This open access book is a groundbreaking volume that creates a new field within the intersection of "global health" and "LGBTQ health" delineating specific health challenges and resiliencies. There has been increasing awareness of the importance in recognizing LGBTQ health issues and disparities. However, there is a dearth of research and scholarship that examines LGBTQ health through global and comparative perspectives. This book addresses this gap.

In the pursuit of scientific inquiry, the disciplines in public health have often emphasized reductionist perspectives that are particularized to a specific locale, municipality, or country. This book's provision of broader perspectives, cross-cutting disparities and issues, and socio-political-cultural contextualization inform the development of new research, policies, interventions, and programs. Students benefit by learning about LGBTQ health research, policies, and programs in various countries and regions. Public health researchers benefit by learning about research conducted in various countries and regions, along with understanding how research has been linked to and impacted by various policies and programs. Policymakers benefit from learning about overarching and comparative perspectives that could inform more effective policies, including those connected to multiple locations. Practitioners learn about various public health practices in multiple countries and regions that could contribute to novel and creative solutions and approaches within the respective contexts.

The nine chapters of this volume facilitate greater socio-political-cultural awareness, sensitivity, and competence; undertake an in-depth literature review of health factors and outcomes; and provide recommendations for increasing health-related capacity through development and collaborations between agencies, organizations, and institutions across countries and/or regions.

Global LGBTQ Health: Research, Policy, Practice, and Pathways is primarily intended for students and instructors in public health, medicine, nursing, other health professions, psychology, social work, LGBTQ or gender/sexuality studies, human rights, and the social sciences. The book is also a useful resource for public health researchers and practitioners, policymakers, and healthcare and social service providers.

1.                   Introduction

Authors: Sel J. Hwahng & Michelle R. Kaufman

1.1  Why global LGBTQ health?

1.2  Genesis of the book

1.3  On COVID-19

1.4  History, culture, and religion

1.5  Racial/ethnic stratification and indigeneity

1.6  Intersectionality

1.7  Chapter summaries

2.                LGBTQ Stigma

Authors: Valerie A. Earnshaw, Carmen Logie, Jeffrey A. Wickersham, and Adeeba Kamarulzaman

2.1  Stigma definitions and key concepts

2.1.1        Functions of stigma

2.1.2        Stigma contextualized

2.1.3        Intersectional stigma

2.2  LGBTQ stigma manifestations and experiences

2.2.1        Structural stigma

2.2.2        Individual level

2.3  Processes linking LGBTQ stigma with health

2.3.1        Social isolation

2.3.2        Access to resources

2.3.3        Biological, psychological, and behavioral responses

2.4  Interventions to address LGBTQ stigma

2.4.1        Structural change

2.4.2        Stigma reduction among perceivers

2.4.3        Enhancing resilience among targets

2.5  Conclusion

3.             Global LGBTQ Mental Health

Authors: Richard Bränström, Tonda L. Hughes, and John E. Pachankis

3.1  Differences in mental health between LGBTQ individuals and cisgender heterosexual individuals

3.1.1        Types of mental health problems

3.1.2        Cultural differences in understanding mental health

3.2  Differences in mental health across diverse populations of LGBTQ individuals

3.2.1        Age and sex

3.2.2        Sexual identity and gender identity

3.2.3        Socioeconomic status

3.2.4        Race/ethnicity

3.2.5        Migration status

3.2.6        Geographic variations in LGBTQ mental health

3.3  Determinants of LGBTQ mental health

3.3.1        The cross-cultural relevance of minority stress theory

3.3.2        Cross-country variation in structural stigma

3.3.3        Barriers to societal integration across countries

3.4  Interventions to improve LGBTQ mental health

3.4.1        Interventions to reduce LGBTQ stigma

3.4.2        Interventions to promote coping with stigma

3.5  Future directions

3.5.1        Improved research methodologies for global LGBTQ mental health

3.5.2        Comparative research to identify cultural variation in LGBTQ mental health

3.5.3        Dissemination of LGBTQ-affirmative mental health interventions

3.5.4        Aging-related dementia and cognitive decline

3.6  Conclusion

4.             If You D on't Ask, You D on't Count: Elements to Consider in Understanding Global Sexual and Gender Minority Data on Non-Communicable Diseases

Authors: Jane A. McElroy & Bennett J. Gosiker

4.1  Introduction

4.2  On the impact of COVID-19

4.3  Chronic stress and Immune dysregulation

4.4  Factors contributing to chronic illnesses

4.5  Health disparities theories

4.6  Methodological considerations

4.7  Conclusion

5.                Sexual and Gender Minority Population's Health Burden of Five Non-Communicable Diseases: CVD, Cancer, Diabetes, Asthma, COPD

