New Ideas in Psychology 79 (2025) 101178

Contents lists available at ScienceDirect

New Ideas in Psychology

journal homepage: www.elsevier.com/locate/newideapsych

Presenting a strengths-based ecological model for promoting well-being

among LGBTQ+ adults
Alexandra Cowand a,* , Konrad Bresin a , Nathan R. Todd b , Yara Mekawi a
a
Department of Psychological and Brain Sciences, University of Louisville, USA
b
Department of Psychology, University of Illinois Urbana-Champaign, USA

A R T I C L E I N F O A B S T R A C T

Keywords: Models of LGBTQ+ health demonstrate factors influencing mental and physical health (e.g., unique stressors due
LGBTQ+ health to living in a heterosexist and cissexist society). However, current models of LGBTQ+ health do not adequately
Well-being organize how strengths throughout multiple ecological levels influence the well-being of LGBTQ+ individuals. In
Multi-level model
this paper, we propose and describe an ecological model of LGBTQ+ strengths impacting the specific health
Strengths-based approach
outcome of LGBTQ+ well-being. This model integrates and organizes literature on intersectionality and LGBTQ+
experiences, LGBTQ+ individual well-being outcomes, and LGBTQ+ strengths across ecological levels of indi­
vidual, interpersonal, organizational, community, and structural. Model strengths, limitations, and applications
are discussed.

1. Introduction levels of the individual, interpersonal, organizational, community, and

structural have potential to elucidate how LGBTQ+ adults survive and
Strengths-based approaches recognize and prioritize the assets, thrive living in an oppressive society and point to multi-level in­
skills, and resources of marginalized groups to promote positive health terventions to further promote well-being.
outcomes and well-being, which is a complementary approach to In this paper, we propose an ecological strengths-based model of
research that traditionally is deficit-based (Gahagan & Colpitts, 2017; LGBTQ+ well-being where we integrate ecological models with LGBTQ+
Guo & Tsui, 2010; Perrin et al., 2020; Silverman et al., 2023). In this strengths and well-being. This model is meant to inform future research
paper, we focus on adult lesbian, gay, bisexual, transgender, queer, plus and the generation of testable hypotheses. Moreover, the model centers
(LGBTQ+) communities to understand how their strengths, forged in context, strengths, and well-being at levels beyond the individual (e.g.,
resistance to oppression, promote well-being. We use acronyms and what strengths in one’s local community promote LGBTQ+ well-
language from various studies and theories (e.g., LGBTQ+ individuals, being?). To set the stage for our integrated model, we first discuss
lesbian, gay, and bisexual (LGB) individuals, sexual and gender minority strength-based approaches in LGBTQ+ research, LGBTQ+ well-being,
(SGM) individuals) when referencing studies with LGBTQ+ sub­ the need to consider intersectionality in LGBTQ+ research, existing
populations. Although focus on the pernicious impact of marginalization multi-level models in LGBTQ+ research, and ecological models more
and LGBTQ+ mental health disparities is needed (DuBois et al., 2024; generally. We then present our integrated model organized by individ­
Johnson et al., 2024; Moagi et al., 2021; Mongelli et al., 2019), a ual, interpersonal, organizational, community, and structural levels of
strengths-based approach sheds light on a different set of phenomena analysis concluding with a description of interconnectedness across
and opens doors for novel inquiry to promote wellness (Blackburn & levels. We present implications and future directions for research, clin­
Todd, 2022; Frost, 2017; Gahagan & Colpitts, 2017; Perrin et al., 2020). ical work, and community practice. Overall, our model advances the
Specifically, strengths-based approaches that emphasize resilience and literature by articulating the connection between multiple levels of
strengths of LGBTQ+ adult populations across ecological levels, such as strengths and LGBTQ+ well-being and organizes existing areas of
community and structural-level resiliency factors, no longer put the research on LGBTQ+ strengths and well-being within an ecological
onus on the individual experiencing oppression to “be more resilient” framework to provide needed clarity to guide future research, preven­
(Frost, 2017; Meyer, 2015). Strengths-based approaches that focus on tion, and intervention.

* Corresponding author. University of Louisville, 317 Life Sciences Building University of Louisville Louisville, KY 40292, USA
E-mail address: [email protected] (A. Cowand).

https://doi.org/10.1016/j.newideapsych.2025.101178
Received 24 June 2024; Received in revised form 13 June 2025; Accepted 18 June 2025
Available online 21 June 2025
0732-118X/© 2025 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
A. Cowand et al. New Ideas in Psychology 79 (2025) 101178

