Transgender and/or nonbinary (TNB) people often highlight romantic partners as a key source of social support related to their TNB identity. Accordingly, there is a need for validated measures to quantify TNB identity support in romantic relationships. We used a multi-phase process to develop and evaluate a multidimensional measure of TNB identity support from romantic partners. First, we generated items based on prior qualitative research, then used cognitive interviews with six TNB young adults (ages 18-30 years) to refine the items. Second, we piloted 59 items in a survey of 321 TNB people (16 years and older) reporting on current or recent romantic relationships. Using those data, we performed exploratory factor analysis to identify subscales, then selected 19 items based on factor loadings, item-subscale correlations, α-if-item-deleted, discrimination parameters, and item information curves. Third, we used weekly diary survey data from 299 romantically partnered TNB young adults (ages 18-30 years) to perform confirmatory factor analysis and assess reliability at the within- and between-relationship levels. Results indicate that the 19-item Transgender/Nonbinary Identity Support from Partners Scale (TISPS) is a reliable and valid measure of overall TNB identity support and five subtypes of support: Facilitation [of identity exploration], Identity Validation, Celebration, Allyship, and Understanding. The TISPS demonstrated strong psychometric properties at the between-relationships level, including a consistent factor structure, good full-scale and subscale reliability, and measurement invariance across key characteristics. The TISPS can be used in clinical and community settings and future research on the role of social support in TNB mental health.

Sexual and gender minority (SGM) individuals are at a higher risk for cannabis and alcohol use disorders than cisgender, heterosexual individuals. However, little research has examined attempts to quit or reduce alcohol or cannabis use in SGM individuals. A few key risk factors for unsuccessful quit attempts identified in the general population-namely, substance use problems, mood disorders, coping-motivated use, and stress-are experienced at higher rates among SGM individuals than their cisgender, heterosexual peers. The prevalence of these risk factors and substance use disorders may put SGM individuals at higher risk of poor cessation outcomes. The current study aimed to cross-sectionally examine alcohol and cannabis use problems, minority stress, solitary use, and motives for use in association with cessation/reduction attempts in a sample of 408 sexual minority women and gender diverse individuals assigned female at birth. Results indicate that individuals who experienced more alcohol or cannabis use problems or frequently use substances to cope are more likely to have attempted to quit but less likely to have succeeded. Other alcohol and cannabis use motives, mental health, and solitary use were also associated with cessation outcomes but with less consistent patterns. Minority stress was unrelated to cessation attempts. Findings suggest a high desire to quit coupled with a low likelihood of success, especially among heavy users or those using alcohol or cannabis to cope. This highlights the need for prospective research and further examination of the role of coping on cessation attempts in this population.

Assessing adolescent sexual identity is complicated, and contemporary sexual identities are gaining greater complexity and variation. However, current measures do not capture the diversity of contemporary identities among adolescents. Thus, our study utilized a large national dataset of sexual minority adolescents aged 14-17 years ( = 2,558) in the United States to propose a taxonomy of sexual identities among adolescents. Participants responded to a close-ended sexual identity question, followed by an open-ended qualitative question. Using the steps outlined in content analysis procedures, two researchers independently coded the open-ended responses, which were then discussed to establish consensus. Coding of open-ended responses to the sexual identity question resulted in 8 categories, with more than 25% of adolescents identifying with less common sexual identity labels. We further tested differences in sexual identity among responses to the close-ended question, sociodemographic characteristics, and mental health outcomes using chi-square and analysis of variance tests. We found overall differences in sexual identification by close-ended responses, age, and assigned sex at birth. However, we did not find any difference in sexual identity by race and ethnicity or urbanicity. We also found differences in sexual identity by mental health symptoms and suicidal outcomes, especially among respondents who identified with less common sexual identity labels. Findings from our study provide cutting-edge information on sexual identities that better captures the current state of adolescent sexual identity classification in the U.S. Future research should employ this taxonomy of eight sexual identity categories to collect data that reflect contemporary evidence.

