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Purpose: This paper presents an exploratory analysis of minority stress and resiliency processes among parents in LGBTQ families. The paper examines two unique minority stress processes – (1) parents experiencing sexual and/or gender minority stress due to the stigmatization of their own identities as individuals and (2) parents sharing the gender minority stress faced by their transgender and gender expansive (TGE) child, and in the context of their parent–child relationship.

Methodology: Between 2017 and 2018 in-depth, in-person qualitative interviews on the topics of gender, stress, and resilience were conducted with 12 parents in LGBTQ families. Audio recordings were transcribed and then open coded using ATLAS.ti qualitative data analysis software. Analyses of data were informed by critical intersectional theories that locate gender and sexuality within structures of social and racial oppression.

Findings: Interview data indicate that minority stress is experienced by parents experiencing sexual and/or gender minority stress due to the stigmatization of their own identities, as well as among parents sharing the gender minority stress faced by their TGE child in the context of their parent–child relationship. Parents described community resilience and minority coping through interpersonal, community, and institutional support. This paper provides evidence that sexual and gender minority stressors are enhanced and resiliency factors are reduced among those experiencing racism and economic disadvantage.

Research limitations: This is an exploratory study conducted with a small sample of parents in a specific geographic area.

Originality/Value: These data provide initial evidence to support further analyses of the dyadic minority stressors within parent–child relationships in LGBTQ families

Purpose: Sexual minority youth are more likely than their heterosexual peers to consider and attempt suicide, in part due to victimization experienced within schools. While existing research suggests that rates of school victimization and suicidality among sexual minority students vary by school and community context, less is known about variation in these experiences at the state level.

Methodology: Using data from a large, representative sample of sexual minority and heterosexual youth (2017 Youth Risk Behavior States Data, n = 64,746 high school students in 22 states), multilevel models examine whether differences between sexual minority and heterosexual students in victimization and suicide risk vary by state-level policies.

Findings: Results suggest that disparities between sexual minority and heterosexual boys in bullying, suicide ideation, and suicide attempt are consistently smaller in states with high levels of overall policy support for LGBTQ equality and nondiscrimination in education laws. Sexual minority girls are more likely than heterosexual girls to be electronically bullied, particularly in states with lower levels of LGBTQ equality. Disparities between sexual minority and heterosexual girls in suicide ideation are lowest in high equality states, but state policies are not significantly associated with disparities in suicide attempt among girls.

Value: Overall, findings suggest that state-level policies supporting LGBTQ equality are associated with a reduced risk of suicide among sexual minority youth. This study speaks to the role of structural stigma in shaping exposure to minority stress and its consequences for sexual minority youth's well-being.

Rates of anxiety, depression, and suicidality have long been known to be elevated among LGBTQ+ communities and it was expected that the COVID-19 pandemic would deepen systemic injustices and inequities in mental health outcomes. However, it remains difficult to document inequities as surveillance systems do not typically capture LGBTQ+-inclusive data necessary to study the impact of COVID-19 on LGBTQ+ population health. This chapter reports on two studies designed to address this gap. The COVID-19 Impacts Study (CIS) documented the early mental health and social impacts of COVID-19 among sexual and gender minority adults, as well as adults with HIV, during the first round of shut-downs and initial economic disruptions. Subsequently, the Youth and Young Adults COVID-19 Study (YYA) measured the impacts of COVID-19 on the mental health outcomes, testing/vaccination behaviors, and stigmatization experiences of LGBTQ+ and BIPOC (Black, Indigenous, People of Color) young people. Several recommendations are discussed – including mandated collection of data on sexual orientation and gender identity in all surveillance systems, policy solutions to better address access and cost barriers, and deep and meaningful engagement that empowers communities.

Purpose: This chapter examines the implementation of lesbian, gay, bisexual, transgender, and queer (LGBTQ) health curricula in medical education, focusing on how this content is presented to students to understand if these curricula can fulfill goals of achieving healthcare equity for LGBTQ populations.

Methodology: This research draws on data from six months of participant observation of an academic medical center and school and 28 interviews with medical faculty, students, community members, administrators, and LGBTQ Health Center employees.

Findings: This research has three findings: (1) this medical school has variable definitions for LGBTQ health, making it a hybrid form of knowledge based in (a) understanding the unique health needs of; (b) being culturally competent to; and (c) being a (structural) advocate for LGBTQ patients; (2) LGBTQ health is integrated into multiple courses in the curriculum; and (3) LGBTQ health is becoming a medical specialty frequently delivered to students by LGBTQ health experts.

Research limitations and implications: This research used snowball sampling to recruit participants engaged in LGBTQ health at the institution; it therefore risks self-selection bias. Findings from this study are not generalizable.

Originality: This research argues that LGBTQ health experts engage in a new kind of diversity and inclusion work because (1) these health experts are not always LGBTQ identified; (2) this work is not necessarily unpaid or involuntary; and (3) it involves a hybrid knowledge requiring an understanding of LGBTQ identity, medical knowledge, and social science. Because these LGBTQ health experts opt into this work, and broadly define it, a message available to other physicians and students is that LGBTQ health remains elective.

