{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T07:30:18Z","timestamp":1785828618487,"version":"3.56.0"},"reference-count":62,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T00:00:00Z","timestamp":1611532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["T32MH116140"],"award-info":[{"award-number":["T32MH116140"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K23DA043418"],"award-info":[{"award-number":["K23DA043418"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Mental health disparities among transgender and gender diverse (TGD) populations have been documented. However, few studies have assessed differences in mental health symptom severity, substance use behavior severity, and engagement in care across TGD subgroups. Using data from the electronic health record of a community health center specializing in sexual and gender minority health, we compared the (1) severity of self-reported depression, anxiety, alcohol use, and other substance use symptoms; (2) likelihood of meeting clinical thresholds for these disorders; and (3) number of behavioral health and substance use appointments attended among cisgender, transgender, and non-binary patients. Participants were 29,988 patients aged \u226518 who attended a medical appointment between 2015 and 2018. Depression symptom severity (<jats:italic>F<\/jats:italic>= 200.6, p &lt; .001), anxiety symptom severity (<jats:italic>F<\/jats:italic>= 102.8, p &lt; .001), alcohol use (<jats:italic>F<\/jats:italic>= 58.8, p &lt; .001), and substance use (<jats:italic>F<\/jats:italic>= 49.6, p &lt; .001) differed significantly by gender. Relative to cisgender and transgender individuals, non-binary individuals are at elevated risk for depression, anxiety, and substance use disorders. Gender was also associated with differences in the number of behavioral health (\u03c7<jats:sup>2<\/jats:sup>= 51.5, p &lt; .001) and substance use appointments (\u03c7<jats:sup>2<\/jats:sup>= 39.3, p &lt; .001) attended. Engagement in treatment among certain gender groups is poor; cisgender women and non-binary patients assigned male at birth were the least likely to have attended a behavioral health appointment, whereas transgender men and cisgender women had attended the lowest number of substance use appointments. These data demonstrate the importance of (1) assessing gender diversity and (2) addressing the barriers that prevent TGD patients from receiving affirming care.<\/jats:p>","DOI":"10.1371\/journal.pone.0245872","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T18:31:07Z","timestamp":1611599467000},"page":"e0245872","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":70,"title":["Differences in mental health symptom severity and care engagement among transgender and gender diverse individuals: Findings from a large community health center"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5918-6645","authenticated-orcid":true,"given":"Amelia M.","family":"Stanton","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail W.","family":"Batchelder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norik","family":"Kirakosian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Scholl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3296-0407","authenticated-orcid":true,"given":"Dana","family":"King","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Grasso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6221-8895","authenticated-orcid":true,"given":"Jennifer","family":"Potter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth H.","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conall","family":"O\u2019Cleirigh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,1,25]]},"reference":[{"key":"pone.0245872.ref001","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/S0140-6736(16)00684-X","article-title":"Global health burden and needs of transgender populations: a review","volume":"388","author":"SL Reisner","year":"2016","journal-title":"Lancet"},{"key":"pone.0245872.ref002","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1001\/jamapediatrics.2018.2140","article-title":"Nonconforming gender expression and associated mental distress and substance use among high school students","volume":"172","author":"R Lowry","year":"2018","journal-title":"JAMA Pediatr"},{"key":"pone.0245872.ref003","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.cpr.2018.03.003","article-title":"A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States","volume":"66","author":"SE Valentine","year":"2018","journal-title":"Clin Psychol Rev"},{"key":"pone.0245872.ref004","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.jadohealth.2016.04.006","article-title":"Social epidemiology of depression and anxiety by gender identity","volume":"59","author":"SL Reisner","year":"2016","journal-title":"J Adolesc Health"},{"key":"pone.0245872.ref005","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.jadohealth.2018.07.006","article-title":"Minority stress factors associated with depression and anxiety among transgender and gender-nonconforming youth","volume":"64","author":"G Chodzen","year":"2019","journal-title":"J Adolesc Health"},{"key":"pone.0245872.ref006","unstructured":"Webb A, Matsuno E, Budge S, Krishnan M, Balsam K. Non-binary gender identities: Fact sheet. APA Division 44; https:\/\/www.apadivisions.org\/division-44\/resources\/advocacy\/non-binary-facts.pdf"},{"key":"pone.0245872.ref007","unstructured":"James SE, Herman JL, Rankin S, Keisling M, Mottet L, Anafi M. The Report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality; 2016."