Current Projects

Survey of LGBTQIA+ Older Adults in California: From Challenges to Resilience

The California Department of Aging (CDA) is supporting research partners and a statewide coalition of LGBTQIA+ community-based organizations to design and launch California’s first statewide survey documenting the needs, hopes, and priorities of mid-life and older LGBTQIA+ residents across the state.

This survey of mid-life and older LGBTQIA+ residents will paint an up-to-date and comprehensive statewide portrait. To offer insights into the experiences of marginalized and underserved LGBTQIA+ communities, the survey team will oversample Black, Indigenous, People of Color (BIPOC), Hispanic/Latinx, and Asian Pacific Islander (API) communities, as well as rural and frontier communities. The survey data will form a first-ever baseline data set, available to other researchers in an open-source format to encourage additional research and policy attention to the needs of mid-life and older LGBTQIA+ Californians.

A Comparative Effectiveness Study of PTSD Treatments Among Sexual and Gender Minority Populations

FundingPatient-Centered Outcomes Research Institute (PCORI)

This project will compare two PTSD treatments that are known to work but haven't been tested in LGBTQIA+ people: Cognitive Processing Therapy (CPT) and STAIR Narrative Therapy (SNT) to find out which ones work the best for LGBTQIA+ people in real-world settings. Right now clinicians and patients don't have the information they need to know which treatments are likely to help them the most. The project will reach patients across the state of CA, including rural settings in CA where it can be difficult to access both PTSD treatment and LGBTQIA+ affirming care.


Mitchell Lunn & Juno Obedin-Maliver (Co-Directors), & Annesa Flentje (Associate Director and UCSF Site Director)

With over 29,000 participants currently enrolled, The PRIDE Study is a national, online, prospective, longitudinal cohort study that asks: How does being a sexual or gender minority influence physical, mental, and social health? Dr. Flentje is Associate Director of The PRIDE Study, leading the mental and social health portions of The PRIDE Study. Our lab also works on studies nested within The PRIDE Study; current topics of study include substance use and employment discrimination.

Select publications:
Grindlay K, et. al. (2024). Interest in over-the-counter progestin-only pills among transgender, nonbinary, and gender-expansive individuals in the United States. doi: link

Tran NK, et. al. (2024). Inequities in Conversion Practice Exposure at the Intersection of Ethnoracial and Gender Identities. doi: link

Artime, T. M., et. al. (2024). Mental health treatment experiences among sexual and gender minority individuals: Trauma exposure, barriers, microaggressions, and treatment satisfaction. doi: link

Flentje, A., et. al. (2024). Substance use over time among sexual and gender minority people: Differences at the intersection of sex and gender. doi: link

Full list of publications can be found: here

Within The PRIDE Study:
The Biological Underpinnings of Stress Among SGM People

Stress can change our behavior and the way our body works. Our goal is to learn more about the biological impact of minority stress and substance use, mental health, and changes in DNA methylation over time among LGBTQ+ people across the country.

Flentje, A., et. al. (2024). Substance Use Over Time Among Sexual and Gender Minority People: Differences at the Intersection of Sex and Gender. doi: link

Cicero, E. C., et. al. (2023). Acceptability of Biospecimen Collection Among Sexual and/or Gender Minority Adults in the United States. doi: link

Flentje, A. (2023). Challenges and pitfalls in research understanding the immunological impacts of minority stress among sexual and gender minority populations. doi: link 

Bosley, H. G., et. al. (2023). A Pragmatic, Person-Centered View of Cannabis in the United States: Pursuing Care That Transcends Beliefs. doi: link

Gene expression outcomes in interventions for substance-using, HIV+ minority men​​​​​

Funding: National Institute on Drug Abuse & Center for AIDS Research, UCSF Gladstone Institute

Image description: White and black outlines depicting inflammatory cells (LabTV Educational Foundation)How does sexual minority stress get "under the skin"? This study examines the direct and indirect pathways (i.e., through stimulant use) whereby sexual minority stress (comprised of internalized stigma, concealment, experiences and expectations of discrimination, violence, or mistreatment) may be associated with gene expression and DNA methylation related to functional inflammatory processes among sexual minority men living with HIV who use substances.

Within The PRIDE Study: Physical, Mental, & Social Impacts of the Novel Coronavirus on SGM People

The novel coronavirus (officially called SARS-CoV-2), which causes COVID-19 disease, has spread across the world and is now classified as a pandemic. This study will examine how the novel coronavirus has impacted LGBTQ+ communities including physical, mental, and social health impacts. It will also identify the emergence of symptoms of the novel coronavirus among LGBTQ+ people and will assess the experiences of health care interactions for those with respiratory illnesses.

The PRIDE Study Ancillary Study: Trauma and Victimization Among Sexual and Gender Minority People

LGBTQ people often face discrimination and violence in their communities. This study will identify which LGBTQ communities are most at risk for discrimination and violence and how community policies such as non-discrimination laws are related to discrimination and violence. 

AWARENESS: A CBT Intervention for Minority Stress
   1. Sexual Minorities
   2. LGBTQ+ People

Funding: National Institute on Drug Abuse & Lesbian Health Fund

Image description: Two people holding hands, one wearing a rainbow sweatband on their wrist.AWARENESS is a new 9-session, 1-on-1 cognitive-behavioral intervention targeting sexual minority stress. We piloted and tested the intervention with sexual minority men living with HIV. Currently, we are piloting and testing the interventon with sexual minority women and LGBTQ+ people.

Flentje, A., et. al. (2022). AWARENESS: A cognitive behavioral intervention to reduce intersectional minority stress among sexual minority men living with HIV who use substances. doi: link

Flentje A. (2020). AWARENESS: Development of a cognitive-behavioral intervention to address intersectional minority stress for sexual minority men living with HIV who use substances. doi: link