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. 2026 Jul 26;36(3):e70237. doi: 10.1111/jora.70237

Resource access and use: Impacts on distal minority stressors for racial and sexual diverse youth in rural and urban contexts

Shauntal J Van Dreel 1,✉, Joshua Rusow 1, Jules Wood 1, Harmony Rhoades 1, Jeremy Goldbach 1,#
PMCID: PMC13401741  PMID: 42502898

Abstract

Sexually and racially diverse (SD) adolescents experience elevated proximal and distal minority stressors that vary across school, community, and policy contexts. Limited research has examined how access to and use of LGBTQIA+ supportive structures, such as Gender and Sexualities Alliances (GSAs), LGBTQIA+ community centers, and affirming school staff, shape distal minority stress for racially and sexually diverse youth across geographic settings. Using cross‐sectional national sample data of SD adolescents from the Adolescent Stress Experiences Over Time Study (ASETS; N = 1076), this study applied binary logistic regression and linear regression to assess how racial identity, urbanicity, and structural access to and use of LGBTQ community centers and school affirmative SD groups are associated with distal sexual minority stress domains (homonegative climate, social marginalization, and intersectional stress), friend social support, and coping skills. Results indicated that GSA presence, regardless of individual participation, was associated with reduced odds of minority stress across all domains, while attending a GSA was further associated with increased use of engagement‐oriented coping strategies. Conversely, community center attendance was associated with higher odds of social marginalization, suggesting contextual variability in the protective impacts of community‐based supports. Geographic differences in distal minority stress were evident in only one domain, homonegative climate, and rurality was not significantly associated with differences in peer social support or coping. Findings underscore the importance of school‐embedded, structurally inclusive supports for reducing minority stress and bolstering resilience among sexually and racially diverse adolescents, and highlight ongoing gaps in support for youth outside urban areas or in restrictive community climates. Future research should examine culturally grounded mechanisms that enhance the effectiveness of supportive structures and ensure inclusivity across racial and geographic contexts.

Keywords: Coping, Homonegative climate, Intersectionality, LGBTQIA+ adolescents, Minority stress, Peer social support, Racial and sexual diversity, Resource access and use, Rural‐urban disparities, Social marginalization

Structured supports within schools and communities play a critical role in reducing both proximal and distal stressors experienced by sexually diverse (SD) adolescents. Although prior studies emphasize the protective influence of inclusive supports, few have explored how these supports vary across racial backgrounds and geographic regions, particularly in terms of the impact availability, accessibility, and utilization of LGBTQIA+ resources have on minority stress (Elliott et al., 2022). For SD adolescents in rural communities, inclusive support structures are critically important, with strong links to enhanced mental health, and educational outcomes (Paceley et al., 2019). Supports like Gender and Sexualities Alliances (GSA: formerly called Gay Straight Alliances), LGBTQIA+ community centers, and affirming school staff help foster safer, more inclusive spaces that promote youth well‐being. Yet, the mental health and academic benefits of GSAs appear to be less robust for racially minoritized adolescents, prompting important questions about whose needs these spaces best serve (Baams et al., 2021).

THEORETICAL CONSIDERATIONS

The present study is conceptually grounded in the sexual minority stress theory and ecological systems theory, highlighting the interconnections among sexual and racial identity, contextual social and community resources, and the K–12 public school environment (Brooks, 1981; Bronfenbrenner, 2005; Hatzenbuehler & Pachankis, 2016; Meyer, 2003). Sexual minorities experience increased social stressors that lead to worse mental health outcomes and increased psychiatric disorders compared to their heterosexual peers (Brooks, 1981; Meyer, 2003). Applying minority stress theory, adolescents within these groups face compounded effects of proximal (expectations of rejection, concealment, internalized homophobia) and distal stressors (discrimination, prejudice, violence) during a pivotal developmental period, resulting in increased rates of self‐harm, substance use, identity‐based bullying and victimization, truancy, and suspensions (Goldbach et al., 2014; Fontanella et al., 2015; Russell et al., 2011). Adolescence is particularly critical in this context, as it represents the developmental period during which sexual identity formation and disclosure most commonly occur, exposing youth to minority stressors at a time when psychosocial and neurological systems are still maturing and especially sensitive to social experiences (Goldbach & Gibbs, 2017; Sisk & Gee, 2022). These concurrent developmental demands, navigating identity while managing elevated stigma, underscore why access to affirming structural supports during adolescence, rather than at other life stages, may have distinct and lasting implications for minority stress, and resilience (Mallory et al., 2021; Poteat et al., 2020). These stressors are shaped by various identity and contextual factors, including racial and ethnic identity, social support, geographic location, school culture, and community resources (Day et al., 2019; Goldbach et al., 2023; Green et al., 2018; Truong et al., 2020).

Contextualized minority stress can best be understood through the ecological systems theory, which highlights the nested and fluid interaction of intersectional identities within the individual, family, community, and institutional levels, reinforcing how factors cannot be understood in isolation (Bronfenbrenner, 2005; Elliott et al., 2022). School and community‐specific support structures can play a critical role in buffering the proximal and distal stressors experienced by sexually diverse youth. Within Bronfenbrenner's model, schools, peer support, and supportive teacher relationships exist at the micro level, with community center programming and resources within the exosystem being influenced by local government funding, and assets (Bronfenbrenner, 2005). However, there is a limited understanding of how sexually and racially diverse adolescents experience distal minority stress across geographic landscapes, which may have varying macro system influences (social norms, political systems, and culture) and how this is operationalized through access to institutional‐level supports, like GSAs in K–12 school settings in the United States and community‐based inclusive services (Paceley et al., 2019). Current findings provide conflicting understandings of rural and urban SD adolescent experiences in their communities due to contextual complexities between macro, exo, and micro system dynamics that influence support and disparities.

SCHOOL AND COMMUNITY RESOURCE ACCESS AND USE

Studies indicate that supportive relationships, such as positive teacher interactions and peer social support, can be found in both urban and rural settings, regardless of the availability of LGBTQIA+ resources (Rand & Paceley, 2022). While identity‐related factors often outweigh geographic differences in shaping health outcomes for LGBTQIA+ youth, rural youth face unique barriers like stigma, distance, and community intolerance, which can limit access to support and inhibit identity disclosure (Dwyer et al., 2015; Paceley et al., 2020; Price‐Feeney et al., 2019; Rand & Paceley, 2022). Although GSAs and affirming school climates are often linked to better behavioral health outcomes, their effectiveness varies, especially for racially diverse and rural youth, who may feel excluded or unsafe in these spaces (De Pedro et al., 2018).