Bi+ and transgender and gender diverse (TGD) people experience high rates of suicidal ideation (SI), theorized to result from experiencing oppression-based stress. However, the role of resilience in moderating these effects remains largely unexplored, especially among bi+ TGD individuals. The current study aims to address these limitations by examining if resilience factors (i.e., support, self-affirmation) moderate the associations between cissexism-based stress (i.e., rejection, non-affirmation, internalized transphobia) and SI (i.e., frequency, severity). We used cross-sectional data from an online study of bi+ adults. The analytic sample consisted of 205 TGD individuals ( = 26.59, = 7.37, = 18 - 49); 39.0% identified as White, 24.9% Latine, 8.8% Black, 20.0% Multiracial, and 7.3% other racial identities. cissexism-based stress (rejection, non-affirmation, internalized transphobia), resilience factors (self-affirmation, support), and mental health (SI frequency, SI severity) were assessed. Self-affirmation moderated the association between rejection and SI. At mean and high levels, but not low levels of self-affirmation, rejection was significantly related to higher frequency and severity of SI. No other associations between cissexism-based stress and SI were moderated by resilience factors. Higher rates of non-affirmation, internalized transphobia, and self-affirmation were associated with a higher frequency of SI. Although TGD identity-related support does not buffer the effects of cissexism-based stress, self-affirmation may be important to consider when addressing SI among bi+ TGD people. Findings suggest that self-affirmation may be associated with other factors that make TGD people more likely to encounter cissexism-based stressors, and thus more vulnerable to SI.

A growing body of research among sexual minority (e.g., gay, lesbian, bisexual) populations has highlighted unique mental health treatment needs and barriers to care. Despite the rapid proliferation of novel treatments across diverse delivery modalities to address these needs and barriers, few studies have assessed sexual minority people's preferences for mental health treatment. This study described sexual minority youth and young adults' mental health treatment preferences regarding treatment focus (e.g., support in coping with LGBTQ-related stressful events), treatment setting (e.g., in-person, remote), and counselor involvement (e.g., counselor-led, self-guided). Participants included a sample of U.S. sexual minority youth enrolled in an online LGBTQ-affirmative therapy study (=120), a population-based sample of sexual minority young adults in Sweden (=472), and a community sample of U.S. sexual minority youth ( = 9,423). This study also explored whether demographic, mental health and mental health treatment, and minority stress factors were associated with preferences for treatment focus, treatment setting, and counselor involvement. Across samples, a higher proportion of participants endorsed counselor-led compared to self-guided treatment. Most participants across samples endorsed a desire for in-person treatment, while endorsement of remote treatment varied based on contextual factors (e.g., age, anxiety symptoms). Internalized stigma and family rejection were associated with increased likelihood of desiring a treatment focus on coping with LGBTQ-related stressful events. Findings emphasize the need to balance trade-offs between accessibility of services and treatment preferences when implementing interventions for this population at scale.

As part of a larger study on minority stress with transgender and gender diverse (TGD) participants, this daily diary study explored associations between daily marginalization and gender non-affirmation with alcohol and cannabis use, as well as general and TGD-specific coping motives for use. We examined the mediating effects of general (e.g., rumination) and identity-specific (e.g., internalized stigma) processes that may help explain how stigma impacts alcohol or cannabis use. There were 167 participants ( age = 25.4; 82.2% White), including trans men (49.1%), trans women (18.6%), genderqueer (10.2%), and nonbinary participants (22.2%). Participants completed 56 consecutive daily surveys reflecting on their alcohol and cannabis use, reasons for use, and related variables. Reporting more daily marginalization and gender non-affirmation was associated with an increased likelihood of endorsing both general and TGD-specific motives for use on the same day. Higher levels of gender non-affirmation were associated with an increased likelihood of drinking on the same day. There were no significant prospective associations with alcohol or cannabis use related variables. At the between-person level, TGD people who experienced higher levels of daily marginalization also reported an increased likelihood of using cannabis and consumed more alcohol on average. In concurrent analyses, the association between daily marginalization and gender non-affirmation with general or TGD-specific coping motives was partially explained by increases in internalized stigma, rumination, and isolation. Future research is needed to identify other intervening variables that may help to explain these associations.

