Addressing Sexual and Gender Minorities Intersecting Structural Stigma: An Evidence-Based Holistic Care

Sexual and gender minorities (SGMs or LGBTQI+) are overburdened with health inequities, both medical and psychiatric disorders. SGM individuals also face minority stress (discrimination, marginalization, and microaggression) and different levels of stigma levied on them by society because of their SGM identity. The constellation of minority stress and stigma are compounded for SGM individuals with multiple intersecting minoritized identities (racial and ethnic minority [REM]). The confluence of these intersecting minoritized identities overwhelms healthy coping mechanisms leading to allostatic stress overload and negatively impacting health outcomes for SGM population, especially for REM SGM communities. Innovative structural- and clinical-level interventions that address the drivers of REM SGM health inequities are urgently needed. This chapter examines the use of civic engagement, education, community building, allyship, and other clinical interventions to address SGM intersecting structural stigma while also providing evidence-based point-of-care resources for clinicians and SGM individuals. An in-depth analysis of a conversation between SGM health researchers Dr. Agor and Mr. Daici further illuminates the need for a radical shift in how the healthcare system and society treat SGM populations, thus providing experiential evidence for widely documented phenomena among SGM people.