Research on the differential impact of access versus use of inclusive interventions like GSAs on minority stress for diverse SM adolescents remains limited and it remains uncertain whether the mere presence of such resources is sufficient to impact minority stress or if active engagement is necessary to realize their benefits fully (Elliott et al., 2022; Paceley et al., 2019). Access to resources might point to broader supportive climates in both microsystem school commitment and exosystem priorities of local government funding for inclusive community center programming, shaped by macrosystem social norms and culture that shift from heteronormative and cisnormative standards, thereby impacting sexual minority stress levels experienced by adolescents. Individuals who have access and choose to use structured resources, such as GSAs, might experience differing levels of student engagement and support for the GSA by teachers and administrators, as well as a lack of racial diversity and understanding from school‐designated supportive staff, thus prompting diverging impacts on minority stress levels and experiences of community and social support. School and community inclusive resources and clubs additionally exist within more hostile contextual environments and macrosystems with minimal resources to support successful implementation, counteracting their promotive effects (De Pedro et al., 2018). As SD adolescents attend more inclusive programming, are connected with the LGBTQIA+ community, and further their critical consciousness and knowledge of self‐identity and exploration, they may additionally become more aware of ongoing social marginalization and homonegativity and report higher minority stress or mental health issues (Chan, 2024; Costa et al., 2026; Godfrey et al., 2019). Therefore, understanding how these structural resources are associated with minority stress, a known correlate of poor health outcomes, could provide evidence for interventions aimed at improving the health and well‐being of LGBTQIA+ adolescents. In addition to examining specific contextual minority stressors, it is essential to further explore how differences between access and actual use shape resilience pathways such as peer social support, and coping.

INTERSECTIONAL STRESSORS AND PROTECTIVE FACTORS

Racially minoritized LGBTQIA+ adolescents experience compounding mental health challenges and minority stress due to racist and anti‐LGBTQIA+ harassment and discrimination (Mallory & Russell, 2021; Schmitz et al., 2020; Thoma & Huebner, 2013). Culturally grounded support systems and inclusive school policies addressing race and LGBTQIA+ status are critical to fostering safety and well‐being for adolescents with intersecting racial and sexual diversity. Yet, less attention has been paid to how intersectional inclusivity impacts varying types of minority stress across geographic contexts and within LGBTQIA+ and adolescent‐specific resources in schools and the broader community (Truong et al., 2020). Research indicates that peer and community relationships affirming both racial and LGBTQIA+ identities can promote a sense of belonging and more adaptive coping (Adeyeba et al., 2025; Truong et al., 2020). Intersectional stress due to racist and LGBTQIA+ discrimination may also be alleviated through identity‐congruent friendships and supportive environments (Truong et al., 2020; Hailey et al., 2020; Sarno et al., 2021). Culturally grounded coping strategies, such as peer mentorship, affirming social ties, and shared cultural values, have also been found to enhance emotion regulation and decrease depression and suicidality for racially and sexually minoritized adolescents (Barnett et al., 2023; Truong et al., 2020). Collectively, these findings highlight social support and coping as central mechanisms that can strengthen resilience among sexually and racially diverse youth as a counterbalance to minority stressors.

It is especially important to examine if these mechanisms of change work similarly for racially and ethnically diverse LGBTQIA+ adolescents. Research in this area is relevant and pressing, as many states continue to ban school curricula, supportive inclusive identity groups, and library books containing LGBTQIA+ and racial justice content and representation. Racist and anti‐LGBTQIA+ policies, specifically targeting the K‐12 public school system, have increased steadily in many states creating political battlegrounds with detrimental impacts on the ongoing mental health crisis within the sexual and gender minority adolescent communities.

CURRENT STUDY

This study aims to examine how associations of minority stress, coping, and peer support among sexually and racially diverse adolescents differ based on geographic location (urban versus rural), GSA and LGBTQIA+ community center access and use, and the presence of LGBTQIA+ affirming school staff. Given the limited research on varying types of minority stress for SD youth across contextual factors and intersectional identities, this study aimed to address three central research questions: (1) How is distal minority stress among sexually and racially diverse adolescents associated with various socio‐ecological indicators (geographic location and resource availability and use)? (2) Do associations of distal minority stress differ between sexually diverse adolescents living in rural or urban contexts? and (3) How are peer social support and coping among sexually and racially diverse adolescents associated with intersectional identities and as a function of the role of various socio‐ecological indicators? We hypothesize that access to school and community resources will be associated with decreased distal minority stress for SD adolescents, and further decrease with use of those resources. We additionally hypothesize that rural adolescents of all racial identities will have higher associations of distal minority stressors compared to their urban peers. Finally, based on prior literature, our exploratory hypothesis is that minority SD adolescents will demonstrate higher associations of intersectional and social marginalization minority stressors and more variability in reported coping and friend social support compared to their White peers.

MATERIALS AND METHODS

Procedure

Data for this secondary analysis come from the Adolescent Stress Experiences over Time Study (ASETS) longitudinal cohort (Schrager et al., 2022). The ASETS study was approved by the Institutional Review Board (IRB) at the University of Southern California. Sexually diverse adolescents answered surveys semi‐annually on experiences of stress and health patterns. Initial recruitment for this study occurred between 2018 and 2019. The IRB determined that parental consent could exhibit additional risk for adolescent sexually diverse participants; therefore, parental consent was waived. Participants were recruited online or through participant referrals and consented remotely via chat or phone conversation. After enrollment, participants completed an online survey which took approximately 30–45 min. A multistep fraud checking process removed fraudulent responses (including duplicates, those who missed validation checks, those who completed the survey in an unreasonably short time, and those who misrepresented their identity to gain access). Participants were provided a nominal electronic gift card for their time. Patient and parent/guardian consent were not applicable for the current secondary analysis.

Participants

The analytic sample for this study (N = 1076) included all longitudinally enrolled participants from Wave 1 of the ASETS cohort. Participants ranged in age from 14 to 17 years at enrollment. The sample was racially and ethnically diverse, including youth who identified as American Indian or Native American, Asian or Pacific Islander, Black or African American, Latino or Hispanic, multiracial, or White. Urbanicity was determined using participants' ZIP codes, recoded into a binary indicator (0 = rural, reference; 1 = urban) following recommended guidelines for adapting Rural–Urban Commuting Area (RUCA) codes (McGuire et al., 2023). Specifically, ZIP codes classified as “urban” corresponded to RUCA version 3.1 codes 1.0, 1.1, 2.0, 2.1, 4.1, 5.1, 7.1, 8.1, and 10.1; all other valid RUCA v3.1 codes were classified as “rural.” For ZIP codes lacking a RUCA 3.1 score due to classification changes between versions, the RUCA version 2.0 code was used. Complete demographic characteristics of the sample, including breakdowns by minority stressor exposure, social marginalization, intersectional stress, friend social support, and mean engagement coping scores by subgroup, are presented in Tables 1 and 2.