We compared religious development from early adolescence to middle adulthood between sexual orientations. Data were from Waves I-V of the National Longitudinal Study of Adolescent to Adult Health (Add Health) restricted data sets using participants from the self-weighting core sample who had complete data for predictors and covariates (=10,879 at Wave I; ages 12-21). Time-varying effect modeling examined changes in religious affiliation (any affiliation vs no affiliation), importance, attendance, and prayer across ages 12 to 41 as a function of sexual orientation in adulthood (heterosexual, 86.1%; mostly heterosexual, 9.6%; bisexual, 1.6%; mostly gay/lesbian, 0.9%; gay/lesbian, 1.4%; and asexual, 0.5%). For the heterosexual group, levels of religious affiliation and attendance were highest at age 12 and decreased until age 20 and then stabilized. Importance and prayer remained relatively stable across time. Affiliation, attendance, importance, and prayer were generally significantly lower in the mostly heterosexual, bisexual, and mostly gay/lesbian groups compared to the heterosexual group. Affiliation did not significantly differ from heterosexual individuals at most ages for the gay/lesbian and asexual groups. Attendance and importance were significantly lower for the gay/lesbian group in middle adulthood and significantly lower for the asexual group in adolescence. Prayer was also significantly lower in middle adulthood for the mostly gay/lesbian group and in adolescence for the asexual group. Prayer was significantly higher in adolescence for the gay/lesbian group. Religiosity changes over development and varies by sexual orientation, particularly between those who are heterosexual and who have sexual orientations that are non-monosexual.

Leveraging a novel experimental heterosexism mood induction paradigm, this study tested the effects of vicarious exposure to heterosexism on internalized heterosexism-based processes (i.e., internalized heterosexism, heterosexism-specific rejection sensitivity, and sexual orientation rumination) among a sample of sexual minority young adults. Participants were 101 sexual minority young adults, ages 20-35 ( = 26.46 years old; = 3.49), who engaged in recent heavy drinking and were recruited from the community (51.5% female sex assigned at birth; 76.3% cisgender; 51.5% plurisexual; and 42.6% racial and ethnic minorities). They completed three experimental mood induction trials counterbalanced over three laboratory visits on different days: heterosexism stress, general stress, and neutral. Results indicated that the heterosexism stress condition produced more internalized heterosexism, heterosexism-specific rejection sensitivity, and sexual orientation rumination than the general stress and neutral conditions, while controlling for demographic variables and exposure to structural heterosexism during adolescence. These effects were small to medium in their magnitude. Moreover, exploratory analyses indicated that these effects were somewhat larger among participants who resided in states with high structural heterosexism during adolescence. As further specificity, we documented no statistically significant differences between the general stress and neutral conditions. This study provides the first experimental evidence that vicarious exposure to heterosexism elicits internalized heterosexism-specific processes among sexual minority young adults. These novel findings extend and have implications for heterosexism-based stress and stigma models.

Gender-affirming hormone therapy (GAHT) and medically necessary surgical interventions (MNSI) play vital roles in helping transgender and gender diverse (TGD) individuals align their bodies with their gender identity. However, research in this area has primarily focused on TGD adults, leaving TGD youth and young adults (TGD-YYA)'s experiences understudied. Even less is known about demographic and psychosocial correlates of hormone and MNSI utilization among TGD-YYA, which is the focus of this cross-sectional study. From 2020 to 2021, 284 TGD-YYA in the U.S. ( =21.7 years) reported recent hormone use, MNSI engagement, depression, lifetime experiences of discrimination, and gender congruence. Participants were categorized into three mutually exclusive groups for analysis: Group 1: MNSI and hormone use in the past three months (26.1%), Group 2: Hormones only (26.4%), and Group 3: Neither (no hormone or MNSI use; 47.5%). ANOVA models examined group differences in psychosocial correlates of hormone and MNSI use. Overall, 26.1% of the sample reported receiving MNSI and 51.1% reported using hormones. Depression scores were significantly higher in Groups 2 and 3 than Group 1, s < .05. Lifetime discrimination scores were significantly higher in Groups 1 and 2 than Group 3, s < .001. Finally, gender congruence was significantly higher in Group 1 than Group 2, which was higher than Group 3, s < .001. Our findings suggest that the use of gender-affirming care-whether hormones, MNSI, or both-is associated with significantly lower depression and greater gender congruence. These findings highlight a beneficial role of including MNSI with recent hormone use on TGD-YYA's mental health and experiences of gender congruence.

