Archives of Sexual Behavior

, Volume 44, Issue 7, pp 1843–1860 | Cite as

A Transdiagnostic Minority Stress Treatment Approach for Gay and Bisexual Men’s Syndemic Health Conditions

  • John E. Pachankis
Special Section: Sexual Health in Gay and Bisexual Men


Developing and deploying separate treatments for separate conditions seems ill-suited to intervening upon the co-occurring, and possibly functionally similar, psychosocial conditions facing gay and bisexual men. This article argues for the need to create transdiagnostic interventions that reduce multiple syndemic conditions facing gay and bisexual men at the level of their shared source in minority stress pathways. This article first reviews psychosocial syndemic conditions affecting gay and bisexual men, then suggests pathways that might link minority stress to psychosocial syndemics based on recent advancements in emotion science, psychiatric nosology, and cognitive-affective neuroscience, and finally suggests cross-cutting psychosocial treatment principles to reduce minority stress−syndemic pathways among gay and bisexual men. Because minority stress serves as a common basis of all psychosocial syndemic conditions reviewed here, locating the pathways through which minority stress generates psychosocial syndemics and employing overarching treatment principles capable of simultaneously alleviating these pathways will ultimately create a transdiagnostic approach to improving gay and bisexual men’s health. Clinical research and training approaches are suggested to further validate the pathways suggested here, establish the efficacy of treatment approaches tied to those pathways, and generate effective methods for disseminating a transdiagnostic minority stress treatment approach for gay and bisexual men’s psychosocial syndemic health.


Gay and bisexual men HIV prevention Syndemic Psychotherapy Mental health intervention Sexual orientation 



The preparation of this article was supported by a research grant from the National Institute of Mental Health (R34-MH096607; John E. Pachankis, Principal Investigator). The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.


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© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Social and Behavioral Sciences Division, Department of Chronic Disease Epidemiology, Yale School of Public HealthYale UniversityNew HavenUSA

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