Open research questions in LGBTQ Health, Identity, and Policy

What the literature leaves open

• 14 Transformational learning suggests that simply providing information is insufficient; instead, clinicians benefit from structured opportunities to reflect on their assumptions, practice new skills, and receive feedback in psychologically safe environments.

  Preparing Pediatric Hospital Medicine Physicians to Care for Transgender Youth: A Call to Action · 2026 · DOI

• ”5While previous research has examined the care of TGD youth in inpatient psychiatric care, primary care, and emergency settings,6 there remains a gap in understanding the perspectives of pediatric hospital medicine (PHM) physicians.

  Preparing Pediatric Hospital Medicine Physicians to Care for Transgender Youth: A Call to Action · 2026 · DOI

• Abstract Objective This study was conducted to fill a gap in the literature with regard to unique challenges and assets faced within the relationships of transgender and nonbinary (TNB) individuals with cisgender partners.

  Acceptance, Disclosure, and Relationship Maintenance Strategies in Transgender and Nonbinary Individuals with Cisgender Partners · 2026 · DOI

• Despite the importance of affirmative practice within disability services, limited research has examined factors associated with DSPs’ self-efficacy in providing LGBTQ+-affirmative services and care to individuals with IDD.

  Knowledge, affirmativeness, and experience as factors associated with self-efficacy in LGBTQ+-affirmative services for individuals with IDD · 2026 · DOI

• Future research should consider measuring multiple components of religiosity to better understand the role of religiosity in attitudes toward TNB people, as well as whether attitudes vary as a function of specific religious denomination. As the scope of this study was limited to the screening component of recruitment, it is unclear whether these find- ings would be observed in other aspects of the recruitment process, such as interviews. Sex Roles (2026) 92:37 1 3 37 Page 12 of 15 There is a need for further research on whether those who are politically conservative discriminate against transgen- der men, transgender women, non-binary individuals, and other gender diverse identities (e.

  Discrimination Toward Transgender and Non-Binary People: The Moderating Roles of Political Conservatism and Religiosity in Hiring Decisions · 2026 · DOI

• Future research should explore students’ perspectives on how teachers teach LGBTQ+-inclusive topics and the potential impact on peer victimization and school climate.

  LGBTQ+ Students’ Perspectives On School Safety: a Qualitative Study · 2026 · DOI

• Limited research exists to identify specific symptoms that may indicate increased risk of suicidality among Black transgender women who do not disclose SI-limiting clinicians' ability to identify those at risk of suicidality.

  A Comparison of Post‐Traumatic Stress and Depressive Symptoms by Suicidal Ideation Among Black Transgender Women · 2026 · DOI

• Background The HIV-related needs of transgender and gender diverse (TGD) people who have sex with men in Australia are under-researched, impeding the effective use and targeting of HIV and sexual health services.

  Assessing the HIV prevention needs of transgender men and non-binary people who have sex with men: an analysis of repeated, cross-sectional behavioural surveillance, 2019–2023 · 2026 · DOI

• The sampling technique combined with a relatively short period of data collection is a limitation of the study. The potential issue with the sampling technique lies with the hashtags used to find videos with transgender content. Searching hashtags such as transgender and genderdiverse provided videos that were generally positive; therefore, to access a range of videos, the first author used search terms such as conservative and antitrans. Even outside of TikTok, the concept of the transgender individual is often a polarizing topic of debate. We might assume that if one is neutral about a certain topic, they will not create content about it on social media. Despite this, the search terms used in this study may have led to somewhat divided areas of the issue. A longer period of data collection would have allowed the “for you” page to provide transgender-related videos over time on multiple accounts to ameliorate this potential limitation. Another limitation of this study is our exclusion of the comments section on the TikTok videos. While this study focused on the rich data of the TikTok videos themselves, the comments sections may have provided useful information on whether the videos were being praised or rejected. This information could give us further insight into public perceptions of TGE children and topics.

  Children and Parents Learning About Transgender Topics Through TikTok · 2026 · DOI

• Future research should examine how policies affect, for example, trans staff on precarious contracts, queer and trans people of color, disabled LGBTIQ+ students, or LGBTIQ+ refugees and migrants in higher education.