Authors: Jane A. McElroy & Bennett J. Gosiker

5.1  Introduction

5.2  Cardiovascular disease (CVD)

5.2.1        Epidemiology of CVD in sexual minority populations

5.2.2        Epidemiology of CVDD in transgender and non-binary populations

5.3  Cancer

5.3.1        Epidemiology of cancer in sexual minority populations

5.3.2        Epidemiology of cancer among transgender populations

5.4  Diabetes Mellitus

5.4.1        Epidemiology of diabetes mellitus in sexual minority populations

5.4.2        Epidemiology of diabetes mellitus in transgender and non-binary populations

5.5  Asthma

5.5.1        Epidemiology of asthma in sexual minority populations

5.5.2        Epidemiology of asthma in transgender and non-binary populations

5.6  Chronic Obstructive Pulmonary Disease (COPD)

5.6.1        Epidemiology of COPD in sexual minority populations

5.6.2        Epidemiology of COPD in transgender and non-binary populations

5.7  Conclusion

6.             Community and Social Support

Authors: Chichun Lin & Sel J. Hwahng

6.1  Introduction

6.2  Support in families

6.2.1        Parental support

6.2.2        Sibling support

6.3  Support in schools

6.4  Support in other relationships

6.4.1        Intimate partners

6.4.2        Parenting and family-building

6.4.3        Colleague support

6.4.4        LGBTQ elders

6.5  LGBTQ communities

6.5.1        Same-sex male communities

6.5.2        Same-sex female communities

6.5.3        Bisexual communities

6.5.4        Transgender and non-binary gender communities

6.5.5        Biphobia and transphobia in lesbian/gay communities

6.5.6        Intersex communities

6.5.7        Asexual/aromantic communities

6.5.8        Online communities and social media

6.5.9        Religious and spiritual groups

6.5.10    BDSM/leather and polyamory communities

6.5.11    Other support groups

6.5.12    LGBTQ-related organizations

6.6  Conclusion

7.          HIV/AIDS Among Sexual and Gender Minority Communities Globally

Authors: S. Wilson Beckham, Jennifer Glick, Jowanna Malone, Ashleigh J. Rich, Andrea Wirtz, & Stefan Baral

7.1  Introduction

7.1.1        Subpopulations

7.2  Methodological and ethical challenges in global HIV research among SGM

7.2.1        Ethical issues

7.2.2        Methodological issues

7.3  Multi-level factors and interventions

7.3.1        Structural level factors

7.3.2        Structural interventions

7.3.3        Interpersonal & community level factors

7.3.4        Interpersonal/community-level interventions

7.3.5        Individual & biomedical level factors

7.3.6        Individual-level & biomedical interventions

7.4  Chronic disease & sexual and gender minorities living with HIV

7.5  Conclusions

7.6  Future directions

8.       Global Epidemiology and Social Ecological Determinants of Substance Use Disparities, Consequences of Use, and Treatment Options Among Sexual and Gender Minority Populations

Authors: Matthew J. Mimiaga, Lynn Klasko-Foster, Christopher Santostefano, Harry Jin, Taryn Wyron, Jackie White Hughto, & Katie Biello

8.1  Introduction

8.2  Epidemiology

8.2.1        Epidemiology of substance use among sexual and gender minorities: Africa and the Middle East

8.2.2        Epidemiology of substance use among sexual and gender minorities: Asia and Australia

8.2.3        Epidemiology of substance use among sexual and gender minorities: Central and South America

8.2.4        Epidemiology of substance use among sexual and gender minorities: North America

8.2.5        Epidemiology of substance use among sexual and gender minorities: Europe

8.3  Social ecological determinants

8.3.1        Sexual and gender minority stress model: A framework for understanding disparities

8.3.2        Psychosocial factors that potentiate substance use

8.3.3        Social, interpersonal, and cultural factors that drive use among sexual and gender minorities

8.3.4        The role of contextual, environmental, and structural factors in substance use among sexual and gender minorities

8.4  Consequences of use

8.4.1        HIV, Hepatitis C virus, and other sexually transmitted infections

8.4.2        Chronic disease

8.4.3        Incarceration

8.4.4        Social isolation

8.5  Intervention and treatment options

8.5.1        Alcohol use

8.5.2        Smoking

8.5.3        Stimulant use disorder

8.5.4        Opioid use disorder

8.5.5        Need for integrated services

9.             Victimization and Intentional Injury in Global LGBTQI Populations

Authors: Casey D. Xavier Hall, G. Nic Rider, Nova Bradford, Eunice M. Areba, & Katy Miller

