Researchers continually identify gender dysphoria as a significant mental health concern for many transgender individuals. Physical and mental health providers use the existing medical model to conceptualize and design treatment for gender dysphoria. This means that gender dysphoria is currently viewed and treated as an internal concern isolated to the individual. Researchers have also identified that external factors, such as discrimination and societal prejudice, have a significantly negative impact on the health of transgender individuals. Given that current conceptualizations of gender dysphoria focus on internal contributors to distress, external factors that also potentially contribute to gender dysphoria have not yet been explored. To address this gap in the literature, I conducted a study to identify and assess the severity of various external factors that may contribute to self-reported levels of gender dysphoria in transgender individuals. I recruited 195 participants who identify as transgender and who report experiencing gender dysphoria. Participants completed a survey that included the Transgender Congruence Scale, the Gender Preoccupation and Stability Scale, the Multidimensional Scale of Perceived Social Support, Gender Minority Stress and Resilience subscales, and the Gender Dysphoria from External Contributors Measure, a series of Likert-type scales developed for the present study that measure frequency of gender dysphoria experienced in a variety of external contexts. I conducted hierarchical multiple regression analyses to evaluate predictors for gender dysphoria from external contributors and gender dysphoria from internal contributors. Gender dysphoria from internal contributors was significantly associated with gender dysphoria from external contributors (r = 0.51). Several predictors uniquely predicted external contributors (i.e. gender-related rejection and gender-related discrimination) while others uniquely predicted internal contributors (i.e. internalized transphobia). Findings indicate that focusing solely on internal contributors generates an incomplete conceptualization of gender dysphoria. The results from this study allow for a more comprehensive understanding of gender dysphoria and the ways in which it impacts many transgender individuals. These results will be helpful in developing more accurate measures of gender dysphoria, which will lead to more effective, inclusive, and affirmative treatments for gender dysphoria and for transgender individuals in general.

Individuals with LGBTQ+ identities face discrimination and bigotry, components of their minority status stress, often on a daily basis (Meyer, 2003). Elevated levels of minority stress have been negatively associated with relationship satisfaction (e.g. Rostosky, 2007), such that as minority stress increases, relationship satisfaction often decreases as well. This is an examination of the relationship between general stress, identity-related stress, minority stress, and relationship satisfaction for sexual/gender minority and heterosexual, cisgender individuals who were currently in couple relationships lasting 6 months or longer. All participants completed the Romantic Perceptions Survey, Gender Relations Scale, and Daily Hassles Scale – Short Form. The LGBTQ+ participants also completed the LGBT Minority Stress Measure. I conducted t-test comparisons to examine group differences between heterosexual, cisgender participants and LGBTQ+ participants on relationship satisfaction, identity-related stress, and general stress. The LGBTQ+ and participants exhibited significantly higher levels of relationship satisfaction, general stress, and self-rated identity-related stress than did heterosexual, cisgender participants. I also conducted two hierarchical linear regressions to determine how general stress and identity related stress impacted relationship satisfaction for heterosexual, cisgender participants, and how general stress, identity related stress, and minority stress impacted relationship satisfaction for LGBTQ+ couples. Results of the hierarchical linear regressions were interpreted and found that general and self-rated identity-related stressors in combination predicted relationship satisfaction for LGBTQ+ participants, and general stress alone best predicted relationship satisfaction for heterosexual, cisgender participants. Specific minority status stress did not further contribute to the explanation of relationship satisfaction for LGBTQ+ participants. Results are discussed in terms of implications for research and practice.

