody (anti-HBs), hepatitis B surface antigen (HBsAg), hepatitis C antibody (anti-HCV), and human immunodeficiency virus antibody-I and- II (anti-HIV-1 and -2). Chi-square and Fisher’s exact test were used to detect the associations between variables.

Results

A total of 1325 participants were recruited for the analysis. The majority were females (60.5%) and aged 15–17 years (58.9%). A total of 14.5% smoked, 22.4% drank alcohol, 14.2% were tattooed, and 61.4% had their ears pierced. Among the 30.3% who had sexual experience, 42.0% experienced one-night stands, 26.9% had sexual contact with a prostitute within 1 year prior to the study, 18.9% used alcohol prior to having sexual intercourse, and 15.7% had been tested for HIV/AIDS previously. Among males, 11.5% were males who had sex with males (MSM), and 4.6% were bisexual. Among females, 83.0% were females who had sex with males, and 5.0% were females who had sex with females. Different sexes and tribes were found to have significantly different risk behaviors and sexual behaviors, such as overall males having a greater proportion of sexual experience than females, and Lahu, Akha and Hmong had a higher proportion of sexual experience, having sexual experience with one-night stands, and having sexual experience with a prostitute 1 year prior to the study than others. Among the 836 obtained blood samples, none were positive for anti-HIV-I and -II, 6.4% were positive for anti-HBs, 1.9% were positive for HBsAg, and 0.2% were positive for anti-HCV.

Conclusion

Hill tribe youths in Thailand are at risk of STIs such as HBV and HCV infections according to their risk behaviors and sexual behaviors, which differ between sexes and tribes. Effective behavioral interventions should be promoted among hill tribe youths to minimize the risk for these diseases in the future.

Frequent Experience of LGBQ Microaggression on Campus Associated With Smoking Among Sexual Minority College Students

Introduction

Lesbian, gay, bisexual, or queer/questioning (LGBQ) microaggressions refer to often-unintentional insults, assaults, and invalidations that denigrate sexual minorities. While experiencing hostile discrimination and violence has previously been associated with elevated rates of smoking cigarettes for LGBQ college students, the relationship between LGBQ microaggressions and smoking is unknown.

Methods

Data from a national anonymous online survey of sexual and gender minority college students were used to examine the relationship between past month cigarette smoking and interpersonal LGBQ microaggressions. Multivariable logistic regression assessed the relationship between smoking and frequent (chronic) experiences of microaggressions, using a hierarchical procedure to control for demographics, predictors of smoking, and academic factors.

Results

Past year frequent LGBQ microaggression was reported by 48% of respondents and was more common among students who smoked in past 30 days. Experiencing past year physical violence was reported by 15% and did not differ by smoking status. Past year frequent experience of microaggressions was associated with increased odds of 1.72 (95% CI 1.03-2.87) for past 30-day smoking after adjusting for age, gender, race, socioeconomic indicators, alcohol misuse, physical violence, as well as academic stress and engagement.

Conclusions

The results indicate that frequently experiencing LGBQ microaggressions is a risk factor for LGBQ college students smoking cigarettes. The mechanisms underlying this relationship require additional research, as does identifying positive coping strategies and institutional strategies to address LGBQ microaggressions on campuses. Tobacco control efforts should consider the impact of microaggression on the social environment for the prevention and treatment of tobacco use among LGBQ individuals.

Implications

Microaggressions related to sexual minority identity include subtle forms of discrimination experienced during daily interactions that can create hostile and stressful social environments for a socially disadvantaged group. Prior research has demonstrated that LGBQ college students have higher rates of cigarette smoking, and that experiencing identity-based violence is a risk factor. This study revealed that experiencing frequent LGBQ microaggressions on college campus is associated with increased likelihood of current smoking among LGBQ college students.

Sexual orientation-related stigma and relationship functioning among female same-sex couples

This article discusses how sexual orientation-based stigma serves to undermine functioning in female same-sex relationships. We particularly focus on the unique roles of interpersonal stigma (e.g., victimization, microaggressions) and structural stigma (e.g., institutional forms of discrimination), highlighting critical limitations and gaps in this literature and offering suggestions for future studies. We also discuss the need for future work on sexual orientation-related stigma and relationship functioning to consider the unique experiences of bisexual women, intersecting identities, and couple-level perspectives on stigma.

Overlooked and Invisible: Everyday Experiences of Microaggressions for LGBTQ Adolescents

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) adolescents face a number of challenges in their lives related to heterosexism and cissexism. Drawing on the microaggressions framework, we conducted two focus groups with LGBTQ adolescents (n = 11; ages 14-18, six trans/genderfluid, one person of color) to (1) explore the type and nature of microaggressions experienced by LGBTQ adolescents; (2) assess the relevance of existing LGBTQ microaggression taxonomies for this group; and (3) understand the impact of microaggressions on LGBTQ adolescents. Participants' experiences of microaggressions reflected complex forms of discrimination emerging from the intersections of sexual and gender identity.

Advancing Research on LGBTQ Microaggressions: A Psychometric Scoping Review of Measures

Understanding the nature and consequences of LGBTQ microaggressions is critical to fostering equity and wellbeing among sexual and gender minorities. Yet little guidance is available for researchers seeking psychometrically robust measures of subtle LGBTQ slights, invalidations, and insults. To address this gap, we conducted a scoping review of multi-item quantitative measures that included at least one question addressing LGBTQ microaggressions. This article reports the study characteristics and psychometric properties of 27 original measures we identified and their subsequent adaptations. The article concludes with an assessment of strengths and limitations of LGBTQ microaggression measurement, highlighting aspects of measurement innovation on which future researchers can build. As microaggressions remain a powerful and underexplored mechanism of sexual and gender minority oppression, this review will help to both advance methodological quality in this critical research area and enhance our understanding of how microaggressions manifest in the lives of LGBTQ individuals.