TABLE 1.

Demographics of sexually diverse adolescent study sample at ASETS baseline longitudinal follow‐up.

Total N (%)
Total 1076
Urbanicity
Rural 213 (19.8%)
Urban 863 (80.2%)
Race
White 625 (58.09%)
Asian/Pacific Islander 72 (6.69%)
Black/African American 90 (8.36%)
Am. Indian/Native Am. 31 (2.88%)
Latino/Hispanic 147 (13.66%)
Multiracial 111 (10.32%)
Sexual orientation
Mostly heterosexual (straight), somewhat attracted to people of your own gender 55 (5.11%)
Bisexual or Pansexual 458 (42.57%)
Mostly homosexual (gay/lesbian), but somewhat attracted to people of the opposite gender 214 (19.89%)
100% homosexual (gay/lesbian) 328 (30.48%)
Unsure 21 (1.95%)
Gender*
Male 357 (33.2%)
Female 719 (66.8%)
Age M (SD) 15.83 (1.09)
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Note: In the initial wave of the ASETS data collection, gender was only collected in binary male or female without additional, more expansive gender identity options. Pansexual was described to participants as “individuals who are attracted to people regardless of gender identity.”

*gender was only collected in the binary form. 

TABLE 2.

Descriptive characteristics of study sample by distal minority stressors, friend social support, and reported coping (N = 1076).

Total N (%) Experienced homonegative climate MS Experienced social marginalization MS Experienced intersectionality MS Reported friend social support Coping
N (% of Total) N (% of Total) N (% of Total) N (% of Total) M (SD)
Total 1076 502 (46.7%) 318 (29.55%) 506 (47.03%) 956 (88.9%) 25.168 (5.36)
Urbanicity
Rural 213 (19.8%) 130 (61.03%) 72 (33.8%) 88 (41.31%) 185 (87.26%) 24.5 (5.5)
Urban 863 (80.2%) 372 (43.11%) 246 (28.5%) 418 (48.44%) 771 (89.34%) 25.3 (5.2)
Race
White 625 (58.09%) 316 (50.56%) 181 (28.96%) 196 (31.36%) 557 (89.12%) 25.07 (5.3)
Asian/Pacific Islander 72 (6.69%) 26 (36.11%) 19 (26.39%) 58 (80.56%) 65 (90.28%) 25.4 (5.1)
Black/African American 90 (8.36%) 32 (35.56%) 19 (21.11%) 71 (78.89%) 77 (85.56%) 24.1 (5.8)
Am. Indian/Native Am. 31 (2.88%) 18 (58.06%) 51 (35.48%) 17 (54.84%) 29 (93.55%) 25.6 (5.8)
Latino/Hispanic 147 (13.66%) 59 (40.14%) 53 (36.05%) 96 (65.31%) 128 (87.67%) 25.5 (5.5)
Multiracial 111 (10.32%) 51 (45.95%) 35 (31.53%) 68 (61.26%) 100 (90.09%) 25.8 (5.4)
GSA (N = 1017)
GSA No Pres. or Use 361 (35.5%) 196 (54.29%) 137 (37.95%) 189 (52.35%) 308 (85.56%) 23.9 (5.3)
GSA presence 339 (33.33%) 125 (36.87%) 79 (23.3%) 133 (39.23%) 307 (90.56%) 25.6 (5.2)
GSA Use 317 (31.17%) 153 (48.26%) 83 (26.18%) 150 (47.32%) 290 (91.48%) 26.0 (5.3)
Community center (CC) (N = 1067)
CC No Pres. or Use 814 (76.29%) 393 (48.28%) 235 (28.87%) 376 (46.19%) 719 (88.44%) 24.8 (5.3)
CC Presence 181 (16.96%) 73 (40.33%) 46 (25.41%) 83 (45.86%) 166 (91.71%) 26.2 (5.5)
CC Use 72 (6.75%) 32 (44.44%) 34 (47.22%) 43 (59.72%) 62 (86.11%) 26.1 (5.3)
Affirming school staff (N = 1045)
No 256 (24.5%) 127 (49.61%) 79 (30.86%) 126 (49.22%) 208 (81.25%) 23.6 (5.4)
Yes 789 (75.5%) 364 (46.14%) 229 (29.02%) 366 (46.39%) 721 (91.38%) 25.7 (5.2)
Peer social support (N = 1075)
No 119 (11.07%) 69 (57.98%) 51 (42.86%) 62 (52.1%) ‐ 21.6 (5.8)
Yes 956 (88.93%) 432 (45.19%) 266 (27.82%) 444 (46.44%) ‐ 25.6 (5.1)
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Measures

Distal minority stress

Three sub‐scales of the The Sexual Minority Adolescent Stress Inventory (SMASI) were used to assess experiences of minority stress over the past 30 days (Schrager et al., 2018). The social marginalization subscale captured stressors related to adolescents' school, neighborhood, and community environments. The homonegative climate subscale focused specifically on school‐based stressors, while the intersectional subscale measured stress experiences arising from the interaction of adolescents' sexual and racial identities. Sample items include: “Other youth refuse to hang out with me because I am LGBTQ” (social marginalization); “It's hard to be an LGBTQ person at my school” (homonegative climate); and “Other people who are in my racial/ethnic community judge me for being LGBTQ” (intersectionality). For this analysis, separate sub‐scale totals were calculated for homonegative climate, social marginalization, and intersectional stress. The SMASI has demonstrated good internal consistency and validity in adolescent sexually diverse samples (Schrager et al., 2018). Internal consistency was assessed using McDonald's omega. Values were excellent for homonegative climate (ω = .94) and social marginalization (ω = .95), and good for the intersectional subscale (ω = .87; Cicchetti, 1994). Each subscale was then dichotomized to create a dummy variable reflecting minority stress exposure over the past 30 days: No exposure (subscale total = 0; reference category) and Exposure (subscale total > 0). This dichotomization approach is grounded in the binary Yes/No item structure of the SMASI itself (Schrager et al., 2018), wherein each item functions as an indicator of stressor presence or absence, and reflects the conceptually meaningful distinction between any exposure to a minority stressor versus none—consistent with minority stress theory's core premise that exposure to stigma‐related stressors is the proximate mechanism driving health disparities (Meyer, 2003). While continuous scoring preserves variance, dichotomization offers a theoretically grounded and interpretable operationalization of stressor exposure. Consistent with the original Yes/No format, items were coded as 0 = No (reference) and 1 = Yes, with Yes indicating the presence of the stressor.