  LGBTIQ+ Inclusion Policies in Higher Education and Research: A Critical Scoping Review · 2026 · DOI

• The scale of this study and its diverse populations led to some technical issues. To reduce respondent burden, a rout- ing system was used. Despite pre-testing, this introduced routing errors and missing data for some variables. The data are subject to three main sources of bias: unequal internet access and varying reliance on dating apps; self-selection bias (Evans et al., 2007; Mercer et al., 2016; Prah et al., 2016) and difficulty ensuring equivalent meaning across different language versions of the questionnaire. Geopolitical changes during the survey period also affected data collection. Some countries were excluded from funding for political reasons, and conflict hampered participation in other areas. Representative samples of MSM, transgender and non- binary people are unavailable, so EMIS participants are unlikely to be fully representative. However, online sam- ples of homosexually active men tend to be more diverse than those recruited through gay venues and are broadly demographically representative for MSM who have sex exclusively with men (Prah et al., 2016). This is not yet demonstrable for trans or non-binary people due to a lack of health data. Online recruitment via dating apps offers efficient access to key populations for HIV prevention and care. Geolocation features allow targeted outreach, and trust in familiar organisations boosts participation (Ocasio et al., 2021). Younger MSM tend to see dating apps as a typi- cal way of meeting partners (Arthur & Cabaniss, 2021). Those recruited via dating apps tend to be younger, more sexually active, engage in more risk and precautionary behaviours, and report more sexual harms (Prah et al., 2016)— an important focus within EMIS-2024. As these groups are the target of prevention efforts, these recruit- ment biases are acceptable. Engagement is also enhanced when people feel the survey is relevant and impactful (Brosnan et al., 2019). In this respect, receiving dedicated long-term core fund- ing — as EMIS did in previous rounds through the EU Health Programme — can lend greater authority, includ- ing in relation to national public health institutions. The EMIS-2024 experience also highlights that, in many countries across the WHO European Region, collabora- tion between NGOs and governmental bodies could be strengthened. Moreover, the defunding of HIV preven- tion in several countries has negatively affected both the capacity and willingness of community organisations to engage in such studies. For national stakeholders, how- ever, it may be more cost-effective to conduct fewer standalone studies in this population and instead rely on international approaches that produce comparable data across countries. Multilingual surveys help include ethnic minorities and expand the scope of questions (Im et al., 2016). Offering EMIS in 35 languages improved accessibility and may have yielded samples more representative of MSM diversity, especially among migrant MSM, than other convenience sampling approaches. Nonetheless, translation challenges remain. Cultural and linguistic differences can distort meaning. Instruments developed in one cultural context may not translate seam- lessly to another (Im et al., 2016). Both qualitative and statistical checks are necessary to ensure conceptual equiva- lence (Ware et al., 1995). Using gender-neutral language in translations posed fur- ther issues, especially in languages with gendered grammar (e.g., German, French, Italian, Spanish, Portuguese, Greek), or non-gendered languages (e.g., Turkish, Hungarian) (Hord, 2016).

  European Men-Who-Have-Sex-With-Men and Trans People Internet Survey (EMIS-2024): Design and Methods · 2026 · DOI

• Much remains unknown about those experiencing greater marginalisation. While there is conflicting evidence whether gay fathers locate themselves among other gay and lesbian parents (Armesto and Shapiro 2011 ; Goodfellow 2015 ), these Canadian gay fathers do not do so.

  The Gay Parental Turn: Canadian Gay Fathers and the Reorganization of Care and Community · 2026 · DOI

• Second, the causes of the changed profile of patients referring to gender clinics, now relatively many more natal females with adolescent onset GD and co-occurring mental health problems than before 2010, are poorly understood.

  The moral case for non-medical interventions in adolescents with gender dysphoria · 2026 · DOI

• Our findings indicate that while ensemble names are largely moving toward inclusivity, other categories—particularly concert attire, housing, and voice part assignment—vary widely in how they might impact TGX students.

  The voice of policy: a national content analysis of “gendered” U.S. All-State choir policies · 2026 · DOI

• Parental acceptance moderated the impact of peer-based WBV, but not parental WBV, on some DEBs Future research should explore these intersections and moderations longitudinally.

  LGBTQ+ Familial Acceptance as a Moderator Between Weight-Based Victimization and Disordered Eating Behaviors Among LGBTQ+ Youth · 2026 · DOI

• Due to limited research, little is known about gay male soldiers and police officers’ encounters with cisheteronormative occupational cultures in their training experiences post-1994.

  Navigating Cisheteronormativity in Military and Police Training: Experiences of Black Gay Male Soldiers and Police Officers in South Africa · 2026 · DOI

• Although an increasing number of LGBTQ+ individuals are becoming parents, their experiences of sex during pregnancy and postpartum have not been studied.

