Real-Time Stress Experiences and Physiological and Psychological Responses Among LGBTQ+ Young Adults: Findings from the Stress and Heart Pilot Study

LGBTQ+ individuals experience disparities in cardiovascular health, but little is known about how daily minority and general stress affect physiological and psychological responses in real-world settings. Twenty LGBTQ+ young adults aged 18–27 completed a 14-day exploratory pilot study using ecological momentary assessment (EMA) with four daily smartphone surveys and continuous smartwatch-based sensor monitoring. This study is among the first to combine EMA with wearable sensor data to capture autonomic stress responses to minority stressors in naturalistic settings. Outcomes included a physiological stress score derived from heart rate variability during the 60 min before each EMA completion, as well as positive and negative affect (PA and NA). Four stress measures, Everyday Discrimination Scale (EDS), Sexual Orientation Microaggression Inventory Short Form (SOMI-SF), EMA of stressful events (EMA-SE), and current perceived stress (CPS), and a combined variable (COMB) were examined. In mixed-effects within-person models, all stress measures showed trends in the expected direction, with higher physiological stress scores, lower PA, and higher NA, though these varied in magnitude and statistical significance. SOMI-SF showed the strongest association with physiological stress, while general stress measures showed stronger associations with affect. These preliminary findings suggest that LGBTQ+-specific and general stressors may differentially engage physiological and psychological response systems; however, caution is warranted given the small sample size.