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Individuals with diverse and multiple marginalized identities are often underrepresented in psychological research, and it is crucial to fill this gap in the literature and provide insight into the different contextual factors affecting these populations (Roberts et al., 2020). While research on LGBTQ+ stressors and related health concerns and resources is expanding, it must be acknowledged that some of the prior quantitative research findings and the current measures to address LGBTQ+ populations do not cover the spectrum of lived experiences of sexual- and gender-diverse identities, especially those with multiple intersecting marginalized identities (e.g., a transgender immigrant of color; Watson-Singleton et al., 2021). Employing research designs, such as mixed methods, may be key to maximizing communications with minoritized groups and improving our current understanding of the cultural norms, language use, experiences of discrimination, stigma, and isolation- and health-related challenges that LGBTQ+ individuals face.

A mixed-methods study consists of both quantitative and qualitative data in a single study where data are collected concurrently or sequentially and involves integration of data at one or more phases of the research study (Creswell et al., 2003, p.165; Teddlie & Yu, 2007). In this sense, a mixed-methods design accounts for the strengths of both the quantitative and qualitative designs. The combination of both approaches may provide a wider and representative sample to corroborate and generalize hypotheses to similar understudied populations, while still providing a comprehensive assessment of the lived experiences of diverse groups. Given that fewer studies focus on populations with multiple marginalization experiences, researchers may have to use instruments or apply theoretical frameworks that are validated and developed, respectively, in predominantly non-Hispanic White samples, to guide the formation of research questions. In such instances, researchers may benefit from an exploratory sequential mixed-methods design, which first goes into the qualitative strand of the study design to explore lived experiences of individuals, followed by the quantitative strand where themes generated from the qualitative strand can be analyzed and generalized (Creswell & Plano Clark, 2017). Another design known as the explanatory sequential mixed-methods design allows collecting feedback from participants to help shape the study and to implement the research findings that impact people and their communities. This design can be beneficial for testing the effectiveness of clinical interventions. In such cases, qualitative interviews after collecting the surveys may answer questions about different barriers, difficulties and deficiencies that diverse communities experience related to the intervention/program that may affect effectiveness and adherence. People’s participation in generating such information can lead to useful changes in their lives (Ponterotto et al., 2013).

With this background in mind, we designed a concurrent mixed-methods study (for data collection) to understand experiences and narratives of LGBTQ+ identifying adults residing in Spain. Here we provide a summary of how data collection (n = 17 interviews; n = 670 quantitative questionnaires) took place. For our study, we turned to strategies such as including researchers from diverse cultural, sexual and gender identities in our team. Additionally, we appropriated the fluidity and flexibility of mixed-methods research based on the feedback and response of the participants. The first part of the study consisted of an online survey (quantitative strand), followed by individual interviews (qualitative strand) of some of the participants who were interested in sharing their experiences, stressors and mental health concerns. Participant recruitment was through social media, especially Twitter and Instagram, which are known to be critical online spaces for LGBTQ+ communities to connect (Fox & Ralston, 2016; Miller, 2015). Influencers and nine LGBTQ+ associations from different cities (i.e., Madrid, the Canary Islands) were contacted and requested to share a Qualtrics link to our study survey that resulted in a strikingly high participation by LGBTQ+ individuals who were committed to sharing their experiences, albeit confidentially. Throughout the process of instrument construction (e.g., interview guide, scales to be used), data collection and analyses, the three authors reflected on their own identities (RRT: transgender man from Mexico residing in Spain; ICG: cisgender women from Spain residing in the United States; RC: cisgender women from India residing in the United States). Interestingly, through the qualitative interviews we found that the most frequent reasons for participation were 1) the opportunity to increase LGBTQ+ visibility, 2) helping those LGBTQ+ individuals who may be in need, and 3) to be represented, heard and respected in education and training programs, as they have often felt misunderstood and marginalized even when participating in programs designed for LGBTQ+ individuals.

Here is an example of a narrative: “agradezco muchísimo que quieras escuchar la voz de las personas, de lo que podemos contarte que de otra manera no nos hubiéramos conocido nunca y no hubieras podido tener este o ninguna de nuestras vivencias contadas. Yo creo que es un pasito para el futuro.  Con lo cual si hay ni una gota de agua que yo puedo aportar a ese, va a este mar. Pues feliz, por supuesto, feliz y encantada.”

Translation (in English): “I am very grateful that you want to listen to people's voices, about which we can tell you, that otherwise we would never have met, and you would not have been able to have this or any of our experiences told. I think it is a little step for the future. With which if there is a drop of water that I can contribute to the sea. Well, I’m happy, of course, happy and delighted.”

We hope to present our study findings at future conferences, to nonprofits and to service-providing organizations to give a voice to our participants’ lived experiences. In conclusion, while it is important to increase the number of research articles on LGBTQ+ related topics, it is important to include LGBTQ+ individuals’ voices, which in turn can inform future research and contextually competent health care strategies. This can easily be carried out with the help of a mixed-methods design that results in a more holistic and accurate understanding of the phenomena under study by not ignoring contextual factors (Bartholomew & Brown, 2012; Mertens, 2015).

About the Authors

Román Ronzón-Tirado, PhD Student, (he/his) is a research assistant in the Department of Biological and Health Psychology at the Autonomous University of Madrid, Spain. His research focuses on the analysis of risk and protective factors for intimate partner violence in Latinx and LGBTQ+ populations. He is interested in the development of cross-cultural measurements and cross-cultural validation of intervention programs among minorities.
Ruby Charak, PhD, (she/her/ella) is an associate professor in the Department of Psychological Science and director of the Adversities in Childhood and Trauma Studies Lab at the University of Texas Rio Grande Valley, Edinburg, Texas. Her research encompasses the identification of adverse interpersonal processes, including child maltreatment, polyvictimization, technology-mediated abuse, and traumatic stress reactions, such as PTSD in adolescents and emerging adults. She has worked extensively with individuals with multiple marginalized and intersecting identities.
Ines Cano-Gonzalez, MA, (she/her/ella) is a PhD student in the clinical psychology program at the University of Texas Rio Grande Valley, Edinburg, Texas. She has a Bachelor of Arts in psychology, a Master of Arts in criminal profiling (University of Barcelona, Spain), and a Master of Arts in forensic and legal psychology. Her research focuses on the study of trauma across the lifespan in ethnically diverse groups and LGBTQ+ populations.  


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