2. Strengths-based approaches in LGBTQþ research interviews and objective measures such as access to affirming health­
care, access to affordable housing, and having health insurance (Amato
In a field that is dominated by deficit-based approaches and psy­ et al., 2024; Beard et al., 2017; Dickinson & Adams, 2014; Disabato
chopathology, it is essential for psychological research to explore the et al., 2016; Edwards et al., 2023; National Academies of Sciences, 2020;
strengths that promote health and well-being among LGBTQ+ pop­ Olvera Alvarez et al., 2018; Roberts & Christens, 2021; Van De Weijer
ulations (Blackburn & Todd, 2022). Strengths are defined broadly as et al., 2022). Positive well-being for LGBTQ+ individuals is associated
factors across multiple ecological levels, which historically or currently with various factors such as greater social support (Amato et al., 2024;
are an asset to a person or community (Guo & Tsui, 2010). Detwiler et al., 2022; Edwards et al., 2023; Frost et al., 2016; McDonald,
Strengths-based approaches emerged in the field of social work in the 2018; Toplu-Demirtaş et al., 2018), positive LGBTQ+ identity (Doyle
1990s as a way framework for understanding resilience, resistance, and et al., 2021; Riggle & Mohr, 2015; Rostosky et al., 2018; Tebbe et al.,
other resources used by individuals to promote well-being (Guo & Tsui, 2024), having fulfilling activities (e.g., hobbies and engaging in crea­
2010; Saleebey, 1996). These strengths-based approaches in social work tivity) (Amato et al., 2024; Edwards et al., 2023), financial access
capitalize on the various ways marginalized groups in society exhibit (Amato et al., 2024; Edwards et al., 2023), and greater access to
strength (Guo & Tsui, 2010) and aim to increase agency of people over affirming social spaces (Case & Hunter, 2012; Dickinson & Adams, 2014;
their health and well-being (Gahagan & Colpitts, 2017). Literature Edwards et al., 2023; National Academies of Sciences, 2020; Olvera
highlights a variety of LGBTQ+ strengths such as positive self-esteem, Alvarez et al., 2018; Perales, 2022). Qualitative research studies have
proactive coping, social support, affirming work/school environments, found LGBTQ+ individuals describe their well-being and thriving looks
and social activism (Colpitts & Gahagan, 2016; Gahagan & Colpitts, like having authentic and meaningful relationships, having calmness,
2017; Hudson & Romanelli, 2020; Perrin et al., 2020; Vaughan & and maintaining purpose (Amato et al., 2024), authenticity, connection
Rodriguez, 2014). Integrating and organizing the existing literature on to others, perspective shifting, and agency (Tebbe et al., 2024), and
LGBTQ+ strengths which promote well-being benefits the field and so­ self-love, kinship, and social responsibility (Joe et al., 2023). Overall,
ciety by increasing ease and ability for people to identify factors which well-being is multifaceted, multilevel, and focuses on positive subjective
increase resiliency and thriving for LGBTQ+ individuals. and objective outcomes rather than illness and deficit.
Our proposed model takes an identity-specific strengths approach, A recent literature review of LGBTQ+ publications highlighted
highlighting the ways that LGBTQ+ individuals’ identities and lived research on LGBTQ+ well-being, specifically empirical research using
experiences are a source of strength (Silverman et al., 2023). We also ecological perspectives (Blackburn & Todd, 2022). Blackburn and Todd
extend strengths to other levels of analysis, for example by focusing on (2022) explored how some interpersonal level, community level, and
the presence of LGBTQ+ specific organizations and policies that aim to structural level factors impact LGBTQ+ well-being, emphasizing the
protect or support the LGBTQ+ community. Further, this proposed importance of understanding the individual within context. Further, the
model organizes LGBTQ+ strengths to provide insights into questions review found links between socio-political action, LGBTQ+ community
such as: What does thriving look like for LGBTQ+ people of various connectedness, and well-being of LGBTQ+ individuals (Blackburn &
positionalities, and how can we leverage aspects of policies, organiza­ Todd, 2022; Frost et al., 2019; Roberts & Christens, 2021). Given recent
tional supports, families, etc. to create thriving LGBTQ+ communities? cultural events (e.g., COVID-19 pandemic), several studies have used a
What does resiliency look like for LGBTQ+ people, and in what ways can multi-level approach to understand the impacts of these events on the
the various ecological levels bolster individual and community resil­ mental health of LGBTQ+ individuals. LGBTQ+ populations’ health and
iency? How can we proactively build the types of environments and well-being was disproportionately impacted by COVID-19 pandemic
foster collective experiences which draw upon existing individual and across multiple levels including: job loss/disruption, decreases or loss of
community strengths? These questions illustrate the benefit of focusing access to gender affirming care, serious financial concerns (organiza­
on strengths and how such strengths may connect to LGBTQ+ tional and structural factors), decreases in community events and
well-being. affirming programming (community factors), decreased interpersonal
support and connection (interpersonal factors), and struggles coping
3. LGBTQþ well-being with social isolation (individual factors) (Buspavanich et al., 2021;
Drabble & Eliason, 2021). This research shows a promising start to
Well-being refers to a state of feeling positive emotions (e.g., examining well-being for LGBTQ+ populations. Yet, there is still a need
contentment) and successfully functioning within the context of one’s for organizing and integrating literature on LGBTQ+ well-being pro­
environment (e.g., relationships, life purpose) (Jarden & Roache, 2023; moting factors across multiple ecological levels.
Ruggeri et al., 2020). Scholars have long recognized that well-being is
distinct from an absence of illness and that health promotion is distinct 4. Intersectionality in relation to LGBTQþ research
from treating illness (World Health Organization, 2004). In general,
well-being is experiencing positive outcomes at multiple levels of anal­ Although the LGBTQ+ community is demographically diverse, the
ysis (Prilleltensky, 2012). The mental health field presents multiple majority of LGBTQ+ research has only taken into consideration the
types of well-being. Some psychologists conceptualize subjective impact of heterosexism and cissexism (Balsam et al., 2011; Mongelli
well-being as a subjective state of happiness or pleasure in life that one et al., 2019). However, other systems of oppression affect many
can experience (Diener, 1984), whereas others conceptualize it as LGBTQ+ communities, and any ecological model of strengths focused on
holding a positive view of oneself, positive affect, and living a life of these communities should therefore incorporate intersectionality.
meaning and purpose (Ryff, 1989). Other mental health fields such as Developed by Black feminist scholars and activists, intersectionality
social work and public health focus on other types or domains of theory posits that systems of oppression (e.g., racism, sexism, hetero­
well-being such as satisfaction with objective material needs, such as sexism, ableism, classism) are interconnected and the impacts of these
food, shelter, and clothing (Disabato et al., 2016; National Academies of systems differ depending on individuals’ identities and proximity to
Sciences, 2020). More broadly, well-being may include having adequate power (Collective, 1977; Collins, 1990; Crenshaw, 1990). Acknowl­
access to education, employment, healthcare, and connection to one’s edging intersectionality offers critical insights that may otherwise have
community (Prilleltensky, 2012). For LGBTQ+ individuals, well-being been missed when solely focused on only heterosexism and cissexism.
relates to how they feel and function, including domains of physical, Using an intersectional lens is critical because it challenges the
mental, and social health (National Academies of Sciences, 2020). notion of homogeneity among LGBTQ+ individuals and honors the re­
To date, LGBTQ+ well-being is captured in research studies through ality that one’s experience of and consequences faced because of het­
subjective measures such as self-report measures and qualitative erosexism or cissexism may be strongly influenced by their proximity to