Emerging research on sexual and gender diverse youth (SGDY) with disabilities (e.g., developmental or learning disabilities, physical disabilities) has begun to document the social- and health-related disparities that this population faces due to holding multiple marginalized identities. However, not all SGDY know their disability status, and those who are not aware of their disability status represent a unique group who might differently experience mental health challenges. Thus, the current exploratory study examined mental health differences among youth with diverse sexual and gender identities ( = 10,505) across three disability statuses: youth with disabilities, without disabilities, and those who did not know their disability status. Compared to SGDY with and without disabilities, SGDY who did not know their disability status were younger, less able to cope with stress, and less likely to identify as asexual. When considering anxiety and depressive symptoms, SGDY who did not know their disability status reported similar levels of anxiety/depression as their counterparts who reported having a disability, though effect sizes were very small. These exploratory findings have implications for how we measure and understand the experiences of SGDY who are not aware of their disability status; stakeholders should consider continuing to work to remove barriers that may thwart SGDY's ability to be diagnosed and offered support for disabilities.

Although research has shown that social support generally is beneficial to mental health among trans and nonbinary (TNB) adults, less is known regarding what forms of support and the degree to which they mitigate the harms of minority stress on mental health over time. This study investigated differences in types of social support and their association with mental health over time in a sample of 2,411 TNB adults, predominantly younger in age (53% 18-30 years old), diverse in sexual orientation (97.5%, LGBQA+, 2.5% straight/heterosexual), gender identity (53.3% non-binary, 26% trans man, 12.4% trans woman), and similar in race and ethnicity to the US national population. We conducted a latent profile analysis (LPA) to identify social support typologies. A three-profile solution classified participants into a Low (39.6%), Moderate (40.7%), or High Support profile (19.7%). Significant variability in gender-related support experiences was noted for those in the Moderate and High Support profiles, while those in the Low Support profile had almost uniformly little to no support from family. Mental health outcomes differed between the profiles; Low Support participants reported significantly worse depression and PTSD symptoms; demographically, the greatest proportion of participants with marginalized identities clustered in the Low Support profile. Finally, we tested profile membership as a moderating variable in the association of minority stressors with mental health over time. Few significant differences emerged between groups, suggesting that being in a higher support profile may not necessarily buffer the harms of minority stress on mental health over time. Intervention implications are discussed.

Research has clearly documented high rates of human immunodeficiency virus (HIV) infection among transfeminine (TF) people (including trans women). This research has largely overlooked nonbinary people assigned male at birth (NBAMAB) despite their gender fluidity. This study examined similarities and distinctions in the occurrence and frequency of condomless anal sex (CAS) with casual male partners and associated drug use among TF and NBAMAB people. Between November 2017 and March 2020, a total of 2,758 TF and 2,347 NBAMAB adult (aged ≥18 years) participants living in the US completed an online survey assessing sociodemographics, drug use, sexual behavior, relationship status and relationship characteristics among those who were partnered. Multigroup hurdle models indicated that the occurrence and frequency of CAS with casual male partners did not differ significantly between TF and NBAMAB people who were not in a relationship. Partner gender and sexual agreement predicted CAS with a casual partner among TF but not NBAMAB respondents. Those TF participants with male partners and nonmonogamous sexual agreements had the highest odds of engaging in CAS and the highest frequency of CAS when they did. In both groups, illicit drug use was associated with higher occurrence and frequency of CAS with casual male partners. Cannabis use was not associated with either. The findings align with prior studies highlighting TF individuals' risk for HIV infection, particularly those who are single and partnered TF with male partners and nonmonogamous agreements. Despite being largely overlooked in HIV research, some people who identify as NBAMAB may engage in similar behaviors as TF individuals.

