Development and Validation of the Sexual Minority and Religious Identity Integration (SMRII) Scale

Despite the psychosocial strain of homonegative religious attitudes, many people with minoritized sexual identities also hold religious identities and benefit from integrating their sexual minority and religious identities. However, for research and clinical practice to advance, a reliable and valid measure of sexual and religious identity integration is needed. The present study reports on the development and validation of the Sexual Minority and Religious Identity Integration (SMRII) Scale. Participants were comprised of two subsamples for whom sexual and religious identity is particularly salient (Latter-day Saints and Muslims) as well as a third subsample of the general sexual minority population-totaling 1,424 individuals (39% POC, 62% cisman, 27% ciswoman, 11% trans/non-binary/genderqueer). Exploratory and confirmatory factor analyses indicated that the 5-item scale measures a single unidimensional construct. This scale demonstrated good internal consistency in the total sample (α = .80) as well as metric and scalar invariance along relevant demographics. The SMRII also evidenced strong convergent and discriminant validity, significantly correlating with other measures of religious and sexual minority identity typically between r = .2 and r = .5. Taken together, initial findings indicate that the SMRII is a psychometrically sound measure that is brief enough to be utilized in research and clinical settings.Public Significance Statement: This article introduces the Sexual Minority and Religious Identity Integration Scale (SMRII) as a reliable and valid assessment of the degree to which individuals integrate their sexual minority and religious identities. This five-item measure is brief enough to be utilized in both research and clinical settings.

Sexual harassment, sexual assault, violence, self-esteem, and the role of LGBTQ-specific parental support in a sample of Latinx sexual and gender minority youth

INTRODUCTION

Oftentimes as result of racism, cissexism, and heterosexism, many Latinx and sexual and gender minority (SGM) youth are victims of sexual harassment, sexual assault, and violence. These experiences of victimization are in part related to increased negative mental health outcomes such as decreased self-esteem. Some research links LGBTQ-specific parental support to mental health outcomes among Latinx SGM youth, yet, no research has explored the role of LGBTQ-specific parental support with self-esteem among Latinx SGM youth.

METHODS

In a sample of 1,012 Latinx SGM youth (ages 13-17), we assessed: (a) associations between sexual harassment, sexual assault, and violence and self-esteem, (b) association between LGBTQ-specific parental support and self-esteem, and (c) whether LGBTQ-specific parental support moderated the relation between sexual harassment, sexual assault, and violence and self-esteem. Main effect and moderation analyses examined interactions between LGBTQ-specific parental support with sexual harassment, sexual assault, and violence on self-esteem.

RESULTS

Latinx SGM youth experienced low levels of LGBTQ-specific parental support and various degrees of sexual harassment, sexual assault, and violence. Also, transgender and nonbinary/genderqueer Latinx youth experienced lower self-esteem than their Latinx cisgender counterparts. Increased LGBTQ-specific parental support was related to increased self-esteem. We also identified a significant interaction between sexual harassment, sexual assault, and violence and LGBTQ-specific parental support, such that parental support was more protective at low levels rather than high levels of sexual harassment, sexual assault, and violence among Latinx SGM youth.

CONCLUSIONS

Findings add to a growing body of research about the importance of LGBTQ-specific parental support for Latinx SGM youth, and the need to examine culturally appropriate approaches to understand parent-child relationship among these communities.

Tending to the Flock: The Experiences of LDS Clergy with LGBTQ Congregants

Clergy from theologically conservative churches face challenges in providing counsel to LGBTQ (lesbian, gay, bisexual, transgender, and queer/questioning) congregants and use diverse strategies to address them. Thirty-three clergy from the Church of Jesus Christ of Latter-Day Saints participated in a qualitative survey. Results revealed that implementing church policy while simultaneously addressing the needs of LGBTQ congregants and diverging views posed challenges for clergy. Focusing on listening, love, and spiritual counsel while avoiding messages of defectiveness were helpful for LGBTQ congregants.

The multilevel correlates, contributions, and consequences of leader humility in humanitarian aid work

Objective

Leader humility has been linked to many positive outcomes but not examined in humanitarian aid work. Three studies examined the multilevel correlates, contributions, and consequences of leader humility in Medair-a large, multinational, faith-based aid organization. Study 1 examined correlates of leader humility in a sample of 308 workers and 167 leaders. Study 2 explored multilevel contributions of leader humility in 96 teams comprised of 189 workers. Study 3 utilized a subsample (50 workers, 34 leaders) to explore consequences of Time 1 leader and team humility on outcomes 6 months later.