},{"key":"pone.0245872.ref008","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1007\/s10508-019-01533-9","article-title":"High burden of mental health problems, substance use, violence, and related psychosocial factors in transgender, non-binary, and gender diverse youth and young adults","volume":"49","author":"ME Newcomb","year":"2020","journal-title":"Arch Sex Behav"},{"key":"pone.0245872.ref009","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1089\/lgbt.2016.0113","article-title":"Disparities in exposure to intimate partner violence among transgender\/gender nonconforming and sexual minority primary care patients","volume":"4","author":"SE Valentine","year":"2017","journal-title":"LGBT Health"},{"key":"pone.0245872.ref010","doi-asserted-by":"crossref","first-page":"95","DOI":"10.3109\/09540261.2015.1106446","article-title":"Non-binary or genderqueer genders","volume":"28","author":"C Richards","year":"2016","journal-title":"International Review of Psychiatry"},{"key":"pone.0245872.ref011","first-page":"12","article-title":"The gender issue: A portrait of gender today","volume":"321","author":"ER Green","year":"2017","journal-title":"Journal of National Geographic Society"},{"key":"pone.0245872.ref012","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1037\/cou0000339","article-title":"Health disparities between genderqueer, transgender, and cisgender individuals: An extension of minority stress theory","volume":"66","author":"GT Lefevor","year":"2019","journal-title":"Journal of Counseling Psychology"},{"key":"pone.0245872.ref013","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1080\/15532739.2018.1452660","article-title":"A comparison of mental health symptomatology and levels of social support in young treatment seeking transgender individuals who identify as binary and non-binary","volume":"20","author":"N Thorne","year":"2019","journal-title":"International Journal of Transgenderism"},{"key":"pone.0245872.ref014","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0221583","article-title":"Comparing the health of non-binary and binary transgender adults in a statewide non-probability sample","volume":"14","author":"SL Reisner","year":"2019","journal-title":"PLoS One"},{"key":"pone.0245872.ref015","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1089\/lgbt.2017.0275","article-title":"Self-reported physical and mental health of gender nonconforming transgender adults in the United States","volume":"5","author":"CG Streed","year":"2018","journal-title":"LGBT Health"},{"key":"pone.0245872.ref016","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1891\/LGBTQ.2019-0002","article-title":"Comparing the health of transgender women, transgender men, and gender non-conforming individuals using population-level data","volume":"1","author":"AA Guy","year":"2020","journal-title":"Annals of LGBTQ Public and Population Health"},{"key":"pone.0245872.ref017","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1037\/a0029597","article-title":"A conceptual framework for clinical work with transgender and gender nonconforming clients: An adaptation of the Minority Stress Model","volume":"43","author":"ML Hendricks","year":"2012","journal-title":"Professional Psychology: Research and Practice"},{"key":"pone.0245872.ref018","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1037\/0033-2909.129.5.674","article-title":"Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence","volume":"129","author":"IH Meyer","year":"2003","journal-title":"Psychological Bulletin"},{"key":"pone.0245872.ref019","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1007\/s11121-013-0393-7","article-title":"Minority stress and substance use in sexual minority adolescents: A meta-analysis","volume":"15","author":"JT Goldbach","year":"2014","journal-title":"Prev Sci"},{"key":"pone.0245872.ref020","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10865-013-9523-8","article-title":"Minority stress and physical health among sexual minority individuals","volume":"38","author":"DM Frost","year":"2015","journal-title":"J Behav Med"},{"key":"pone.0245872.ref021","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1080\/23794925.2020.1765433","article-title":"Evidence-based psychological practice for transgender and non-binary youth: Defining the need, framework for treatment adaptation, and future directions","volume":"5","author":"CA Coyne","year":"2020","journal-title":"Evidence-Based Practice in Child and Adolescent Mental Health"},{"key":"pone.0245872.ref022","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1089\/lgbt.2019.0223","article-title":"Sexual minority stress theory: Remembering and honoring the work of Virginia Brooks","volume":"7","author":"AJ Rich","year":"2020","journal-title":"LGBT Health"},{"key":"pone.0245872.ref023","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.psym.2014.08.004","article-title":"Prevalence of psychiatric and substance abuse symptomatology among HIV-infected gay and bisexual men in HIV primary care","volume":"56","author":"C O\u2019Cleirigh","year":"2015","journal-title":"Psychosomatics"},{"key":"pone.0245872.ref024","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1007\/s11524-015-9989-5","article-title":"The predictive syndemic effect of multiple psychosocial problems on health care costs and utilization among sexual minority women","volume":"92","author":"SE Valentine","year":"2015","journal-title":"J Urban Health"},{"key":"pone.0245872.ref025","doi-asserted-by":"crossref","first-page":"2356","DOI":"10.2105\/AJPH.2015.302851","article-title":"Adherence to mammography screening guidelines among transgender persons and sexual minority women","volume":"105","author":"AR Bazzi","year":"2015","journal-title":"Am J Public Health"},{"key":"pone.0245872.ref026","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1080\/15532739.2017.1394954","article-title":"Non-binary youth: Access to gender-affirming