Flentje Annesa, Sunder Gowri, Tebbe Elliot
Community Health Systems, School of Nursing, University of California, San Francisco, CA, USA.
Department of Psychiatry and Behavioral Sciences, Alliance Health Project, School of Medicine, University of California, San Francisco, CA, USA.
J Behav Med. 2025 Feb;48(1):22-42. doi: 10.1007/s10865-024-00539-6. Epub 2025 Jan 9.
Here we present an updated systematic review identifying studies published 2019-2024, since our prior systematic review in 2020, that examine the association between minority stress and a biological outcome among sexual and gender minority (SGM) people. Pubmed, Web of Science, and Embase were queried to identify studies that examined an association between minority stress (including prejudice events and conditions, anticipation of rejection and discrimination, concealment or disclosure of SGM identity(ies), internalized stigma, or structural stigma) and a biological health outcome among SGM people. Included studies were coded for methodological approaches, study population, minority stress measure, biological outcomes, count of overall analyses, and count of analyses where an association was detected. Fifty-nine studies met inclusion criteria and included a total of 391 analyses between an element of minority stress and a biological outcome, among which 38% of analyses detected an association (44% detected this association when study outliers were removed). All elements of minority stress demonstrated associations with outcomes: multicomponent measures, prejudice events and conditions, and structural stigma demonstrated the highest proportion of associations. Associations with minority stress were detected for general physical health, sleep, immune, cardiovascular, metabolic, hormonal, brain health, allostatic load, epigenetic and transcriptional regulation. The highest proportion of associations were detected among sleep, immune, cardiovascular, and hormonal outcomes. These studies evidence associations between minority stress and biological outcomes among gender minority people in addition to evidence among sexual minority people. Future research should consider increasing rigor in methodology and expanding our understanding of moderators and mediators of these relationships.
本文呈现了一项更新的系统评价，该评价识别了自我们2020年的前一项系统评价以来，于2019 - 2024年发表的研究，这些研究探讨了性少数和性别少数（SGM）人群中少数群体压力与生物学结果之间的关联。我们检索了PubMed、科学网和Embase，以识别那些研究少数群体压力（包括偏见事件和情况、对排斥和歧视的预期、SGM身份的隐瞒或披露、内化耻辱或结构性耻辱）与SGM人群生物学健康结果之间关联的研究。纳入的研究按照方法学途径、研究人群、少数群体压力测量方法、生物学结果、总体分析数量以及检测到关联的分析数量进行编码。59项研究符合纳入标准，共包括391项关于少数群体压力因素与生物学结果之间的分析，其中38%的分析检测到了关联（去除研究离群值后，44%的分析检测到了这种关联）。少数群体压力的所有因素均显示与结果存在关联：多成分测量、偏见事件和情况以及结构性耻辱显示出的关联比例最高。在一般身体健康、睡眠、免疫、心血管、代谢、激素、大脑健康、应激负荷、表观遗传和转录调控方面均检测到了与少数群体压力的关联。在睡眠、免疫、心血管和激素结果中检测到的关联比例最高。这些研究证明了在性别少数人群中少数群体压力与生物学结果之间的关联，此外在性少数人群中也有相关证据。未来的研究应考虑提高方法学的严谨性，并扩大我们对这些关系的调节因素和中介因素的理解。
