Sexual and gender minority (SGM) individuals face marked disparities in substance use. The present narrative review explores research on substance use in SGM communities using a minority stress theory lens. We define the SGM population and minority stress, and explore stresses and substance use disparities in adolescence, adulthood, and older age. Though research on this topic is beginning to highlight the relationship between stress and substance use for SGM individuals, more work is needed on older SGM populations and in translating research findings to effective interventions.

Bisexual individuals may experience pervasive binegativity originating from both heterosexual and lesbian/gay (L/G) individuals as a result of various psychosocial and relational factors. The present study aimed to explore how partner gender is particularly associated with experiences of binegativity from heterosexual and L/G persons and to examine how such experiences are related to internalized binegativity. A total of 350 self-identified cisgender bisexual men and women from across the United States were recruited online for this study. Participants completed an online survey battery assessing levels of both experienced and internalized binegativity. Regression analysis results indicated that binegativity from L/G persons, but not heterosexual persons, was significantly and positively associated with internalized binegativity. A significant interaction between binegativity from L/G persons and partner gender revealed a stronger association among those in same-gender relationships, such that those with same-gender partners who reported binegativity from L/G persons experienced more internalized binegativity than those with other-gender partners. When further examined by gender, these findings appeared to be driven by the relation among women, but not men, as women in same-gender relationships who reported binegativity from L/G persons reported the highest levels of internalized binegativity. Among men, binegativity from heterosexual, but not L/G, persons was significantly related to internalized binegativity independent of partner gender. The present study highlights key gender differences in interpersonal factors related to binegativity and have important implications for clinical practice with bisexual clients facing stigma and advocacy work addressing bisexual discrimination. Public Significance StatementResults from an analysis of 350 bisexual individuals shed light on binegativity experienced by women in same-gender relationships from lesbian/gay persons, binegativity experienced by men from heterosexual persons, and the influence of these experiences on increased internalized stigma. This study highlights the differential influence of relationships on bisexual prejudice experienced by men and women and calls attention to potential interpersonal barriers relevant to clinical and advocacy work with bisexual people.

Lesbian, gay, bisexual, and queer (LGBQ) youth continue to be disproportionately at risk for depression. During COVID-19 social distancing, LGBQ youth who live with family may be more consistently exposed to potentially discriminatory family situations, and may receive reduced community and mental health support. However, the Internet offers opportunities to interact with lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities by watching videos of, and developing one-way relationships-or parasocial relationships-with, LGBTQ media personalities on platforms such as YouTube. The current study explored how parasocial relationships with LGBTQ YouTubers may moderate the links between family support, loneliness, and depression symptoms among LGBQ emerging adults living with their parents during the COVID-19 pandemic. A sample of 183 LGBQ emerging adults (age 18 -23) was recruited from the United States in mid-July 2020. Results of a moderated mediation regression indicated that parasocial relationship strength moderated the links between family support and loneliness, and loneliness and depression symptoms. The associations between family support and loneliness, and between loneliness and depression symptoms, were weakened by high parasocial relationship strength. These findings contribute to understanding parasocial relationships' connections to well-being among marginalized groups during a crisis and highlight the potential of online solutions to emerging mental health disparities being experienced by LGBQ youth disproportionally affected by the COVID-19 pandemic. Public Significance StatementParasocial relationships are one-way relationships with media personalities that may have associations with well-being for socially marginalized groups. In our study, high parasocial relationship strength weakened the associations between family support and loneliness, and between loneliness and depression, among LGBQ emerging adults living with their parents during the COVID-19 pandemic.

Despite growing use of online dating apps, guidelines from health service psychology (HSP) programs and associations often do not address dating app use while engaging in clinical work. This qualitative study explored how 11 diverse graduate students in HSP doctorate programs navigate their own dating apps use. We used semistructured individual interviews and a consensual qualitative research methodology to identify core areas of experience among participants and major themes. Regarding app use, participants discussed the necessity of using dating apps to meet others (particularly sexual minority individuals), concerns about seeing clients on apps, and strategies for mitigating identification on dating apps by clients. Regarding program messages about dating app use, participants identified receiving general social media messages, a lack of messages about dating app use by sexual and gender minority trainees, a lack of messages implying negative attitudes, outright negative attitudes, professional repercussions, and dating app stigma. Dating apps are used in a different manner than general social media, so it is important for programs and professional organizations to provide students with guidance on ethical dating app use while doing clinical work. We outline strategies for integrating dating apps into professional social media ethics training.

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