Method

Participants completed measures of humility (general, relational, team), leader and team attributions (e.g., effectiveness, cohesion, and growth-mindedness), organizational outcomes (e.g., job engagement and satisfaction; worker and team performance), and psychological outcomes (e.g., depression, anxiety, compassion satisfaction, and flourishing).

Results

Leader and team humility contributed to multilevel positive attributions about leaders (as effective and impactful), teams (as cohesive, psychologically safe, and growth-minded), and oneself (as humble), and those attributions contributed to organizational and psychological outcomes. Teams' shared attributions of their leader's humility contributed to higher worker job satisfaction and team performance. Longitudinally, for workers and leaders, leader and team humility were associated with some positive organizational and psychological outcomes over time.

Conclusion

In humanitarian organizations, leader humility seems to act as an attributional and motivational social contagion that affects aid personnel's positive attributions about their leaders, teams, and themselves. In turn, these multilevel positive attributions contribute to several positive team, organizational, and psychological outcomes among workers and leaders.

Does Internalized Stigma Change the Way that Religiousness Relates to Depression for People with Marginalized Sexualities?

Drawing on minority stress and intersectionality theories, we examine whether the relationship between religiousness and depression among people with marginalized sexualities changes as a function of their experience of internalized stigma. Analyses of a sample of 260 people with marginalized sexualities suggested that the relationship between religiousness and depression was moderated by internalized homonegativity. Simple slopes analyses revealed that when people with marginalized sexualities reported higher degrees of internalized homonegativity, the relationship between religiousness and depression was positive. Conversely, when people with marginalized sexualities reported lower degrees of internalized homonegativity, religiousness was negatively related to depression. Dismantling analyses using subscales of the Internalized Homonegativity Inventory suggested that these effects are largely driven by personal homonegativity and participants' views of the morality of homosexuality. Taken together, these results suggest that religiousness may be positive for people with marginalized sexualities when they experience low degrees of internalized stigma. Further, results suggest that both people with marginalized sexualities' negative self-views and negative views of people with marginalized sexualities generally may affect the ways in which people with marginalized sexualities experience religiousness, and how it ultimately impacts them psychologically.

Attachment, Minority Stress, and Health Outcomes Among Conservatively Religious Sexual Minorities

Sexual minority (SM) members of the Church of Jesus Christ of Latter-day Saints (LDS) face increased exposure to minority stressors as well as concerns of attachment injuries relative to their heterosexual counterparts. The Integrated Attachment and Sexual Minority Stress Model outlines the mutually reinforcing associations between adult attachment and sexual minority stress, positing that adult attachment is both influenced by experiences of minority stress and simultaneously capable of shaping minority stress experiences in adulthood. The present study explored how adult attachment style directly and indirectly affects minority stressors and health outcomes for LDS SMs. A sample of 602 LDS SMs completed a quantitative survey assessing attachment, minority stress, and health. Results indicated that an insecure attachment style related to increased minority stressors and depression, whereas a secure attachment style related to decreased minority stressors and increased life satisfaction. Further, attachment moderated the relationship between minority stressors and health outcomes, such that experiences of minority stress were related to a decrease in life satisfaction only for securely attached LDS SMs. However, securely attached LDS SMs still reported better health than insecurely attached LDS SMs, even when reporting high degrees of minority stressors. These findings add to the growing body of literature suggesting that attachment style has direct and indirect effects on health outcomes for SMs, including those from conservative religious backgrounds.

Religion/Spirituality, Stress, and Resilience Among Sexual and Gender Minorities: The Religious/Spiritual Stress and Resilience Model

Although many sexual and gender minorities (SGMs) consider themselves religious or spiritual, the impact of this religiousness or spirituality (RS) on their health is poorly understood. We introduce the religious/spiritual stress and resilience model (RSSR) to provide a robust framework for understanding the variegated ways that RS influences the health of SGMs. The RSSR bridges existing theorizing on minority stress, structural stigma, and RS-health pathways to articulate the circumstances under which SGMs likely experience RS as health promoting or health damaging. The RSSR makes five key propositions: (a) Minority stress and resilience processes influence health; (b) RS influences general resilience processes; (c) RS influences minority-specific stress and resilience processes; (d) these relationships are moderated by a number of variables uniquely relevant to RS among SGMs, such as congregational stances on same-sex sexual behavior and gender expression or an individual's degree of SGM and RS identity integration; and (e) relationships between minority stress and resilience, RS, and health are bidirectional. In this manuscript, we describe the empirical basis for each of the five propositions focusing on research examining the relationship between RS and health among SGMs. We conclude by describing how the RSSR may inform future research on RS and health among SGMs.

