Publications

Abstract

This study aimed to examine the psychometric properties, including factor structure, internal consistency, and measurement invariance of the Eating Pathology Symptoms Inventory (EPSI) in a large national sample of transgender and gender-diverse (TGD) adults.The sample consisted of 2098 TGD adults-including transgender men (n = 599), transgender women (n = 293), and gender-diverse individuals (n = 1206)-who completed online self-report surveys. Using a subset of the sample, exploratory factor analysis (EFA) was conducted to identify underlying factor structures, followed by confirmatory factor analysis (CFA) to confirm the model fit within each population in the remainder of the sample. Multi-group confirmatory factor analysis (MG-CFA) was used to assess measurement invariance across transgender men, transgender women, and gender-diverse individuals.The EPSI's eight-factor structure was supported across all three TGD groups with strong model fit: transgender men (CFI = 0.985, RMSEA = 0.047, SRMR = 0.078), transgender women (CFI = 0.948, RMSEA = 0.048, SRMR = 0.085), and gender-diverse individuals (CFI = 0.962, RMSEA = 0.040, SRMR = 0.060). Measurement invariance analyses supported that the EPSI was invariant across the groups, facilitating meaningful group comparisons using the inventory. Internal consistency, assessed using McDonald's omega, was acceptable for all subscales (ω = 0.74-0.94).This study provides psychometric support for the EPSI in TGD groups. The results indicate that the EPSI performs reliably and consistently across these groups for assessing eating pathology among gender minority people.

View details for DOI 10.1002/eat.24433

View details for PubMedID 40183494

Abstract

Cisgender sexual minority adults are at elevated risk for eating disorders; however, community norms for certain eating disorder measures are lacking for this population. This study aimed to establish community norms for the Eating Pathology Symptom Inventory (EPSI) among cisgender gay, lesbian, bisexual + (individuals who identify as bisexual or pansexual; bi +) adults.Cross-sectional data were analyzed from 2062 cisgender participants-including 925 gay men, 573 lesbian women, 116 bi + men, and 448 bi + women-enrolled in The PRIDE Study, a national longitudinal cohort of sexual and gender minority adults in the United States. Participants completed the EPSI, and descriptive statistics were calculated for the eight EPSI scales.We report mean scores, standard deviations, medians, interquartile ranges, and percentile ranks for the eight EPSI scales within cisgender sexual minority populations. Distinct patterns of eating-pathology symptoms were evidenced among the cisgender sexual minority groups. Cisgender bi + women exhibited the highest scores for Body Dissatisfaction, Binge Eating, and Restricting compared to other groups, whereas cisgender bi + men reported the highest scores for Excessive Exercise. Cisgender gay men had significantly higher scores for Muscle Building and Negative Attitudes Toward Obesity compared to other groups.These findings offer valuable benchmarks for interpreting EPSI scores in the assessment and treatment of eating disorders among cisgender sexual minority individuals.Level V: based on descriptive results.

View details for DOI 10.1007/s40519-025-01742-3

View details for PubMedID 40183833

View details for PubMedCentralID 10379623

Abstract

This study aimed to describe how minority stress and employment discrimination are associated with job quality (ie, employment type and income) among sexual- and gender-minority (SGM) workers.We conducted a pooled cross-sectional analysis of the 2021 and 2022 surveys from a national study of SGM adults in the United States. Using multinomial logistic regression models and stratification by six gender groups, we examined associations of minority stress and past-year employment discrimination with job quality.Among 4221 workers, 22.0% experienced precarious employment and 6.8% were unemployed. Approximately half earned ≤US

View details for DOI 10.1016/j.fertnstert.2025.03.012

View details for PubMedID 40118331

Abstract

Despite increased recognition of and support for family building among lesbian, gay, bisexual, transgender, queer, Two-Spirit, and other sexual and gender minoritized (LGBTQ2S+) populations, there is still little evidence describing the experiences of pregnancy care within these populations in quantifiable ways. This paper describes our pilot study process and the feasibility of implementing a community-developed survey measuring respectful pregnancy care within LGBTQ2S+ communities.Using a participatory action research approach, a Community Steering Council developed and piloted the Birth Includes Us survey. To assess the feasibility of the survey, recruitment was assessed through how participants heard about the study, and enrollment and survey completion were tracked in the REDCap survey platform. We used descriptive statistics to report the demographics of the pilot sample.Recruitment through social media, predominantly Facebook, was an effective route to reach the target population, accounting for over 60% of the sample. Of the 404 eligible participants who opened the survey, 91% completed the survey. The pilot study sample represented 41/50 states in the USA and 5/13 provinces and territories across Canada. While only 17% of the sample were members of racially minoritized communities, there was wide representation across genders and sexualities.The findings of this feasibility pilot study will inform the implementation of the Birth Includes Us survey to ensure the recruitment, enrollment, and retention of diverse participants. Lessons learned from this process will also support researchers in developing mitigating strategies to minimize the harm incurred during the process of LGBTQ2S+ family building.

View details for DOI 10.1111/birt.12911

View details for PubMedID 40066909

Abstract

Structural stigma towards gender minority (GM; people whose current gender does not align with sex assigned at birth) people is an important contributor to minority stress (i.e., stress experienced due to one's marginalized GM identity), although existing variables are unclear in their inclusion of social norms, or societal stigma, as a key component of the construct. We examined potential variables representing structural stigma, including variables that are inclusive of societal stigma, to identify those that most strongly relate to minority stress outcomes. We tested variables identified in the literature as measures of structural stigma inclusive of societal stigma (LGBT + Business Climate Index, state voting behaviors, and Google Trends search data), the most commonly used structural stigma variable (State Policy Environment Tally), and proxy variables (region, population density) for comparison. The relationships between structural stigma and minority stress model outcomes were tested in a sample of GM participants from The Population Research in Identity and Disparities for Equality (PRIDE) Study (N = 2,094) 2019 Annual Questionnaire using a structural equation model (SEM). Lower structural stigma (i.e., higher LGBT Business Climate Index) was associated with lower experienced stigma (β= -0.260, p < .01) and lower anticipated stigma (β= -0.433, p < .001). Greater conservative voting behavior was associated with less experienced stigma (β= -0.103, p < .01). Living in a more densely populated county was also associated with lower anticipated stigma (β=-0.108, p < .001) and greater identity outness (β = 0.053, p < .05). Two of the identified structural stigma variables that were inclusive of societal stigma (i.e., LGBT + Business Climate Index, conservative voting behaviors) and one proxy variable (population density) were associated with minority stress outcomes. However, the most commonly used variable for structural stigma (State Policy Environment Tally) was not associated with any outcomes. The State LGBT + Business Climate Index showed the most promise for use as a structural stigma variable in future research. The application of this variable should be investigated further to explore its association with health outcomes and to inform efforts to reduce health equity barriers experienced by GM people through addressing structural stigma in a manner inclusive of societal stigma.

View details for DOI 10.1038/s41598-024-85013-8

View details for PubMedID 39848993

View details for PubMedCentralID 4689648

View details for DOI 10.1037/sgd0000789

View details for Web of Science ID 001386419000001

View details for DOI 10.1037/sgd0000783