primary health care","volume":"19","author":"BA Clark","year":"2018","journal-title":"International Journal of Transgenderism"},{"key":"pone.0245872.ref027","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1089\/lgbt.2017.0215","article-title":"Healthcare experiences among young adults who identify as genderqueer or nonbinary","volume":"5","author":"JE Lykens","year":"2018","journal-title":"LGBT Health"},{"key":"pone.0245872.ref028","doi-asserted-by":"crossref","first-page":"892","DOI":"10.2105\/AJPH.91.6.892","article-title":"The evolution of the Fenway Community Health model","volume":"91","author":"K Mayer","year":"2001","journal-title":"Am J Public Health"},{"key":"pone.0245872.ref029","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3928\/0048-5713-20020901-06","article-title":"The PHQ-9: A new depression diagnostic and severity measure","volume":"32","author":"K Kroenke","year":"2002","journal-title":"Psychiatr Ann"},{"key":"pone.0245872.ref030","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"RL Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"key":"pone.0245872.ref031","unstructured":"Babor T, De La Fuente M, Saunders J, Grant M. AUDIT\u2014The Alcohol use Disorders Identification Test: Guidelines for use in Primary Health Care. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/67205\/WHO_MSD_MSB_01.6a.pdf?sequence=1"},{"key":"pone.0245872.ref032","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/0306-4603(82)90005-3","article-title":"The drug abuse screening test","volume":"7","author":"HA Skinner","year":"1982","journal-title":"Addict Behav"},{"key":"pone.0245872.ref033","doi-asserted-by":"crossref","first-page":"109","DOI":"10.2174\/157016207779316369","article-title":"Routine collection of patient-reported outcomes in an HIV clinic setting: the first 100 patients","volume":"5","author":"HM Crane","year":"2007","journal-title":"Curr HIV Res"},{"key":"pone.0245872.ref034","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.jad.2018.02.051","article-title":"Levels of depression in transgender people and its predictors: Results of a large matched control study with transgender people accessing clinical services","volume":"235","author":"GL Witcomb","year":"2018","journal-title":"J Affect Disord"},{"key":"pone.0245872.ref035","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1037\/a0031774","article-title":"Anxiety and depression in transgender individuals: the roles of transition status, loss, social support, and coping","volume":"81","author":"SL Budge","year":"2013","journal-title":"J Consult Clin Psychol"},{"key":"pone.0245872.ref036","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1037\/sgd0000081","article-title":"Development of the Gender Minority Stress and Resilience Measure","volume":"2","author":"RJ Testa","year":"2015","journal-title":"Psychology of Sexual Orientation and Gender Diversity"},{"key":"pone.0245872.ref037","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1007\/s11930-017-0111-8","article-title":"Non-binary\/genderqueer identities: A critical review of the literature","volume":"9","author":"E Matsuno","year":"2017","journal-title":"Curr Sex Health Rep"},{"key":"pone.0245872.ref038","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1080\/00224499.2016.1142495","article-title":"Microaggressions toward lesbian, gay, bisexual, transgender, queer, and genderqueer people: A review of the literature","volume":"53","author":"KL Nadal","year":"2016","journal-title":"Journal of Sex Research"},{"key":"pone.0245872.ref039","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1080\/00224499.2019.1608422","article-title":"Invalidation experiences among non-binary adolescents","volume":"57","author":"KC Johnson","year":"2020","journal-title":"The Journal of Sex Research"},{"key":"pone.0245872.ref040","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1080\/09581596.2016.1158786","article-title":"Young bisexual women\u2019s perspectives on the relationship between bisexual stigma, mental health, and sexual health: a qualitative study","volume":"27","author":"CE Flanders","year":"2017","journal-title":"Critical Public Health"},{"key":"pone.0245872.ref041","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1080\/15299716.2016.1200510","article-title":"Attitudes toward bisexuality according to sexual orientation and gender","volume":"16","author":"KM Hertlein","year":"2016","journal-title":"Journal of Bisexuality"},{"key":"pone.0245872.ref042","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/s12888-016-0767-z","article-title":"Sexual orientation and symptoms of common mental disorder or low wellbeing: combined meta-analysis of 12 UK population health surveys","volume":"16","author":"J Semlyen","year":"2016","journal-title":"BMC Psychiatry"},{"key":"pone.0245872.ref043","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.2105\/AJPH.2009.174169","article-title":"A population-based study of sexual orientation identity and gender differences in adult health","volume":"100","author":"KJ Conron","year":"2010","journal-title":"Am J Public Health"},{"key":"pone.0245872.ref044","article-title":"Mental health and substance use diagnoses and treatment disparities by sexual orientation and gender in a community health center sample","author":"AW Batchelder","journal-title":". LGBT Health. In press"},{"key":"pone.0245872.ref045","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.jadohealth.2018.02.003","article-title":"Chosen name use is linked to reduced depressive symptoms, suicidal ideation, and suicidal behavior among transgender youth","volume":"63","author":"ST Russell","year":"2018","journal-title":"J Adolesc Health"},{"key":"pone.0245872.ref046","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1080\/15538605.2014.853641","article-title":"Coping