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Rural populations are traditionally understudied, especially as it is concerned with the experiences of sexual minority women. Previous research has found that sexual minorities experience worse health outcomes in comparison to heterosexual individuals, which could be due to minority stress (the unique stressors they face as sexual minorities, such as discrimination and concealment of sexual orientation) (Meyer, 2003). More recent research has found that the relationship between minority stress and health outcomes has been mediated by social variables, like social isolation (Hatzenbuehler et al., 2009). Thus, the current study examined the indirect effects of proximal minority stress of concealment on self-rated health and quality of life through various social factors (community connectedness, social support, indirect support seeking, and belongingness). Participants included 134 sexual minority women in Northeast Tennessee. Participants completed the following measures: the Short Form LIHS (Szynmanski & Chung, 2001); Indirect Social Seeking Scale (Barbee & Cunningham, 1995); the Multidimensional Scale of Perceived Social Support (Zimet, Dahlem, Zimet, & Farley, 1988); the Belongingness Scale (Malone et al., 2012); the Connectedness to the LGBT Community Scale (Frost & Meyer, 2012); WHOQOL-BREF (World Health Organization, 1998); SF36v2 (Health Survey, 1996). In order to test that belongingness, social support, indirect support seeking, and community connectedness mediated the relationship between concealment to quality of life and self-rated health, a mediational analysis was conducted using PROCESS (Hayes, 2014) macro. Analysis showed that concealment was indirectly linked through belongingness with quality of life and self-related health. Concealment significantly predicted belongingness (b = -.327, p = .021), which in turn significantly predicted self-rated health life (b = .214, p = .004) and quality of life (b = .251, p < .001). A mediational analysis was conducted, and it was found that concealment had an indirect effect on self-rated health through belongingness (effect = -.070, 95% CI = -.1865, -.0105) and indirect effect on quality of life through belongingness (effect = -.066, 95% CI = -.161, -.001). All other mediational analyses were nonsignificant. Our results suggest that cognitive aspects of social life, like perceived belongingness, may be an important mechanism through which minority stress affects health.

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Unique factors associated with the experience of spirituality and religiosity for many in lesbian, gay and bisexual (LGB) communities include minority stress. Using structural equation modeling, we examined whether minority stress mediates the relationship between spirituality and psychological quality of life (QOL). Results indicate minority stress mediates the relationship between spirituality and psychological QOL for gay men and bisexuals. However, minority stress is not a significant mediator for lesbians. Therefore, lesbians may experience minority stress and its relationship to psychological QOL differently than gay men and bisexuals due to higher societal acceptance. This study provides support for examining lesbians, gay men and bisexuals separately rather than as one sexual minority group.

Indiana University-Purdue University Indianapolis (IUPUI) / AIM People with marginalized sexual orientations experience mental health and substance use problems at a higher rate compared to heterosexuals. Experiences of discrimination have been identified as a significant factor in explaining such disparities, and a growing body of literature has developed seeking to explore the contexts in which discrimination occurs. However, one context that is understudied is the online environment. Based on Meyer’s (2003) Minority Stress Model (MSM), it is postulated that specific proximal group-specific processes mediate the relationship between discrimination and health outcomes, with other social factors providing protective effects. However, research is sparse empirically investigating different mechanisms, consequences, and potential modifying factors for sexual minority young adults experiencing online heterosexist discrimination (OHD). Thus, the current study aims to explore experiences of OHD among young adults. METHODS Using the MSM as a guiding framework, the study examined proximal factors of internalized heterosexism, online concealment, and rejection sensitivity as mechanisms underlying the effect of OHD on health outcomes and online social support as a moderating factor. 383 young adults (18-35) with marginalized sexual orientations were recruited from an introductory psychology subject pool, two online crowdsourcing platforms (Prolific, MTurk), and the community. They completed measures of OHD, online social support, online concealment, rejection sensitivity, internalized heterosexism, psychological distress, and substance use. RESULTS Path analyses in Mplus revealed that two proximal stressors (rejection sensitivity, sexual orientation concealment) were positively related to psychological distress as a result of OHD. Sexual orientation concealment was associated with increased risk for cannabis use due to OHD. Online social support from LGBTQ+ peers did not buffer these relationships. CONCLUSION The MSM is a viable guiding framework in exploring OHD. Rejection sensitivity and online sexual orientation concealment are important constructs to consider for future research and may be ideal treatment targets for individuals experiencing psychological distress or engaging in cannabis use due to OHD.