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other systems of oppression. For example, anti-LGBTQ+ policies that this population would be based on gender identity, for example, inter­
harm individuals in a health context may be worsened for disabled in­ nalized transphobia or discrimination because of one’s gender identity
dividuals (e.g., disability being used to deny gender affirming care) (Hendricks & Testa, 2012). Building on Meyer’s (2003) minority stress
(Horner-Johnson, 2021; Rodríguez-Roldán, 2020). Using another model, Hatzenbuehler (2009) proposed a psychological mediation
intersection as an example, one study highlighted how poverty can framework to identify the psychological processes that influence the
worsen access to care for LGBTQ+ individuals (Irazábal & Huerta, move from stress to psychopathology in sexual minority populations.
2016). Importantly, the authors highlight connections between cissex­ This framework conceptualizes stress as the risk factor for which psy­
ism and heterosexism and unstable housing (i.e., LGBTQ+ individuals chopathology can develop through psychological processes rather than
running away from or being kicked out of their families), which is as a mediator in the relationship between social status and psychopa­
directly tied to cycles of poverty. LGBTQ+ individuals with few socio­ thology (Hatzenbuehler, 2009). The psychological mediation frame­
economic resources experience worse outcomes (Levandowski et al., work aims to identify causal relations, which Meyer (2003) noted were
2022; McGarrity, 2014) and using an intersectional lens allows for next steps to take in the minority stress research sphere. Criticisms of
making connections between how systems of oppression, such as cis­ these stress and disparities-based frameworks have notably highlighted
sexism and classism, are inextricably linked. the unintended consequences of focusing only on the health disparity
In additional application of intersectionality, there is mounting evi­ pathways in research for LGBTQ+ populations can further the very so­
dence that LGBTQ+ people of color in the United States experience high cial stigma which leads to these disparities (Braveman, 2006; Frost,
likelihoods of experiencing violence, incarceration, mental health con­ 2017).
cerns, unemployment and poverty resulting from various forms of
racism, cissexism, and heterosexism (De Vries, 2015; Howard et al., 5.2. Stigma models
2019; Hudson & Romanelli, 2020; Kattari et al., 2015; Reisner et al.,
2014). Importantly, there is evidence that LGBTQ+ people of color Stigma frameworks of LGBTQ+ health have paved a way in under­
encounter microaggressions based on their race, gender, sexual orien­ standing the influence of social contexts on the health of LGBTQ+ in­
tation, or combination of these (Nadal et al., 2015). Some studies show dividuals (Fox et al., 2018; Hatzenbuehler, 2016). Link and Phelan
LGBTQ+ people of color experience greater mental health concerns (2001) conceptualize stigma as “access to social, economic, and political
compared to White LGBTQ+ individuals (Alegría et al., 2007; Kim & power that allows the identification of differentness, the construction of
Choi, 2010; Layland et al., 2020; Sutter & Perrin, 2016; Whitfield et al., stereotypes, the separation of labeled persons into distinct categories,
2014). Other studies have found that while LGBTQ+ Black Americans and the full execution of disapproval, rejection, exclusion, and
endorse greater psychological distress, they reported less mental health discrimination” (Link & Phelan, 2001, p. 367). Recent research (e.g.,
concerns compared to White Americans (Barnes & Bates, 2017; Wilson Stigma Mechanisms in Health Disparities Framework, Stigma and HIV
et al., 2022). These inconsistent findings highlight the importance of Disparities Model, Health Stigma and Discrimination Framework) sup­
studying resiliency and strengths-based factors among LGBTQ+ com­ ports the multi-level impacts of stigma (individual, interpersonal,
munities of color. structural) on health outcomes of LGBTQ+ individuals (Chaudoir et al.,
Although the endless ways that intersecting systems of oppression 2013; Earnshaw et al., 2015; Stangl et al., 2019; Todd et al., 2024).
differentially harm LGBTQ+ individuals based on other identities Stigma has most commonly been studied on the individual (e.g., inter­
cannot be sufficiently articulated here due to space constraints, the ex­ nalized stigma) and interpersonal (e.g., bullying) levels, with structural
amples provided highlight how using an intersectional lens can deepen forms of stigma (e.g., policies) being integrated more recently into the
our understanding of LGBTQ+ health and elucidate relationships among stigma literature (Hatzenbuehler, 2016; Hatzenbuehler et al., 2024;
systems of oppression. Hatzenbuehler & Pachankis, 2021; Todd et al., 2024). While stigma
models and frameworks provide crucial understanding of the multi-level
5. Existing models of factors that shape LGBTQþ health nature of stigma in impacting LGBTQ+ individuals, they do not articu­
late the impacts on positive sides of structural level factors (e.g., positive
Virginia Brooks presented the first development of a model that used attitudes from society, supportive and affirming policies).
a systems theory approach to conceptualize the experiences of sexual
minority individuals and multilevel systems of social and cultural 5.3. Health equity models
stressors that lead to psychological and biological stressors (Brooks,
1981). With the multi-level minority stress model, Brooks laid the The health equity promotion model takes a life course perspective
foundation conceptualizing LGBTQ+ health using multiple ecological through which intersecting identities, multi-level determinants of
levels which continues in other models to this day (Rich et al., 2020). We health, and risk and resiliency factors contribute to LGBT health
now review a few of these models to demonstrate how other scholars (Fredriksen-Goldsen, Simoni, et al., 2014). They, however, include very
have incorporated factors beyond the individual. Although these models little information on how systems of oppression, beyond heterosexism
do not focus on strengths, they provide a foundation for our application and cissexism, are relevant to the LGBTQ+ community and how systems
and integration of some of their key ideas into our ecological model of of oppression are inextricably linked to one another (English et al., 2018;
strengths. Fredriksen-Goldsen, Simoni, et al., 2014; McPherson & McGibbon,
2014). Furthermore, the health equity promotion model does not
5.1. Minority stress model consider the impacts on well-being or wellness of LGBTQ+ individuals
(Fredriksen-Goldsen, Simoni, et al., 2014).
Meyer (2003) proposed the most established framework in psycho­ The Sexual and Gender Minority Health Disparities Research
logical research called the minority stress model. The minority stress Framework, an adaptation of the Minority Health and Health Disparities
model posits the influence that one’s identities and environment have on Research Framework, illustrates the multiple levels (individual, inter­
stressors; these stressors, general and minority, along with coping, personal, community, and societal) of unique factors which impact the
impact both positive and negative mental health experiences (Meyer, health of sexual and gender minority (SGM) populations (Alvidrez et al.,
2003). These minority stressors, which are unique to minoritized pop­ 2019). Highlighted are various positive and negative factors, which have
ulations’ experiences, chronic, and socially based, are conceptualized in potential to impact a SGM individual’s health, where health is concep­
two categories: distal and proximal (Meyer, 2003). Hendricks and Testa tualized broadly and without much definition (Alvidrez et al., 2019).
(2012) adapted Meyer’s minority stress model for transgender and This framework informed the model presented in this article, where we
gender nonconforming (TGNC) populations. Minority stress factors for synthesize the current literature of strengths-based factors across