  LGBTQ+ Couples’ Sexual Health Experiences During Pregnancy and Postpartum: A Qualitative Survey Study · 2026 · DOI

• Prevention programs rarely addressed the specific risks LGBTQ+ students encounter, and school staff often lacked the training or authority to respond effectively.

  Navigating vulnerability: LGBTQ+ students’ experiences of child sexual abuse in Thai schools · 2026 · DOI

• The research addresses a significant gap in the literature by focusing on CSA through an LGBTQ+ lens in a Southeast Asian context, highlighting systemic neglect and the need for inclusive safeguarding measures.

  Navigating vulnerability: LGBTQ+ students’ experiences of child sexual abuse in Thai schools · 2026 · DOI

• Despite these limitations, the study offers important insights into a highly under-researched population and sets the stage for larger-scale and longitudinal studies on CSA risks among LGBTQ+ youth in Southeast Asia.

  Navigating vulnerability: LGBTQ+ students’ experiences of child sexual abuse in Thai schools · 2026 · DOI

• Little is known about the role that a bi + person’s partner/s plays in shaping their experiences of minority stress—in particular, the gender of the partner can frame the relationship as either heteronormative-presenting or queer-presenting, meaning the gender of the partner has the potential to be both protective and a risk factor.

  Exploring How Bi + People Differently Experience Minority Stress Events According to the Gender of Their Partner/s · 2026 · DOI

• Drawing on Kuhn’s account of paradigms and the theory-ladenness of observation, I show that disagreements in paediatric gender medicine reflect not merely gaps in knowledge but deeper metaphysical and normative divergences about sex, gender, health, human development, and the legitimate goals of medical intervention.

  Why Do the Bells Toll? · 2026 · DOI

• The study’s innovation lies in its adoption of a comprehen- sive framework that encompasses the entire displacement continuum, from pre-migration experiences to post-arrival integration challenges. Given our focus on Spain, a coun- try with evolving policies towards LGBTIQ+ rights and a growing influx of refugees, this research offers timely insights into how host countries can better support the unique needs of LGBTIQ+ migrants. The study’s findings will inform policy and practice, enhancing the capacity of social services and healthcare providers to address the com- plex mental health and social inclusion needs of this vulner- able population. The current study has limitations that should be consid- ered. The methods adopted are suitable for describing and interpreting the phenomenon studied, but do not allow for transferibility of the findings. Secondly, in alignment with qualitative methodology, the study prioritized the depth and richness of the narratives over numerical quantity. The pur- posive sampling criteria effectively facilitated data satura- tion, thereby ensuring the credibility and rigorousness of the findings. Regarding data processing, interviews were conducted in Spanish, English, and Farsi, and were subse- quently translated and analyzed in Spanish. For the purpose of this article, the findings were translated into English. While it is possible that some subtle nuances may have been lost during this process, bilingual experts working in con- stant interaction with the authors provided translation and editing services during the analysis and writing phases to mitigate this risk. Finally, because participation was volun- tary, only those who were most interested in the topic agreed to take part. Therefore, the results may not apply to individ- uals who are less engaged with or motivated by this topic. Finally, it is important to acknowledge the research team’s positionality. All authors are actively engaged in LGBTIQ+ research or advocacy, and one author possesses lived experience as a refugee. While these insider perspec- tives provided vital contextual insights and facilitated trust with the participants, such positionality inherently shapes the research lens (Dwyer and Buckle 2009, Berger 2015). Despite the rigorous reflexivity protocols established in our methodology to mitigate bias, our interpretations are inevita- bly influenced by these backgrounds to some degree. Future research incorporating diverse methodological approaches and external perspectives will continue to enrich the under- standing of LGBTIQ+ migrant experiences in Spain.

  Experiences of LGBTIQ+ Migrants Across the Migration Trajectory in Spain: Interpersonal, Structural, and Systemic Challenges · 2026 · DOI