Peer social support

The Multidimensional Scale of Perceived Social Support (MSPSS) is a 12‐item self‐report questionnaire designed to measure perceived social support from three sources: family, friends, and significant others, using a 7‐point Likert scale. Higher scores reflect greater perceived social support. Examples of friend support items include, “My friends really try to help me,” and “I can talk about my problems with my friends.” The MSPSS has demonstrated strong reliability and validity across diverse adolescent populations, with Cronbach's alpha values typically ranging from .85 to .91 (Zimet et al., 1988). In the current sample, alpha for the peer support subscale was 90. The peer support subscale was dichotomized to create a binary indicator distinguishing youth with low or no perceived peer support from those with adequate peer support. Consistent with the MSPSS scoring conventions established by Zimet et al. (1988), in which mean subscale scores of 1–2.9 reflect low support and scores of 3.0 and above reflect moderate to high support, the dichotomization threshold of 4 was selected to reflect a meaningful distinction between clearly low support (scores 1–3) and adequate or higher support (scores 4–7). While the continuous scale captures finer gradations in perceived support, this binary operationalization aligns with the conceptual distinction between support insufficiency and support adequacy that is most relevant to the study's research questions. For this analysis, mean scores were calculated for the subscale measuring peer social support and were dichotomized into either “No/Low Peer Social Support” (scores 1–3) or “Peer Social Support” (scores 4–7).

Coping

Coping was measured using the Coping Strategy Inventory‐Short Form (CSI‐SF) (Addison et al., 2007). The CSI‐SF is a 16‐item self‐report measure used to assess how individuals respond to stress using different coping approaches (Tobin, 2001). The CSI‐SF has shown strong reliability and validity across adolescent populations (Addison et al., 2007). In the current sample, Cronbach's alpha for the engagement coping subscale was .75. This study used the measure to address the engagement domain of coping, across both problem focused and emotion focused strategies (8 items total). Sample engagement‐oriented items include “I step back from the situation and try to put things into perspective” (problem engagement) and “I let my feelings out to reduce the stress” (emotion engagement). Respondents rated how often they used each coping strategy on a Likert‐type scale ranging from 1 (Never) to 5 (Almost Always), and engagement coping items were summed to create a composite score for analysis.

GSA presence and use

GSA presence at school was measured using a categorical three‐answer response (Yes/No/Unsure) for the question “Does your school have a group or club specific to the LGBTQ+ community (such as a GSA, QSA, etc.)” This variable was recoded into a binary format, merging “Unsure” into the “No” response category, as the adolescents' lack of knowledge on the type of service removes integral aspects of inclusive group access and use comparisons (No = 0 reference; Yes = 1). While collapsing “Unsure” responses into the “No” category may introduce some degree of misclassification, such that adolescents who are uncertain about GSA availability may attend schools with GSAs they are unaware of, the potential for underestimating access and biasing findings toward null effects is outweighed by parsimony and interpretability. GSA attendance and use were measured using a categorical three‐answer response (Yes/No/Unsure) for the question “Have you participated in meetings or activities sponsored by an LGBTQ+ club at your school?” For analytic consistency, responses of Unsure were recoded into the No category, resulting in a binary variable (No = 0, reference; Yes = 1). A single variable was then created to represent levels of GSA engagement: no access or use (0; reference), access without use (1), and access and use (2).

Supportive school staff

Participants reported on supportive adults at school by responding to a single binary item, “I had at least one LGBTQ supportive adult/teacher at school” (No = 0 reference; Yes = 1).

Community center access and use

Access to LGBTQIA+ inclusive community centers and programming was measured using a binary question (No = 0 reference; Yes = 1) “If you wanted to go to an LGBTQ+ center, do you currently have regular access to one? Meaning, you know where one is and you have a way to get there.” LGBTQIA+ community center use was measured categorically using a four‐point Likert scale (1 = Never; 2 = Sometimes; 3 = Often; 4 = regularly) “I spent time at an LGBTQ center.” This variable was recoded into a binary format, where Never (1) was categorized as No (0; reference group) and responses from sometimes (2) to regularly (4) were categorized as Yes (1). From this, a dummy variable was constructed to distinguish levels of engagement: No access or use (0; reference), access only (1), and access and use (2). While recoding “Unsure” responses for community center access into the “No” category could result in misclassification and attenuate observed associations between community center access and study outcomes, it stands to reason that participants without knowledge of a community center would thus not recognize access to one even if it were technically available.

Data analytic plan

Descriptive statistics were calculated to summarize the demographic characteristics of the sample and the prevalence of minority stressors, peer social support, community resources, and coping behaviors. Bivariate associations between demographic variables (e.g., age, race/ethnicity, urbanicity) and all variables of interest (access to GSAs or community centers, minority stress domains, and social support) were assessed using Pearson chi‐square tests for categorical variables.

To address Research Question 1, how distal minority stress among sexual and racially diverse adolescents is associated with socio‐ecological indicators including geographic location and resource availability and use, three binary logistic regression models were conducted, with homonegative climate minority stress, social marginalization minority stress, and intersectional minority stress each serving as separate binary outcomes. Independent variables in each model included urbanicity, race/ethnicity, GSA engagement level, LGBTQ community center engagement level, and the presence of affirming school staff.

To address Research Question 2, whether associations of distal minority stress differ between sexually diverse adolescents living in rural versus urban contexts, urbanicity was included as a focal predictor in each of the three logistic regression models described above, allowing for direct examination of urban/rural differences in the likelihood of experiencing each minority stress domain, net of other socio‐ecological factors.

To address Research Question 3, how peer social support and coping among sexually and racially diverse adolescents are associated with intersectional identities and socio‐ecological indicators, two additional models were estimated. A binary logistic regression model was used to predict the likelihood of peer social support, and a multiple linear regression model was used to predict engagement‐oriented coping scores. In both models, independent variables included urbanicity, race/ethnicity, GSA engagement, community center engagement, and the presence of affirming school staff, permitting examination of how these contextual and identity‐related factors jointly relate to support and coping outcomes.

Participants were included in the analytic sample if they had complete data for all variables included in the relevant model. Missing data were handled using listwise deletion. Rates of missingness were low across all variables, ranging from 0.1% for peer social support to 5.5% for GSA engagement. Listwise deletion produces unbiased estimates when data are missing completely at random (MCAR); under missing at random (MAR) conditions, it introduces bias that worsens as the proportion of missing data increases and as the determinants of missingness are unaccounted for in the analysis model (Graham, 2009; Newman, 2014). Given the nature of the ASETS recruitment and data collection procedures, there was no clear evidence of systematic missingness that would suggest a missing not at random (MNAR) mechanism. While multiple imputation (MI) is recommended as a best practice under MAR assumptions (Dong & Peng, 2013; Lang & Little, 2018), two considerations support the use of listwise deletion here. First, when the missingness mechanism is uncertain or potentially MNAR, simulation research has demonstrated that MI can be more biased than listwise deletion, even when observed variables are strongly correlated with the incomplete ones (Pepinsky, 2018). Second, the complete case estimator used by listwise deletion can remain unbiased under MAR conditions when the determinants of missingness are controlled for in the regression model—a condition plausibly met in the present analyses (Arel‐Bundock & Pelc, 2018). The combination of low missingness rates and absence of evidence for systematic nonresponse supports the use of listwise deletion in this analysis.

