Given systemic marginalization, LGBTQIA+ populations face persistent health inequities. While religiosity and spirituality (RS)-factors commonly studied in relation to health-are often associated with improved mental health in general populations, their impact among LGBTQIA+ individuals is less clear. This preregistered systematic review synthesizes findings across 55 quantitative studies (N = 512,551) to examine associations between RS and psychological wellbeing among LGBTQIA+ adults. Guided by the Religious/Spiritual Stress and Resilience (RSSR) model-which conceptualizes RS as both a potential stressor and source of resilience-findings reveal RS to be a highly ambivalent force. RS is associated with distress when linked to internalized homo/bi/transphobia, identity conflict, and exclusion, but also with resilience through meaning-making, spiritual coping, and affirming communities. Spirituality is more consistently associated with positive outcomes, and internalized homo/bi/transphobia emerges as a key mediator of psychological distress. This review refines the RSSR model by centering internalized homo/bi/transphobia and ambivalence as core analytic constructs. Findings also have critical implications for clinical care, spiritual support, and theory development, underscoring the need for LGBTQIA+-affirming practices that address both the harms and healing potentials of RS in their lives.
Prada et al. (Tue,) studied this question.