Sexual and Gender Minority Mental Health Research

The Office of Disparities Research and Workforce Diversity (ODWD) coordinates sexual and gender minority–related research and activities at NIMH.

Sexual and gender minority (SGM) populations include, but are not limited to, individuals who identify as lesbian, gay, bisexual, asexual, transgender, non-binary, Two-Spirit, queer, and/or intersex. Individuals with same-sex or same-gender attractions or behaviors and those with a variation in sex characteristics are also included. These populations may also encompass those who do not self-identify with one of these terms but whose sexual orientation, gender identity or expression, or biological traits are characterized by non-binary constructs of sexual orientation, gender, and/or sex.

The NIMH recognizes that more mental health research involving SGM populations is essential to gain a better understanding of the complex factors impacting the well-being and mental health needs of SGM individuals and to reduce the mental health disparities experienced by many in the SGM community.

In 2016, the NIH formally designated sexual and gender minorities as a health disparity population alongside racial/ethnic minorities, socioeconomically disadvantaged populations, underserved rural populations, and as of 2023, people living with disabilities.

ODWD works closely with the Sexual and Gender Minority Research Office , the National Institute of Minority Health and Health Disparities (NIMHD) , and other NIH Institutes, Centers, and Offices  to address disparities in SGM populations.

NIMH staff are working to:

• Advance rigorous research on the mental health of SGM populations in both the extramural and intramural research communities.
• Remove barriers to planning, conducting, and reporting NIMH-supported research on SGM mental health.
• Expand SGM mental health research by fostering partnerships and collaborations with a strategic array of internal and external stakeholders.
• Foster a highly skilled and diverse workforce in SGM mental health research.
• Encourage data collection related to SGM populations in research and the health research workforce.

NIMH sexual and gender minority research priorities

Mutable and mechanistic causes of disparities

NIMH has a specific interest in identifying mutable and mechanistic causes of disparities  in mental health clinical (including suicide thoughts and behaviors, the impact of violence , stigma, trauma, and family rejection) and functional outcomes (including severe mental illnesses) from which interventions targeting health equity can be developed and tested.

This could include individual, family, provider, clinic-level, or system-level interventions based on the empirical evidence for the contributing factor(s). Descriptive studies of the prevalence and characteristics of mental disorders in SGM individuals are considered low priority.

Non-mental health specialty settings

NIMH is interested in studies of how non-mental health specialty settings (e.g., SGM social or support groups, human resources or employee assistance programs, educational settings, etc.) can contribute to and support screening, referral, diagnosis, and treatment or prevention of mental illness and suicide behavior in SGM populations.

Stigma

NIMH supports the development and testing of stigma reduction interventions that address social and cultural barriers that aim to:

• Change knowledge/attitudes/beliefs, behavior (e.g., clients, providers, etc.), or structures (e.g., clinics, systems, etc.)
• Improve access, engagement, retention, treatment adherence, quality of care, and mental health outcomes (including suicide risk) for SGM individuals across the life course

Studies targeting SGM disparities using an intersectional lens

The NIMHD Workshop on Health Disparities Among Sexual and Gender Minorities  highlighted that SGM people with intersecting minoritized and marginalized identities (i.e., racial or ethnic identities, lower SES, rural, and disability status continue to be a risk for poorer mental health outcomes. NIMH is interested in studies that examine, identify, or clarify mechanistic targets for intervention and intervention adaptations for sexual and gender minorities from racial or ethnic minority groups to achieve equity in mental health outcomes among those groups (see the National Advisory Mental Health Council Workgroup report, recommendation 2.4.1, page 19, for additional guidance).

Additionally, NIMH is interested in studies that include measurement and intervention of social determinants of health on mental health outcomes for sexual and gender minority groups.

HIV disparities and prevention

NIMH is interested in:

• Studies to better understand disparities in HIV rates and outcomes among SGM individuals living with HIV and how to mitigate them
• Studies that assess the factors impeding scale up of efficacious HIV prevention interventions for SGM individuals and develop approaches to address these barriers

Sufficiently powered studies

NIMH also seeks studies that:

• Include sufficient numbers of SGM participants to be able to examine SGM mental health mechanisms and outcomes through an intersectional lens
• Disaggregation of SGM data to be able to sufficiently examine unique mental health experiences of various identities
• Enable secondary data analyses to advance novel strategies for improving the quality of mental health care for SGM individuals