RESULTS

We conducted bivariate chi‐square tests to evaluate whether the means of these outcomes, or other demographic factors, were different among demographic groups. Statistically significant findings from bivariate analysis are as follows. There were statistically significant differences by race for homonegative climate (χ 2 (5, N = 1076) = 15.65, p = .008) and intersectional minority stress (χ 2 (5, N = 1076) = 160.25, p < .001). Race was also differently distributed according to urbanicity (χ 2 (5, N = 1076) = 60.75, p < .001), and GSA use or access (χ 2 (10, N = 1017) = 26.38, p = .003). Access or use of a GSA was differently distributed by urbanicity (χ 2 (2, N = 1017) = 93.15, p < .001), as was access or use of a LGBTQ community center (χ 2 (2, N = 1067) = 33.66, p < .001). Access or use of a GSA was statistically associated with the presence of friend social support (χ 2 (2, N = 1016) = 7.2, p = .027). None of the outcomes or other demographic factors were distributed differently by sex assigned at birth. Results from the logistic regressions predicting domains of minority stress (homonegative climate, social marginalization, and intersectional) are listed in Table 3. Results from the logistic regression predicting peer social support and regression predicting engagement‐oriented coping strategies are listed in Table 4. Race and urbanicity were entered as simultaneous independent variables in all models. Although distributions urbanicity varied by race/ethnicity, there were insufficient cross‐category sample sizes to estimate interaction effects between these variables.

TABLE 3.

Relative odds of homonegative climate, social marginalization, and intersectional minority stress.

Homonegative climate Social marginalization Intersectional
OR p 95% CI OR p 95% CI OR p 95% CI
Urbanicity (ref. rural) .655 .016* [.45, .88] 1.1 .624 [.75, 1.6] 1.15 .475 [.79, 1.7]
Race (ref. White)
Asian/Pacific Islander .666 .14 [.38, 1.1] 1.1 .843 [.59, 1.9] 12.3 .000*** [6.3, 23]
Black or African American .577 .03* [.35, .95] .665 .169 [.37, 1.2] 9.5 .000*** [5.3, 17]
Am. Indian/Native Am. 1.29 .494 [.16, 2.7] 1.13 .765 [.52, 2.5] 2.5 .015* [1.2, 5.3]
Latino/Hispanic .706 .079 [.48, 1.0] 1.4 .107 [.93, 2.1] 4.6 .000*** [3.1, 7.0]
Multiracial .984 .944 [.63, 1.5] 1.2 .444 [.75, 1.9] 3.7 .000*** [2.4, 5.9]
GSA (ref. no presence or use)
GSA presence .603 .003** [.43, .84] .461 .000*** [.32, .66] .436 .000*** [.30, .63]
GSA use 1.03 .879 [.73, 1.5] .500 .000*** [.34, .73] .642 .022* [.44, .94]
Community Center (CC) (ref. no presence or use)
CC presence .717 .2119 [.47, 1.1] .914 .741 [.56, 1.5] .890 .614 [.57, 1.4]
CC USE 1.06 .820 [.63, 1.8] 2.57 .001** [1.5, 4.4] 1.24 .468 [.69, 2.2]
Affirming school staff (ref. not present) .861 .343 [.63, 1.2] 1.06 .894 [.75, 1.5] .855 .359 [.61, 1.2]
Pseudo R 2 .032*** .035*** .141***
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Note: *p < .05, **p < .01, ***p < .001. Total number of observations in each of the three minority stress models (N = 980).

Abbreviations: CI, confidence interval; OR, odds ratio.

TABLE 4.

Peer social support and coping by urbanicity, race, GSA presence & use, LGBTQ+ community center presence & use.

Peer social support Coping
OR p 95% CI β p 95% CI
Urbanicity (ref. rural) .982 .948 [.58, 1.7] .268 .553 [−.62, 1.2]
Race (ref. White)
Asian/Pacific Islander .931 .870 [.40, 2.2] −.317 .646 [−1.7, 1.0]
Black or African American .840 .639 [.40, 1.7] .268 .149 [−2.2, .33]
Am. Indian/Native Am. 2.07 .333 [.47, 9.1] .268 .371 [−1.0, 2.8]
Latino/Hispanic .832 .541 [.46, 1.5] .268 .881 [−.91, 1.1]
Multiracial .951 .887 [.47, 1.9] .268 .189 [−.38, 1.9]
GSA (ref. no presence or use)
GSA presence 1.43 .170 [.86, 2.4] 1.05 .016* [.19, 1.9]
GSA use 1.43 .206 [.82, 2.5] 1.24 .007** [.35, 2.1]
Community center (CC) (ref. no presence or use)
CC presence 1.40 .409 [.63, 3.1] .979 .066 [−.06, 2.0]
CC use .644 .264 [.30, 1.4] .258 .710 [−1.1, 1.6]
Affirming School Staff (ref. not present) 2.05 .001*** [1.3, 3.2] 1.63 .000*** [.84, 2.4]
Pseudo R 2 .0301*** .0404***
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Note: *p < .05, **p < .01, ***p < .001. Total number of observations in the Peer Social Support logistic regression and Coping linear regression models (N = 980).

Abbreviations: CI, confidence interval; OR, odds ratio; β, linear regression coefficient.

Model 1: Homonegative climate minority stress

Urban youth were less likely to report any experience of homonegative climate compared to rural youth (OR [95% CI] = .655 [.45, .88], p = .016). Black/African American youth were also less likely to report homonegative climate experiences, compared to White youth (OR [95% CI] = .577 [.35, .95], p = .03). No other race/ethnicity group had statistically different odds of homonegative climate experience compared to White youth. Youth in schools with a GSA that they did not attend (compared to schools with no GSA) had decreased odds of homonegative climate experiences (OR [95% CI] = .603 [.43, .84], p = .003). However, youth who attended their school's GSA were not statistically more or less likely to report experiencing homonegative climate than youth in schools without a GSA (OR [95% CI] = 1.03 [.73, 1.5], p = .879). There were no statistically significant associations between homonegative climate experiences and presence/use of LGBTQ community centers or presence of affirming school staff.