Sexuality, Religiousness, and Mental Health among Sexual Minority Latter-day Saints in Other-Gender Relationships

To guide therapists working with sexual minority individuals considering entering in an other-gender relationship, we present data from 82 sexual minority, current Latter-day Saints in other-gender relationships, 155 sexual minority, former Latter-day Saints in same-gender relationships, and 123 cisgender/heterosexual, current Latter-day Saints in other-gender relationships. Results suggest that relative to cisgender/heterosexual individuals, sexual minority individuals (both in same- and other-gender relationships), report being less happy in their relationship, viewing porn and masturbating more often, and experiencing greater religious struggles. Sexual minority individuals in both same- and other-gender relationships reported happiness in their relationships and lives; however, the two groups differed in a variety of ways. We found that, on average, sexual minority individuals in other-gender relationships (a) have less satisfying sex lives, (b) somewhat follow church teachings about sexual practices, (c) experience conflict about their life choices, (d) nuance their religious views to distinguish between affirming and nonaffirming beliefs, (e) have difficult faith journeys, and (f) do not appear to experience mental health difficulties because of their relationship status. We encourage therapists to explore sexual, relational, and religious domains with their clients in helping each determine whether an other-gender relationship is possible for them.

Unpacking the Internalized Homonegativity-Health Relationship: How the Measurement of Internalized Homonegativity and Health Matter and the Contribution of Religiousness

Internalized homonegativity (IH) is widely recognized to negatively influence the health of lesbian, gay, bisexual, and queer/questioning (LGBQ +) individuals. It is not clear, however, the role that religiousness may play in the relationship between IH and health or how differing conceptualizations of IH or health may influence this relationship. We conducted a multi-level meta-analysis of 151 effect sizes from 68 studies to examine the relationship between IH and health as well as what may moderate this relationship. Results suggested that IH was consistently and negatively related to health (r = - .28). Analyses suggest that IH was most strongly related to mental health and well-being, evidencing a relatively weaker (though still negative) relationship with physical or sexual health. Analyses of different ways to measure IH suggest that scales that conceptualize IH to include distress (e.g., the Internalized Homonegativity Inventory) report stronger relationships with health than scales that conceptualize IH orthogonally from distress (e.g., the Internalized Homonegativity scale of the Lesbian, Gay, Bisexual Identity Salience Scale [LGBIS]). We failed to find significant moderation effects for religiousness, though it was hard to evaluate this relationship due to the poor quality of most measures of religiousness. We encourage researchers to use measures of IH that conceptualize IH orthogonally from distress (e.g., the LGBIS) and to use more nuanced measures of religiousness (e.g., religious belief, religious activity). We also encourage researchers to focus on how IH impacts less-often studied measures of health (e.g., physical health, suicidality).

Affirming and nonaffirming religious beliefs predicting depression and suicide risk among Latter-Day Saint sexual minorities

Sexual minorities (SMs) who are current/former members of the Church of Jesus Christ of Latter-day Saints (LDSs) report high levels of depression and risk for suicide. Recent research has suggested that specific LDS religious beliefs may be related to these negative mental health outcomes. Using two independent online samples of current/former LDS SMs (Sample 1 = 403; Sample 2 = 545), we tested associations of affirming/nonaffirming LDS beliefs with depression and suicide risk cross-sectionally (Sample 1), and then longitudinally (Sample 2) tested if religious/spiritual struggles and internalized stigma mediated these relationships. Cross-sectionally, nonaffirming LDS beliefs were associated with higher depression, but effects disappeared when religious/spiritual struggles and internalized stigma were entered in the model. Affirming LDS beliefs were unrelated to depression and suicide risk. Longitudinally, after including earlier levels of internalized stigma, religious/spiritual struggles, depression, and suicide risk as controls, nonaffirming beliefs indirectly predicted more depression 2 months later (Time 3) through internalized stigma at 1 month (Time 2). These results suggest LDS beliefs may play an important role in the development and experience of depression for LDS sexual minorities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

"You're not gay; You're a child of god": Microaggressions experienced by LGBTQ+ teens and their parents in the Church of Jesus Christ of Latter-day saints

