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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

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: 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.

Purpose: The goal of Volume 21 of Advances in Medical Sociology, entitled Sexual and Gender Minority Health, is to showcase recent developments and areas for future research related to the health, well-being, and healthcare experiences of LGBTQA+ (Lesbian, Gay, Transgender, Queer, Asexual, and related communities that do not identify as heterosexual) persons and communities.

Approach: In this introduction to the volume, we trace the historical development of research on sexual and gender minority (SGM) health, discussing how priorities, theories, and evidence have evolved over time. We conclude with brief suggestions for future research and an overview of the articles presented in this volume.

Findings: Research on SGM health has flourished in the past two decades. This trend has occurred in conjunction with a period of intense social, political, and legal discourse about the civil rights of SGM persons, which has increased understanding and recognition of SGM experiences. However, recent advances have often been met with resistance and backlash rooted in enduring social stigma and long histories of discrimination and prejudice that reinforce and maintain health disparities faced by SGM populations.

Value: Our review highlights the need for additional research to understand minority stress processes, risk factors, and resiliency, particularly for those at the intersection of SGM and racial/ethnic or socioeconomic marginality.

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.

Health science librarians occupy a unique place in librarianship, guiding healthcare professionals and the public to quality sources of medical research and consumer health information in order to improve patient outcomes and quality of life. A broader impact of health sciences librarianship is its advocacy for improvements in public health. In recent years, health science librarians have been actively involved in advocating for adequate, responsive, and culturally competent health care for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals. Health sciences librarians have advocated for LGBTQ+ individuals through a variety of specialized outreach projects to address health disparities found in the LGBTQ+ community such as HIV/AIDS, women’s health, or substance abuse, have collaborated with public health agencies and community-based organizations to identify health disparities and needs, and have implemented outreach to address these needs.

This chapter maps the landscape of health sciences librarian outreach to LGBTQ+ people. The authors develop this theme through case studies of health science librarians providing health information to the LGBTQ+ community and healthcare professionals. Following an overview of advocacy for LGBTQ+ health by the US National Network of Libraries of Medicine and professional information organizations, they conclude the chapter by discussing the “pioneering” nature of these projects and the common threads uniting them, and by identifying the next steps for continued successful outreach through the development of an evidence base and tailoring of outreach and resources to address other demographic aspects of the members of the LGBTQ+ community.

Lesbian, gay, and bisexual (LGB) individuals experience institutionalized prejudice within society and in their working lives. This prejudice increases the stress that these individuals experience within the workplace. Thus, in this chapter, we outline the mechanisms of LGB-workplace stress, detailing the antecedents, outcomes, and strategies to remediate this form of stress. We first outline theoretical conceptualizations of workplace stress before explaining how sexual orientation minorities experience additional workplace stressors due to their specific, stigmatized identities. Then, we explain how the stressors of formal discrimination, interpersonal discrimination, stigma consciousness, internalized heterosexism, concealment, and social isolation each contribute to workplace stress and ultimately health and workplace outcomes. Finally, we discuss several strategies that organizations, stigmatized individuals, and allies can engage in to prevent and cope with each of these LGB-related workplace stressors. In so doing, this chapter encourages researchers and practitioners to continue to develop more comprehensive and effective strategies to combat the negative outcomes experienced by these and all other stigmatized employees, thereby promoting more healthy and inclusive organizations.

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.