Model 2: Social marginalization minority stress

There were no associations between urbanicity or race/ethnicity and the odds of reporting social marginalization experiences. Youth at schools with GSAs were less likely to report social marginalization (compared to youth at schools without GSAs), whether they attended the GSA (OR [95% CI] = .50 [.34, .73], p < .001) or not (OR [95% CI] = .461 [.32, .66], p < .001). However, youth who attended an LGBTQ Community Center were more likely to report social marginalization, compared to youth in communities without such a center (OR [95% CI] = 2.57 [1.5, 4.4], p < .001). There were no differences in reported social marginalization if a community center was present, but not attended (OR [95% CI] = .914 [.56, 1.5], p = .741). However, due to the low sample sizes of youth who had access to a community center, these results should be considered preliminary. Presence of an affirming school staff member was not associated with social marginalization experiences.

Model 3: Intersectional minority stress

Unsurprisingly, all racial/ethnic minority youth had a higher likelihood of reporting intersectional minority stress compared to White youth. However, there was no difference in odds of reporting intersectional minority stress by urbanicity (OR [95% CI] = 1.15 [.79, 1.7], p = .475). Youth in schools with GSAs were less likely to report intersectional minority stress than those in schools without GSAs, whether they attended the GSA (OR [95% CI] = .642 [.44, .94], p = .022) or not (OR [95% CI] = .436 [.30, .63], p < .001). Presence/use of LGBTQ community centers or presence of affirming school staff were not associated with intersectional minority stress experiences.

Model 4: Friend social support

The likelihood of having supportive peers was not significantly associated with urbanicity or race/ethnicity. Further, presence or attendance of a GSA or LGBTQ community center (compared to having no access to these things) was not associated with the likelihood of having supportive peers. The only variable in the model significantly associated with the likelihood of reporting peer support was the presence of affirming school staff I (OR [95% CI] = 2.05 [1.3, 3.2], p = .001).

Model 5: Coping strategies

Use of engagement‐oriented coping strategies was not associated with urbanicity or race/ethnicity. Presence of a GSA was associated with reporting greater use of coping strategies (compared to no GSA access). This association was higher for youth who attended a GSA (β = 1.24, p = .007) than those who had access to a GSA but did not attend (β = 1.05, p = .016). Presence of an affirming school staff member was also associated with greater use of engagement‐oriented coping strategies (β = 1.63, p < .001).

DISCUSSION

Our findings support prior research that rural adolescents experience higher levels of minority stress related to homonegative climate, such as experiences of verbal and physical harassment, compared to youth in more urban areas (Dwyer et al., 2015; Kosciw et al., 2009; Paceley et al., 2019; Palmer et al., 2012; Rand & Paceley, 2022). As the homonegative climate measure used in this study (which comes from the Sexual Minority Adolescent Stress Inventory (SMASI)) specifically measures harassment and stress experiences within the school setting, these findings may point to rural–urban disparities in broader school‐level assets that could buffer minority stress. Such assets—including trusted adults, the presence of specific information and support for LGBTQIA+ identities, and inclusive policies—have been consistently shown to be less common in rural schools. In this study, rurality was not significantly associated with higher levels of social marginalization or intersectional minority stress, nor did rural adolescents have significantly varying levels of peer social support or coping skills. This suggests that despite known differences in school assets and higher rates of homonegative climate experiences, there nevertheless may exist affirming relationships and protective factors across geographic contexts helping to moderate the impact of these resource disparities for rural youth. These rurality findings vary from our initial hypothesis that rural adolescents would report experiencing more distal minority stressors across all three models. Our findings indicate that school‐specific research in rural settings requires further examination to understand contextual and school structure dynamics at play for SD adolescents. As our study did not directly assess how specific contexts and dynamics may operate as buffers between resource‐poor environments and youth outcomes, and given the higher rates of homonegative climate experiences among rural youth, these findings warrant future research into the factors associated with resilience for youth in rural settings (Price‐Feeney et al., 2019; Rand & Paceley, 2022).

The race and ethnicity of SD adolescents in this study had variable associations with minority stress outcomes, with Black students less likely to report homonegative climate stress than White students and no statistically significant differences in social marginalization stress, contrary to our original hypothesis. Racially minoritized adolescents, apart from American Indian and Alaska Native (AI/AN) respondents, reported descriptively lower levels of homonegative climate stress than their White peers, offering a counter‐narrative to prior research findings and underscoring the need to explore school‐based protective factors that may contribute to resilience outside of GSAs and supportive staff. The variance observed among AI/AN SD adolescents may be due in part to the small sample size (n = 31) and limited statistical power when compared to their White counterparts.

This study did not explicitly assess what factors were associated with lower homonegative climate stress for racial and ethnic minority youth. Future research could explore whether existing cultural and community protective factors within racial and ethnic communities serve as potential sources of resilience for racial and ethnic minority students. Another possible interpretation of these somewhat unexpected findings is that students navigating compounded stressors across multiple marginalized identities may weigh experiences differently, such that school‐based homonegative climate related only to sexual identity registers as comparatively less salient than intersectional homonegative climate. While the Sexual Minority Adolescent Stress Inventory (SMASI) includes subscales measuring homonegative climate minority stress within schools and intersectional minority stress across life domains more broadly, this distinction may limit its ability to capture the combined racist and homonegative experiences of sexual and racial minoritized adolescents specifically within school settings. It is also possible that school settings, as more structured and regulated environments, offer a degree of protection not consistently present in broader community settings, where racial and ethnic minority youth may encounter fewer formal safeguards against racial discrimination.

As expected, all racially marginalized students were more likely to report experiences of intersectional minority stress—validating both our hypothesis and the fact that this domain within SMASI is designed to capture experiences of intersectional stress unique to racial and ethnically marginalized LGBTQ+ youth (Schrager et al., 2018). Based on prior research, we know that intersectional social support from adults and peers who are aligned with multiple identities can operate as chosen family and intergenerational sources of support for youth, underscoring the importance of racial/ethnic school composition of both staff and students, in combination with other intersectional identities, for truly supportive school environments (Hailey et al., 2020; Robinson et al., 2026). These findings underscore the ongoing need to better understand how schools and communities can effectively create intersectionally grounded supports that provide spaces for affirmation and self‐exploration, with the downstream hopes of improving outcomes for sexually and racially diverse youth (Sarno et al., 2021; Truong et al., 2020). Further, as this study found that GSA presence and access were both associated with reduced intersectional minority stress experiences, GSAs that are thoughtfully designed and supported by staff and students who hold racial/ethnic and other intersectional identities may help ensure that these school programs are inclusive and have meaningful minority stress‐reduction impacts for racial and ethnic minority students.