This exploratory study investigated the impact of the COVID-19 pandemic on stress biomarkers and allostatic load for Black and Latina transgender women living with HIV (BLTWLH), as well as COVID-19 infection, hospitalization, and vaccination status. LITE Plus is a longitudinal cohort study of BLTWLH designed to identify pathways linking biopsychosocial stress to HIV co-morbidities. Participants were enrolled between October 2019-June 2022. Descriptive statistics compared stress biomarkers and allostatic load index (ALI) scores pre- (to March 2020) and post-onset pandemic onset (January 2021-December 2022). Frequencies and proportions are reported for COVID-19 indicators. Of the cohort, 26 BLTWLH completed study visits both pre- and post-onset pandemic onset ("pre-onset"; "post-onset"). Post-onset, chronic stress biomarkers were elevated across all body systems. Sample ALI distribution shifted post-onset, with elevated mean, median, IQR and proportion above the median. Of the 108 participants who completed any post-onset visits, 19% had ever tested positive for COVID-19 and 4% reported a COVID-19 related hospitalization. COVID-19 vaccination uptake was 70% and 24% had received a booster. Of those unvaccinated, 15% intended to be vaccinated, 9% were unsure and 6% did not intend to be vaccinated. BLTWH deployed various strategies to cope with pandemic effects and 22% reported unmet COVID-19-related support needs. ALI for BLTWLH was high compared to other populations in the literature, suggesting unique vulnerabilities to biopsychosocial stress and chronic disease risk. Despite high engagement with COVID-19 prevention including vaccination intention and uptake, BLTWLH experienced heavy COVID-19 burden and unmet support needs.

Understanding the frequency and patterns of experiencing changes in sexual orientation identity (SOI) is critical to the health of adolescents and young adults (AYA). Failure to measure and acknowledge change experiences may miss opportunities to tailor care, such as sexual and reproductive health care, accordingly. Much of the prior research among AYA assesses change either retrospectively, or prospectively over relatively long time intervals. The study objective was to prospectively examine the prevalence and sociodemographic patterns of sexual orientation identity change over a short interval among adolescents and young adults (AYA). AYA ages 14-25 years in the United States who participated in two consecutive waves of a longitudinal, online cohort survey in 2021 (N=1,628) were included in the analyses. Self-reported SOI at baseline and follow-up (2 months later) were compared. Overall, 11.4% of AYA reported a different SOI at follow-up. SOI change was more common among transgender boys/men (30.4%) and nonbinary people (25.7%) compared to cisgender girls/women (11.9%) and cisgender boys/men (7.4%; p<0.01). Participants selecting "not sure" or who preferred to self-identify/write-in their SOI were most likely to report SOI change (55.8% and 81.8%, respectively) compared to those identifying as heterosexual (4.3%), queer (13.6%), and bisexual (18.9%) AYA (p<0.01). Participants reporting sexual minority identities at baseline who experienced a change in SOI (n=110) often reported another sexual minority identity at follow-up (54.5%). Surveys with a single time measure of SOI likely underestimate the extent of SOI change among AYA and may introduce bias in addressing needs of AYA experiencing SOI change.

Posttraumatic stress symptoms are very high among sexual and/or gender minority (SGM) people. Development and testing of trauma interventions with SGM people is needed, but first we need to understand who among SGM people are at greatest risk of posttraumatic stress symptoms, how minority stress may contribute, and the frequency of substance use comorbidity with significant posttraumatic stress symptoms among SGM people. General linear models and logistic regressions were used to examine demographic differences, minority stress, and substance use related to posttraumatic stress symptoms among a national sample of SGM people ( = 4,589, = 32.1, 55% cisgender). All gender groups had greater posttraumatic stress symptoms than the reference group of cisgender men. All sexual orientation groups, except for straight/heterosexual SGM people, had greater posttraumatic stress symptoms than participants in the reference gay/lesbian group. Younger age or identifying as American Indian or Alaska Native, or Hispanic, Latino, or Spanish was associated with more posttraumatic stress symptoms. Non-specific and SGM-specific minority stress were each related to greater odds of significant posttraumatic stress symptoms, even after accounting for Criterion A events. Among participants with significant posttraumatic stress symptoms, 13.6% were at risk for alcohol use disorder, and 56.4% were at risk for other substance use disorder. Marginalized SGM subgroups have more posttraumatic stress symptoms. Interventions for SGM people should consider minority stress coping strategies and substance use comorbidities.