LGBTQ Microaggressions and Microaffirmations in Families: Scale Development and Validation Study

Subtle experiences of both invalidation and support are common for LGBTQ adolescents within their family systems. LGBTQ microaggressions increase the risk for negative health outcomes, while small acts of support and affirmation can bolster adolescent wellbeing. Research on family-level microaggressions and microaffirmations is limited, due to the absence of a theoretically informed and psychometrically tested measure of these constructs. To address this gap, we designed the LGBTQ Microaggressions and Microaffirmations in Families Scale. Using a large national sample of LGBTQ adolescents (N = 952, 14-19 years old), the current article presents the (1) process of item generation, (2) descriptives of scale items, (3) scale's confirmatory factor structure, and (4) indicators of scale reliability and validity. The scale's four-factor structure was confirmed, while demonstrating good reliability and predictive validity. The scale provides researchers with a psychometrically valid measure to assess the lifetime frequency and correlates of LGBTQ microaggressions and microaffirmations.

Hearing "That's So Gay" and "No Homo" on Campus and Substance Use Among Sexual Minority College Students

Sexual orientation microaggressions are common on college campuses and can contribute to negative outcomes; yet little is known about their relationship with substance use outcomes. Among a convenience sample of cisgender sexual minority college students (n= 574; 57.0% female, 24.9% people of color, 50.7% gay/lesbian; 72.4% public school) from 37 states (67.8% Midwest), this analysis investigates the association between hearing "that's so gay" and "no homo" on campus and hazardous alcohol use and the frequency of illicit drug use. Using multivariable regression analyses, the commonly heard phrases "that's so gay" and "no homo" were each found to significantly increase the risk for hazardous drinking and the frequency of drug use among students. Efforts should be made to create more welcoming campus climates for sexual minority students by reducing the use of these microaggressions and, in the meantime, offering supports to mitigate their harmful effects.

A Critical and Intersectional Model of LGBTQ Microaggressions: Toward a More Comprehensive Understanding

This article summarizes a proposed critical and intersectional model of LGBTQ microaggressions that can be used by scholars and practitioners from multiple disciplines. Drawing on critical and intersectional paradigms and decades of research from multiple fields, we constructed a model that acknowledges the breadth, depth, scope, and complexity of LGBTQ microaggressions. This proposed model includes the following elements: hegemonic influences, intersectional complexities, perpetration, interpersonal and environmental contexts, and responses.

Bully victimization, depression, and the role of protective factors among college LGBTQ students

This study surveyed 347 lesbian, gay, bisexual, transgender, and questioning college students from across the United States concerning their bully victimization, depressive symptoms, and sources of support. Participants responded to an online survey that asked them about their victimization experiences during the 3 months prior to the survey. The results indicate that four types of bully victimization (verbal, relational, cyber, and physical) occur during the college years, and that victimization relates positively to depressive symptomatology in sexual minority college students. The 4 forms of bullying did not relate to depression in the same manner for each of the 5 sexual minority subgroups. Peer support, but not family and campus support, provided a buffer against depression for lesbian, gay, and bisexual students. This study involved a sample exclusively comprising sexual minority college students, and the findings show the need for colleges to address bully victimization and its effects in this population.

Social Ecological Correlates of Family-Level Interpersonal and Environmental Microaggressions Toward Sexual and Gender Minority Adolescents

Microaggressions are associated with mental and behavioral health problems and are common experiences for sexual and gender minority adolescents (SGMA). Little is known about the social ecological correlates of family-level interpersonal and environmental microaggressions for SGMA. Utilizing a national sample of SGMA (N = 1,177), this study (a) identified the frequencies of family-level interpersonal and environmental microaggressions by participant demographics and (b) examined individual-, family-, and structural-level factors associated with interpersonal and environmental microaggressions. Outness to parents, a transgender or genderqueer identity, and higher levels of gender role non-conformity were associated with higher frequencies of interpersonal microaggressions. Higher levels of family-level child maltreatment and religiosity were associated with higher frequencies of interpersonal and environmental microaggressions. State-level non-discrimination protections were associated with lower frequencies of environmental microaggressions. Suggestions for increased individual-level support for gender non-binary adolescents as well as family targeted preventive strategies are discussed. Areas for future research are highlighted.

LGBTQ+ Young Adults on the Street and on Campus: Identity as a Product of Social Context

Lesbian, gay, bisexual, queer, and other sexual and gender minority (LGBTQ+) young adults face unique identity-related experiences based on their immersion in distinctive social contexts. The predominant framework of performing separate analyses on samples of LGBTQ+ young people by their primary social status obfuscates more holistic understandings of the role of social context. Using 46 in-depth interviews with LGBTQ+ college students and LGBTQ+ homeless young adults, we ask: How are LGBTQ+ young adults' capacities for "doing" their gender and sexual identities shaped by their distinctive social contexts? In developing their identities, both groups of LGBTQ+ young adults navigated their social environments to seek out resources and support. Most college students described their educational contexts as conducive to helping them develop their identities, or "undo" rigid norms of gender and sexuality. Homeless young adults' social environments, meanwhile, imposed complex barriers to self-expression that reinforced more normative expectations of "doing" gender and sexual identities.