A key strength of examining distal minority stressors across three domains using distinct models is the ability to disentangle how access to and use of structural supports shape stress experiences across multiple ecological levels. Leveraging distinct SMASI subscales enabled us to isolate stressors experienced within school contexts (homonegative climate), those spanning school and community environments (social marginalization), and stressors operating at the intersection of racial/ethnic and LGBTQIA+ identities (intersectional), thus capturing distinct yet interrelated facets of sexually and racially diverse adolescents' lived experiences. Across the three minority stress models, results reveal how access to and participation in structural and contextual cultural assets, like GSAs and LGBTQ+ community centers, shape minority stress and resilience experiences among racially and sexually diverse adolescents. GSAs and LGBTQ+ community centers are community‐driven responses to marginalization that can create affirming spaces, foster connection, and facilitate resource sharing within both school and broader community contexts. In this study, the presence of a GSA, regardless of individual participation, was associated with reduced minority stress across all three measures and improved coping. While this study did not measure mechanisms by which the presence of a GSA—regardless of individual‐level use—may impact minority stress and coping, these findings suggest that GSA existence could reflect other inclusive school structures that may contribute to more affirming environments for all LGBTQ+ students, or be indicative of broader institutional support and acceptance among school staff and within the district. Additionally, students who reported engagement with GSAs had lower odds of social marginalization and intersectional stress and increased coping skills, highlighting the dual importance of structural availability and individual connection to affirming resources.

While homonegative climate stress was not statistically significantly higher among GSA users in models compared to those in schools with no GSA, in descriptive findings, youth who attended GSAs were more likely to have reported this type of stress in the past 30 days (48.3%) compared to those in schools with GSA presence, but who did not use the GSA (36.9%; Table 2). These findings align with prior research demonstrating GSAs produce lower levels of safety for some SGM youth (De Pedro et al., 2018; Rand & Paceley, 2022). While the specific mechanisms of this relationship are unknown, this may suggest that as community building and knowledge expand through GSA participation, sexually diverse adolescents develop greater self‐identified coping skills while also becoming more aware of homonegative climate, possibly due to increased visibility and exposure associated with their involvement. The unexpected finding that LGBTQ+ community center attendance was associated with greater social marginalization stress for SD adolescents adds further evidence to the possibility that increased visibility could be associated with greater exposure to minority stress experiences. This finding raises important questions about disclosure, help‐seeking behaviors, and the role of these centers in buffering minority stress regardless of geographic location. One potential explanation for this pattern—not measured in this study—is a self‐selection effect, whereby sexually diverse adolescents with higher baseline experiences of social marginalization are more likely to seek out and use supportive community programs. At the same time, community center programs may vary in their capacity to provide genuinely inclusive, safe, and affirming spaces, particularly for sexually and racially diverse adolescents in less supportive community climates.

Neither access to nor participation in inclusive community centers significantly contributed to adolescents' self‐identified coping skills. This finding suggests that community‐based programming may have differential impacts compared to school‐based supports, and while we did not directly measure how resilience or coping skills might moderate this relationship, this finding may reflect differences in how community centers vs. schools foster individual skill development and enhance resilience through coping mechanisms. Further, as schools are deeply embedded in adolescents' daily lives, the comparatively higher access to and use of school‐based supports in our study—relative to community‐based programs—may be attributed to greater awareness, familiarity, and overall accessibility of school programming for adolescents. The considerably lower rate of community center use in this sample (6.8%) as compared to GSA use (31.2%) may reflect the lower general accessibility of community centers vs. school programming for students who may not have their own transportation or may not have disclosed their identity to families (and therefore are not accessing settings that may lead to visibility of their identities in the wider community); (McInroy et al., 2019; Mehus et al., 2017; Wagaman et al., 2020); however, this rate likely also reflects the broad range of community contexts and wide disparities in access to these centers across the country (Rosentel et al., 2020; Sallabank et al., 2023).

In this study, the presence of affirming school staff was not related to differences in minority stress experiences, but was associated with higher levels of peer social support and greater coping skills. Given the centrality of schools in adolescents' everyday environments, these findings may point to affirming school staff as a critical factor in shaping resilience skills for youth even within settings with high levels of minority stress and victimization. It is also possible that the influence of school‐based supports may depend on the presence and actions of affirming staff who directly shape students' experiences of safety, belonging, and resilience (Ross‐Reed et al., 2019). Future research may directly support effective interventions by examining how the capacity for building and supporting resilience factors for LGBTQIA+ students may be strengthened by the presence of affirming staff within schools. Combined with the association of coping skills with GSA presence and access, these findings reinforce the importance of structural support within schools to support SD students in buffering the impact of negative minority stress experiences (Elliott et al., 2022; Paceley et al., 2019).

These findings contribute to a growing understanding of how racially and sexually diverse youth navigate and thrive within school and community contexts by identifying protective structures and relationships that support their well‐being and decrease minority stress (Ballard et al., 2017; Ross‐Reed et al., 2019). However, limited inclusion of racially and sexually diverse adolescents in rural research contexts constrains our understanding of minority stress in these settings and reinforces metronormative assumptions that rural and remote communities are inherently less inclusive for racially and sexually diverse individuals. Future research should further investigate the mechanisms by which structural resources shape minority stress experiences, particularly in relation to help‐seeking behaviors and culturally grounded forms of resilience among racially and sexually diverse adolescents.

LIMITATIONS

Metronormativity in sampling limited our ability to analyze the interaction of rurality with race/ethnicity. Further participant sampling in rural areas, with specific emphasis on racially marginalized adolescents, would have expanded understanding of intersectional factors on distal minority stressors. Future research should emphasize purposeful sampling of rural schools and communities to ensure adequate representation of settings with limited or no established LGBTQIA+ supportive infrastructures. Our findings were further constrained by the limited presence of Gender and Sexuality Alliances (GSAs) in rural contexts, which restricted the ability to capture the nuanced ways these organizations and their use shape experiences of belonging, peer support, and coping among sexually and gender diverse adolescents. Expanding research in rural areas can help clarify how informal support and community connection operate in the absence of more formalized school and community‐based resources. Due to the limited statistical power for some racial/ethnic groups when compared to their White counterparts, comparisons of use and access of structural resources in addition to rural and urban comparisons by race and ethnicity were unable to be included as interaction analyses in our models. Without school and community level measures of racial composition and policy context, racial differences in minority stressors, coping, and social support remain only partially explained by this study.

An important limitation of the baseline ASETS data is the use of cisnormative gender identity options (limited to “male” and “female”) in collecting participants' demographic information. As a result, this study was unable to examine the experiences of gender‐expansive and transgender adolescents in relation to distal minority stressors across socio‐ecological factors. In the current US political and legislative climate, it is critical to understand the distinct minority stress experiences of transgender and gender‐expansive adolescents, particularly those navigating intersecting racial and sexual identities.

While the sample size for this study was a strength, the entirety of the sample was recruited online and completed surveys asynchronously from the research team. This may bias our findings to include adolescents with more consistent internet and electronic device access, as well as limit the opportunities for adolescent participants to ask clarifying questions on any scales or measurement questions before completing the surveys. Recruitment for the study was advertised through platforms like Facebook, YouTube, and Instagram, which limited the sample to only include adolescents on those platforms. The study was additionally cross‐sectional in nature, limiting the ability to observe trends over time or beyond the 30‐day minority stress experiences.

