Cortisol Recovery Differs Among Sexual and Gender Diverse Couples Compared With Cisgender Heterosexual Couples

Positive romantic relationships are linked to physical health through stress buffering. A growing number of studies have used the Trier Social Stress Test (TSST) to examine cortisol reactivity and recovery among couples. To date, research has focused on stress-exposed individuals' cortisol output, often neglecting support-providing partners' responses and their contribution to the couple's recovery. Further, beyond documented sex differences in reactive cortisol, gender and sexual orientation have been related to variability in stress reactivity. Yet, sexual and gender diverse (SGD) couples have received little attention among these studies.

One hundred one couples ( N= 202), including 42 SGD couples, took part in a 2-hour laboratory protocol. One partner underwent the TSST and the other acted as a support during filmed discussions before and after the task. Both partners provided 7 saliva samples and completed anxiety and sociodemographic measures.

Male sex was predictive of stronger cortisol reactivity among stress-exposed participants ( β s=0.04 to 0.06; p s=.005 to .045), whereas female sex was predictive of higher cortisol secretion among supporting partners ( β s=0.06 to 0.08; p s=.009 to .027). Among stress-exposed participants, no difference in total cortisol output was found when comparing gender and sexual orientation subgroups ( p s > .14). Notably, SGD couples presented lower cortisol secretion after the TSST than cisgender heterosexual couples ( β s=-0.03 to -0.05; p s=.026 to .035).

Sex differences were observed among stress-exposed individuals and supporting partners. Critically, SGD couples may uniquely benefit from partner support in recovering from stress when compared with cisgender heterosexual couples.