and psychological distress among genderqueer individuals: The moderating effect of social support","volume":"8","author":"SL Budge","year":"2014","journal-title":"Journal of LGBT Issues in Counseling"},{"key":"pone.0245872.ref047","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1080\/15532739.2017.1370627","article-title":"Non-binary and binary transgender youth: Comparison of mental health, self-harm, suicidality, substance use and victimization experiences","volume":"20","author":"KA Rimes","year":"2019","journal-title":"International Journal of Transgenderism"},{"key":"pone.0245872.ref048","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1089\/lgbt.2016.0044","article-title":"Geographic and Individual differences in healthcare access for U.S. transgender adults: A Multilevel Analysis","volume":"3","author":"JM White Hughto","year":"2016","journal-title":". LGBT Health"},{"key":"pone.0245872.ref049","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1177\/0011000019827568","article-title":"Health care experiences of transgender binary and nonbinary university students","volume":"47","author":"AE Goldberg","year":"2019","journal-title":"The Counseling Psychologist"},{"key":"pone.0245872.ref050","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1037\/sgd0000177","article-title":"Missteps in psychotherapy with transgender clients: Promoting gender sensitivity in counseling and psychological practice","volume":"3","author":"L Mizock","year":"2016","journal-title":"Psychology of Sexual Orientation and Gender Diversity"},{"key":"pone.0245872.ref051","first-page":"151","article-title":"Toward defining, measuring, and evaluating LGBT cultural competence for psychologists","volume":"22","author":"MS Boroughs","year":"2015","journal-title":"Clin Psychol (New York)."},{"key":"pone.0245872.ref052","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1111\/acer.12158","article-title":"Gender differences in lifetime alcohol dependence: results from the national epidemiologic survey on alcohol and related conditions","volume":"37","author":"S Khan","year":"2013","journal-title":"Alcohol Clin Exp Res"},{"key":"pone.0245872.ref053","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1007\/s00127-015-1088-0","article-title":"The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings","volume":"50","author":"DS Hasin","year":"2015","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"pone.0245872.ref054","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1089\/lgbt.2018.0207","article-title":"Disparities by sexual orientation persist for major depressive episode and substance abuse or dependence: Findings from a national probability study of adults in the United States","volume":"6","author":"AB Chaudhry","year":"2019","journal-title":"LGBT Health"},{"key":"pone.0245872.ref055","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1001\/jamapsychiatry.2015.0584","article-title":"Epidemiology of DSM-5 Alcohol Use Disorder","volume":"72","author":"BF Grant","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"pone.0245872.ref056","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.drugalcdep.2015.04.008","article-title":"Substance use and treatment of substance use disorders in a community sample of transgender adults","volume":"152","author":"AS Keuroghlian","year":"2015","journal-title":"Drug Alcohol Depend"},{"key":"pone.0245872.ref057","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1111\/jsm.12711","article-title":"Non-suicidal self-injury in trans people: associations with psychological symptoms, victimization, interpersonal functioning, and perceived social support","volume":"12","author":"L Claes","year":"2015","journal-title":"J Sex Med"},{"key":"pone.0245872.ref058","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/hsc.12239","article-title":"Self-injury among trans individuals and matched controls: prevalence and associated factors","volume":"24","author":"A Davey","year":"2016","journal-title":"Health Soc Care Community"},{"key":"pone.0245872.ref059","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1080\/15532739.2015.1064336","article-title":"Racial and ethnic differences in experiences of discrimination in accessing health services among transgender people in the United States","volume":"16","author":"SK Kattari","year":"2015","journal-title":"International Journal of Transgenderism"},{"key":"pone.0245872.ref060","first-page":"13","article-title":"A gender not listed here: Genderqueers, gender rebels, and otherwise in the National Transgender Discrimination Survey","volume":"2","author":"J Harrison","year":"2012","journal-title":"LGBTQ Public Policy Journal at the Harvard Kennedy School"},{"key":"pone.0245872.ref061","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.drugalcdep.2014.11.012","article-title":"Missing data in substance abuse research? Researchers\u2019 reporting practices of sexual orientation and gender identity","volume":"147","author":"A Flentje","year":"2015","journal-title":"Drug & Alcohol Dependence"},{"key":"pone.0245872.ref062","volume-title":"Understanding the well-being of LGBTQI+ populations","author":"National Academies of Sciences E","year":"2020"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0245872","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T03:48:18Z","timestamp":1697687298000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0245872"}},"subtitle":[],"editor":[{"given":"Siyan","family":"Yi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,1,25]]},"references-count":62,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,1,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0245872","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,25]]}}}