Investigation of Health Risk Patterns Across Sexual and Gender Minority Identities

The Minority Stress Model posits gender and sexual minorities experience stigma-related stressors, that increase their risk for poor mental and physical health. Historically, these groups have been considered one “community” (lesbian, gay, bisexual, transgender, queer: LGBTQ), with similar experiences including: shared social groups and deviation from gender norms (e.g. gender roles and expression, and relationships). As research into the experiences of LGBTQ individuals increases, evidence supports people with different sexual orientations (e.g. lesbian/gay vs. bisexual) and gender experiences (e.g. cisgender vs. transgender) within the community are diverse, and should not be researched as one population. By researching each gender and sexual orientation individually, we can capture the diversity of experiences and uncover specific public health needs for each subgroup. As this perspective expands, our understanding of health needs for lesbian and gay individuals continues to develop. However, less represented LGBTQ subgroups (e.g. bisexual and transgender) remain understudied. This dissertation consisted of three manuscripts investigating minority stress and health behaviors across trans and nontrans genders among LGBTQ identified individuals. Transgender (N=460) and cisgender (nontransgender) LGBQ (N=523) individuals were recruited from trans and LGBT-related social networks. All three manuscripts utilized the same data. The first manuscript examined the measurement invariance of the Everyday Discrimination Scale (EDS) and the Discrimination-Related Vigilance Scale (DRVS) across transgender and cisgender gender identities. Partial metric invariance was found across trans and cis, and across gender within trans respondents for the EDS. Full scalar invariance was found across trans and cis for the DRVS, but partial metric invariance across gender within trans individuals. In general, transgender individuals reported more perceived discrimination and vigilance. The second manuscript compared the rates of health behaviors across LGBTQ genders to investigate the distinct health risks for each group. After accounting for age, most differences across gender identity and trans status were small. The largest differences were found in vegetable consumption and psychological distress. Cisgender women reported more vegetable consumption than all other groups. On average, transgender men, women, and nonbinary-identified individuals reported more depression and anxiety than cisgender men and women. The third manuscript examined subtypes of physical activity across transgender and cisgender groups with replicated cluster analyses. The same five cluster subtypes were found across 2 subsamples of transgender and 2 subsamples of cisgender respondents: (1) Overall Active, (2) Vigorous Active, (3) Moderate Active, (4) Walkers, and (5) Inactive. On average, individuals in the overall active and vigorous active subtypes rated their overall health higher than people in the other subtypes