Background: Men who have sex with men (MSM) have been consistently shown to be at-risk for adverse mental health outcomes due to the stresses of being a sexual minority, yet studies show that some MSM successfully navigate these barriers. Given this, less is known about the environmental and social/emotional conditions to which minority stress is amplified (or attenuated). More specifically, we comparatively investigate rural versus urban MSM, as rural MSM are often neglected in research compared to their predominantly featured urban counterparts. We also examine how levels of “outness” (the degree to which an individual discloses their sexual identity to others around them) interacts with gay related rejection (a specific type of minority stress). Investigating these conditions not only increases our understanding of the functions of minority stress, but also increases the likelihood of successful prevention and intervention by researchers and practitioners. Methods: The sample included 156 MSM recruited from rural and urban areas in Oklahoma. Participants had a mean age of 35.4 years (SD = 12.4), and the majority identified as non-Hispanic White (77.4%). We used a moderated multiple linear regression in order to test the relationship from gay related rejection, rurality/urbanity, and outness (as a moderator) to levels of loneliness. Next, in order to capture nuanced differences not revealed in the full model, we used a split-sample regression method using the same variables on rural and urban MSM, respectively. Results: Results broadly show that higher levels of gay related rejection are statistically associated with higher levels of loneliness in MSM (p< .01). Urban MSM had significantly higher loneliness scores that rural MSM (p< .05). Despite this, outness moderated this link in rural, but not urban MSM (p< .01). In other words, higher levels of outness amplified the deleterious effects of gay related rejection in terms of loneliness in the rural sample only. The moderating effects of outness was not significant in the urban sample, meaning that levels of outness did not impact gay related rejection in urban MSM. Discussion: Although previous research shows that coming out is generally associated with positive affect in MSM, our stratified results show this not to be the case with MSM living in rural communities. The more “out” a rural MSM was, the more that gay related rejection increased loneliness. This may serve as an important implication for practitioners who assimilate the majority of studies (which use urban MSM) linking higher levels of outness with positive affect. Research usually aggregates rural and urban MSM together, yet we posit that these populations should not be treated homogenously, as our results show differences in rural versus urban samples.

While research indicates that religiosity has a generally salutary effect on physical and mental health in the general population, its effect on sexual and gender minority (SGM) individuals is less clear given many religions’ negative attitudes towards SGM people. In SGM individuals, religiosity has been associated with internalized stigma and lack of family support, both of which have been identified as minority stressors. Perhaps because of this association, many SGM individuals switch to a more accepting religious community than they were raised in or abandon religion altogether. Previous research has found differential impacts of public displays of religiosity (attendance at religious services or activities) and private displays (importance of religion to an individual or private prayer) on a variety of health behaviors in population-based studies of adolescents, highlighting the importance of examining these variables separately. In this study, the authors examined how public religiosity, as measured by frequency of attendance at religious services, and private religiosity, as measured by self-reported importance of religion to the individual, was associated with internalized stigma and family support in a sample of 251 SGM individuals assigned female at birth. Because parental influence on religious behavior of individuals still living at home is likely greater than the influence on those living elsewhere, the analytic sample was restricted to participants who were still living with their parents or caregivers. Separate regression analyses were conducted for each minority stress variable onto each measure of religiosity, controlling for gender identity and race. Results indicated that greater frequency of religious attendance was associated with higher levels of internalized stigma (β = .13, p = .04), while greater endorsement of religious importance was associated with higher levels of general family support (β = .14, p = .03). Religious attendance was not associated with family support, nor was religious importance associated with internalized stigma. These results contradict findings from population-based studies indicating that public religiosity is associated with social support while private religiosity is associated with self-esteem, adding to previous literature that suggests religiosity affects SGM individuals differently compared to their cisgender and heterosexual peers. Our results also illustrate a differential impact of public and private displays of religiosity on minority stressors and family relationships in SGM individuals. Overall, the effects of religiosity on minority stressors were small, suggesting that religious attendance and importance are not strongly associated with minority stressors. Nevertheless, our results suggest that religiosity may be both a risk and a resilience factor for minority stressors for SGM individuals. Study limitations included very few individuals who endorsed high levels religiosity, which limited our ability to detect associations between religiosity and the minority stress variables.

