We conducted a multilevel meta-analysis of 390 effect sizes from 167 studies with 157,923 participants examining the relationship between connectedness with lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) communities and health-related outcomes, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted our initial search in January 2023 in APA PsycInfo, ERIC, Medline, and Open Dissertations, selecting studies that (a) measured LGBTQ+ community connectedness, (b) measured health, and (c) provided an estimate of the relationship between LGBTQ+ community connectedness and health. We found that connectedness with LGBTQ+ communities promotes mental health (r = .11), well-being (r = .17), and physical health (r = .09). Conversely, we found that connectedness with LGBTQ+ communities promotes substance use among younger participants, likely through behavioral engagement with LGBTQ+ others. We found that connectedness with LGBTQ+ communities was related to less mental health and more suicidality for younger people, likely because younger LGBTQ+ people seek out connectedness in response to this psychological distress. We also found that connectedness was not as health-promoting for LGBTQ+ individuals with multiple marginalized identities and that psychological feelings of belongingness with LGBTQ+ communities are generally more health-promoting than behavioral community engagement. Results from a narrative review and moderation meta-analyses suggested that, contrary to predictions made by minority stress theory, connectedness with LGBTQ+ communities does not buffer the relationship between minority stressors and health. Rather, meta-analytic mediation analyses suggested that proximal minority stressors negatively impact health-related outcomes by reducing connectedness with LGBTQ+ communities and that distal minority stressors are often less impactful on health-related outcomes because they promote connectedness with LGBTQ+ communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

我们进行了一项多层次的元分析，研究了来自167项研究的390个效应量和157,923名参与者之间的联系，这些研究探讨了与同性恋、异性恋、双性恋、跨性别者及酷儿/疑问身份（LGBTQ+）社区的连接感与健康相关结果之间的关系。我们的研究遵循《系统评价和元分析首选报告项目》指南进行。我们在2023年1月在APA PsycInfo、ERIC、Medline和Open Dissertations数据库中进行了初始搜索，选择了符合以下标准的研究：(a) 测量了LGBTQ+社区连接感；(b) 测量了健康状况；以及(c) 提供了LGBTQ+社区连接感与健康之间关系的估计值。

我们发现，与LGBTQ+社区的联系促进了心理健康（r = .11）、幸福感（r = .17）和身体健康（r = .09）。相反，我们还发现，与LGBTQ+社区的联系会增加年轻参与者的物质使用，这可能是通过行为上与LGBTQ+群体互动实现的。此外，我们发现在较年轻的个体中，与LGBTQ+社区的联系较少导致心理健康问题和自杀倾向增加，原因很可能是年轻的LGBTQ+个体为了应对心理压力而寻求社交连接。

我们也发现，具有多重边缘化身份的LGBTQ+个体从中受益较小，并且对LGBTQ+社区的心理归属感比行为上的社群参与更能促进健康。叙事综述和调节元分析的结果表明，与少数群体压力理论的预测相反，与LGBTQ+社区的联系并不能缓解少数群体压力因素与健康之间的关系。反而，元分析中介效应分析显示，近期的少数群体压力因素通过减少与LGBTQ+社群的连接来负面影响健康相关结果，并且长期的少数群体压力因素往往对健康相关的结果影响较小，因为它们促进了与LGBTQ+社区的联系。(PsycInfo数据库记录 © 2024 APA, 所有权利保留)