Stress Processes and Resilience Pathways of Sexually and Gender Diverse Communities: A Narrative Review of 15 Years of Evolving Research Priorities and Practices.

Sexually and gender diverse (SGD) people in North America have navigated significant sociopolitical shifts that continue to shape their lived experiences. Given the persistent exposure to stigma, SGD communities are disproportionately vulnerable to stress-related health disparities. While sexual and gender minority stress models highlight the detrimental impact of stigma, research also emphasizes the role of protective factors and resilience pathways in mitigating these effects. This narrative review of my research program over the last 15 years explores stress physiology as a potential mechanism linking stigma to long-term health and wellness trajectories among SGD populations. Through a selection of key findings and that of my collaborators, I discuss the physiological underpinnings of stress adaptation among SGD people and our evolving research approaches in partnership with the community. Specifically, my work examines allostatic load, a measure of cumulative physiological "wear and tear" resulting from chronic stress. While our initial work focused on the impacts of marginalization, this work increasingly highlights the strengths and adaptive capacities within SGD communities. By bridging stress physiology with resilience frameworks, we aim to inform interventions that promote health equity and well-being for SGD communities worldwide.