Issue: Lesbian, gay, bisexual, and transgender (LGBT) adults use tobacco at rates nearly 50% higher than nonLGBT adults. Tobacco use is the leading cause of cancer, and LGBT populations have a documented cancer prevalence disparity. LGBT people are less likely to use resources known to improve cessation success, such as counseling and medications, and less likely intend to use tobacco quitlines when trying to quit. Providing LGBT-inclusive services may increase quitline reach and participation for LGBT people at risk for developing cancer. Setting: LGBT people living in rural areas have limited supportive health resources. Quitlines are among the most accessible cessation resources, and are developing LGBT inclusive practices to improve LGBT tobacco cessation outcomes. Project: National Jewish Health and LGBT HealthLink, a program of CenterLink, have worked to enhance LGBT-inclusivity in tobacco quitlines through cultural competency trainings, and field tested sexual orientation and gender identity (SOGI) questions on the intake survey. Building on the success of developing tobacco quitline LGBT community engagement best practices, we conducted a cross-sectional analysis of tobacco quitline data for Kentucky, Iowa, Colorado, and Montana to determine progress in LGBT community reach and engagement in tobacco treatment, and opportunities to improve tobacco quitlines for rural LGBT populations. We specifically explored quitline reach for rural LGBT populations, and treatment engagement (number of completed counseling calls, completing 3+ counseling calls [evidence-based counseling], receiving medication, and receiving 3+ counseling calls and receiving medication [guideline-based treatment]). Results: Across four states (KY, IA, CO, MT) from January 2017-June 2018, 2,094 callers self-identified as LGBT, and 269 (13%) lived in rural areas. Although differences were statistically non-significant (p>.05), rural LGBT had lower rates of quitline enrollment after calling (77% vs 80%), completed more calls on average once enrolled (2.1 vs. 2.0), and more completed at least 3 counseling calls (27% vs. 26%). Rural LGBT were less likely to receive NRT (OR=0.62, 95% CI=0.42-0.90) compared to their Urban counterparts, and consequently fewer received full guideline-based treatment (21% vs. 22%, p=ns). Lessons Learned: This collaborative project explored the ‘real-world’ clinical experience related to tobacco quitline reach and engagement of rural LGBT communities in states with large rural populations. Quitline engagement is a surrogate for understanding whether tobacco treatment is responsive to population level differences. Thus, the lower rates of enrollment in treatment use of cessation medication once enrolled among rural LGBT populations are concerning because the combination of counseling and NRT is related to a higher probably of quitting smoking. Given the reach of quitlines, it is critical to provide culturally responsive intersectional training on rural and LGBT cultural issues to tobacco cessation counselors, encourage tobacco quitlines to collaborate with local LGBT community-based organizations, and monitor quitline engagement rates of LGBT people.

