Session: Intersectionality Matters: Minority Stress, Health, and Mental Health in Racial Sexual and Gender Minorities (Society for Social Work and Research 29th Annual Conference)

Background and Purpose: Research has established that a key factor leading to increased rates of poor health and mental health outcomes among sexual and gender minorities (SGM) is exposure to intersectional discrimination: systemic inequities and experiences of discrimination occurring amid multiple identities and/or social positions (e.g., race/ethnicity, gender identity, sexual orientation). Studies often do not focus on populations facing intersectional discrimination despite evidence suggesting they experience stress at higher rates relative to their majority counterparts. It is imperative to understand the health implications of intersectional discrimination and minority stress on SGM youth and adults to address this complex social justice problem. The purpose of this symposium is to discuss how minority stress is associated with health and mental health in racially-ethnically diverse SGM populations and identify possible solutions through improving mental health services for SGM populations. The speakers will also discuss implications for collaborative research and practice to improve the health and well-being of both racialized SGM and SGM, respectively.

Methods and Results: The papers presented in this symposium employed quantitative and qualitative methods, using national datasets and in-depth interviews that draw upon the perspectives of racially and ethnically minoritized SGM individuals and practitioners that serve this population.

The first paper used quantitative data to evaluate how experiences of gender minority stress in Black and Latine Transgender and Gender Expansive populations can influence health behaviors and, subsequently, preexposure prophylaxis (PrEP) uptake. Findings show that heavy substance use can decrease PrEP uptake while higher levels of gender affirmation can mitigate the impact of family rejection on heavy substance use.

The second paper used qualitative data to examine the process of experiencing enacted stigma and smoking in Black, Indigenous, and People of Color (BIPOC) sexual minority men. Smoking was a temporary fix from the negative effects of stigma and a helpful tool in anticipating stigma. However, while intersecting identities can influence experiences of stigma, participants also highlighted that identity consciousness and access to community can be protective factors from the effects of enacted stigma and smoking.

The third paper used quantitative data to assess the relationship of mental health, past cigarette use and e-cigarette use in BIPOC SGM young adults. The study found associations between e-cigarette use and mental health outcomes in BIPOC SGM young adults, along with variations by gender presentation.

The fourth paper used qualitative data from interviews with mental health clinicians to understand multi-level factors that foster inequities in mental health services for SGM youth. The findings demonstrated that mental health organizations risk discouraging SGM youth from engaging with mental health services when they fail to demonstrate unequivocal support for SGM populations and substantiate that position by actually delivering affirming care.

Conclusion: The papers in the proposed symposia provide data that acknowledge the intersecting identities of racial SGM populations that are understudied and sparse in the extant literature. Moreover, it also provides opportunities to consider solutions for improving health and mental health services in this population that would cultivate positive coping mechanisms, healthy behaviors, and overall well-being.