Young sexual minority women's definition of community: Toward addressing health disparities in the LGBTQQ community

In accord with Healthy People 2020 goals, the elimination of lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQQ) health disparities will require community-level strategies to address stigma, discrimination, and prejudice linked to poor health. We explored how young sexual minority women (YSMW) define LGBTQQ community, community connection, community engagement, and community tensions because these concepts have implications for development and evaluation of health disparities interventions. A total of 30 YSMW (aged 18-24 years) from Michigan participated in semistructured, in-depth interviews. Participants varied by sexual identity, residency, and race/ethnicity. We analyzed transcribed interviews using thematic analysis and compared emergent themes across sexual identity, residency, and race/ethnicity. Women described community connection in terms of organizational involvement, participation in LGBTQQ spaces, and collective social identity. Participants noted how community connections were linked to stigma towards the LGBTQQ community. YSMW highlighted how divisive tensions exist within subgroups constituting the LGBTQQ community, hindering opportunities for social advocacy, unified policy priorities, and community-level interventions. The heterogeneity of YSMW's experiences identifying with the LGBTQQ community and engaging within LGBTQQ spaces suggest that researchers should attend to the role of community dynamics when developing health disparities interventions and policies. Efforts to reconcile tensions within the LGBTQQ community may strengthen and advance policymakers' ability to address sexuality-related disparities.