A review of minority stress as a risk factor for cognitive decline in lesbian, gay, bisexual, and transgender (LGBT) elders

Abstract

Lesbian, gay, bisexual, and transgender (LGBT) older adults comprise a unique and growing subset of the aging population. The historical context in which they came of age was imbued with victimization and discrimination. These experiences are subjectively stressful and collectively known as minority stress. Older LGBT adults continue to face stressors related to their gender and sexual identities in their daily lives. Importantly, chronic minority stress (CMS), like other forms of chronic stress, is harmful to health and well-being. CMS contributes to LGBT health disparities, including cardiovascular disease and depression, conditions that in turn increase risk for premature cognitive decline. Furthermore, long-term exposure to stress hormones is associated with accelerated brain aging. Yet, the cognitive functioning of LGBT elders and the influence of CMS on their cognition is all but unexplored. In this review, we examine the influences of CMS in LGBT elders and connect those influences to existing research on stress and cognitive aging. We propose a testable model describing how CMS in LGBT elders heightens risk for premature cognitive aging and how ameliorating factors may help protect from CMS risk. Research is desperately needed to calibrate this model toward improving LGBT quality of life and mental health practices.

Creating Supportive Environments for LGBT Older Adults: An Efficacy Evaluation of Staff Training in a Senior Living Facility

“…Minority stress theory (Meyer, 2003) purports that stressors specific to an LGBT identityfor instance, direct discrimination, fear of stigma, internalized homophobia, and concealment of a minority identityhelps to explain sexual orientation and gender identity differences in health. Indeed, a recent review of the literature showed that exposure to chronic minority stress is related to health declines among LGBT older adults (Correro & Nielson, 2019).…”

Experiences of LGBTIQA+ People with Disability in Healthcare and Community Services: Towards Embracing Multiple Identities

“…For LGBTIQA+ people with disability, experiences of discrimination and oppression are compounded by intersecting, marginalised experiences and social identities, leading to multiple minority stresses [19]. 'Minority stress' refers to how marginalised groups experience stress that arises from experiences of stigma and discrimination, which leads to increased negative physical and mental health and social wellbeing outcomes [20]. Social support and networks have been shown to be protective factors against poor general health, disability and depression among lesbian, gay and bisexual people [21].…”

Commentary: Valuing the Vulnerable – The Important Role of Transgender Communities in Biomedical Research

“…7 Mental health stressors and disorders differ significantly between cisgender and transgender individuals. 8 Mustanski and colleagues have found that among lesbian, gay, bisexual and transgender (LGBT) youth with steadily high or increasing levels of victimization from adolescence to early adulthood were at higher risk for depression and posttraumatic stress disorder. 9 These experiences of victimization and discrimination have been collectively labeled as minority stressors, and have been associated with harm to health and well-being.…”

“…More specifically, these chronic stressors contribute to LGBT health disparities, and increase the risk for cognitive decline. 8 How these stressors interact, if at all, with the neuroanatomy of transgender persons, remains unclear. There are conflicting findings about the neuroanatomy of transgender persons and whether it more closely resembles the neuroanatomy of their natal sex or their gender identity.…”