Mindfulness-Based Interventions for Sexual and Gender Minorities: a Systematic Review and Evidence Evaluation

Sexual and gender minorities (SGMs) disproportionately experience psychological and behavioral health issues. Research regarding the use of mindfulness-based (e.g., Mindfulness-based Stress Reduction) and mindfulness-informed (e.g., Acceptance and Commitment Therapy) interventions in this population is emerging. The current study sought to provide a comprehensive overview of this developing field, critically evaluate evidence of efficacy and acceptability from extant mindfulness-based intervention (MBI) trials, inform future MBI research targeting SGMs, and offer recommendations in this area of research. We conducted a systematic review of mindfulness-based trials that targeted SGMs. Study abstracts and full texts were screened and summarized, followed by a narrative synthesis. Study quality, characteristics, and findings on efficacy and acceptability were evaluated. Among 769 studies reviewed, a total of 13 trials were included in the narrative synthesis, including six randomized controlled trials. Only one included trial (7.7%) targeted transgender and gender non-conforming individuals. Heterogeneity in study design, population, and findings was noted. Acceptability and retention varied largely by trial. We highlight some promising aspects of initial evidence evaluation, such as the utility of MBIs in improving behavioral outcomes and health indicators via biomarkers. Risk of bias was determined as high in most RCTs (66.7%). Emerging evidence suggests preliminary support for continued research regarding MBIs for SGMs, yet findings are limited by the small number of trials and varied research quality. Several recommendations are provided for future research, including improving of rigor, exploring of mechanism of change, the need for adaptations of MBIs to best engage and benefit SGMs, and critical evaluation in selection of measurements.