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multiple levels. a general strengths-based approach, well-being, and ecological systems

theory. We now organize and integrate these areas to present our
6. Drawing from ecological models to inform the proposed strengths-based ecological model of LGBTQ+ well-being in Fig. 1. We
multi-level model describe each level (individual, interpersonal, organizational, commu­
nity, structural) and present empirical examples of work to illustrate the
Ecological models inform many of the previously reviewed models types of questions and new knowledge that can be created by focusing
(Alvidrez et al., 2019; Brooks, 1981; Fredriksen-Goldsen, Simoni, et al., on strengths and well-being at multiple levels. We also use bi-directional
2014; McLeroy et al., 1988; Meyer, 2003), with many drawing on arrows to note that all levels are interconnected and interdependent.
Bronfenbrenner’s seminal work in developing ecological systems theory Overall, the strength of our model is to help guide future conceptuali­
(EST, Bronfenbrenner, 1977, 1979). We, too, draw on EST as we reso­ zation, empirical research, and identifying targets for intervention, all in
nate with Bronfenbrenner’s observation that it is important to study service of showcasing LGBTQ+ strengths and promoting LGBTQ+ well-
individuals within their ecological systems, such as by examining sys­ being.
tems of interpersonal connection (micro-systems; e.g., family, peers),
how different microsystems interact (mesosystem; e.g., overlap between 7.1. Individual-level factors
family and schools), how factors that do not include the individual
nevertheless may impact the individual (exosystem; e.g., school board Individual-level factors refer to characteristics that occur within a
decision impacting students), and the importance of larger societal person. Research demonstrates that LGB adults facilitate psychological
norms and laws (macrosystem; e.g., U.S. law shaping access to health­ well-being and subjective well-being through general positive identity
care). Other EST literature builds on Bronfenbrenner by integrating a factors such as self-compassion and LGBTQ+ specific identity factors
focus on social networks as important to understanding ecological levels such as identity centrality and authenticity (Beard et al., 2017; Carvalho
(Neal & Neal, 2013). Moreover, other scholars have maintained the key & Guiomar, 2022; Nouvilas-Pallejà et al., 2018; Riggle et al., 2017;
ideas of Bronfenbrenner’s EST while using different language and terms Rostosky et al., 2018; Toplu-Demirtaş et al., 2018). Taken together,
to depict the different levels of analysis. For example, the Sexual and bolstering positive identity factors can lead to well-being among sexual
Gender Minority Health Disparities Research Framework reviewed minority populations. Literature identifies several individual-level fac­
earlier (Alvidrez et al., 2019) uses levels of individual, interpersonal, tors that can enhance well-being in the face of minority stressors. Gen­
community, and societal to depict people in context. Other frameworks eral flexible coping styles such as self-monitoring, resilience, and
also include “organizational” as a distinct level between interpersonal self-esteem as well as LGBTQ+ specific flexible coping styles, such as
and community (McLeroy et al., 1988). To preserve as much specificity identity consciousness, are protective factors against minority stressors
as possible, in the proposed model we include the levels of individual, impacts on well-being (Cooke & Melchert, 2019; Douglass et al., 2017;
interpersonal, organizational, community, structural, and societal. We Selvidge et al., 2008).
now turn to presenting the proposed model that will include and extend There have been inconsistencies reported on the impact of outness,
beyond these factors with a focus on LGBTQ+ strengths and well-being an LGBTQ+ specific factor, on well-being. A body of literature investi­
at each level of analysis. gating the relation between outness and well-being reveals outness is
related to higher levels of well-being among LGB populations (LaSala,
7. Proposing a multi-level strengths-based model of LGBTQþ 2000; Stevens, 2004; Whitman & Nadal, 2015). While other research,
well-being highlights the importance of differential outness of sexual orientation
identity depending on the context to promote well-being (Legate et al.,
The literature reviewed so far has provided a review of LGBTQ+ 2012). Roberts and Christens (2021) found that while outness was
health conceptualized on multiple ecological levels, strengths-based directly related to higher levels of well-being among White LGBT in­
approaches to LGBTQ+ health, and LGBTQ+ well-being as an impor­ dividuals, outness was not related to higher well-being for Black or
tant outcome in LGBTQ+ health research. We also defined and described Latine LGBT individuals. This study was one of the first to investigate

Fig. 1. Proposed Strengths-Based Ecological Model Promoting Well-Being Among LGBTQ + Adults
Note. The left side of the figure displays the level of analysis, the right side gives examples from the research literature. Please note that all levels of the model are in
dynamic interaction with one another.