Like other teens in conservative religious environments, LGBTQ+ teens raised in the Church of Jesus Christ of Latter-day Saints (CJCLDS) likely experience unique microaggressions. Furthermore, like other conservatively religious parents of LGBTQ+ teens, active Latter-day Saint (LDS) parents who openly support their LGBTQ+ teens likely both witness microaggressions toward their teens and may personally experience microaggressions. The present study sought to understand parents' and teens' experiences of microaggressions in conservative religious contexts by focusing specifically on the microaggressions experienced by (a) LGBTQ+ teens raised in the CJCLDS and (b) their active LDS parents. Thematic analysis of separate interviews with 19 dyads of LGBTQ+ teens and their active LDS parents (38 total interviews) revealed various ways in which they experienced verbal, nonverbal, and environmental microaggressions. We highlight parents' and teens' shared experiences of microaggressions that may be uniquely related to their religious contexts, such as assumptions that LGBTQ+ teens or their parents are not faithful and exclusionary Church policies. Additionally, we identified microaggressions that specifically targeted parents of LGBTQ+ teens, such as comments suggesting parents should limit their support for their teens. Finally, we found that parents had vicarious experiences with microaggressions through witnessing or learning about microaggressions that targeted their teens. Findings highlight the ways that the religious contexts in which microaggressions occur can influence the way that microaggressions are communicated to and experienced by LGBTQ+ teens - and their parents.

Intersectional microaggressions, depressive symptoms, and the role of LGBTQ-specific parental support in a sample of Latinx sexual and gender minority youth

INTRODUCTION

Latinx and sexual and gender minority (SGM) youth experience higher incidents of racism, cissexism, and heterosexism in the forms of overt discrimination and microaggressions. These experiences could in part explain increased negative mental health outcomes, such as depressive symptoms. Evidence points to the possibility that LGBTQ-specific parental support buffers the effects of intersectional microaggressions on depressive symptoms among Latinx SGM youth.

METHODS

In a sample of 1292 Latinx SGM youth (ages 13-17), we assessed: a) the association between LGBTQ-specific parental support and depressive symptoms, b) the associations between three forms of intersectional microaggressions and depressive symptoms, and c) whether parental LGBTQ-specific parental support moderated the relationship between three forms of intersectional microaggressions and depressive symptoms. Main effect and moderation analyses examined interactions between LGBTQ-specific parental support with each of the three forms of intersectional microaggressions on depressive symptoms.

RESULTS

We found that Latinx transgender youth experienced higher intersectional microaggressions compared to their cisgender counterparts and that Latinx SGM youth who reported lower LGBTQ-specific parental support experienced higher depressive symptoms. We also identified a significant interaction between intersectional microaggressions and LGBTQ-specific parental support, suggesting that parental support was more protective at low rather than high levels of intersectional microaggressions.

CONCLUSIONS

Findings suggest a need for future work examining culturally appropriate approaches to foster a supportive parent-child relationship among Latinx SGM youth and their parental figures.

Ways to Navigate Sexual Minority and Latter-day Saint Identities: A Latent Profile Analysis

Using a sample of 815 sexual minorities (SMs) with current or historical engagement with the Church of Jesus Christ of Latter-day Saints, we examined (a) how many empirically distinct ways there are to navigate SM and religious identities and (b) whether these ways were related to health. A latent profile analysis, which grouped participants by religious/spiritual (i.e., religious commitment, service attendance, Christian orthodoxy) and SM identity (i.e., outness, identity centrality, sexuality support) variables, yielded a three-group solution: engaged Latter-day Saint (LDS) individuals, moderately engaged LDS individuals, and lapsed LDS individuals. Participants in these three classes did not significantly differ in SM variables or in physical health, mental health, or life satisfaction. Engaged LDS participants reported less substance use and more meaning in life than lapsed LDS participants, likely due to their religious engagement.

"I Just Wanted Support": Examining How LDS Clergy May Effectively Minister to Sexual and Gender Minority Congregants

This study explored why members of the Church of Jesus Christ of Latter-day Saints (LDS) who identify as sexual or gender minorities (SGM) speak with clergy regarding their SGM identities, as well as what LDS SGMs find helpful and unhelpful in these conversations. A sample of 25 current or former LDS SGMs participated in semi-structured interviews, which were analyzed using thematic analysis. Participants reported six overarching reasons for talking with clergy, including church procedures, seeking guidance, seeking emotional comfort, seeking repentance, seeking openness, and other people's initiation. Participants reported several ways clergy were helpful, including empathic listening, openness, and affirmative spiritual care. Participants further reported several ways clergy were unhelpful, including punishing, lacking empathic listening, having a limited worldview, and pathologizing. Clergy may benefit from understanding why LDS SGMs are speaking with them, and from utilizing helpful approaches such as empathic listening skills in their ministering efforts.

"I Come Out Because I Love You": Positive Coming Out Experiences Among Latter-day Saint Sexual and Gender Minorities

BACKGROUND

Coming out conversations are pivotal and stressful experiences for sexual and gender minorities (SGMs). Coming out can lead to more affirmation, safety, confidence, and improved relationships. However, adverse coming out experiences can lead to damaged relationships and ostracization, which may be more likely in conservative religious contexts.

PURPOSE

The purpose of the current study was to explore what leads to positive coming out experiences for SGM members of the Church of Jesus Christ of Latter-day Saints.