• Several limitations should be considered when interpret- ing the findings of this study. First, we relied on partici- pants’ retrospective recall of SOGIE change efforts and cross-sectional assessments of current internalized stigma and depression symptoms. Retrospective reporting may be influenced by recall bias and social desirability, which could lead some individuals to minimize, reinterpret, or avoid dis- closing coercive practices. While this design allows us to examine associations between SOGIE change efforts, inter- nalized stigma, and depression symptoms, it does not allow for conclusions about causal mechanisms. Future longitudi- nal research is needed to document how exposure to these practices during adolescence may shape identity develop- ment and mental health outcomes into adulthood (Higbee et al., 2022; Ryan et al., 2020). Moreover, although several associations reached statistical significance, their magni- tudes were small, and therefore the practical significance of these findings should also be interpreted with caution. Second, our study estimated the prevalence of SOGIE change efforts using a single survey item that was specifi- cally created for this study based on anecdotal evidence on the nature of SOGIE change efforts in Thailand. Although our research expert board, youth advisory board, and pilot testers assessed the face validity and clarity of the item, it was not possible to formally assess the reliability or validity of the item in greater detail. Furthermore, we were unable to collect detailed quantitative data about the specific characteristics of these experiences, such as their format, duration, and the underlying motivations for initi- ating them. While the qualitative findings of the broader Sexuality Research and Social Policy1 3 study (Ojanen et al., 2023) provide some insights, more comprehensive data on these dimensions would help iden- tify which forms of SOGIE change efforts may be particu- larly harmful and better inform targeted interventions and policy responses. Third, our measures of internalized stigma and depres- sion symptoms relied solely on self-report, which may be subject to social desirability bias. Future research could incorporate additional data sources (e.g., clinician ratings of depression symptoms) to mitigate such bias and strengthen the validity of these assessments. Fourth, due to the absence of a sampling frame for gender and sexually diverse youth in Thailand, we relied on con- venience sampling. This approach, while necessary given the hidden and marginalized nature of the population, may underrepresent certain groups of gender and sexually diverse youth (e.g., those living in rural areas, less connected to social media, less engaged with LGBTIQNA+ community networks, or having more traumatic experiences; Salway et al., 2019). Although we attempted to recruit participants from different regions across the country and over a half of the participants reported living in rural areas, this study may not fully capture the experiences of gender and sexually diverse youth from diverse geographic and socioeconomic backgrounds in Thailand. As such, the generalizability of our findings should be interpreted with caution.

  Sexual Orientation and Gender Identity and Expression Change Efforts Among Gender and Sexually Diverse Youth: Associations With Internalized Stigma and Depression Symptoms · 2026 · DOI

• ARTICLE IN PRESS ARTICLE IN PRESS ACCEPTED MANUSCRIPT This study is not without limitations. We acknowledge that our method for measuring medication dispensing is a proxy, as we will not have access to data detailing whether a patient took their medication as dispensed or used the right dosage and frequency. However, this measure is endorsed by the Pharmacy Quality Alliance (PQA), utilized by the Centers for Medicare and Medicaid Services (CMS), and influences 41% of Medicare Star Ratings (70,71). Proportion of Days Covered is known as the “foundation for enabling optimal results,” as it is the strongest available measure within claims data and critical for economic evaluations, policy decision-making, and insights for clinical outcomes of interest (72). We also assumed that medications were interchangeable if there was a dispensing switch within 30 days, which could potentially overestimate a patient’s PDC. We also did not have medication strength or dosage information for a patient’s antidepressant, which could vary by individual. Without this information, there may be differences in medication dispensing by dosage strength that we are not able to measure in this study. We were unable to determine if the length of antidepressant days’ supply was directed by one’s health provider, which is why we move away from describing the individual as “non-adherent” and towards discussing dispensing so as to understand larger barriers and facilitators that may influence antidepressant medication taking. Further, previous studies evaluating medication dispensing have also found early discontinuers to have similar health to long-term users, as this group may have improved symptoms where medication was no longer necessary (73). Future research should explore medication use with data that includes measurement of symptoms and reasons for discontinuation of antidepressant use. Additionally, this claims dataset may not capture all psychiatric-related claims as it is possible to receive psychiatric-related care outside of insurance coverage, such as ARTICLE IN PRESS ARTICLE IN PRESS ACCEPTED MANUSCRIPT psychotherapy. We also do not have information on symptom severity of depressive disorders and anxiety in claims data, which could be major time-varying factors impacting dispensing pattern trajectories. Claims databases also do not obtain patient- reported outcomes and therefore we are not able to measure side effects and the potential impact of side effects on treatment discontinuation. We also did not assess second-line treatment of antidepressants for TGD people with recurrent depression or anxiety. Future research should consider including evaluating antidepressant dispensing trajectories among TGD people using tricyclics and monoamine oxidase inhibitors antidepressants as a second-line treatment for a recurrent mental health condition. Seasonal differences, particularly in depressive disorders, may have occurred for patients especially during winter months in the US (October to March), which could affect dispensing levels. As our measure was descriptive, we did not adjust for seasonal differences, especially as past findings found longer term exposures were more likely to cause confounding than short term exposures (74). As we assessed dispensing patterns over 6 months, we did not anticipate this to be a major issue in our measurement. MarketScan does not report income or racial demographic information of enrollees, which precludes our study from assessing potential differences by socio- economic status or race, which are important drivers of health inequities within the US (75). Additionally, this claims dataset only contains claims from private insurance providers, limiting our results from being generalizable to the entire TGD patient population, although previous studies have found most TGD people have private health insurance (>50%) (76,77). Finally, as there is no gold standard within claims data of gender identity, we cannot measure how many additional TGD people were not identified in the claims dataset who did not seek gender-affirming medical care. ARTICLE IN PRESS ARTICLE IN PRESS ACCEPTED MANUSCRIPT However, previous research using claims data applied TGD-related diagnosis codes alone and were able to obtain a sensitivity of 89% and specificity of 99%, suggesting that conservative CPs have high accuracy in identifying TGD people who receive gender-affirming care (78).