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A. Cowand et al. New Ideas in Psychology 79 (2025) 101178

racial and ethnic differences in the impact of coming out on well-being relationship (Sarno et al., 2022).
and future research should consider how intersecting identities can in­ Frost et al. (2016) assessed social support networks among sexual
fluence this relationship and all factors that can promote well-being minority individuals inNew York City and found with major support
(Roberts & Christens, 2021). This example of outness and intersection­ needs (e.g., borrowing money) heterosexual men and women and
ality highlights the interactions between different ecological levels – lesbian and bisexual women relied more on their non-chosen families,
that the context surrounding outness matters in whether outness is while gay and bisexual men relied more on their chosen families within
linked to well-being. Most of the literature investigating outness’s the LGBTQ+ community. This study further found racial and ethnic
connection to well-being has focused on eudemonic well-being or psy­ minority sexual minority individuals reported less overall support from
chological well-being, which illuminates the need to investigate out­ their social support networks compared to racial and ethnic majority
ness’s relationship to subjective well-being (LaSala, 2000; Legate et al., sexual minority peers (Frost et al., 2016). The strong support networks
2012; Roberts & Christens, 2021; Whitman & Nadal, 2015). of racial and ethnic minority individuals come from other racial and
Gender minority populations have differing experiences living in a ethnic minority individuals in the LGBTQ+ community (Frost et al.,
cissexist society compared with sexual minority populations. Several 2016), which highlights the importance of creating community support
studies indicate that TGNC individuals experience lower levels of well- by and for LGBTQ+ people of color. Overall, these findings demonstrate
being compared with their cisgender, heterosexual peers (Bockting the diverse strengths and needs for LBGTQ + individuals when it comes
et al., 2016; Stewart et al., 2018). As such, research has examined what to promoting well-being.
unique individual-level factors promote well-being among transgender
and gender non-conforming populations. Consistencies have emerged 7.3. Organizational-level factors
from the limited research, identifying general health, self-worth, and
positive identity attitudes as individual-level factors that are associated Organizational-level factors, such as organizational policies, prac­
with greater well-being (Doyle et al., 2021; Singh et al., 2011; Stanton tices, or specific LGBTQ+ supports, are another important level
et al., 2017). This work has used both hedonic and eudemonic measures contributing to the well-being of LGBTQ+ individuals and can occur
of well-being and as these are separate, but related concepts it is across a variety of organizations (e.g., school or university, workplace,
important to continue to investigate how well-being promoting factors and healthcare settings). Research demonstrates the positive impacts
relate to both. These individual-level factors identified by empirical inclusive policies, curriculum, training for teachers, and affirming
literature highlight strengths and resiliency that individuals in this clubs/groups has on well-being for LGBTQ+ adolescents (Black et al.,
community possess. 2012; Johns et al., 2019; Russell et al., 2021), but for the sake of this
Individual-level factors are not a one-size-fits-all pathway to well- model focusing on adults we will not go in depth into that literature.
being for all members of the LGBTQ+ community. Context, identities, Woodford et al. (2018) examined the impact in a university setting of
and intersecting systems of oppression must be considered when eval­ pro-LGBTQ+ policies (e.g. gender identity inclusive antidiscrimination
uating what individual-level factors might be relevant for a particular policies) and LGBTQ+ institutional resources (e.g. LGBTQ+ student
person. Thus, a key takeaway from our model is to put individual-level support initiatives) on the well-being and experiences of sexual minority
factors in the context of other layers of analysis and other intersections college students. They discovered that pro-LGBTQ+ policies and re­
of identity. For example, Vaughan et al. (2021) identified sources are associated with higher levels of psychological well-being
individual-level character strengths that promote psychological amongst sexual minority college students (Woodford et al., 2018).
well-being among LGBTQ+ Muslims including self-reported connection Research has explored how other organizations can make changes to
to spirituality, integrity, creativity, prudence, social intelligence, love, promote well-being for LGBTQ+ individuals. Roberson et al. (2024)
fairness, and citizenship. While these particular strengths were identi­ provide a conceptual framework for organizational changes which can
fied among a group of LGBTQ+ Muslims, this does not mean that they improve the workplace and well-being of LGBTQ+ employees. They
are the same strengths other members in the LGBTQ+ community view note that incorporating LGBTQ-supportive practices within organiza­
as important for them. This is consistent with other findings, as dis­ tions can help foster a shared understanding of the organization and
cussed above, that coming out is associated with greater levels of members of the organization’s values, which in turn, can create an
well-being for some populations and not for others (LaSala, 2000; Legate LGBTQ affirming environment (Roberson et al., 2024). Examples of
et al., 2012; Vaughan et al., 2021). Individuals exist within broader these supportive organizational practices include: “Transgender
institutions, communities, and social groups, all of which influence the healthcare and family planning services for LGBTQ individuals; Gender-
aforementioned individual-level factors (e.g., character strengths are and LGBTQ-inclusive language in organizational communications and
molded by a person’s environment and culture) and well-being of handbooks; Outreach and other advocacy practices to influence the
LGBTQ+ populations. adoption of pro-LGBTQ legislation; Engaging with LGBTQ markets and
communities, such as inclusive marketing and supplier diversity pro­
7.2. Interpersonal-level factors grams.” (Roberson et al., 2024, p. 1158)
In addition to organizational characteristics, organizations them­
Interpersonal-level factors refer to characteristics of interpersonal selves may be formed that contribute to well-being. For example, set­
relationships, such as affirming and stable relationships and social tings or spaces which are created by and for LGBTQ+ people (Maton,
support (Frable et al., 1998; Frost et al., 2016; Johns et al., 2013). Social 2008). In the literature, settings such as this have been called “coun­
support during adulthood via quality social relationships with chosen terspaces,” or settings where marginalized communities and individuals
families, non-chosen families, and friends is a notable factor that has can experience support, foster positive self-concept, and foster com­
been associated with higher levels of psychological well-being for both munity (A. D. Case & Hunter, 2012; McConnell et al., 2016). Organi­
sexual and gender minoritized populations (Meyer, 2015; Roberts & zations in a given community can invest in the creation and maintenance
Christens, 2021; Stanton et al., 2017). For some members of the of affirming spaces or counterspaces to promote well-being for LGBTQ+
LGBTQ+ community, romantic or intimate relationships are an impor­ populations. For example, Gay Straight Alliance/Genders and Sexual­
tant influence on health and well-being. Higher relationship quality, ities Alliance (GSA) groups are counterspaces within school settings.
defined as satisfaction with the relationship and social support from a Other organizations in one’s community, like an LGBTQ+ Center, also
partner, is related to greater individual well-being for sexual and gender may function as a specific organization formed to contribute to
minorities (Sarno et al., 2022). Thus, interventions targeting improve­ well-being (see below for more examples of organizations in one’s
ment of relationship quality for LGBTQ+ individuals in romantic re­ community). Thus, organizational factors may be present across all
lationships could foster greater well-being for those individuals in the kinds of organizations (e.g., schools, workplace) and there may be

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organizations themselves that contribute to well-being. 2020).