METHOD

A sample of 25 current or former Latter-day Saint (LDS) SGMs participated in semi-structured interviews, which were analyzed using thematic analysis.

RESULTS

Participants reported five actions they did that contributed to a beneficial coming out experience: being selective, increasing self-understanding and acceptance, preparing before, decreasing pressure on self, and validating the relationship with the person they came out to. Participants further reported six responses from others that contributed to a beneficial coming out experience: showing loving acceptance, utilizing empathic listening skills, offering and expressing support, celebrating, affirming that the relationship is not changed, and advocating.

CONCLUSIONS AND IMPLICATIONS

The present study extends current knowledge on coming out experiences by demonstrating specific beneficial approaches and responses to coming out. Given participants' lack of focus on religiousness in their reports, these findings may be applicable to both religious and nonreligious SGMs. Our findings extend current knowledge on coming out experiences by demonstrating that both SGM approaches and others' responses are critical to creating a more positive coming out conversation. Future research is needed to understand the efficacy and effects of these coming out approaches and responses.

Is Conservative Religiousness Inherently Associated with Poorer Health for Sexual Minorities?

Results of path analysis involving sexual minority participants (N = 1317) from diverse sociopolitical contexts revealed health outcomes to be associated with internalized homonegativity and the resolution of conflict between religious and sexual minority identities. Contrary to expectations, several markers of religiousness were not directly associated with either improved or worsened health outcomes for depression or anxiety. However, religious activity moderated the influence of internalized homonegativity (IH) on depression such that IH was less strongly related to depression among individuals who frequently attended religious services than among individuals who infrequently attended religious services. These findings have special salience for advancing a more accurate understanding of conservatively religious sexual minorities and directing culturally sensitive research, clinical services, and public policy.

Parental Support, Depressive Symptoms, and LGBTQ Adolescents: Main and Moderation Effects in a Diverse Sample

OBJECTIVE

Research has documented the importance of parental support as a protective factor against depressive symptoms among lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth. In this study, we assessed the relations between LGBTQ-specific parental support and depressive symptoms.

METHOD

Participants were 6,837 LGBTQ youth (ages 13-17) with diverse racial and ethnic, gender, and sexual identities. Main effect and moderation analyses examined interactions between LGBTQ-specific parental support with demographic variables on depressive symptoms, considering demographics as moderators.

RESULTS

We found that participants of color reported less LGBTQ-specific parental support than their White counterparts, that transgender and genderqueer participants reported less LGBTQ-specific parental support than their cisgender counterparts, and that non-monosexual participants reported less LGBTQ-specific parental support than their monosexual counterparts. Disparities in depressive symptoms were found for individuals who identified as Native American and Latinx, non-monosexual, and transgender and genderqueer, such that these groups reported higher levels of depressive symptoms. Further, we found a significant interaction between LGBTQ-specific parental support and ethnicity, with LGBTQ-specific parental support being less strongly associated with participants who identified as Latinx compared to those who did not identify as Latinx. We also found a significant interaction between LGBTQ-specific parental support and gender identity, with LGBTQ-specific parental support being more strongly related to depressive symptoms among participants who did not identify as boys compared to cisgender boys .

DISCUSSION

We discuss how to assess the impact of interlocking systems of oppression when working with LGBTQ youth and their parental figures.

The Congregational Structure of Homonegativity: Why Place of Worship May Matter More than Frequency of Worship

Using 239 congregants from 14 randomly selected places of worship in the Southern United States-and a mega-analysis of 577 congregants from 34 similarly-located places of worship-we examined the relationship between religiousness and homonegativity. Multilevel models examining the effects of religiousness on homonegativity indicated that service attendance was more strongly related to homonegativity as a congregation-level variable than as an individual-level variable. Interaction effects between service attendance and the affirmativeness of a congregation were not significant, suggesting that the frequency of participation with a homonegative congregation is not related to homonegativity. These findings imply that the religiousness of a congregation is more closely related to homonegativity than the religiousness of an individual and that individuals may select a congregation that matches their views on same-sex sexuality. Homonegativity may serve a signaling function, enabling congregants to affiliate with a congregation with attitudes toward same-sex sexuality similar to their own.