  Trajectories of antidepressant dispensing among privately insured transgender people in the United States · 2026 · DOI

Most-cited papers in LGBTQ Health, Identity, and Policy

• Family Acceptance in Adolescence and the Health of LGBT Young Adults · Journal of Child and Adolescent Psychiatric Nursing · 2010 · 1,101 citations
• Transgender Youth and Life‐Threatening Behaviors · Suicide and Life-Threatening Behavior · 2007 · 489 citations
• Measuring Community Connectedness among Diverse Sexual Minority Populations · The Journal of Sex Research · 2011 · 423 citations
• The health equity promotion model: Reconceptualization of lesbian, gay, bisexual, and transgender (LGBT) health disparities. · American Journal of Orthopsychiatry · 2014 · 409 citations
• Intimate Partner Violence in Transgender Populations: Systematic Review and Meta-analysis of Prevalence and Correlates · American Journal of Public Health · 2020 · 370 citations
• Lesbian, Gay, Bisexual, and Transgender Adolescent School Victimization: Implications for Young Adult Health and Adjustment · Journal of School Health · 2011 · 363 citations
• Sexual orientation concealment and mental health: A conceptual and meta-analytic review. · Psychological Bulletin · 2020 · 342 citations
• Health and Care Utilization of Transgender and Gender Nonconforming Youth: A Population-Based Study · PEDIATRICS · 2018 · 332 citations
• Health Care Providers’ Implicit and Explicit Attitudes Toward Lesbian Women and Gay Men · American Journal of Public Health · 2015 · 322 citations
• Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation · PEDIATRICS · 2020 · 318 citations

Most recent work

• How Epistemic Stances Shape Quality of Life Through Healthcare Barriers in LGBTQ + populations: A Comparison between Cisgender and Transgender, Nonbinary, and Questioning Individuals · Sexuality Research and Social Policy · 2026
• An exploratory mapping LGBTQ+ research and intervention priorities in Southeast Asia (2025–2035) · Psychology and Sexuality · 2026
• Pride or Profit: Assessing the Authenticity of the Pride Flag as an Identity Safety Cue for LGBTQ+ Americans · Journal of Social Issues · 2026
• Sexual Orientation and Gender Identity and Expression Change Efforts Among Gender and Sexually Diverse Youth: Associations With Internalized Stigma and Depression Symptoms · Sexuality Research and Social Policy · 2026
• Intraoperative complications during gender-affirming laparoscopic hysterectomy in transgender men receiving testosterone: a case series · BMC Surgery · 2026
• Associations Between Sexual Orientation and Disorders of Gut-Brain Interaction in Sexual Minority Populations · Clinical Gastroenterology and Hepatology · 2026
• Trans is not the new gay: How psychoanalytic elitism and the rejection of science are creating a repetition of the past · The International Journal of Psychoanalysis · 2026
• Centering intersectional cultural humility in mindfulness-based interventions for immigrant lesbian, gay, bisexual, transgender, and queer youth · School Psychology International · 2026
• The Poetic Life Narratives of Midlife and Older Bisexual Adults: Struggle, Survival, and Healing in Three Acts · Research on Aging · 2026
• Exploring Educational Experiences and Outcomes for Plurisexual Students in High School Settings: A Scoping Review and Meta-Synthesis of Empirical Literature · Journal of Bisexuality · 2026

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