FUTURE DIRECTIONS

Future qualitative and mixed‐methods research could deepen and extend the current findings by examining the nuanced relationships between engagement in inclusive supportive structures, such as GSAs, and the concurrent patterns of increased promotive coping alongside heightened experiences of distal minority stress in homonegative school climates. Such inquiry beyond quantitative metrics could help illuminate how visibility, disclosure, and identity affirmation within supportive spaces might simultaneously strengthen individual coping resources while exposing youth to broader social or structural stigma. Additionally, community‐based participatory approaches and in‐depth qualitative methods could help in gaining a more specific understanding of why participation in community‐based programming was associated with higher distal minority stress and decreased self‐reported peer social support and coping would allow researchers and practitioners to identify contextual mechanisms, such as program inclusivity, geographic accessibility, or community climate, that influence these outcomes. This knowledge can help shape more targeted and context‐responsive strategies for designing and implementing supports that actually fit the realities of rural sexual and racially diverse youth. With that grounding, interventions can better reduce minority stress and build resilience among sexually and racially diverse adolescents, especially in rural or more restrictive policy environments.

Future research should build on these findings by examining how rural sexual and racially diverse youth navigate the intersecting impacts of policies that are restrictive toward both racial and sexual/gender minority populations. In 2025, nearly 44% of sexually diverse adolescents resided in states with restrictive or hostile policy climates characterized by negative or low SGD youth policy scores (Movement Advancement Project, 2025). These conditions highlight the importance of understanding how broader policy contexts shape adolescents' lived experiences within local environments, particularly in rural communities. Although rural adolescents are just as likely as their urban peers to identify as sexually diverse, representing an estimated 1.3 million youth across the United States, metronormativity and sampling biases have contributed to their persistent underrepresentation in research, particularly for racially diverse adolescents. Future studies should therefore focus on identifying the contextual factors that exacerbate minority stress during use of inclusive services and constrain access to affirming supports, including community centers and GSAs, within rural areas.

CONCLUSION

Findings from this study reinforce prior evidence that rural adolescents of all races experience heightened minority stress related to homonegative school climate, while also complicating metronormative assumptions by showing no associations of consistent rural disadvantage in social marginalization or intersectional minority stress. While both the presence of school‐based supports and student attendance were associated with increased promotive coping behaviors and reduced social marginalization and intersectional minority stress, only the presence of a GSA, rather than attendance, was significantly associated with lower levels of homonegative school climate compared to schools without a GSA. The presence of a GSA appears to function as both a structural and symbolic protective factor that shapes school‐wide climate, whereas attendance reflects a more proximal, engagement‐based form of resilience. Participation may be the mechanism through which youth acquire concrete coping skills and experience reductions in social marginalization and intersectional stress, underscoring the complementary importance of institutional support and individual‐level engagement. These findings reinforce prior literature and emphasize the importance of school‐based structural supports, especially affirming staff, in influencing minority stress, coping, and resilience among sexually diverse youth. The presence of affirming adults appears to have a protective effect by both reducing exposure to stressors and strengthening youth ability to navigate hostile or exclusionary environments through enhanced coping. Through ongoing affirmation, advocacy, and skills‐based support, affirming staff may not only foster individual resilience but also contribute to substantive reductions in adolescent experiences of systemic minority stress. At the same time, the lack of impact on intersectional minority stress points to potential limitations in existing staff training and composition and the compounded effects of layered minority stressors, suggesting that intersectionality‐inclusive approaches may not yet be fully integrated into school practices and sexually and racially diverse adolescents continue to experience compounding minority stressors.

POSITIONALITY STATEMENT

Our authorship team includes prolific early, mid, and late career scholars and a PhD student with established collaborative relationships. We are an all‐White authorship team, with four authors identifying as sexually diverse, and two authors identifying as transgender or nonbinary. Three authors bring lived experience from growing up in rural communities within the United States and approach this work with lived familiarity of rural social, educational, and community contexts. The team has an extensive history of conducting research with sexually diverse adolescent communities. This team brings complementary expertise spanning rural minority stress and school climate among sexually diverse youth; advanced biostatistical and multilevel modeling approaches to understanding sexually diverse adolescents' sexual relationships and mental health outcomes; and the study of sexually diverse adolescents' social networks, supports, and relational environments. Collectively, their work centers on improving mental health outcomes, reducing substance use, and advancing LGBTQIA+‐specific, school‐based interventions, including the development and validation of psychometric measures of minority stress for sexually and gender diverse adolescents. One of the contributors, Dr. Goldbach, is a posthumous senior author, and this publication is dedicated to their honor.

AUTHOR CONTRIBUTIONS

Jules Wood: Conceptualization; writing – original draft; writing – review and editing. Harmony Rhoades: Conceptualization; funding acquisition; writing – original draft; methodology; writing – review and editing; supervision. Joshua Rusow: Writing – original draft; methodology; writing – review and editing; formal analysis. Jeremy Goldbach: Conceptualization; funding acquisition; data curation. Shauntal J. Van Dreel: Conceptualization; investigation; writing – original draft; methodology; visualization; validation; writing – review and editing; formal analysis; project administration; data curation.

FUNDING INFORMATION

Secondary data analyzed in this study came from Dr. Jeremy Goldbach's National Institute on Minority Health and Health Disparities funded US longitudinal cohort study of sexually diverse adolescent experiences of stress and health patterns (5R01MD012252). This funding source was not used during the study design, analysis of data, interpretation of results, or writing of this manuscript. One of the authors of this study is a National Institute of Mental Health (NIMH) T32 Predoctoral Fellow in Mental Health Services Research, and subsequently, their work on this project was funded by this fellowship (T32MH019960).

CONFLICT OF INTEREST STATEMENT

There are no existing conflicts of interest associated with this study.

ETHICS STATEMENT

Ethics approval for this study is covered under the Washington University in St. Louis Institutional Review Board (202212035), last approved on 10/15/2025.

CONSENT

Informed participant assent was obtained in the initial data collection for the Adolescent Stress Experiences over Time Study (ASETS) longitudinal cohort. Initial recruitment for this study occurred between 2018 and 2019. The IRB determined that parental consent could exhibit additional risk for adolescent sexually diverse participants; therefore, parental consent was waived. A patient consent statement was not applicable for this study because the data were de‐identified and analyzed as part of a secondary analysis.

ACKNOWLEDGMENTS

This study is made possible by the work and former grant of Dr. Jeremy Goldbach. Dr. Goldbach is a posthumous senior author, and this publication is dedicated to his honor.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Associated Data

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Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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