First do no harm: Principles of care for clients with sexual identity confusion and/or conflict

Individuals who experience sexual identity confusion and/or conflict face unique stressors and life circumstances for which they may seek psychotherapy; however, little specific guidance exists for therapists working with clients who experience sexual identity confusion and/or conflict. To meet this need, we present a framework for therapists whose clients experience distress related to sexual identity confusion and/or conflict. We first define and describe sexual identity confusion and conflict, situating both in developmental theories of sexual identity. We then review clinical approaches that have been used historically to inform treatment with clients experiencing sexual identity confusion and/or conflict. Next, we discuss guiding ethical and clinical principles to inform such a clinical approach. Then, we provide assessment and treatment recommendations. We conclude by discussing considerations for working with clients who are diverse in gender identity, race/ethnicity, age, sexual orientation, and religious affiliation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Sexual Orientation Complexity and Psychosocial/Health Outcomes

Individuals whose sexual attraction or behavior varies from others' expectations based on their sexual identity were initially described as exhibiting sexual orientation discordance. This conceptualization has been challenged as inaccurate and value-laden, and "branchedness" has been suggested as a value-neutral description. Using a United States national sample of 4,530 participants from the 2013-2014 Center for Collegiate Mental Health database, we challenge the empirical distinctness of the phenomenon of sexual orientation discordance by 1) replicating previous work that indicates that branched individuals evidence unique psychosocial and health outcomes relative to non-branched individuals and 2) using stepwise regression to demonstrate that these differences in outcomes can be accounted for by variation in sexual attraction, behavior, and identity and that "discordance" between indicators failed to explain additional variation in outcomes. We encourage researchers to adopt non-normative language and conceptualizations in their study of sexual orientation complexity and branchedness.

Suicidal ideation among active and nonactive/former Latter-day Saint sexual minorities

Sexual minorities (SMs) in the Church of Jesus Christ of Latter-day Saints (LDS) experience a number of unique risks related to their religious/spiritual and SM experience that may increase their likelihood of experiencing suicidal ideation (SI) and ultimately dying by suicide. However, it is unclear which aspects of these experiences are responsible for elevated SI. It is further unclear whether religiousness/spirituality and minority stress relate to SI similarly for active and nonactive/former LDS SMs. To address this gap, we examined data from 602 active and nonactive/former LDS SMs. Active and nonactive LDS SMs reported similar degrees of SI and minority stress but differing degrees of religiousness/spirituality with active LDS SMs reporting more religiousness/spirituality than nonactive/former LDS SMs. Several variables were associated with increased SI in both groups including positive religious coping, interpersonal religious struggles, internalized homonegativity, and concealment. Other variables were associated with decreased SI in both groups including resolving conflict between sexual and religious identities, family support, and friend support. Our results suggest that whether LDS SMs are active in their faith is an important factor to consider when understanding how religiousness/spirituality and minority stress relate to SI.

The relationship between religiousness and health among sexual minorities: A meta-analysis

Meta-analyses suggest that religiousness/spirituality (R/S) is consistently and positively associated with health (average r = .15); however, the strength and direction of this relationship is much less clear among sexual minorities, and many sexual minorities experience tension related to R/S. To address this, we present results from the first meta-analysis of the relationship between R/S and health among sexual minorities. Using 279 effect sizes nested within 73 studies, multilevel meta-analyses suggest a small but positive overall relationship between R/S and health among sexual minorities (r = .05), with a substantial amount of residual heterogeneity. Moderator analyses clarify that this relationship is particularly positive when R/S is conceptualized as spirituality (r = .14) or as religious cognition (e.g., belief; r = .10). The relationship between R/S and health disappears or becomes negative when participants are sampled from sexual minority venues (e.g., bars/clubs; r = .01). Minority stress, structural stigma, and causal pathways theories provide some structure to understand results; however, none of these theories is able to explain results fully. We synthesize these theories to provide an initial theoretical explanation: the degree to which R/S promotes or harms sexual minorities' health depends on (a) where the individual is in their sexual identity development/integration; (b) what their current R/S beliefs, practices, and motivations are; and (c) how well their environmental circumstances support their sexual and/or religious identities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Sexual Minorities who Reject an LGB Identity: Who Are They and Why Does It Matter?

Although some persons with minority sexual orientations do not identify as lesbian, gay, or bisexual (LGB), Minority Stress Theory (Meyer, 2003) has largely been developed utilizing LGB-identified samples. We examined a sample (n = 274) of sexual minorities with diverse religious and sexual identity labels to determine if those rejecting versus adopting an LGB identity were different in terms of religious, sexual, relational, and health characteristics. Results suggested those who reject an LGB identity are more likely to be religiously active, full members of their church, and highly intrinsic and theologically conservative in their religious viewpoint. They further reported having slightly more lifetime heterosexual attractions, fantasies, and behaviors; greater internalized homonegativity; and being more interested in having children and a child-centered family life. They were also more likely to be single and celibate or in a heterosexual relationship. Contrary to expectations, these differences were not associated with health differences in depression, anxiety, and social flourishing. LGB-identified participants did report higher life satisfaction than those rejecting an LGB identity, but this difference was not interpretively meaningful when considered in reference to population norms. We conclude with a discussion of the potential implications of our findings for research, legal and professional advocacy, and clinical care.