In this chapter, we explore the lived experiences of transgender and gender non-conforming (TGNC) prisoners, arguably the most vulnerable minority in the prison estate, using the data from our correspondence study with transgender women and non-binary individuals incarcerated in male establishments in England and Wales. We provide a brief review of the extant literature, describe the English prison system and the regulations concerning transgender prisoners, and analyze two axes of vulnerability of TGNC prisoners: social (stemming from relationships between prisoners) and institutional (resulting from the prison regime). Along the social axes, we find, in contrast with prior research, that our respondents defied the stereotypes of trans prisoners as submissive to males in a hypermasculine prison society and as involved primarily in abusive relationships. Along the institutional axes, we find that, despite the progressive by international standards transgender prison regulations, prisoners were subject to vicissitudes in treatment that negatively affected their ability to express their gender and their health. Focusing on access to gender-affirming items (clothing, prosthetics, make-up) and gender-affirming medical treatment, we develop recommendations for the prison service that could improve the conditions of confinement for TGNC prisoners.

Through scholarly personal narrative (Nash, 2004), this chapter outlines a multifaceted approach to creating safer brave spaces for queer and trans students within a predominantly Hispanic-serving, public research university with a mainly commuter student population in South Florida. All spaces require courageous acts of authenticity on the part of its occupants. Thus, the creation of safer brave spaces is acknowledged as a practice since safety is an ideal to be worked toward especially for those with less power and privilege, such as queer and trans people as opposed to straight and cisgender people. Experiences of heterosexism and cisgenderism are positively associated with psychological distress among queer and trans college students (Goldberg, Kuvalanka, & Black, 2019; Sue, 2010; Woodford, Kulick, Sinco, & Hong, 2014). Research suggests empowerment and the acquisition of power is a positive coping mechanism for resisting and overcoming experiences of heterosexism and cisgenderism (Mizock, 2017; Nadal, Davidoff, Davis, & Wong, 2014; Todoroff, 1995). Administrators are called upon to mindfully create spaces that empower queer and trans students. Quick tips throughout the chapter highlight that queer and trans students should be given opportunities to determine their own risks, choose their own mentors, create their own spaces, have their own voices centered, realize their own solutions, fail and learn from setbacks, and deconstruct systems of power. At the University level, administrators should work to educate and change policies that further support students' opportunities to courageously exist and persist authentically in spaces across the university as a whole and not just in designated centers.

Every employee embodies manifestations of every demographic that attach to him or her different minority and majority statuses at the same time. As these statuses are often related to organizational hierarchies, employees frequently hold positions of dominance and subordination at the same time. Thus, a given individual’s coping strategies (or coping behavior) in terms of minority stress due to organizational processes of hierarchization, marginalization, and discrimination, are very often a simultaneous coping in terms of more than one demographic. Research on minority stress mostly focuses on single demographics representing only single facets of workforce diversity. By integrating the demographics of age, disability status, nationality, ethnicity, race, sexual orientation, and religion into one framework, the intersectional model proposed in this chapter broadens the perspective on minorities and related minority stress in the workplace. It is shown that coping with minority stress because of one demographic must always be interpreted in relation to the other demographics. The manifestation of one demographic can limit or broaden one’s coping resources for coping with minority stress because of another dimension. Thus, the manifestation of one demographic can determine the coping opportunities and coping behavior one applies to situations because of the minority status of another demographic. This coping behavior can include disclosure decisions about invisible demographics. Therefore, organizational interventions aiming to create a supportive workplace environment and equal opportunities for every employee (e.g., diversity management approaches) should include more demographics instead of focusing only on few.

Purpose: We review theory and research to suggest how research on sexual and gender minority (SGM) population health could more completely account for social class.

Approach: First, we review theory on social class, gender, and sexuality, especially pertaining to health. Next, we review research on social class among SGM populations. Then, we review 42 studies of SGM population health that accounted for one or more components of social class. Finally, we suggest future directions for investigating social class as a fundamental driver of SGM health.

Findings: Social class and SGM stigma are both theorized as “fundamental causes” of health, yet most studies of SGM health do not rigorously theorize social class. A few studies control socioeconomic characteristics as mediators of SGM health disparities, but that approach obscures class disparities within SGM populations. Only two of 42 studies we reviewed examined SGM population health at the intersections of social class, gender, and sexuality.

Research implications: Researchers interested in SGM population health would benefit from explicitly stating their chosen theory and operationalization of social class. Techniques such as splitting samples by social class and statistical interactions can help illuminate how social class and SGM status intertwine to influence health.

Originality: We synthesize theory and research on social class, sexuality, and gender pertaining to health. In doing so, we hope to help future research more thoroughly account for social class as a factor shaping the lives and health of SGM people.

Although employee race has been an actively investigated area of scientific inquiry for decades, a thorough and informed understanding of the role of race in the organizational sciences has eluded us for a number of reasons. The relationship of race and stress in organizations is a prime example of this neglect and deficiency in our knowledge base, as little work has been done in this area. We attempt to address this limitation in the literature by proposing an inductively derived, review-centric framework that attempts to articulate the multiple intermediate linkages that explain the process dynamics taking place in the relationship between employee race and health and well-being in organizations. We argue that socialization processes, social networks, information and resource access, and mentoring contribute to distance and differences between racial minorities and nonminorities concerning control, reputation, performance, and political understanding and skill, which in turn, creates barriers to success, and increased stress and strain for racial minorities. The implications of this framework along with directions for future theory and research are discussed in this chapter.