Notice of Special Interest in Research on the Health of Sexual and Gender Minority (SGM) Populations

Notice Number: NOT-MD-19-001

Key Dates
Release Date: March 13, 2019

Related Announcements
None

Issued by
National Institute on Minority Health and Health Disparities (NIMHD)
National Center for Complementary and Integrative Health (NCCIH)
National Cancer Institute (NCI)
National Human Genome Research Institute (NHGRI)
National Heart, Lung, and Blood Institute (NHLBI)
National Institute on Aging (NIA)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
National Institute of Allergy and Infectious Diseases (NIAID)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
National Institute on Drug Abuse (NIDA)
National Institute of Dental and Craniofacial Research (NIDCR)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
National Institute of Environmental Health Sciences (NIEHS)
National Institute of Mental Health (NIMH)
National Institute of Neurological Disorders and Stroke (NINDS)
Office of Behavioral and Social Sciences Research (OBSSR)
Office of Disease Prevention (ODP)
Office of Research on Women’s Health (ORWH)
Sexual & Gender Minority Research Office (SGMRO)

Purpose

This Notice calls for research on the health of sexual and gender minority populations. "Sexual and gender minority" is an umbrella term that encompasses lesbian, gay, bisexual, and transgender populations as well as those whose sexual orientation, gender identity and expressions, or reproductive development varies from traditional, societal, cultural, or physiological norms. This includes individuals with disorders or differences of sex development (DSD), sometimes known as intersex.

Although there has been an increase in SGM-focused health research in recent years, there remains a need for further research on the health of these populations. This Notice encourages research that describes the biological, clinical, behavioral, and social processes that affect the health and development of SGM populations and individuals and their families, and that leads to the development of acceptable and appropriate health interventions and health service delivery methods that will enhance health and development of these populations.

Types of research which are relevant to this Notice include, but are not limited to:

  • Epidemiological research that examines patterns of risk, morbidity and mortality related to diseases or health conditions that have not been adequately studied in SGM populations.
  • Etiological or mechanistic research examining how biological, behavioral, social, and/or environmental factors contribute to health outcomes and health disparities for SGM populations.
  • Research leading to interventions to ameliorate health disparities in SGM populations, including formative research to identify and develop appropriate intervention content as well as pilot testing of interventions to establish feasibility, acceptability, and preliminary efficacy.
  • Large-scale design, implementation and evaluation of preventive and/or treatment interventions addressing health issues in SGM populations.

Possible funding opportunity announcements (FOAs) or their re-issues to which SGM-related research may be submitted include but are not limited to Parent FOAs for Research (R), Career Development (K), and Fellowship (F) awards (see "Parent Announcements (for Unsolicited or Investigator Initiated Applications)": https://grants.nih.gov/grants/guide/parent_announcements.htm.

Applicants should carefully note the participating Institutes/Centers on each FOA. Applications must be in the mission of an Institute/Center listed in Components of Participating Organizations on the FOA. Offices listed on this Notice may consider co-funding applications assigned to an Institute/Center that participates on the FOA.

Investigators are strongly encouraged to reach out to the relevant contacts as listed below to identify which FOAs may be most appropriate for their proposed project or application.

Applicants should indicate the Notice number (NOT-MD-19-001) in Field 4.b on the SF 424 application form and refer to NOT-MD-19-001 in the abstract to assist in identifying applications submitted to this Notice.

Areas of programmatic interest to NIMHD include but are not limited to:

  • Observational studies on how social determinants, such as minority stress, stigma and discrimination, lack of access to culturally competent healthcare, social networks, and social support, may cause, sustain, or ameliorate health disparities.
  • Epidemiological studies on the relationship between intersectionality of SGM status with other health disparity population membership and health outcomes. In addition to SGM populations, NIH-designated health disparity populations include racial/ethnic minorities, socioeconomically disadvantaged populations, and underserved rural populations.
  • Intervention studies in community and healthcare settings to reduce health disparities.

NIMHD encourages projects to use approaches that encompass multiple domains (e.g., biological, behavioral, socio-cultural, environmental, physical environment, health system) and multiple levels (e.g., individual, interpersonal, community, societal) to understand and address health disparities in SGM populations (see the NIMHD Research Framework, https://www.nimhd.nih.gov/about/overview/research-framework.html, for examples of health determinants of interest). Animal studies and studies focused on SGM populations outside of the US are not priorities for NIMHD under this Notice.

