Q&A: Promoting a sense of belonging for LGBTQ+ people may lessen health issues

June is Pride Month, an excellent occasion to celebrate and reflect on the many strides the LGBTQ+ community has made in American society in recent decades.

That said, lingering stigmas persist, causing LGBTQ+ people significant stress and leading to higher rates of physical and mental health issues than cisgender heterosexuals. For Jes Matsick, associate professor of psychology and women's, gender and sexuality studies, and several Penn State colleagues, the subject served as the impetus for a review article recently published in the journal Nature Reviews Psychology.

Matsick and co-writers Jonathan Cook, associate professor of psychology, psychology graduate students Jude Sullivan and Emerson Todd, and doctoral program alumna Mary Kruk examined conditions that give LGBTQ+ people the chance to thrive, finding in particular that a sense of belonging can effectively lessen their various health problems.

The researchers summarized factors found within psychological, public health and public policy literature that contribute to a sense of belonging for LGBTQ+ people at the individual, interpersonal, community and societal levels.

"Our multi-pronged approach," they wrote, "encourages the flourishing of LGBTQ+ people as individuals while addressing structural forces that shape their psychosocial well-being."

Matsick, who runs the University's Underrepresented Perspectives Lab, recently discussed some of the group's findings.

How did the idea for the article come about?

I was invited to contribute a review article about LGBTQ+ people's psychological experiences. There is a lot of research about the challenges that LGBTQ+ face and, while we find that work to be important for exposing stigma—e.g., homophobia, transphobia, racism—we wanted to showcase how LGBTQ+ can thrive too.

A way to do that is to think about their sense of belonging and pathways toward strengthening their belonging. Also, we didn't want to put the responsibility of belonging on LGBTQ+ people themselves, so we took a multi-level approach to think about how individuals, communities and societies can interactively enhance belonging for LGBTQ+ people.

What was it about the concept of belonging within the LGBTQ+ community that interested you, and how did it fit within your broader research interests?

Belonging has always interested me because it is such a fragile yet powerful psychological state. The need to belong is a fundamental human need. It varies moment to moment and place to place, and it has a tremendous influence on our overall well-being. Much of my research is focused on how to strengthen people's sense of belonging and I particularly focus on people who often get messages that they don't belong, based on gender, sexual orientation, race, body type, etc. This review article provides space for us to review our own work alongside that of others. It includes nearly 300 references.

What were some of the primary takeaways in terms of the relationship between a sense of belonging and better mental and physical health outcomes for LGBTQ+ people?

One key takeaway from our article is that efforts to improve belonging for LGBTQ+ people work best when we target multiple levels that have influence on people's psychological belonging. For example, creating and protecting LGBTQ+-friendly community spaces is a great idea, but we also need to attend to dynamics and tensions within people's households and families.

Or, while intervening within schools and workplaces to strengthen the belonging of LGBTQ+ students and employees is useful, we likewise need to advocate for higher-order laws and policies. Our goal is to encourage a cross-level approach to increase belonging—one that promotes the flourishing of LGBTQ+ people as individuals while critically addressing structural forces that contribute to belonging too.

Belonging can also positively contribute to physical health. Generally speaking, when LGBTQ+ people feel like they belong, they might feel less stress, and stress is known to lead to chronic health conditions like cardiovascular disease and inflammation. More work in this area is needed, but we suggest that belonging would be a promising mechanism of both psychological and physical health.

Also, it is worth noting that a sense of belonging within health care contexts can be particularly important for building relationships between LGBTQ+ people and medical personnel to ensure preventative, routine and higher-quality health care for LGBTQ+ people.

What are some specific ways LGBTQ+ people can feel more of a sense of belonging?

We included a large table in our article to summarize what can be done to improve belonging. For example, at the level of the individual, the literature suggests that coming out—or disclosing one's identity—to supportive others had a positive impact on LGBTQ+ people's belonging.

At the interpersonal level, various types of positive relationships can help people feel a greater sense of belonging, such as having affirming parents, healthy sexual and/or romantic relationships with others, or what we refer to as "chosen family," which are close and caring relationships that are built beyond families of origins and, in some ways, provide the love and intimacy that LGBTQ+ individuals might lack from those who are more traditionally considered "family."

At the community level, LGBTQ+-centered spaces and neighborhoods are positively related to belonging, as are the presence of LGBTQ+ and allyship networks at works and schools, including gay-straight alliances.

At the level of society, anti-discrimination protections are positively related to belonging, and so are what we call "identity safety cues," i.e., cues within a given situation that signal to LGBTQ+ people that they are safe or valued in that setting and unlikely to experience stigma based on their sexual orientation and gender identity. My lab has published several papers, and have others in progress, about how safety cues help to boost LGBTQ+ people's sense of belonging in various settings.

You put together a group of Penn State-affiliated collaborators for the project. Why was that important to you?

Our authorship team represents researchers across different academic ranks, racial and ethnic identities, sexual orientations, gender identities and generations. The diversity within my research team is a major strength. We each brought unique insights to the work based on our interests, expertise and different life experiences. It was also the first of hopefully many opportunities that I will collaborate with my friend and Penn State colleague Dr. Jonathan Cook. He brings a great deal of expertise in thinking about intervention and issues surrounding identity disclosure and concealment.

Further, as a mentor, I was eager to provide two of my co-authors—Emerson Todd and Jude Sullivan, doctoral students in psychology and women's, gender, and sexuality studies—with their first opportunity to write and contribute to such a high-impact journal article.

I'm a very hands-on adviser and I wanted them to be actively engaged in reading and writing for this article. I assigned each of them to a smaller section of the paper that the team had outlined together. We traded drafts of sections, worked through edits and comments, and followed similar procedures in the journal revision process too. Overall, it was an effective learning opportunity for my students and rewarding for me to see them understand academic publishing better through this experience.

Do you intend to pursue additional research related to the topic?

Yes, we have several projects in progress about belonging. For example, Emerson and I are examining the information that transgender people rely on to determine their belonging as they navigate different situations. And Jude and I are studying belonging among older LGBTQ+ adults, who often contend with social isolation, loneliness and various forms of stigma, such as ageism and homophobia.

Overall, my research lab appreciates the power of belonging and we want to understand what can be done to improve it.