9.1  Victimization and intentional injury in LGBTQI populations

9.2  Frameworks for understanding intentional injury and victimization in. LGBTQI populations

9.2.1        Syndemics

9.2.2        Minority stress and multilevel influences

9.2.3        Colonization, intergenerational trauma, and historical trauma

9.2.4        LGBTQI rights as human rights

9.3  Types of intentional injury and victimization

9.3.1        State-sanctioned victimization

9.3.2        Community and organizational victimization

9.3.3        Interpersonal victimization across the life course

9.3.4        Polyvictimization

9.4  Risk factors for victimization

9.5  Health consequences of victimization

9.6  Prevention and interventions

9.6.1        Decolonization

9.6.2        Structural/policy interventions

9.6.3        Organizational or community interventions

9.6.4        Individual interventions

9.7  Conclusions and highlight gaps in the literature

Sel J. Hwahng, PhD (they/them/their) is assistant professor in the department of Women's and Gender Studies, Health and Sexuality track, at Towson University. They are also pursuing an Sc.M. degree in Cardiovascular Epidemiology at Johns Hopkins University, Bloomberg School of Public Health. Their current research focuses on women of color and LGBTQ nutritional and cardiometabolic health disparities utilizing social, behavioral, and epidemiological methods. They also lead an ontological-based leadership course at higher education institutions. They are a recipient of grants, awards, and fellowships from organizations/institutions such as the National Institute on Drug Abuse, National Institutes of Health, American Public Health Association, International AIDS Society, Association for Women in Psychology, and American Heart Association. Publications include over 30 articles and book chapters in peer-reviewed journals and edited volumes. Dr. Hwahng is also editor of the book seriesGlobal LGBTQ Healthin which this volume is featured. 

Michelle R. Kaufman, PhD (she/her/hers) is associate professor in the Department of Health, Behavior & Society and the Department of International Health at the Bloomberg School of Public Health at Johns Hopkins University in Baltimore, Maryland, USA. She is a social psychologist by training. Dr. Kaufman's research focuses on the social determinants of health, particularly the role of gender and sexual identity. She has spent over 20 years studying sex, gender, and sexuality as predictors of health disparities in more than 12 countries using mixed and interdisciplinary research methods. Her work is focused primarily in low- and middle-income settings and has been funded by the NIH, USAID, CDC, Fulbright, Gates Foundation, and Bloomberg Philanthropies. Currently she leads the Data for Health Gender Equity Unit, an initiative focused on improving health data systems in 40+ low- and middle-income countries to ensure people of all genders are counted in health data.

This open access book is a groundbreaking volume that creates a new field within the intersection of "global health" and "LGBTQ health" delineating specific health challenges and resiliencies. There has been increasing awareness of the importance in recognizing LGBTQ health issues and disparities. However, there is a dearth of research and scholarship that examines LGBTQ health through global and comparative perspectives. This book addresses this gap.

In the pursuit of scientific inquiry, the disciplines in public health have often emphasized reductionist perspectives that are particularized to a specific locale, municipality, or country. This book's provision of broader perspectives, cross-cutting disparities and issues, and socio-political-cultural contextualization inform the development of new research, policies, interventions, and programs. Students benefit by learning about LGBTQ health research, policies, and programs in various countries and regions. Public health researchers benefit by learning about research conducted in various countries and regions, along with understanding how research has been linked to and impacted by various policies and programs. Policymakers benefit from learning about overarching and comparative perspectives that could inform more effective policies, including those connected to multiple locations. Practitioners learn about various public health practices in multiple countries and regions that could contribute to novel and creative solutions and approaches within the respective contexts.

The nine chapters of this volume facilitate greater socio-political-cultural awareness, sensitivity, and competence; undertake an in-depth literature review of health factors and outcomes; and provide recommendations for increasing health-related capacity through development and collaborations between agencies, organizations, and institutions across countries and/or regions.

Global LGBTQ Health: Research, Policy, Practice, and Pathways is primarily intended for students and instructors in public health, medicine, nursing, other health professions, psychology, social work, LGBTQ or gender/sexuality studies, human rights, and the social sciences. The book is also a useful resource for public health researchers and practitioners, policymakers, and healthcare and social service providers.