The Buckle of the Bible Belt: Sexual minority emerging adults' minority stress in South Central Appalachia

Introduction: Sexual minority emerging adults in Appalachia face multiple sources of stigma and discrimination. Methods: We conducted four focus groups and five one-on-one interviews with sexual minority young adults and community stakeholders. Results: Themes emerged from qualitative analysis: (1) Appalachian culture engenders discrimination and isolation; (2) A need to identify safe spaces; (3) Lack of access to identity-affirming health services; and (4) participants draw strength from limited but persistent resistance, advocacy, and visibility. Conclusion: Sexual minority emerging adults experience intersectional stigma in a socially conservative Appalachian setting. Attention to their unique experiences points toward specific service and community support needs.