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Evaluation ViewAttendees 3

LGBTQ+
Session Type:: Symposia

Symposium 16 - LGBTQ+ Structural Stigma and Health: Advancing the State of the Science Through New Meta-Analytic, Methodological, and Mechanistic Insights

Friday, November 21, 2025
5:00 PM - 6:30 PM CST
Location: Imperial 12, Level 4
CE: 1.5

Keywords: LGBTQ+, Stigma, Mental Health Disparities
Level of Familiarity: Basic to Moderate
Recommended Readings: Lattanner, M. R., et al. (2024). State of the science of structural stigma and LGBTQ+ health: Meta-analytic evidence, research gaps, and future directions. Annual Review of Public Health. https://doi.org/10.1146/annurev-publhealth-071723-013336,   Hatzenbuehler, M. L., et al. (2024). Structural stigma and LGBTQ+ health: A narrative review of quantitative studies. The Lancet Public Health, 9(2), e109–e127. https://doi.org/10.1016/s2468-2667(23)00312-2,   Ford, J. V., et al. (2024). (Re)conceptualizing structural stigma: Insights from a qualitative study of sexual minority men in a longitudinal, population-based cohort. Stigma and Health. https://doi.org/10.1037/sah0000571,   Hollinsaid, N. L., et al. (2023). Incorporating macro-social contexts into emotion research: Longitudinal associations between structural stigma and emotion processes among gay and bisexual men. Emotion, 23(6), 1796–1801. https://doi.org/10.1037/emo0001198,   Burger, J., & Pachankis, J. E. (2024). State of the science: LGBTQ-affirmative psychotherapy. Behavior Therapy,55(6), 1318–1334. https://doi.org/10.1016/j.beth.2024.02.011

Health disparities related to sexual orientation and gender identity exist across multiple health outcomes. Scholars have increasingly interrogated structural stigma—i.e., social policies, attitudes, and other conditions that restrict rights, opportunities, and wellbeing—as one fundamental cause of LGBTQ+ health disparities (Hatzenbuehler, 2016). Studies on this topic have generally found consistent associations between LGBTQ+ structural stigma and adverse mental, behavioral, sexual, and physical health outcomes—although the overall strength of these associations has yet to be quantified (Hatzenbuehler et al., 2024). Unfortunately, the rate of this progress is often eclipsed by the passage of new anti-LGBTQ+ policies and is threatened further by ongoing efforts to defund and delegitimize LGBTQ+ health research. This symposium—led by interdisciplinary scholars at varying career stages—will provide an important update on the state of this science and offer meta-analytic, methodological, and measurement insights—as well as other practical guidance—to ensure that it remains strong.

In the first talk, we will detail comprehensive efforts to update the evidence base on LGBTQ+ structural stigma and health, culminating in a recent meta-analysis demonstrating an effect size comparable to several other well-established macro-social determinants of poor health (e.g., racial residential segregation). This talk will also enumerate state-of-the-art methodological strategies to enhance inferences and put forth a research agenda for overcoming remaining limitations in our understanding of how LGBTQ+ structural stigma is historically experienced, qualitatively perceived, and mechanistically linked to negative health outcomes. Three subsequent talks will exemplify how we have put this agenda into action. Specifically, the second talk will discuss a novel application of natural language processing of historical newspaper texts to quantify early-life structural stigma and examine its life-course effects among sexual minority (e.g., lesbian and bisexual) women in the US. The third talk will illuminate qualitative accounts of structural stigma’s psychosocial consequences among LGBTQ+ people purposefully sampled from US states recently proposing or enacting anti-LGBTQ+ policies, and in particular, among transgender, nonbinary, and gender-diverse people disproportionately targeted by these legislative efforts. Finally, the fourth talk will present results from an ongoing meta-analytic endeavor to uncover individual stigma processes and interpersonal stigma experiences that may function as mechanisms explaining the link between LGBTQ+ structural stigma and poor health.

After these talks, our discussant will draw on his experience studying the role of structural stigma in shaping population health disparities to reflect on lessons learned from more than a decade devoted to this work and set the stage for expanding this field in the decades to come. He will also discuss implications for policy interventions that can reduce LGBTQ+ health disparities and for psychological interventions such as LGBTQ-affirmative cognitive-behavioral therapy that can address the health sequelae of LGBTQ+ structural stigma.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Quantify the size of the effect of LGBTQ+ structural stigma on health compared to other well-established social determinants of health.
  2. Identify at least 3 psychosocial consequences experienced by LGBTQ+ people living in US states recently introducing or passing anti-LGBTQ bills.
  3. Describe 3 methodological strategies that can be used to enhance scientific rigor when studying LGBTQ+ structural stigma and health.
  4. Explain how LGBTQ+ structural stigma undermines wellbeing through 2 individual stigma processes and 2 interpersonal stigma experiences.
  5. Characterize at least one new measurement approach for quantifying early-life LGBTQ+ structural stigma.

Presentations:

  • 5:06 PM - 5:27 PM CST
    (SYM 16) LGBTQ+ Structural Stigma and Individual-level Stigma Processes and Interpersonal-level Stigma Experiences: A Meta-analysis

    Speaker: Nathan L. Hollinsaid, B.S. (he/him/his) – Department of Psychology, Harvard University

    Co-author: Micah R. Lattanner, Ph.D. (he/him/his) – Santa Clara University

    Co-author: Mark Hatzenbuehler, Ph.D. – Harvard University

  • 5:27 PM - 5:48 PM CST
    (SYM 16) The Walls Are Narrowing In: The Mental Health Effects of U.S. State Policies Targeting LGBTQIA+ People

    Speaker: Briana Last, Ph.D. (they/them/theirs) – Stony Brook University

    Co-author: Briana Last, Ph.D. (they/them/theirs) – Stony Brook University

    Co-author: Madeline E. Poupard, B.A. – Stony Brook University

    Co-author: Noah Williamson, B.A. – Stony Brook University

    Co-author: Laura K. Jans, M.A. (she/her/hers) – Stony Brook University

    Co-author: Rafael Esteva Haché, BA – Department of Psychology, Stony Brook University

    Co-author: Nguyen Tran, M.P.H., Ph.D. – Stanford University

    Co-author: Juno Obedin-Maliver, MD, MAS, MPH – Stanford University

    Co-author: Mitchell R. Lunn, M.D., M.S. – Stanford University

    Co-author: Annesa Flentje, Ph.D. – Stanford University

  • 5:48 PM - 6:09 PM CST
    (SYM 16) State of the Science of Structural Stigma and LGBTQ+ Health: Meta-analytic Evidence, Research Gaps, and Future Directions

    Speaker: Micah R. Lattanner, Ph.D. (he/him/his) – Santa Clara University

    Co-author: Sarah McKetta, M.P.H., M.D., Ph.D. (she/her/hers) – Columbia University Mailman School of Public Health

    Co-author: John Pachankis, Ph.D. – Yale University

    Co-author: Mark Hatzenbuehler, Ph.D. – Harvard University

  • 6:09 PM - 6:30 PM CST
    (SYM 16) Measuring Early-life LGBTQ+ Structural Stigma and Examining Its Life-course Effects Among Sexual Minority Women: A Natural Language Processing Approach

    Speaker: Sarah McKetta, M.P.H., M.D., Ph.D. (she/her/hers) – Columbia University Mailman School of Public Health