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Addressing a Conceptual Gap in Sexual and Gender Minority Individuals' Health: The Need for Evolutionary Integration
Andreia A Manão1,2, Sérgio A Carvalho2
1Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Lisbon, Portugal.
Abstract:
Mental health disparities among sexual and gender minority (SGM) populations remain a clinical concern. Existing mental health models have advanced understanding, but often overlook sexual health as a key outcome. We propose that integrating minority and intraminority stress within an evolutionary framework (highlighting processes, e.g., shame, arrested flight, insecure striving) may offer a unifying perspective. We suggest stigma triggers threat-defense systems that shape sexual behavior around survival-oriented social motives (e.g., avoiding rejection), rather than intimacy, pleasure, and care. This commentary highlights the need for clinicians to assess sexual and relational functioning with an evolutionarily-informed framework when working with SGM patients.
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