Tobacco use in the LGBTQ+ community requires public health attention since LGBTQ+ individuals smoke at substantially higher rates than the general public. According to LGBT HealthLink, national prevalence for current tobacco use among LGBT respondents is 33%. In Florida, 2012-2016 data from the Florida Adult Tobacco Use Survey identify 22.4% of non-heterosexual people use tobacco compared to 14.2% of heterosexuals. To reach this priority population, the Health Equity team of Tobacco Free Florida (TFF), within the Florida Department of Health, identified 18 community centers and/or clinics serving the LGBTQ+ population statewide. A search for “tobacco” on each of those organizations’ websites revealed that none included tobacco cessation services as part of their programming. Two organizations had “tobacco” come up in the search results, but those listings were for a single calendar event that had occurred in prior years.
Prior to conducting the scan of the Florida LGBTQ+ websites, TFF had begun applying a health equity lens to program and policy activities. Staff asked LGBT HealthLink to conduct a training on cultural competency for these diverse communities. A list of common definitions of priority populations and data sources for measuring tobacco use was developed. The Cessation Team worked with Optum (Quitline provider) to add gender identity and sexual orientation questions to the intake process. The Area Health Education Centers (AHEC), who provide in-person cessation services, were trained on asking those questions during their intake so additional data could be collected. State and Community Interventions programs in every county were encouraged to include LGBTQ+ organizations in their Tobacco Free Partnerships during health equity training.
With the environmental scan showing a lack of tobacco cessation messaging, the Health Equity team again reached out to LGBT HealthLink to find solutions. Bureau staff, including media vendors, analyzed how other states engaged the LGBTQ+ community. TFF decided to create new media in the form of posters (Take Pride in Being Tobacco Free) and to create a digital banner for Quit Your Way cessation services that would be offered to the centers/clinics in the state. The first targets are in Broward county, home to Wilton Manors, a gay neighborhood that had worked with LGBT HealthLink, so was “primed” for the conversation, and in the Tampa Bay Area. The team also decided to have a presence at 2019 pride events in Miami Beach, Tallahassee, St. Petersburg, and Wilton Manors, and sponsor alternative prom events.
Lessons learned include the importance of appropriate messaging. The media team first designed the posters to be “LGBT” but later re-designed them to be more inclusive, adding “LGBTQ+”. Another important lesson is providing local support to the centers/clinics, which involves engaging the local AHEC to connect with the groups upon the launch of the new materials. AHECs can also train staff in motivational interviewing to encourage center visitors to quit and make fax referrals to TFF. The desired result will be more LGBTQ+ individuals engaged in cessation, and distribution of materials that will counter the normalization of tobacco use in these communities.
 

 Background: More than 2 million older adults aged 60+ in the U.S. self-identify as lesbian, gay, bisexual, transgender and queer (LGBTQ); this number will more than double by 2030. Consistent with findings from the 2011 Institute of Medicine report on LGBT health, LGBTQ older adults living in urban settings face significant challenges in obtaining housing, including lack of affordable housing, increased discrimination, social isolation and greater socioeconomic and health challenges. These difficulties are likely exacerbated by higher burdens of physical and mental health problems, including higher rates of disability, people living with HIV, poor mental health and limited access to or less inclusive healthcare.
Methods: This study explored the lived experiences of LGBTQ older adults currently residing in LGBTQ age-friendly and supportive housing in San Francisco. Our team conducted three focus groups with a convenience sample of LGBTQ older adults (n = 21) currently living for about 8 months in a newly developed LGBTQ senior housing in November 2017. An in-depth interview guided was used to ascertain focus group participants’ health and social service needs, quality of life, and experiences with and potential health benefits of living in LGBTQ age-friendly housing. Interviews ranged from 1.5 to two hours and audio recordings were transcribed verbatim. Thematic analysis was used identify key themes.
Results: The mean age of participants was 62 (range: 56 to 74). The majority identified as cisgender men (57%), 24% cisgender women, and 19% transgender women. The majority identified as black (43%), 38% white, and 14% Latinx. For sexual orientation, 38% identified as straight, 29% gay, 14% queer, and 10% bisexual. Initial themes focused on how supportive housing can support LGBTQ older adults in coping aging and lifetime health concerns (e.g., role in supporting mental health, relieving stress, and HIV/AIDS survivorship), formation of a new community and social support networks, and greater access to LGBTQ-welcoming health and social services.
Discussion: Our initial findings suggest that providing affordable and inclusive housing to vulnerable populations, including LGBTQ older adults, those who were formerly homeless, and/or people living with HIV/AIDS, may provide benefits for their physical, mental and social health. LGBTQ older adults face unique challenges in housing stability given that many live alone, cannot rely on traditional family caregivers, and experience higher rates of disability and discrimination when seeking health and social services. Future research should consider the effects of affordable and inclusive housing on the growing population of LGBTQ older adults in urban settings.