Talley et al. (2023) reviewed the existing literature on policies to
7.4. Community-level factors promote health and well-being for sexual and gender minority adults in
the US. They found protective federal laws (e.g., family adoption pol­
Individuals exist within larger communities such as neighborhoods icies, anti-discrimination policies) are related to improved health and
towns, thus the next level of factors which impact an individual’s well- well-being of LGBTQ+ adults (Talley et al., 2023). On the state level,
being are community-level strengths. Within communities, community- supportive laws (e.g., supportive adoption laws, requirements of insur­
level factors are the events, activities, spaces, and opportunities them­ ance coverage for same-sex partners, protections for transgender and
selves afforded through community structures for involvement. gender non-conforming adults) were positively related to LGBTQ+
Community-level strengths interact with individual-level strengths to health and well-being (Talley et al., 2023). Structural strengths addi­
foster well-being for LGBTQ+ people. Communities can provide an tionally impact institutional, community, interpersonal, and
environment for connection, support, resources, and more for members individual-level factors that promote well-being for LGBTQ+ in­
in the LGBTQ+ community (Shinn, 2015). Meyer (2015) emphasized dividuals, highlighting the embedded influence these factors have
how there are different levels of resilience for LGBTQ+ populations and (National Academies of Sciences, 2020; Neal & Neal, 2013; Stokols,
it is important to study community resilience. Community resilience 2000).
includes LGBTQ+ community organizations, collective action groups,
and community validation, which assist in mitigating the impacts of 7.6. Interconnectedness across levels and importance of intersectionality
minority stressors on well-being among LGBTQ+ populations (Frost
et al., 2019; Meyer, 2015; Nouvilas-Pallejà et al., 2018; Parmenter, A key emphasis of our model is that levels are interconnected. Inte­
Galliher, Wong, et al., 2021; Roberts & Christens, 2021; Stanton et al., grating various ecological level strengths which improve well-being of
2017). A recent meta-analysis highlighted the importance of community LGBTQ+ individuals has been explored seldom in the literature. First,
connection through involvement in LGBTQ+ community events, activ­ we consider bi-directional and direct effects across ecological levels in
ities, and spaces for improved well-being among LGBTQ+ individuals the promotion of LGBTQ+ well-being. Structural-level factors such as
(Lefevor et al., 2024). Thus, the community-level factors are important affirming policies on the state and federal levels can have direct effects
in fostering well-being for the LGBTQ+ community. on interpersonal and community factors on individual well-being. For
Additionally, LGBTQ+ people of color spaces, community support, example, protective state policies decrease discriminatory behaviors and
and connections are an important source of strength and resilience for increase support of LGBTQ+ people among those living in the state
LGBTQ+ communities of color (Hudson & Romanelli, 2020; McConnell which can improve the well-being of LGBTQ+ individuals in the given
et al., 2016; Parmenter, Galliher, Wong, et al., 2021; Perrin et al., 2020). state(Bates et al., 2024; Diamond & Alley, 2022). Further direct effects
LGBTQ+ communities of color may improve psychological and subjec­ include local attitudes of support from community members being
tive well-being among LGBTQ+ people of color (McConnell et al., 2016). associated with better health and well-being outcomes of SGD in­
Communities beyond the LGBTQ+ community are also supports for dividuals ( Diamond & Alley, 2022; Hatzenbuehler et al., 2017).
well-being, including one’s cultural or ancestral community connect­ Another layer we highlight in our model is the need to consider
edness or potentially religious community engagement (Maton, 2008; intersectionality in relation to levels and relations among levels. For
McConnell et al., 2016; Parmenter, Galliher, Wong, et al., 2021; Perrin example, notable community strengths identified by LGBTQ+ people of
et al., 2020; Vaughan et al., 2021; Walters et al., 2006). Connection with color are physical and emotional safety (e.g., can be accomplished
others in one’s communities can foster liberation and fight for change, through direct communication styles on an interpersonal level), re­
thus increasing access and opportunities for community connection sources sharing (e.g., can be accomplished by connection to affirming
through events, activities, and spaces can improve well-being for healthcare providers or institutions), and collective action (e.g., can be
LGBTQ+ populations. accomplished by individual forward thinking to get involved in advo­
cacy) which all demonstrate the interconnectedness of factors across
7.5. Structural-level factors ecological levels (Hudson & Romanelli, 2020). Bowleg (2013) explored
the experiences of Black gay and bisexual men and participants
Structural-level factors include laws, policies, social norms, and described their unique strengths as holding greater life introspection and
structural stigma; all of which shape experiences in one’s ecological mental growth and breaking free from societal conventions. This study
context. The influence of state and federal policies on LGBTQ+ health highlights how well-being and liberation for Black gay and bisexual
has primarily been studied in the context of how harmful policies or lack men, along with all historically marginalized groups, lies in the accep­
of protective policies impact LGBTQ+ populations (Hatzenbuehler, tance of intersectional identities on the individual level and advocacy for
2010, 2014, 2016). LGBTQ+ individuals who lived in states with little to dismantling systems of oppression at the structural level (Bowleg, 2013).
no sexual orientation and gender identity protective policies experi­ Joy, an aspect of well-being, has been researched among Black queer
enced higher levels of minority stress, psychopathologies, and negative people who find joy through self-celebration (individual level),
mental health outcomes (Hatzenbuehler, 2014, 2016; Hatzenbuehler & connection to ancestral pride and values (exist on structural/cultural
Pachankis, 2021; Rabasco & Andover, 2020; Todd et al., 2024). Inclu­ level and expressed on community and interpersonal levels), and posi­
sive policy development and implementation is considered a promising tive representations in media (institutional, structural level) (Denis
direction for promoting well-being among LGBTQ+ populations (Mulé et al., 2025). Interactions between the structural level and interpersonal
et al., 2009). It is essential to consider structural-level factors that pro­ level are also seen among Latine LGBTQ+ individuals. Research dem­
mote well-being among LGBTQ+ populations as supportive environ­ onstrates Latine cultural values, such as familismo or importance of a
ments are a source of strength and resilience (Colpitts & Gahagan, strong family unit and support, play important roles in fathers accepting
2016). Structural factors connect to the social context itself; they can their TGD children (Abreu et al., 2020; Teran et al., 2023); thus, Latine
change the context through mechanisms such as developing new, cultural values, which exist on a structural level, increase familial sup­
affirming policies. Flores et al. (2020) examine arguably one of the port, which exists on the interpersonal level, for Latine LGBTQ+ in­
largest structural factors to impact the LGBTQ+ community, the federal dividuals. Taken together, current literature demonstrates the need to
legalization of same-sex marriage in 2015. This inclusive, and long incorporate intersectionality, with the example above noting focus on
overdue, law increased both subjective and psychological well-being LGBTQ+ people of color, into any model, including this ecological
among LGBTQ+ adults as well as rid the well-being disparities gap be­ strengths-based model.
tween LGBTQ+ individuals and non-LGBTQ+ individuals (Flores et al., The proposed ecological model, additionally, has potential for

