Psychedelic-assisted therapy among sexual and gender minority communities

Abstract

Although research on psychedelic-assisted therapy (PAT) is rapidly expanding, the clinical trial literature has been criticized for its underrepresentation of sexual and gender minority (SGM) and racial communities. Accordingly, there is a pressing need to study the outcomes of PAT in minoritized communities and its effects on the mental health disparities among SGM communities. Here we discuss the potential relevance of minority stress theory and its principles as they relate to PAT for SGM communities. Furthermore, we propose a theoretical framework integrating minority stress theory and its extensions with prominent models of psychedelic action, highlighting the potential of PAT to plasticize entrenched cognitive and behavioral patterns associated with minority stress. Future research should explore the mechanisms by which PAT may interact with minority stress processes and the potential benefits of SGM-affirmative adaptations of PAT. The integration of minority stress theory into PAT research may enrich our understanding of its therapeutic mechanisms while tailoring a promising intervention to individuals disproportionately excluded from effective care. This Perspective discusses the importance of increasing access to psychedelic-assisted therapy to sexual and gender minorities and proposes a theoretical framework integrating minority stress theory to inform the research and guide study design.