Emotional Functioning and Clinical Impact in the LGBTQIA+ Community: A Comprehensive Review with Neuropsychological Perspectives

This article aims to synthesize recent evidence on how minority stress processes shape emotional functioning among LGBTQIA+ adults and to identify implications for psychological care. We searched PubMed, Scopus, and Google Scholar (2017–2024) using terms related to LGBTQIA+, minority stress, emotions, and mental health. Eligible studies included adults identifying as LGBTQIA+ with emotional/affective outcomes; studies centered on primary psychiatric or neurological disorders were excluded. Across studies, distal (e.g. discrimination, microaggressions, structural stigma) and proximal (e.g. concealment, internalized stigma, rejection sensitivity) stressors were consistently associated with emotion dysregulation, elevated anxiety and depressive symptoms, and trauma-related distress. Social support – particularly from peers and close relationships – emerged as a protective factor. Transgender participants frequently showed higher distress and lower perceived support relative to other LGBTQIA+ subgroups. Convergent neurobiological findings implicated hypothalamic – pituitary – adrenal (HPA) axis dysregulation and immune/inflammatory changes. Minority stress robustly relates to altered emotional functioning and contributes to mental health disparities among LGBTQIA+ adults, underscoring the need for LGBTQIA+-affirmative assessment and intervention.