Associations of minority stress and employment discrimination with job quality among sexual- and gender-minority workers

Objectives: This study aimed to describe how minority stress and employment discrimination are associated with job quality (ie, employment type and income) among sexual- and gender-minority (SGM) workers. Methods: We conducted a pooled cross-sectional analysis of the 2021 and 2022 surveys from a national study of SGM adults in the United States. Using multinomial logistic regression models and stratification by six gender groups, we examined associations of minority stress and past-year employment discrimination with job quality. Results: Among 4221 workers, 22.0% experienced precarious employment and 6.8% were unemployed. Approximately half earned <= US$50 000. The mean minority stress score was 14.41, indicating moderate-to-severe minority stress. A one-standard-deviation increase in minority stress was associated with higher odds of precarious employment [adjusted odds ratio (ORadj) 1.17, 95% confidence interval (CI) 1.08-1.26], unemployment [ORadj 1.36 (95% CI 1.19-1.56)], earning <=$20 000 USD [ORadj 1.57 (95% CI 1.36-1.80)], and earning US$20 001-50 000 [ORadj 1.48 (95% CI 1.32-1.66)]. Employment discrimination was reported by 14.4% of all workers and was associated with precarious employment [ORadj 1.25 (95% CI 1.01-1.54)], unemployment [ORadj 2.11 (95% CI 1.54-2.89)], and earning US$20 001-50 000 compared to >= US$100 001 [ORadj 1.45 (95% CI 1.07-1.96)]. Transgender and gender-diverse (TGD) workers faced poorer job quality, greater minority stress, and employment discrimination than cisgender sexual minority workers. Conclusions: Higher minority stress levels and employment discrimination were associated with worse job quality among SGM workers. Future labor market reforms should reduce minority stress and employment discrimination, as well as improve job quality, for SGM workers.