Understandings of sexual and gender identity have expanded beyond traditional binaries, yet we know little about adolescents’ appropriation of identity labels across diverse communities. In a mixed-methods study of adolescents recruited from lesbian, gay, bisexual, transgender, and queer (LGBTQ+) spaces in communities differing in support of sexual and gender diversity, seven patterns emerged: (a) frequent use of nonbinary gender identity labels (23.9% of survey sample), especially in high-support communities; (b) greater comfort among adolescents assigned female at birth (AFAB) with diverse gender expression, which informants attributed to pressures to conform to compulsive masculinity for boys; (c) frequent use of plurisexual (60.8%) and asexual (9.9%) labels, especially among those AFAB, and discussion of online settings as a resource; (d) intersectional patterning of “queer” to describe sexual identity (12.4% of survey sample), with White youth in high-support communities signifying an intellectual/political stance and non-White youth in low-support communities using queer as an umbrella term; (e) resistance to labeling and ambivalence about labels due to intra-community dynamics; (f) labeling challenges among boys of color; and (g) challenges with stigma, sexualization, and violence for transgender and nonbinary youth. Findings highlight how contemporary adolescents engage with and challenge received conceptions of gender and sexuality and how this process is shaped by intersectional identities.

The 21st century has been a time of change in recognition of sexual and gender diversity (SGD) in the United States, but we know little about how community-level variability in support for SGD shapes the experience of youth who hold minoritized sexual or gender (MSG) identities. This study used mixed methods to examine regional variability in community climate for SGD and its relationship with minority stress and mental health for adolescents with MSG identities (e.g., asexual, bisexual, gay, lesbian, transgender, nonbinary). Findings revealed differences in objective indicators, self-reported perceptions, and informant narratives of community climate, but survey and narrative data revealed that adolescents experienced heightened levels of depressive symptoms and minority stress processes across communities. Adolescent informants constructed narratives that identified anxiety/depression and self-harm as primary mental health challenges across communities, linking these experiences to societal stigma and insufficient education about SGD. Sources of resilience included mental health services, in-person resources (e.g., school gender-sexuality alliances [GSAs]), online resources, and peer support. Findings reveal the endurance of cultural ideologies that reinforce stigma (e.g., heterosexism, cissexism), activate minority stress processes (e.g., internalized stigma), and contribute to negative mental health (e.g., depressive symptoms), even for adolescents in supportive community settings. Public Significance StatementDisparities in mental health exist for adolescents with minoritized sexual or gender identities, but we lack sufficient knowledge of how different types of communities might exacerbate or ameliorate minority stress processes. This mixed-methods study allowed for a deep interrogation of the experience of minority stress and mental health for adolescents, providing information on possible interventions (e.g. formal education about sexual and gender diversity) to promote health and wellbeing.