Evidence map›Paper›PMID 39848993›Full record

ArticleScientific reports2025

Relationships between structural stigma, societal stigma, and minority stress among gender minority people.

Kristen D Clark, Mitchell R Lunn, Jae M Sevelius, Carol Dawson-Rose, Sandra J Weiss, Torsten B Neilands, Micah E Lubensky, Juno Obedin-Maliver, Annesa Flentje

Abstract read
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In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kristen D ClarkDepartment of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden. Kristen.Clark@uu.se.
Mitchell R LunnThe PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA.
Jae M SeveliusCenter for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, CA, USA.
Carol Dawson-RoseDepartment of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA.
Sandra J WeissDepartment of Community Health Systems, UCSF Depression Center, University of California, San Francisco, CA, USA.
Torsten B NeilandsCenter for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, CA, USA.
Micah E LubenskyThe PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA.
Juno Obedin-MaliverThe PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA.
Annesa FlentjeThe PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA.

Funding

Gene expression outcomes in interventions for substance using HIV+ minority menK23DA039800 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI FLENTJE, ANNESA · 2015 to 2019
$1.0M
Mentoring clinical investigators in patient-oriented research on substance use and HIVK24DA051328 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SEVELIUS, JAE M. · 2020 to 2024
$771k
The Relationship of Stressors in Health Care to Emotional and Physical Symptoms Experienced by Marginalized PeopleF31NR019000 · NINR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CLARK, KRISTEN DREW · 2019 to 2021
$68k
NIDA NIH HHS K23 DA039800NIDA NIH HHS K24 DA051328NINR NIH HHS F31 NR019000
6 · The paper itself

Abstract

Structural stigma towards gender minority (GM; people whose current gender does not align with sex assigned at birth) people is an important contributor to minority stress (i.e., stress experienced due to one's marginalized GM identity), although existing variables are unclear in their inclusion of social norms, or societal stigma, as a key component of the construct. We examined potential variables representing structural stigma, including variables that are inclusive of societal stigma, to identify those that most strongly relate to minority stress outcomes. We tested variables identified in the literature as measures of structural stigma inclusive of societal stigma (LGBT + Business Climate Index, state voting behaviors, and Google Trends search data), the most commonly used structural stigma variable (State Policy Environment Tally), and proxy variables (region, population density) for comparison. The relationships between structural stigma and minority stress model outcomes were tested in a sample of GM participants from The Population Research in Identity and Disparities for Equality (PRIDE) Study (N = 2,094) 2019 Annual Questionnaire using a structural equation model (SEM). Lower structural stigma (i.e., higher LGBT Business Climate Index) was associated with lower experienced stigma (β= -0.260, p < .01) and lower anticipated stigma (β= -0.433, p < .001). Greater conservative voting behavior was associated with less experienced stigma (β= -0.103, p < .01). Living in a more densely populated county was also associated with lower anticipated stigma (β=-0.108, p < .001) and greater identity outness (β = 0.053, p < .05). Two of the identified structural stigma variables that were inclusive of societal stigma (i.e., LGBT + Business Climate Index, conservative voting behaviors) and one proxy variable (population density) were associated with minority stress outcomes. However, the most commonly used variable for structural stigma (State Policy Environment Tally) was not associated with any outcomes. The State LGBT + Business Climate Index showed the most promise for use as a structural stigma variable in future research. The application of this variable should be investigated further to explore its association with health outcomes and to inform efforts to reduce health equity barriers experienced by GM people through addressing structural stigma in a manner inclusive of societal stigma.

Indexed as

Minority GroupsSexual and Gender MinoritiesSocial StigmaStress, PsychologicalAdultFemaleHumansMaleMiddle AgedSurveys and QuestionnairesYoung AdultGender minorityMinority stressPolicySocial attitudesStigmaStructural stigmaTransgender

Identifiers

PMID39848993
PMCPMC11757992

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.