Previous research indicates that both minority stressors and interpersonal factors may facilitate increased risk for suicidal ideation (SI) among lesbian, gay, bisexual, queer, and other nonheterosexual (LGB+) individuals. These studies examined the potential indirect effects of two interpersonal factors, thwarted belongingness and perceived burdensomeness, on the associations that overt heterosexist discrimination and homonegative microaggressions share with SI. Percentile bootstrapped parallel indirect effects models were tested on a sample of 320 LGB+ community members between the ages of 18 and 74 ( = 30.98, = 7.15; Study 1) and a sample of 139 LGB+ college students between the ages of 18 and 39 ( = 20.12, = 3.03; Study 2). Results showed that perceived burdensomeness fully accounted for the association between heterosexist discrimination and SI in Study 1; however, this model lacked causal specificity. In Study 2, perceived burdensomeness fully accounted for the association between homonegative microaggressions and SI. Thwarted belongingness did not significantly account for any relationships. These findings suggest that perceived burdensomeness, over thwarted belongingness, is an important consequence of experiencing discrimination, particularly regarding its relationship with SI. Results also highlight microaggressions as an especially pernicious form of discrimination that potentially relates to internalized homophobia. Treatment, public health, and policy implications are discussed.

Nonsuicidal self-injury (NSSI), intentional harm to the body without intent to die, is a major public health concern. Transgender people may be at higher risk for NSSI compared to cisgender peers, but evidence is limited regarding prevalence, demographic correlates, and risk factors. This study is the first to examine NSSI in a probability sample of the U.S. transgender population. We analyzed data from the first U.S. nationally representative sample of transgender people which was recruited through random-digit-dial methods and address-based sampling. Using logistic regression, we examined associations between demographic factors, minority stress processes, early life adversity, and lifetime history of NSSI. The sample consisted of 270 transgender individuals; 144 (53.3%) were transfeminine or nonbinary assigned male at birth and 126 (46.7%) were transmasculine or nonbinary assigned female at birth. The mean age was 34.2 (SD = 17.1, range: 18-81); 68.5% identified as non-Hispanic White and 31.5% as Black, Latino, or multi-race. NSSI was reported by 50% of the sample. Victimization and discrimination, adverse childhood experiences, lower nonconformity in childhood gender expression, and transgender community connectedness were associated with higher odds of NSSI. NSSI is common among transgender people in the U.S. Victimization and discrimination, adverse childhood experiences, and factors related to gender identity development may increase vulnerability to NSSI. Additional research is needed to better understand the relationships between these variables and NSSI. Findings can inform tailored interventions to address specific risk factors that affect this population.

Intimate partner violence (IPV), including physical violence, psychological aggression, and coercive control, is highly prevalent among sexual and gender minority young adults assigned female at birth (SGM-AFAB). However, we know little about the contexts in which IPV occurs (e.g., overall tenor of the relationship in which IPV occurred, immediate precursors to IPV incidents) or the motives behind acts of IPV. Aiming to address these gaps in the literature, in 2019 we conducted semi-structured interviews with 39 SGM-AFAB young adults with histories of severe IPV victimization and/or perpetration. Thematic analysis of interviews revealed that IPV commonly occurred in relationships characterized by power differentials, anti-SGM stigma, infidelity, and unhealthy couple dynamics. Conflict was the most common situational context, followed by perceived or real infidelity; IPV was also triggered during technology-based communication, substance use, and breakups. IPV motives varied, including expression of negative emotions, desire to control the partner, jealousy, and self-defense. Relational and situational contexts and motives behind IPV varied by IPV type but not direction. Results highlight the importance of considering context and motivations when seeking to understand SGM-AFAB people's IPV experiences. Findings also suggest that IPV prevention and treatment efforts should include individual and dyadic interventions to improve regulation of negative emotion, awareness of power dynamics, and conflict management among SGM-AFAB and their partners, as well as policy efforts to reduce anti-SGM stigma.

