Minority Stress and Mental Health Outcomes in Gender and Sexual Diverse Groups in Brazil: Evidence on the Mediating Role of Social Support

Abstract Sexual and gender minorities (SGMs) face significant health disparities, largely due to chronic exposure to minority stressors that affect mental health. While research documents these harmful effects, few studies examine how discrimination influences emotional responses or the role of social support in mitigating these impacts. This study examined the relationships among minority stress, social support, and mental health outcomes in 567 SGMs who completed an online survey. Gender nonconforming (GNC) individuals reported the highest negative affect, with bisexual men and women also showing elevated negative affect. Symptoms of stress, anxiety, and depression were most frequent among cisgender women (CISW) and GNC participants. Discrimination experiences were strongly associated with negative affect across gender-diverse groups, though this association extended to psychiatric symptoms only among transgender individuals, not among GNC participants, suggesting that factors beyond discrete discriminatory events may contribute to symptoms in this group. Mediation analyses revealed that social support significantly buffered the impact of negative affect on psychiatric symptoms for cisgender men and, specifically through family and significant-other support, for transgender individuals, but showed no significant indirect effect for CISW or GNC participants. GNC individuals appeared especially vulnerable, reporting both high negative affect and the lowest perceived social support among all groups. These findings suggest that SGM mental health outcomes depend on a complex interplay between minority stressors, affective responses, and symptoms, with the protective role of social support varying substantially across gender identity groups. The results underscore the importance of inclusive research, tailored interventions, and policies that account for the distinct stressors and support needs of the most vulnerable groups.