A Digital, Minority Stress-Focused Single-Session Intervention Benefits Multiply-Minoritized Sexual Minority Adolescents.

Abstract

Objective: Leveraging data from a previously conducted randomized trial, we examined whether Project RISE - a digital single-session intervention focused on minority stress - was associated with equal improvements in levels of internalized stigma, identity pride, hopelessness, depression, and anxiety among youth with a single minoritized or multiply-minoritized identities. We also tested whether higher levels of social support moderated outcomes.

Method: Participants randomly assigned to the intervention were included (n = 261 adolescents 13-16 years old; M age = 15; 51% youth of color; 68% transgender/gender-diverse). Two-way multivariate analysis of covariances examined potential group differences across outcomes, between individuals holding multiple minoritized identities versus one. Moderation analyses were used to investigate whether social support moderated RISE outcomes.

Results: Identifying with multiple minoritized identities was associated with higher levels of identity pride immediately post-intervention. Identifying as a gender minority was associated with slightly greater identity pride post-intervention. Youth who endorsed gender minority identities reported higher levels of hopelessness, depression, and anxiety at 2-week follow-up, relative to cisgender youth. No other differences emerged.

Conclusions: Multiply-minoritized youth, especially gender minority youth, experienced significantly higher levels of identity pride after completing Project RISE. Results highlight the importance of applying an intersectional minority stress framework to online intervention design and considering social contexts (e.g. high versus low social support) when selecting treatments for youth with intersecting identities. Clinicians should consider how interventions specifically addressed intersectional identities when providing evidence-based care.