Same-Sex Attracted, Not LGBQ: The Associations of Sexual Identity Labeling on Religiousness, Sexuality, and Health Among Mormons

In the Church of Jesus Christ of Latter-Day Saints (LDS church), beliefs about same-sex sexual attraction are carefully differentiated from beliefs about same-sex sexual behavior and identity, leading some to reject a lesbian, gay, bisexual, or queer (LGBQ) identity label in favor of declining a sexual identity or describing themselves as experiencing same-sex attraction (SSA). Using data from 1,128 sexual minority Mormons recruited from both politically conservative and liberal circles, we examined the relationship between rejecting an LGBQ identity and religiousness, attitudes toward sexuality, and health outcomes. We found that Mormons who reject an LGBQ identity were significantly more religious and less content with their sexuality but had similar health outcomes relative to LGBQ Mormons. We posit that these differences are best understood by differences in group affiliation and support, intersectional experiences with minority stressors, and the lack of generalizability of LGBQ constructs to those who reject an LGBQ identity.

Homonegativity and the Black Church: Is Congregational Variation the Missing Link?

The Black church in the United States has historically functioned as a bastion for civil rights; however, it may also be a source of pain and suffering for sexual minorities. To examine the influence of individual and congregational variables on attitudes toward same-sex sexuality in the Black church, we collected a sample of 219 participants from 15 randomly selected congregations. Results of three hierarchical linear models indicated that congregation- and individual-level variables emerged as equally important predictors of individuals’ attitudes toward same-sex sexuality. Individual-level religiousness and congregation-level education emerged as significant predictors of homonegativity. Our results suggest that congregations may play a role in enacting homonegative attitudes. We encourage counseling psychologists working with religious Black sexual minority clients to help clients consider characteristics of congregations (e.g., education) and individual religious practices (e.g., overzealous service attendance) that may signal homonegativity. We encourage further work examining the influence of congregational factors on congregants’ attitudes.

Distress and Therapeutic Outcomes Among Transgender and Gender Nonconforming People of Color

Transgender and gender nonconforming (TGNC) People of Color experience stressors unique to both TGNC and racial and/or ethnic minority communities, resulting in disparities in mental health. Guided by minority stress and intersectionality theories, we examined initial anxiety and depression, as well as changes in symptoms, in 41,691 clients from the Center for Collegiate Mental Health 2012–2016 dataset. We sought to understand disparities that may exist in distress and therapeutic response between TGNC and cisgender clients. We also examined the intersection of gender and racial and/or ethnic identities to examine how these trends differ for TGNC People of Color. Results from hierarchical linear modeling indicated greater symptom severity, but a slower remission of symptoms of depression and anxiety, among TGNC clients. Interaction effects were nonsignificant; however, TGNC Clients of Color experienced more distress than either White TGNC clients or cisgender Clients of Color. On average, TGNC clients, compared to cisgender clients, utilized an additional 2.5 sessions of therapy.

Satisfaction and Health Within Four Sexual Identity Relationship Options

Using a sample of 1,782 same-sex attracted (SSA) and lesbian, gay, and bisexual (LGB) identified participants, this study examined similarities and differences among those who are (a) single and celibate (SC); (b) single and not celibate (SNC); (c) in a heterosexual, mixed-orientation relationship (MOR); and (d) in a same-sex relationship (SSR). To reduce bias and increase generalizability, an ideologically diverse research team was formed. Participants in SSRs reported higher levels of some amount of satisfaction with their status (95%) compared to those in MORs (80%), those who are SC (42%) and those who are SNC (40%). The SSR group had the least depression and anxiety and the most life satisfaction and physical health, followed by the MOR group, followed by the two single groups. Results from a stepwise regression predicting satisfaction from important aspects of life and relationships identified that meeting needs for connection, intimacy, and mutual understanding was the strongest predictor of satisfaction across all options. Other significant variables included participant-defined authentic sexual expression, resolving conflicts with religion, and reducing depression and anxiety. Results may inform SSA/LGB individuals who are questioning which option fits best for them and help guide therapists who work with these individuals.

How well do various types of support buffer psychological distress among transgender and gender nonconforming students?