 Social isolation and lack of opportunities to develop close relationships are issues prevalent for older adults. As our society ages and diversifies, there emerges the necessity for specialized programs that cater to the needs of diverse populations within the aging community. Two major components that contribute to the health and well-being of all older adults, but particularly those who identify as lesbian, gay, bisexual, transgender and queer (LGBTQ), are a sense of connectedness and belonging, as well as acceptance. Community involvement and a sense of support are vital. For individuals living at the intersections of age, sexual orientation, gender and other identities, having these supports in place is paramount. For this reason, the development and support of LGBTQ-specific programming is essential when creating a welcoming, culturally competent environment for the aging members of our community.
 Holistic programming, that which considers the biopsychosocial needs of participants, has a better chance of addressing individuals as whole people, sending the message that an organization is invested in its’ participants. It offers more opportunities for individuals to come as they are, learn, express themselves, and gain support, as well to invest in their community and take on leadership roles.
 At Center on Addison, the senior program of Center on Halsted, we hold a biannual patron forum that includes an anonymous satisfaction survey. Participants are encouraged to offer thoughts about current programming as well as ideas for the future. This feedback is used as a basis for discussing how to advance programming that well serves all participants. As a result, we have developed a culture that elicits and encourages feedback, not only for program evaluation, but also in an effort to create an affirming, brave space. When a community feels that their input matters, chances are that the barriers to participation are lessened and individuals are more likely to continue coming together as a community, increasing opportunities for socialization, the development of close relationships and investment in the future of the program, including taking on leadership roles.
 What we have learned is that a program serving older adults is more robust and meaningful when influenced by those for whom there is a direct impact. Considering individuals as whole people with individualized needs, eliciting feedback, and encouraging participation in program development cultivates community investment and support. Feelings of support allow older adults to participate in programming in new and interesting ways, including facilitating their own programs, classes and events. In turn, individuals who feel welcome, accomplished and valued will pass these feelings along to their fellow participants, perpetuating our established culture of inclusivity and appreciation of difference.

Background: Older Black lesbians constitute a woefully understudied population in the United States. While there is a small and growing body of knowledge about LGBTQ (Lesbian, Gay, Bisexual, Transgender, Queer) health and aging, people of color are often invisible. In a review of the published health literature, there were no studies on aging that considered the intersections of age, race, sex, and sexual orientation on health, nor any studies that explicitly centered the health priorities of Black lesbians themselves. The purpose of this study was to explore the health care needs and experiences of Black lesbians over 40 in Metro Atlanta.
Methods: Purposive and snowball sampling were used to recruit Black lesbians age 40 and older to participate in 14 focus groups (FGD) about healthy aging and their health care needs. FGDs included 8-10 participants each for a total of 100. Eligibility included

 

Career development varies among different groups of people who may share vastly different perspectives about why they decided upon a particular career path. Career development differs from career identity and includes an individual’s awareness of which career path is most congruent with one’s personhood and meaning of life. As a result, career development milestones, especially how one comes to see her/himself (self-image), may serve as a means to select, enact, and persist on a particular career path (e.g., education and science). 
This phenomenological study (Generations-study.com) was conducted to explore the life stories and career development of 25 sexual minority educators, including Mr. F., a two-spirit Native American who lives in the Southwest. Data were collected from three cohorts of sexual minority people who were educators (coaches, mentors, and teachers): (a) Post Stonewall Pride cohort (ages 52 – 59 at the beginning of the study in 2015), an institutional advancement cohort tied to the HIV/AIDS epidemic (ages 34 – 41 years old), and an equality cohort of people who came of age during the passage of same-sex marriage equality and gays in the U.S. military (ages 18 − 25). This presentation is twofold: One, to provide an empirical research background on sexual minority people who became educators and two, to introduce attendees to the case study of Mr. F. who has coped with the negative consequences of racism and heterosexism on his home reservation but persevered to become a role model working as a dance instructor in his community. 


