LGBTQ+ Health and Wellbeing Research Group
Unit(s) of assessment: Psychology, Psychiatry and Neuroscience
Research theme: Health and Wellbeing
School: School of Social Sciences
The LGBTQ+ Health and Wellbeing Research Group aims to better understand the lives of this community, especially the minority stress they may experience and the consequential adverse health outcomes.
Our research is concerned with the experiences LGBTQ+ people have themselves, and explores the attitudes hetero-cisnormative people hold towards LGBTQ+ people with the aims of improving attitudes.
Our research also explores the intersections of being LGBTQ+ with other aspects of experience such as race, disability, and class, and how LGBTQ+ people navigate multiple, intersecting forms of structural inequalities.
Case studies of recent research
Living on the margins of society - community belonging, connectedness, and loneliness among the trans and gender-diverse community
Loneliness is considered a public health priority given the increase in the number of people in society feeling lonely, especially following the COVID-19 pandemic. However, loneliness is not experienced equally across society and some communities have been found to be particularly vulnerable, such as trans and gender-diverse (TGD) people.
Even within the UK, where aspects society has been progressive in terms of its LGBTQ+ rights, TGD people still experience discrimination and margination on a daily basis. In the general population (cisgender heterosexual communities), it is these experiences that have been found to be associated with experiences loneliness. However, research with vulnerable populations, such as TGD people is lacking.
Over the past few years, members of the LGBTQ+ Health & Wellbeing research group have drawn their attention to this under-researched area which has involved the projects below.
It has been acknowledged that vulnerable populations were and continue to be disproportionately affected by the pandemic. This research found that TGD youth were one of these populations.
An online survey between May and July in 2020 (when the UK was experiencing is most stringent social distancing regulations) with 161 people found mental health to have deteriorated in this community.
Specifically, a lack of social support, negative interpersonal interactions (often with family) and non-affirmative living environments all contributed.
The full article can be accessed here: Jones, B. A., Bowe, M., McNamara, N., Guerin, E., & Carter, T. (2021). Exploring the mental health experiences of young trans and gender diverse people during the Covid-19 pandemic. International Journal of Transgender Health. DOI: 10.1080/26895269.2021.1890301
Staff: Dr. Beth Jones (PI), Dr. Juliet Wakefield, Kim Szolin (research assistant).
External collaboration: Dr. Tim Cater (University of Nottingham), Dr. Mhairi Bowe (Heriot Watt University)
Gender-affirming support from one’s family is psychologically protective for trans and gender diverse (TGD) youth. However, the psychological processes through which family-based support predicts wellbeing within this population are not understood.
Using the Social Identity Approach to Health we addressed this gap with a sequential mixed-methods design involving the recruitment of TGD youth.
Study 1 utilised an online survey (N=140) to demonstrate that family identification predicted reduced symptoms of anxiety and depression and increased wellbeing, which was mediated by increased social support and reduced loneliness.
Study 2’s semi-structured interviews (N=27) revealed that family support was perceived to be imperfect, which could increase feelings of loneliness. T
hus, to complement and enhance the support available from family, TGD young people created a ‘family of choice’ which was comprised of others from the TGD community. This chosen family was perceived as increasing feelings of belonginess and wellbeing, although barriers to maintaining connections with members of one’s chosen family were experienced because of COVID-19 restrictions.
Together, these studies provide a novel framework to understand how and why family support (from both biological non-biological families) can be protective and/or harmful for young TGD people’s wellbeing.
Staff: Chase Staras (PhD Candidate), Dr. Beth Jones (Director of studies), Dr. Juliet Wakefield, Prof Daragh McDermott.
Collaboration: Nottingham Centre for Transgender Health, Indigo Gender Service
Care at Gender Identity Clinics (GICs) focusses on supporting trans and gender diverse (TGD) people (i.e., those experiencing incongruence between their gender assigned at birth and their gender identity) through their medical transition (i.e., hormones, surgery).
This approach has limitations: not every TGD person seeks medical transition, while all TGD individuals (regardless of whether they undergo a medical transition) are at risk of mental ill-health. Consequently, there is a need for a more holistic approach to TGD healthcare that also supports clients psychologically and emotionally.
The poor mental health commonly experienced by TGD people is thought to have a social cause. Due to their minority identity, many experience frequent discrimination, stigma, and harassment. When transitioning, many also become estranged from important social networks. On the margins of society, there is limited opportunity for meaningful social interaction, and feelings of loneliness (a well-established predictor of depression) are commonplace.
Within the general population, rising levels of loneliness have been addressed through Social Prescribing (SP) initiatives. These involve clients being signposted to and supported in their joining of local community groups (e.g., gardening groups, craft groups). SP has been used successfully with minority groups (e.g., ethnic minorities). According to the Social Cure perspective, which emerged from the Social Identity Approach, the health-related benefits of SP derive from an increased sense of group belongingness, social support, and reductions in loneliness. Nonetheless, despite its theoretical evidence base and relevance, SP is yet to be specifically used with TGD people. This PhD is therefore exploring the effectiveness of SP for TGD people.
Exploring the psychosocial influences on the decision to take pre-exposure prophylaxis amonst Men who have Sex with Men
Staff: Anthony Gifford (PhD Candidate), Prof. Daragh McDermott (Director of Studies), Dr. Beth Jones.
External collaborators: Prof. Rusi Jaspal (University of Brighton)
Pre-exposure Prophylaxis (PrEP) is an established biomedical intervention to help prevent and reduce new Human Immunodeficiency Virus (HIV) infections worldwide. This novel medication is a combination drug of Tenofovir/Emtricitabine, with significant clinical efficacy at preventing users from contracting HIV, even when exposed to the virus. Recent advancements in NHS England policy now make PrEP accessible by certain at-risk populations for free. However, uptake, usage and, adherence, even amongst those deemed clinically at risk of HIV, are inconsistent.