Background: Transgender and gender nonconforming (TGNC) individuals experience an increased prevalence of many psychological disorders, leading many to reach out for support from family, friends, mental health professionals, and religious or community networks. Nonetheless, experiences seeking support are often negative, and many psychotherapists report feeling underprepared to work with TGNC clients. To better understand the experiences of TGNC individuals and better equip psychotherapists in their work with TGNC clients, we investigate which sources of support most successfully buffer psychological distress among TGNC individuals. Aims: This study aims to identify differences in levels of various types of support (social, family, religious, and living-situation) between cisgender and TGNC individuals and examine how these types of support may or may not buffer psychological distress among TGNC individuals. Method: We used a United States national sample of 3,090 students (1,030 cisgender men; 1,030 cisgender women; 349 transgender; 681 endorsing another gender identity) from the Center for Collegiate Mental Health 2012-2015 database which provided basic demographic information through the Standardized Data Set. Psychological distress was measured through the Counseling Center Assessment of Psychological Symptoms 34-item questionnaire. Results: TGNC individuals reported more distress, less family support, more social support, and less frequent religious affiliation than cisgender men and women. Family and social support emerged as the strongest predictors of distress for both TGNC and cisgender individuals. Though religious affiliation and living on-campus buffered distress among cisgender students, they did not buffer distress among TGNC students. Conclusion: Our study highlights disparities in distress and support between TGNC and cisgender individuals. We found that although religious affiliation and on-campus living are beneficial for cisgender students, neither systematically buffers distress for TGNC students. These findings illustrate the impact minority stress and systemic discrimination may have on TGNC individuals and provide suggestions for therapeutic intervention in work with TGNC individuals.

Religious and Sexual Identities: An Intersectional, Longitudinal Examination of Change in Therapy

The current study employs an intersectional framework to understand how well counselors are meeting the needs of lesbian, gay, bisexual, queer, questioning (LGBQQ) and religious clients by examining clients’ initial anxiety and depression levels and changes in these symptoms through psychotherapy. Data from 12,825 participants from the Center for Collegiate Mental Health 2012–2014 data set were analyzed. Results from hierarchical linear modeling indicate lower baseline anxiety and depression among religious clients and faster rates of change of anxiety symptoms among nonreligious clients. LGBQQ clients presented with higher initial anxiety and depression, but there were no differences in rates of change of anxiety and depression between heterosexual and LGBQQ clients. Significant but minimal interaction effects between religious and sexual identities were found, indicating a need for further research. Counselors are encouraged to be mindful of these disparities in therapy.

Measuring Multidimensional Subjective Well-Being with the I COPPE Scale in a Hispanic Sample

The purpose of this study was to provide initial validity evidence for measuring multidimensional subjective well-being in a Hispanic sample with the Interpersonal, Community, Occupational, Physical, Psychological, Economic (I COPPE) Scale. Participants were 641 English-speaking adults who self-identified as Hispanic. Bi-factor analyses were used to evaluate (a) the a priori measurement theory for responses to the I COPPE Scale and (b) convergent relationships of the seven I COPPE subjective well-being factors with scores from established comparison instruments. There was evidence that (a) the a priori hypothesized measurement theory for responses to the I COPPE Scale emerged in an exploratory bi-factor analysis and (b) the I COPPE subjective well-being factors exhibited convergent relationships with scores from comparison instruments. Use of the I COPPE Scale to derive multidimensional measures of subjective well-being may be of potential utility to future research in the interdisciplinary study of human movement and in a diversity of populations in which health disparities may exist.

The inescapability of intersubjectivity in meaning

Comments on the original article "Life is pretty meaningful," by S. J. Heintzelman and L. A. King (see record 2014-03265-001). The current authors welcome Heintzelman and King's discussion of meaning and agree that meaning is necessary for a good human life. The authors endorse a fully subjective understanding of meaning by focusing on personal experiences of purpose, significance, and life making sense. The current authors suggest, however, that (a) a subjective theory of meaning is only one approach to meaning, (b) the subjective theory creates serious difficulties, and (c) intersubjectivity is necessary to adequately understand meaning.

Beyond Harms

Wendt, Gone, and Nagata raise some very important questions about harm in psychotherapy and initiate a valuable dialogue between scholars of potentially harmful therapy and multicultural counseling and psychotherapy. This comment enlarges upon the authors’ view that harms cannot be understood independently of goods by providing an argument that goods have an inherent place in psychotherapy and in multicultural viewpoints. The goods of psychotherapy (e.g., justice, respect) are ordinary and widely endorsed rather than esoteric or objectionable. Identifying these goods makes it possible to organize them into a coherent hierarchy that enables an integration of the primarily individual goods of standard psychotherapy and the primarily communal goods of a multicultural perspective. This can facilitate a mutually informative and enriching dialogue between scholars from these two domains. The hope is to encourage a more open discussion of the goods of psychotherapy, thereby fostering a more reflective, progressive discipline.