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exploring mechanistic relationships between levels to foster well-being. being. Departing from a deficit-based, individualistic perspective, our
Previous literature has shown LGBT community connection mediates proposed model incorporates individual, interpersonal, organizational,
the effect of LGBT sociopolitical involvement and outness on well-being community, and structural-level factors which opens doors for future
(Roberts & Christens, 2021). Within the school setting, presence of GSA research. Future research needs to include interacting effects of multi-
and LGBTQ-focused policies were positively associated with teacher and level factors on LGBTQ+ well-being. For example, longitudinal
peer support of LGBTQ+ students (Day et al., 2020), thus future work methods could explore the impacts of an individual-level intervention
could investigate the mediating effects presence of GSA and (e.g. self-compassion intervention), for LGBTQ+ adults within states
LGBTQ-focused policies has on the relationship between peer and that have anti-discrimination laws compared to those without, exam­
teacher support and well-being of LGBTQ+ youth. Further, exploring the ining these interventions and processes across other identity groups (e.
mediating or moderating effects of protective policies between work­ g., race-ethnicity, ability, religion). Additionally, future research should
place support and LGBTQ+ well-being is another direction supported by also investigate well-being outcomes of this model as multi-level pro­
this proposed ecological model. cesses and not just individual level well-being experiences. For example,
Understanding the Well-Being of LGBTQI + Populations argues there evaluations of community well-being for LGBTQ+ community organi­
are interactive feedback loops between multilevel factors which pro­ zations or counterspaces. Prilleltensky (2012) identifies subjective and
mote well-being (National Academies of Sciences, 2020). Talley et al. objective indicators of well-being across multiple levels, including per­
(2023) policy review highlights the interactive nature of policies in sonal (e.g., objective – money for food, shelter, clothing, etc.; subjective
promoting LGBTQ+ well-being; federal affirming policies need to align – life satisfaction), interpersonal (e.g., opportunities for growth in re­
with state and local affirming policies as well as institutional policies to lationships; subjective – feeling valued in relationships), organizational
increase promotion of LGBTQ+ well-being. For example, Massachusetts (e.g., supportive policies; subjective – feeling valued at work), and
became the first state to have a Commission on Lesbian, Gay, Bisexual, communal (e.g., objective – public awareness campaigns; subjective –
and Transgender Aging in 2013 which had resources and support to feeling safe and protective) (Prilleltensky, 2012). Future research should
create community centers and services for LGBT older adults, under­ investigate objective and subjective measures of LGBTQ+ well-being
stand the impacts of current policies on LGBT older adults in Massa­ across multiple levels and how they interrelate.
chusetts to inform future policies, improve access to mental health There is limited research on structural factors involved in well-being
services to foster those individual level factors promoting well-being promotion of LGBTQ+ populations, with most of this research existing
among the LGBTQ+ community (e.g., self-compassion), and beyond within the fields of public health or law. Given the influence that one’s
(Krinsky & Cahill, 2017). Further interactive effects between ecological environment, institutions, society, and policies have on the lives of
levels could be explored based on this model, looking at how in­ people, structural-level factors must be considered in a model of well-
dividuals’ decisions to come out has differing impacts on their being promotion. Future research can explore structural factors such
well-being for those in states with affirming policies versus those with as policies, community investment, and access to healthcare based on
harmful policies. There is great potential for future empirical research to census data along with subjective measures such as environmental
investigate the interconnectedness of the strengths-based ecological quality of life. For example, “The Health Impact in 5 Years” (HI-5) is an
levels proposed here. initiative that does just that, it highlights the utility of various com­
munity investment interventions in improving the mental health of
7.7. Summary communities of color (Centers for Disease Control and Prevention :
Health Impact in 5 Years, 2018). Adult intervention programs which
Overall, the proposed ecological model provides a needed integra­ improved mental health outcomes in the US were the Housing First
tion for how multilevel factors impact the well-being of LGBTQ+ adults program, Individual Placement and Support (IPS) for employment,
through a strengths-based lens. Assessing strengths from multiple Earned Income Tax Credit, community-led interventions, and mental
ecological levels which together influence the outcome of well-being health literacy campaigns (Alegría et al., 2022). LGBTQ+ research
provides a new focus predominantly on affirming targets of in­ should explore the impacts of community investment interventions on
terventions and research across individual, interpersonal, organiza­ mental health and well-being.
tional, community, and structural levels. Centering well-being as the
primary outcome of this model can shape future work in the field of 8.2. Clinical implications
LGBTQ+ health to focus on ways to improve well-being for LGBTQ+
individuals. This model demonstrates that promoting LGBTQ+ well- The proposed multi-level model for promoting well-being among
being occurs on multiple levels and these factors are informed by the LGBTQ+ populations also has clinical implications. Incorporating
larger sociocultural context and diverse identities that an individual strengths-based individual factors such as positive LGBTQ+ identity
holds. development and self-compassion is one component of facilitating well-
being. The model also demonstrates the importance of considering
8. Implications and future directions higher-level factors such as community connectedness and engagement,
activism, and LGBTQ+ affirming policies in the promotion of health and
The proposed ecological model organizes and integrates the path­ well-being. Implications for clinicians working with LGBTQ+ clients can
ways to LGBTQ+ well-being as contextual, multi-level, strengths-based, include assessments of their environment, community, and interper­
and informed by intersectionality theory. While previous models have sonal dynamics as these can inform the best suited intervention
included positive health outcomes along with negative health outcomes approach. For example, LGBTQ+ individuals who live in states without
in their conceptualization, this proposed model focuses directly on well- protective policies have greater likelihood of internalized homo­
being as the target outcome. The multi-level strengths-based model of negativity and identity concealment (Burton et al., 2019; Millar et al.,
promoting well-being among LGBTQ+ adults is a novel model and has 2016). Thus, they may benefit from LGBTQ+ affirming interventions
several key implications. Thus, we now explore the implications of the (Burton et al., 2019). The proposed multi-level pathways towards
integrative model and highlight future directions of this work. well-being highlight the importance of individual factors in addition to
interpersonal, organizational, community, and structural factors. Thus,
8.1. Research implications interventions should include additional targets of these factors, for
example, supporting clients in engaging with affirming community
This proposed ecological model is meant to help generate testable engagement and acts of resistance (Maton, 2008; Parmenter, Galliher,
associations between multi-level strengths which impact LGBTQ+ well- Wong, et al., 2021). Social safety must additionally be considered in the