Using a phenomenological case study approach (Hays & Singh, 2012; Yin, 2003), researchers identified themes related to: (a) helping identity, (b) levels of outness, (c) levels of support (including interaction with other sexual minority educators), and effectiveness as an educator. Mr. F, in particular, struggled with not only his familial, communal, and ancestral roles and responsibilities, but also with integrating his sexual identity with his career aspirations. Among all of the interviewees who participated in the study researchers founds: older gays and lesbians, all males, and Black and Native Americans discussed their decision to become educators the most. Prejudice that participants experienced was reported to relate to interactions that they had with hostile school personnel. Participants in the younger cohort mostly self-identified as pansexual, bisexual and queer. White people most commonly identified as pansexual, queer, and gay. Black participants most often identified as bisexual and Native Americans most often identified two-spirit. Study findings support and enrich the current literature at the intersection of race and ethnicity, health, career, and education.

BACKGROUND: In the United States, rates of HIV transmission are on course to have over one-half of black gay men become infected. While rural and Southern black communities are uniquely positioned to negotiate such a future, little attention has been paid to the particular experiences of black gay life in the rural South. Further, public health scholars including Chandra Ford and Tonia Poteat have called for work that moves beyond facile descriptors like MSM to consider more robust aspects of identity, which includes geography. Indeed, cultural geographic contexts yield collective life experiences that may be in line with inequitable HIV transmission rates.
This paper provides a potentially transformative model for engaging with black gay men as individuals that represent particular geographic communities in the United States. The study focuses on black gay men in rural Piedmont North Carolina where their identities as southern and rural are too associated with especially grim HIV/AIDS disparity.
 METHODS:This research centers community-based, personal narratives in the form of oral histories with black gay men ages 45 and older. Previous research suggests oral history relays emic understandings of community space in addition to subjective understandings of belonging to such space. In oral history interview, such information is relayed over time for being in narrative form, which further means relaying not-yet-scrutinized causal or associative factors that may go as far as refuting our most basic assumptions as social science researchers regarding what has been cognitively reckoned with by our subjects.
The oral history interview transcripts were coded with MAXQDA to glean how sexual marginalization has been historically negotiated within rural southern communities by the men. Fieldwork and analysis followed the tenets of Ford and Airhihenbuwa’s Public Health Critical Race Praxis (PHCRP).
 RESULTS: While data collection is ongoing, the oral history interviews are relaying how the sexual identities of black gay men have been historically denied and not actively negotiated within their black southern familial and community spaces. Their sexual practices and experiences are characterized as being markedly separate from the familial and religious spaces where they have largely historically socialized with others in their communities. Social collectivity amongst gay men is discussed as occurring in relatively intimate and private spaces in their communities. Some interviewees relay periods of not having sex and engaging with other gay men inside of their rural southern communities and only doing so while visiting or living in northern urban enclaves. Finally, the interviews relay recent times ushering in more integrated sexual-community experiences in their communities (e.g. bringing partners to church).
 DISCUSSION: This research suggests that there is merit in considering the life histories and geographic identities of black gay men in confronting the HIV/AIDS crisis. Their narrations of longstanding community ties provide insights into where they are “showing up” as black gay men and why interventions focused on the black community at-large may fail to reach the particular networks of black LGBTQ people in the rural South.

