Digital intervention to reduce minority stress in sexual and gender minority populations: a pilot feasibility and usability study

Abstract This study aimed to evaluate the feasibility, usability and acceptability of a digital Acceptance and Commitment Therapy intervention (iACT) for lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexually and gender diverse (LGBTQIA+) individuals, while exploring preliminary changes in minority stress and wellbeing-related outcomes. We conducted a four-week pilot study with randomized pre-post design of a self-help iACT program adapted for LGBTQIA+ individuals. Data were collected between June and September 2025. Participants ( N = 85; experimental n = 35, control n = 50) completed baseline and post-intervention assessments of depression, anxiety, stress, psychological flexibility, emotion regulation, minority stress, resilience, and usability. The program demonstrated excellent usability. Participant feedback indicated that the intervention was perceived as useful, accessible, and affirming, promoting self-acceptance, introspection, and reflection. Qualitative feedback also identified limitations, including tasks perceived as overly guided or repetitive, lengthy audio materials, and limited personalization. Exploratory analyses showed that participants in the experimental group demonstrated significant pre-post improvements in psychological distress, stress, emotional clarity, goal-directed behavior, and anticipated discrimination, which survived correction for multiple comparisons, with small-to-large effect sizes. Between-group comparisons favored the experimental group on stress, emotional clarity, and anticipated discrimination, with small-to-medium effect sizes, although these differences did not remain significant after correction. A key limitation was the high and uneven attrition rate (51.4% in the experimental group vs. 15.3% in controls), which warrants caution in interpreting exploratory outcome findings. Overall, findings support the feasibility and acceptability of a self-help iACT program tailored for LGBTQIA+ individuals and suggest preliminary changes in stress, minority stress, and emotion regulation. These results may inform future trials evaluating queer-affirmative digital interventions for individuals facing stigma, non-disclosure, or structural barriers to care.