Over half a million childbearing individuals in the United States (US) each year experience perinatal (pre-
and postpartum) depression. When combined with other perinatal mood and anxiety disorders, this illness
costs society upwards of $14.2 billion in productivity losses, healthcare expenditures, and other costs. Some
key risk factors for perinatal depression include a history of depression and low levels of social support. Sexual
and gender minorities (SGM) are a growing population disproportionally affected by depression and social
isolation due to the discrimination that stems from having a marginalized identity. Discrimination may similarly
increase the risk for perinatal depressive symptoms and other adverse outcomes among SGM gestational
parents; however, little is known about their perinatal health as they are an understudied perinatal population.
SGM gestational parents include pregnant or postpartum individuals assigned female at birth who identify
as a sexual minority (e.g., a lesbian or bisexual woman), a transmasculine individual (e.g., a self-identified
man, transgender man, or non-binary person), or both (e.g., a gay, transgender man). Approximately 2.6-8.7
million SGMs have biological children, and population estimates of SGM gestational parents continue to rise.
The scant studies on SGM gestational parents have been primarily limited to small, cross-sectional samples of
lesbian or bisexual woman outside the US, yet preliminary findings indicate profound loneliness and social
isolation, as well as postpartum depression at rates twice as high as heterosexual women. Social support has
been a promising modifiable target for intervention to prevent or reduce the length and intensity of perinatal
depression. Yet, the specific sources, settings, and types of social support that protect heterosexual women
from perinatal depression are often not available to or inclusive of SGMs due to high rates of estrangement
from biological families and anticipatory fear of experiencing rejection and discrimination in public settings.
To address these gaps, the specific aims of this longitudinal, qualitative study are to: (1) describe
multidimensional social support among SGM gestational parents across the perinatal period, and (2)
characterize SGM gestational parents' perceptions of gaps in and assets of perinatal social support through
photos. We will achieve these aims through three online, descriptive, semi-structured interviews across six
months complemented with modified photovoice methods, an established visual elicitation method that allows
participants to capture and share their experiences through photos. Findings may provide valuable insights on
how discrimination influences the multidimensional aspects of perinatal social support SGMs experience at
multiple levels of their social environment. This research aligns with the NINR wellness area of scientific focus
and will lay the foundation for this predoctoral applicant's program of research by generating foundational
knowledge for developing and testing future culturally-competent, community-based social support intervention
studies to prevent illness (reduce the risk for perinatal depressive symptoms) in a health disparity population.