Background: Housing instability and HIV infection both disproportionately affect men, transgender women, and transgender men who have sex with men. However, there is limited data on how housing instability operates as a structural-level risk factor for HIV, with much of the current data focused on the relationship between homelessness and HIV risk factors. Thus, there remains a need for further exploration of this lesser understood relationship between housing instability (more broadly) and HIV risk factors. Methods: Together 5,000 is a U.S. national cohort study of 16-49 year olds at risk for acquiring HIV. The cohort was recruited via sexual-networking apps for an online survey. Participants were also offered an opportunity for self-administered at-home HIV testing (oral fluid samples returned to a lab for analysis). The cohort is made up of 8554 cismen, 63 transwomen, 53 transmen, and 107 gender non-binary individuals who have sex with men. Covariate-adjusted logistic and linear regression analyses were used to determine who was most likely to report lifetime housing instability, as well as HIV risk factors associated with housing instability. Results: Participants' mean age was 30.4 and 50.9% were persons of color. Over one-quarter (30.9%) of participants reported experiencing lifetime housing instability, and 70.5% of these participants reported housing instability in the past five years. Adjusted logistic regression analyses indicated that Black participants (aOR = 1.33, 95% CI: 1.16-1.53), Multiracial participants (aOR = 1.44, 95% CI: 1.23-1.69), those with less than a High School degree (aOR = 4.10, 95% CI: 3.17-5.31), and participants with a High School degree or GED (aOR = 3.06, 95% CI: 2.66-3.53) were more likely to report lifetime housing instability. Additionally, participants reporting a history of housing instability were more likely to be unsure of their HIV status (aOR = 1.47, 95% CI: 1.34-1.61) and have engaged in sex work in the past 3 months (aOR = 4.07, 95% CI: 3.60-4.60) when compared to their stably housed counterparts. Of those who completed HIV testing at enrollment (n = 5,082), those reporting lifetime housing instability were significantly more likely to receive an HIV-positive test result (aOR = 2.80, 95% CI: 2.12-3.71). Finally, those with a history of housing instability reported having a greater mean number of sexual partners in the past three months (β = 1.6, 95% CI: 1.19-1.98), and were more likely to report having had an STD during their lifetime (aOR = 1.558, 95% CI: 1.173-2.070). Conclusion: In this cohort, lifetime housing instability was associated with multiple factors that put participants at risk for HIV and to be diagnosed with HIV. Greater attention is needed to determine the mechanistic role through which housing instability, as a structural factor, potentiates HIV risk.

Background: The Centers for Disease Control and Prevention (2017) note that gay, bisexual, and other men who have sex with men (collectively referred to as MSM) face more barriers to accessing health care compared to other men. Such barriers include, lack of cultural- and sexual identity-appropriate medical and support services, concerns about confidentiality, and fear of discussing sexual practices or orientation in a medical setting. In comparison to other MSM populations, Latino MSM (LMSM) report having the least amount of access to health care (McKirnan et al., 2012). The purpose of the present study is to elucidate sociocultural (i.e., ethnic identity affiliation, heterosexual self-presentation); structural (social support, neighborhood collective efficacy, nativity); and individual (age, education, income, HIV status) determinants of perceived health care access among LMSM. We hypothesize that ethnic identity affiliation will moderate relations between the aforementioned predictors and perceived access to health care based on increasing evidence that ethnic identity, or one’s sense of belonging and commitment to one’s ethnic group (Phinney, 2003), may be a health protective factor (Santos & VanDaalen, 2016). Methods: Participants were 511 Latino MSM (Mage = 30.75 years, SD = 6.24) participating in a NIH-funded study. They identified as Mexican (50.3%), Cuban (17.2%), Colombian (10.4%), Puerto Rican (7.6%), and 13 other Latino ethnicities (14.5%). Hypothesized predictors include: ethnic identity affiliation (Multigroup Ethnic Identity Measure; Phinney, 1991), heterosexual self-presentation (Conformity to Masculine Norms Inventory-46; Parent & Moradi, 2011), social support (Interpersonal Support Evaluation List-12; Cohen et al., 1985), and neighborhood collective efficacy (Collective Efficacy Scale; Sampson et al., 1997). We also assessed other predictors: nativity, age, HIV status, education, and income. The criterion variable, perceived access to health care (PATHC), was measured via a six-item Access to Health Care measure derived from the HIV Cost and Services Utilization Study (Kinsler et al., 2009). Results: Multiple regression analysis found that men reporting lower ethnic identity affiliation reported higher PATHC (β = -.13, p = .032) than peers. Younger participants reported more PATHC too (β = .19, p = .001). Men with a lower yearly income reported higher PATHC (β = -.19, p = .007). Finally men who were HIV-negative reported more PATHC (β = .16, p = .004) than peers. We tested the hypothesized moderating effects of ethnic identity affiliation (EIA). We found that EIA moderated relations between heterosexual self-presentation and PATHC (β = .122, p = .033) and links between income and PATHC (β = -.18, p = .045). LMSM who endorsed lower EIA and higher heterosexual self-presentation reported more PATHC than peers. LMSM who reported lower income and less EIA indicated more PATHC than peers. Predictors explained 19% of variability in perceived access to health care in this sample. Discussion: Findings identify constructs for psychologists and health care providers to consider when designing interventions to promote access to care among LMSM. The moderating effect of ethnic identity affiliation demonstrates that this cultural factor appears to influence determinants of health care access among LMSM.

