gms | German Medical Science

Background/research question: The scoping review aims to systematically map measurement instruments for sexual minority stress among Lesbian, Gay, Bisexual, and Queer (LGBQ) populations, while the systematic review evaluates the psychometric properties of selected instruments.

Methods: Following PRISMA guidelines, the reviews involved an extensive literature search, resulting in 34,990 references. Selection criteria focused on instruments measuring minority stress in form of discrimination, victimization, as well as positive aspects of minority identity among adult LGBQ populations. For the systematic review, the instruments were evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology.

Results: A total of 98 instruments with 136 references met the criteria and were included in the scoping review. The analysis identified a broad spectrum of instruments, predominantly targeting negative aspects of minority identity, such as internalized homonegativity and stigmatization. The review also uncovered the risk of jingle-jangle fallacy, attributable to inconsistent naming and definition of constructs across instruments.

Eight instruments qualified for further appraisal in the systematic review. The Lesbian, Gay, and Bisexual Identity Scale (LGBIS) and its German adaptation, LGBIS-DE, demonstrated the strongest psychometric properties and are recommended for use. However, the review revealed significant inconsistencies in the conceptualization of minority stress, due to a lack of consensus among instrument developers regarding key factors that should be measured. Additionally, content validity, as defined by COSMIN, was underexplored, affecting the robustness of many instruments.

Conclusion: Both reviews demonstrate a rich diversity in instruments measuring sexual minority stress while highlighting the need for greater standardization in the definition of minority stress constructs. While the LGBIS and LGBIS-DE demonstrated strong psychometric properties, data were not available for all psychometric categories, particularly for content validity, reliability and responsiveness.

Competing interests: The authors declare that there are no conflicts of interest regarding the presented work. MMK, PW, JS, AJ, SC, SF, and MSix have conducted this research independently and have no financial or personal relationships with other people or organizations that could inappropriately influence or bias their work.