A biopsychosocial framework for understanding sexual and gender minority health: A call for action

Lisa M. Christian, Steve W. Cole, Thomas McDade, John E. Pachankis, Ethan Morgan, Anna M. Strahm, Claire M. Kamp Dush

Research output: Contribution to journalArticle

15 Scopus citations


The number of US adults identifying as lesbian, gay, bisexual, transgender, or a different sexual identity has doubled since 2008, and about 40 % of the sexual and gender minority population identify as people of color. Minority stress theory posits that sexual and gender minorities are at particular risk for stress via stigma and discrimination at the structural, interpersonal, and individual levels. This stress, in turn, elevates the risk of adverse health outcomes across several domains. However, there remains a conspicuously limited amount of research on the psychoneuroimmunology of stress among sexual and gender minorities. We developed the Biopsychosocial Minority Stress Framework which posits that sexual minority status leads to unique experiences of minority stress which results in adverse health behavioral factors, elevated psychological distress and sleep disturbance, and immune dysregulation. Moderators in the model include both individual differences and intersectional identities. There is a crucial need to understand the biological-psychological axis of stress among the increasingly visible sexual and gender minority population to increase their health, longevity, and quality of life.

Original languageEnglish (US)
Pages (from-to)107-116
Number of pages10
JournalNeuroscience and Biobehavioral Reviews
StatePublished - Oct 1 2021

Bibliographical note

Funding Information:
This review article was supported by the Eunice Kennedy Shriver National Institute for Child Health and Human Development (NICHD) of the National Institutes of Health through the Ohio State University Institute for Population Research (IPR) grant P2CHD058484 (pilot grant to LMC & CMKD) and 1R01HD094081-01A1 (CMKD). Support was also provided by the Minnesota Population Center ( P2CHD041023 ) and a seed grant from the Ohio State University Department of Psychiatry & Behavioral Health and the Norman Browning Family Research Fund (LMC & CMKD).

Publisher Copyright:
© 2021 Elsevier Ltd


  • Biopsychosocial
  • Gender minority
  • Same-sex
  • Sexual minority
  • Stigma
  • Stress


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