A handful of existing studies have examined positive sexual identity experiences at the daily level. However, these studies have focused predominately on concurrent associations, produced mixed results for most outcomes (e.g., anxious affect, internalized stigma), and have not examined positive gender identity experiences. The current study aims to address these limitations by examining prospective associations between positive sexual and gender identity experiences, affect, proximal stressors (i.e., internalized and anticipated stigma), and perceived coping efficacy. The study also aims to explore contextual factors that may increase the likelihood of these events. We used data from a 30-day ecological momentary assessment study with 429 sexual minority women and gender diverse sexual minorities assigned female at birth (SMWGD). Positive sexual and gender identity experiences prospectively predicted increases in perceived coping efficacy. Positive sexual identity experiences also prospectively predicted increases in positive affect and decreases in internalized stigma. Positive sexual and gender identity experiences were also associated with increases in anxious and depressed affect, but these effects did not persist into the next day. Finally, positive sexual identity experiences were more likely to occur when participants interacted with friends, partners, and sexual and gender minority individuals. Given that reduced perceived coping efficacy and increased internalized stigma link enacted stigma with subsequent increases in anxiety and depression, our findings suggest that positive identity experiences may help to interrupt these processes and build resilience to enacted stigma, although this should be tested by future research.

The purpose of this study was to provide an in-depth, daily, and qualitative examination of oppression-based stress experiences among sexual and gender minority adolescents (SGMA) across varying social contexts-that is, varying interpersonal relationships and social environments. A sample of 94 SGMA were recruited and completed up to 21 days of daily diaries, in which respondents answered an open-ended question surrounding their daily negative experiences-or "lows"-associated with their marginalized identities. A total of 1,629 entries were analyzed using qualitative content analysis methods. Five themes of daily oppression-based stress experiences emerged from the responses, encompassing: (1) social rejection and discomfort, (2) relationship stressors, (3) stress related to identity development and disclosure, (4) negative or inadequate representation, and (5) structural cissexism-related stressors. Our findings further elucidate the content and type of oppression-based stressors SGMA experience across multiple intrapersonal, interpersonal, and structural domains; additionally, we identify salient, intervenable areas for future research to reduce the everyday oppression-based stress experiences of SGMA.

Transgender and gender diverse (TGD) adults experience increased discrimination and victimization relative to cisgender adults, thus elevating their risk for suicidal ideation (SI). Social support and connection to the broader TGD community may mitigate the relationship between gender identity-based stressors (i.e., interpersonal minority stressors), psychological stress processes (i.e., intrapsychic minority stress processes), and TGD adults' risk for SI. The current study examined TGD adults' exposure to interpersonal minority stressors, intrapsychic minority stress processes, perceived social support, community connectedness, and risk for past-year SI. Data came from a U.S. national probability study of TGD adults ( = 274). Survey-weighted linear and log-Poisson regression models measured the association between interpersonal stressors, intrapsychic stress processes, and TGD adults' risk for past-year SI while adjusting for sociodemographic characteristics, perceived social support, and community connectedness. Findings revealed gender nonbinary adults had 1.79 times the risk for past-year SI relative to transmasculine adults (adjusted risk ratio [aRR] = 1.79, 95% confidence interval [CI 1.13, 2.85]). A 1 higher gender-based victimization score was associated with 33% higher risk for past-year SI (aRR = 1.33, 95% CI [1.14, 1.56]), and a 1 higher negative expectations for the future score was associated with 37% higher risk for past-year SI (aRR = 1.37, 95% CI [1.18, 1.59]). Results indicate interpersonal minority stressors and intrapsychic minority stress processes are associated with TGD adults' risk for past-year SI despite controlling for socially-based confounders. Findings may inform the development of interventions to disrupt gender minority stress processes and lower TGD adults' risk for SI.