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Individuals identified as sexual and gender minorities (Box 1) and may internalize the negative attitudes and values of society.This internalized homophobia or transphobia has detrimental effects on their mental health and might result in self-harm or violence among individuals.Sexual and gender minority People identifying themselves as homosexual, bisexual or nonbinary sexual, such as pansexual and polysexual, or people engaging in homosexual, bisexual or nonbinary sexual behaviour or identifying with or expressing as a different gender than the one assigned at birth (male, female or another), or intersex people.

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These searches were supplemented by a scan of the citations in the articles for studies not found in the search and by consultation with individual experts about their knowledge of other studies.

Bisexual A person who is attracted to or has sexual relations with both men and women.

Transgender People whose gender identity and expression does not conform to the norms and expectations traditionally associated with their sex at birth.

Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, United States of America.

On 17 June 2011, the United Nations (UN) Human Rights Council passed a resolution that expressed grave concern at violence and discrimination against individuals based on their sexual orientation and gender identity.“Homophobic and transphobic violence has been recorded in all regions.

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