Stress and Resilience Study (STARS) Protocol: A Multimethod Investigation of Minority Stress, Allostatic Load and Cognition in LGBTQ+ Adults.
Abstract
Background
Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people face significant stigma, a structural and social determinant of health that contributes to persistent health disparities. Minority stress theory proposes that both proximal and distal stressors adversely impact health and well-being, while protective factors act as buffers. This study aims to identify mechanisms through which minority stress and protective factors influence physical and mental health in LGBTQ+ adults and to determine whether these processes differ across subgroups as well as in comparison to cisgender heterosexual adults. We hypothesize that greater levels of minority stress will be linked to increased AL, decreased microbiota diversity, and diminished cognitive performance. We further hypothesize that protective factors will moderate these associations.
Methods
The cross-sectional design aims to recruit a minimum of 360 participants, including diverse LGBTQ+ and cisgender heterosexual subgroups. Data collection will include psychosocial questionnaires, biomarkers assayed from saliva, blood, and stool samples, and a semi-structured interview assessing medical and health history.
Discussion
STARS and the resulting biobank are among the first to integrate psychosocial, cognitive, and multi-system biological measures within LGBTQ+ health research. We will analyze LGBTQ+ subgroups separately rather than as a single heterogeneous population, allowing identification of subgroup-specific risk and protection. Findings are expected to inform the development of targeted, biologically grounded interventions to reduce health disparities in LGBTQ+ communities.