This PhD is broadly exploring a range of psychosocial factors associated with PrEP usage amongst the MSM community. Specifically, it explores the psychological and social influences within the lived experiences of MSM individuals that impact PrEP uptake, usage, and adherence. These influences are often related to stigma, misinformation and social representations of PrEP in a MSM context.
Findings from the PhD are already showing that the stigma towards PrEP is evolving. What was once quite overt, is becoming much more discrete in line with microaggressions both towards PrEP and those who take it. The collective trauma of the HIV/AIDS epidemic is also a large contributing factor to the decision to take PrEP. However, we are also finding positive impacts of PrEP usage both at an intra-personal level as well as at a community level. The impact of this work will hopefully shape the future of public health interventions and allow more informed campaigns to target specific populations and eradicate novel stigmas towards HIV PrEP.
Check out this video for more information about this research, part of our Re:searchers Re:vealed campaign.
International Partnership for Queer Youth Resilience (INQYR)
Staff: Prof. Daragh McDermott, Chase Staras, Anthony Gifford, Liam Cahill, Cameron Glen.
The International Partnership for Queer Youth Resilience (INQYR) is an interdisciplinary and multilingual international research partnership designed to understand and support the resilience of LGBTQ+ youth through technology-engaged research. Led by the University of Toronto, the partnership aims to contribute to a deeper understanding of LGBTQ+ youth resilience that is inclusive of multiple regional contexts in an increasingly digitized world. INQYR aims to do this by using technology-engaged research methods, such as digital photo elicitation, and engaging in technology-focused research with LGBTQ+ youth. INQYR delivers a 2-year training programme for postgraduate researchers working with LGBTQ+ youth through its International Student Training Network (ISTN). AutOnoMe is the first project to emerge from this partnership.
AutOnoME examined how autistic gender minority youth (GMY) experience online spaces. Specifically, how they negotiate and navigate their identities through and within these online spaces. This topic has increasing importance given the disproportionately high levels of discrimination autistic GMY experience due to their intersectional identities, compounded by their expanded use of online platforms (including the variety and greater amount of online discrimination compared to in person interactions).
To better understand autistic GMY experiences, one-to-one semi-structured interviews which included photo elicitation methods were conducted with 18 autistic GMY. This permitted first-hand understandings of autistic GMY online lives which were enhanced by participant images. Participants were recruited through various social media platforms with the support of the research team, INQYR and stakeholders.
Data was analysed using Reflexive Thematic Analysis. Overall, the findings highlight how the current social climate encourages autistic GMY to explore and validate their identities within online spaces. Our participants observed online spaces as safe spaces to do this due to their anonymity, and the opportunity to connect with similar others. Whilst reports of online discrimination and accessibility issues were also prevalent, the benefits outweighed the costs.
This research was timely in gaining sight into the safety and effectiveness of online spaces to better understand how accessibility can be managed, and the lives of autistic GMY improved. This work additionally extended current research methods used with autistic GMY, emphasizing how visual research methods can encourage a naturalistic route into participatory and emancipatory research; vital for seeing beneficial parallel movements in evidence-based practice.
To explore the lived experiences of trans and gender-diverse prisoners residing in the women's prison estate
Staff: Sally Evans (PhD Candidate), Prof. Daragh McDermott (Director of Studies), Dr. Beth Jones, Sally Lopresti.
Prisons assume there are only two genders. Prisoners generally reside in an establishment based upon their legal gender, which for the majority of prisoners is the same as their sex as assigned at birth. Most trans and gender diverse (TGD) prisoners therefore reside within an establishment which does not align with their gender identity, where it is reported that they are at greater risk of verbal, physical and/or sexual abuse.
There is a paucity of research into the lived experience of TGD prisoners, with the majority having been conducted within the USA and with trans women residing within male prisons. However we cannot automatically assume that this would relate to all TGD prisoners residing within women’s prisons. To date, there has been no specific empirical work completed with trans men, non-binary, and/or gender fluid individuals residing in a women’s estate. Therefore, I am undertaking research to explore the lived experiences of TGD prisoners residing in the women's prison estate in England and Wales. The research will apply a qualitative methodology, involving interviews with TGD prisoners within the women’s prison estate.
Exploring the experiences that TGD prisoners have within custody will provide insight which can be used to improve understandings of what works and how the service could be improved. Developing insight into TGD prisoners’ experiences will allow for consideration of how their risks and needs are being met within custody, and how well they are progressing through their sentence plan and therefore whether they are receiving high-quality sentence management. It is proposed that participants may offer insights into how their progression can be supported more effectively by HMPPS.
- Dr Beth Jones, Senior Lecturer in Psychology (Social and Health)
- Professor Daragh McDermott, Associate Dean for Psychology (LGBTQ and Social)
- Dr Bryony Harper, Lecturer in Psychology (Counselling and Psychological Therapies)
- Professor Jon Arcelus, Visiting Professor in Psychology (Psychiatry and Trans Health)
- Dr Nat Thorne, Visiting Fellow in Psychology (Trans Health)
- Dr Belinda Winder
- Dr Danai Serfioti
- Dr Fil Cristino
- Dr Mohammed Malik
- Dr Stephanie Davis
- Dr Treshi-Marie Perera
- Dr Rachel Philips
- Dr Ian Stephen
- Dr Juliet Wakefield
- Sally Lopresti
- Anthony Gifford
- Chase Staras
- Cameron Glen
- Sally Evans
- Shem Williams
- Stephan Eccles
- Liam Cahill