Clinical psychology review · 2026
A systematic review and meta-analysis of interventions addressing sexual and gender minority stress.
СтатьяСистематический обзорМетаанализПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Franco-Rocha Oscar Y, Trainum Katie, Triana-Orrego Juan Camilo, Ghazal Lauren V, Tunis Rachel, Beretvas S Natasha, Magnuson Allison, Mohile Supriya, Bono Madeline H, Henneghan Ashley M, Kamen Charles S
Аннотация
INTRODUCTION: Sexual and gender minority (SGM) populations experience health disparities linked to minority stress (socially-based stressors), including proximal (e.g., SGM internalized stigma) and distal stressors (e.g., negative bias from non-SGM people toward SGM individuals). We synthesized and evaluated the effectiveness of interventions reducing proximal and distal SGM stress.
METHODS: We followed PRISMA and Joanna Briggs Institute guidelines (CRD42024604568). Five databases were searched and eligible studies evaluated interventions reducing minority stress with sufficient data for effect size estimation. We estimated three-level multivariate meta-regression models for distal and proximal minority stress using restricted maximum likelihood estimation and robust standard error estimates.
RESULTS: Fifty-one studies (31 distal, 20 proximal) with 11253 participants (SGM n = 3168) were included. Distal stress interventions yielded a null-to-small pooled effect (g = 0.185, 95% CI = 0.078, 0.292). Psychological interventions had a small effect (g = 0.361, 95% CI = 0.178, 0.544) and outperformed psychoeducation and social contact-based interventions (-0.257 < β < -0.221, p < 0.05). For proximal minority stress, although the overall pooled effect was nonsignificant (g = 0.071, 95% CI = -0.154, 0.297) the intervention × outcome interaction was (Wald Q = 4.661, p = 0.005). Narrative therapy targeting identity affirmation showed a large pooled effect (g = 1.846, 95% CI = 1.032, 2.659). Pairwise contrasts using this intervention-outcome combination as reference indicated that psychoeducation and psychological interventions had greater effects on internalized stigma and perceived social support (2.172 < β < 2.719, p < 0.05).
CONCLUSION: Psychological interventions may reduce both proximal and distal stress. However, aligning interventions to specific minority stressors may yield greater benefit on SGM populations' health.
METHODS: We followed PRISMA and Joanna Briggs Institute guidelines (CRD42024604568). Five databases were searched and eligible studies evaluated interventions reducing minority stress with sufficient data for effect size estimation. We estimated three-level multivariate meta-regression models for distal and proximal minority stress using restricted maximum likelihood estimation and robust standard error estimates.
RESULTS: Fifty-one studies (31 distal, 20 proximal) with 11253 participants (SGM n = 3168) were included. Distal stress interventions yielded a null-to-small pooled effect (g = 0.185, 95% CI = 0.078, 0.292). Psychological interventions had a small effect (g = 0.361, 95% CI = 0.178, 0.544) and outperformed psychoeducation and social contact-based interventions (-0.257 < β < -0.221, p < 0.05). For proximal minority stress, although the overall pooled effect was nonsignificant (g = 0.071, 95% CI = -0.154, 0.297) the intervention × outcome interaction was (Wald Q = 4.661, p = 0.005). Narrative therapy targeting identity affirmation showed a large pooled effect (g = 1.846, 95% CI = 1.032, 2.659). Pairwise contrasts using this intervention-outcome combination as reference indicated that psychoeducation and psychological interventions had greater effects on internalized stigma and perceived social support (2.172 < β < 2.719, p < 0.05).
CONCLUSION: Psychological interventions may reduce both proximal and distal stress. However, aligning interventions to specific minority stressors may yield greater benefit on SGM populations' health.