Background: Anti-sodomy laws have historically been used to discriminate against and harass the LGBTQ+ community. Struck down by the Supreme Court earlier this year in September 2018, Section 377 of the Indian Penal Code was a colonial-era law that penalized non-heteronormative forms of sex, disproportionately targeting men who have sex with men (MSM) and transwomen. This study explored themes that arose across genders (i.e., men, women, and non-binary individuals) within Indian sexual minorities when asked about the impact Section 377 had on them and how the law made them feel. Methods: One hundred and seventy adult Indian LGBTQ+ participants (51% men, 42% women, 7% nonbinary) were surveyed online in 2017 as part of a larger study on minority stress. Participants were presented with the text of Section 377 and a brief description of its legal implications for the LGBTQ+ community. They were then asked to numerically rate the perceived impact of Section 377 on their lives and answer two prompts in an open response format: “Briefly explain how Section 377 impacts your life” (Q1) and “Briefly explain how Section 377 makes you feel” (Q2). These responses were coded and thematically analyzed by gender. Chi-squares were calculated to determine whether the prevalence of themes varied across genders for each question; most statistical comparisons included only men vs. women given the small number of non-binary individuals in the sample. Results: Most participants (90%) perceived Section 377 to have at least some impact on their lives. A variety of detrimental effects were identified: A total of 26 unique themes emerged from the open-response item about perceived impact, and 19 unique themes emerged from the open-response item about associated feelings. Participants reported that the law contributed to their social and legal mistreatment and furthered societal stigma against LGBTQ+ individuals; they expressed concerns about being labeled a “criminal” and living in a society that did not accept them. Participants also felt pressured to conceal their sexual and gender identities and reported feeling fearful, angry, and dehumanized. In response to Q1, which asked about perceived impact of 377, the most prevalent theme was restricted freedom and rights (28.7%), including the ability to be open about their sexual orientation, followed by lack of belongingness to the larger community (13.9%) and fear (12.8%). No significant differences in the prevalence of these themes were found across genders. For Q2, which asked specifically about how 377 made them feel, the most prevalent theme was feeling violated (13.6%), followed by the sense that India is a regressive country (12.9%), and feeling like Section 377 is an unfair, discriminatory law (11.4%). No significant differences were found across genders, except that the theme of feeling violated was more prevalent among women than men (χ2(1)=4.243, p< .05). Discussion: Results suggest that the perceived impact of Section 377 is multifaceted and largely consistent across genders. Despite its recent abolishment, the cultural and psychological effects of 377 necessitate continued intervention and support for India’s LGBTQ+ population.