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A. Cowand et al. New Ideas in Psychology 79 (2025) 101178

clinical space when making recommendations for community engage­ resilience of the LGBTQ+ community and will further action toward
ment or advocacy involvement, as settings that a client anticipates being increasing well-being for LGBTQ+ adults.
unsafe would not be appropriate for them to engage with (Diamond &
Alley, 2022). Finally, clinicians could benefit from their own engage­ CRediT authorship contribution statement
ment and active learning with the model. Emphasizing social justice
engagement and the pervasiveness of White-centric ideology among Alexandra Cowand: Writing – original draft, Methodology,
LGBTQ+ communities, as well as the larger society, could promote Conceptualization. Konrad Bresin: Writing – review & editing, Super­
activism and increase education on systems of oppression among vision, Conceptualization. Nathan R. Todd: Writing – review & editing,
clinicians. Visualization, Methodology. Yara Mekawi: Writing – review & editing,
Supervision.
8.3. Community practice and intervention
Data availability
Finally, this ecological model has strong implications for community
practice and intervention, ranging from workplaces, community orga­ No data was used for the research described in the article.
nizations, policies, and beyond. Workplace initiatives for creating safe
and affirming environments for LGBTQ+ people often target individual- References
level attitudes and supports (García Johnson & Otto, 2019; Huffman
et al., 2020; Perales, 2022). In accordance with the proposed ecological Abreu, R. L., Gonzalez, K. A., Rosario, C. C., Pulice-Farrow, L., & Rodríguez, M. M. D.
model, it would also be effective for these initiatives to additionally (2020). “Latinos Have a Stronger Attachment to the Family”: Latinx Fathers’
acceptance of their sexual minority children. Journal of GLBT Family Studies, 16(2),
include higher level supports like developing strategies to improve 192–210. https://doi.org/10.1080/1550428X.2019.1672232
organizational support for LGBTQ+ employees (e.g., affirming policies, Alegría, M., Mulvaney-Day, N., Torres, M., Polo, A., Cao, Z., & Canino, G. (2007).
gender neutral bathrooms, medical benefits) and explaining these to all Prevalence of psychiatric disorders across Latino subgroups in the United States.
American Journal of Public Health, 97(1), 68–75.
employees. Implications of the ecological model of promoting LGBTQ+ Alegría, M., Zhen-Duan, J., O’Malley, I. S., & DiMarzio, K. (2022). A new agenda for
well-being extend to community organizations as well. For example, optimizing investments in community mental health and reducing disparities.
community organizations who are affirming and supportive can present American Journal of Psychiatry, 179(6), 402–416.
Alvidrez, J., Castille, D., Laude-Sharp, M., Rosario, A., & Tabor, D. (2019). The national
social safety cues for the LGBTQ+ (e.g., pride flags, pronouns on name
institute on minority health and health disparities research framework. American
tags), host local LGBTQ+ support groups, art, talks, educational op­ Journal of Public Health, 109(S1), S16–S20.
portunities, and organize ways for customers, employees, and other Amato, A. T., Wonsiak, T., Handlovsky, I., Ferlatte, O., Kia, H., & Oliffe, J. L. (2024).
Cultivating psychological well-being amongst older gay men: A qualitative
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As noted in the previous examples, a key strength of ecological sys­ Balsam, K. F., Molina, Y., Beadnell, B., Simoni, J., & Walters, K. (2011). Measuring
tems theory and our model is that it shines light on new places for multiple minority stress: The LGBT people of color microaggressions scale. Cultural
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et al., 1988). For example, focusing on organizational and community light on the black–white depression paradox? A systematic review. Social Psychiatry
levels help to move the effort of intervention away from LGBTQ+ people and Psychiatric Epidemiology, 52(8), 913–928.
Bates, A., Kamp Dush, C., & Manning, W. (2024). State-Level LGBTQ + policies and
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