NCCIH is interested in supporting research on the use of complementary and integrative health approaches, including natural products and mind and body interventions, to manage stress, chronic pain, mild anxiety, or depression among SGM populations. NCCIH is also interested in research studying mind and body approaches to improve adherence to treatment (e.g., Medication Assisted Treatment (MAT) for opioid misuse, Antiretroviral therapy (ART) for HIV) and prevention (e.g., Pre-exposure prophylaxis (PrEP) for HIV) regimens to promote health outcomes. Natural products include botanicals, pre/probiotics, and products marketed as dietary supplements. Mind and body approaches include various meditation approaches (e.g., mindfulness), hypnosis or guided imagery, meditative movement approaches (e.g., yoga, tai chi, qi-gong), body-based approaches (e.g., spinal manipulation, massage, mobilization, acupuncture), a combination of these approaches (e.g., meditation and yoga, such as in mindfulness-based stress reduction MBSR), or complex interventions including music and art therapy. NCCIH offers a range of funding opportunity announcements to support clinical trials of natural products and mind and body interventions. Applicants are strongly encouraged to consult with the NCCIH Scientific Research contact prior to developing and submitting an application.

Areas of programmatic interest to NCI include (but are not limited to) studies that:

  • Identify cancer health care needs across the cancer continuum, including prevention, early detection, diagnosis, treatment, survivorship, and end of life care among SGM populations;
  • Increase understanding about the cancer care needs, health outcomes and effective interventions to improve outcomes for SGM individuals;
  • Assess cancer risk to inform improved decision-making, risk reduction interventions, and screening options for early cancer detection in SGM populations;
  • Evaluate interventions that increase rates of screening, follow-up, referral-to-care, and improve symptom management for cancer prevention and control among SGM populations;
  • Increase understanding of the barriers to cancer health care information and treatment that may lead SGM individuals/populations to avoid or delay seeking health care;
  • Examine the relative risk of cancer and cancer risk factors (e.g., smoking, obesity, aging, infections such as HPV or HIV, tobacco use, alcohol consumption, nulliparity) and underlying mechanisms of risk (social, behavioral, biological, clinical) in SGM groups in comparison to their heterosexual counterparts;
  • Investigate cancer patient outcomes, cancer treatment delivery, and healthcare utilization in SGMs;
  • Improve the understanding of the differential risks for certain types of cancers including cervical, breast, ovarian, anal, and other malignancies among SGMs;
  • Examine the potential cancer risks of hormone therapy (including off-label use) among transgender and/or intersex individuals;
  • Investigate prevalence rates of HPV infection in SGM groups and the development of screening interventions and/or recommendations to ameliorate HPV-associated disease;
  • Examine the intersection of contextual factors (e.g., race, geography, socioeconomic status) on cancer health outcomes across SGM groups;
  • Investigate the lack of access to and utilization of cancer health care services, and quality of care received, by SGM populations and impact on health outcomes;
  • Assess the impact of stigma, discrimination, victimization, substance use, and other risk factors on utilization of cancer preventive screening/services;
  • Investigate positive and/or protective factors (e.g., family and/or social support) on cancer prevention.

Areas of programmatic interest to NHGRI include but are not limited to:

  • Development of resources, approaches, and technologies that will accelerate genomic research on the structure of genomes, the biology of genomes, and the biology of disease;
  • Developments that will use genomics to advance the science of medicine, and that will incorporate genomics to improve the effectiveness of healthcare;
  • Research in several cross-cutting areas, including the ethical, legal and societal implications of genomics research, bioinformatics, and research training and career development.

NHLBI provides global leadership for a research, research training, and education program to promote the prevention and treatment of heart, lung, blood, and sleep diseases and enhance the health of all individuals so that they can live longer and more fulfilling lives. The NHLBI encourages research designed to answer the breadth of scientific questions related to heart, lung, blood, and/or sleep diseases, disorders, and phenotypes. The NHLBI seeks research applications (R01 applications only) that will address questions relevant to the NHLBI mission, address gaps in the NHLBI’s portfolio of clinical and epidemiology cohort studies and should align with the NHLBI’s Strategic Vision. NHLBI’s strategic priorities emphasize the continuum of research from basic molecular biology research to implementation science related to heart, lung, blood, and sleep disorders (e.g., Sickle Cell Disease and other hemoglobinopathies; cardiovascular diseases; hypertension prevention and control; asthma; chronic obstructive pulmonary disease (COPD); sleep apnea; and other cardiopulmonary diseases and conditions), self-management of symptoms and disease conditions, and prevention of these diseases and disorders in various populations. The NHLBI also has significant interests in implementation science research for the prevention, control, and treatment of heart, lung, blood diseases, and sleep disorders, particularly research that addresses the development of interventions or strategies that address the translation of proven-effective, evidence-based interventions into clinical, community, and/or other settings; addresses impediments to uptake, scale up, and sustainability of evidence-based research. Please refer to the NHLBI website for more details on the research priorities of the NHLBI: https://www.nhlbi.nih.gov/about/documents/strategic-vision.

NIA is interested in research that can improve the understanding of aging processes and experiences that impact health and well-being in middle-aged and older SGM adults as well as studies focused on early life exposures that contribute to SGM health disparities in adulthood. NIA encourages use of multi-level analysis of individual, dyadic, family, community/institution, and population data, and consideration of multidimensional measures of sexual orientation (identity, attraction, and behavior) and diverse gender categories. NIA supports cross-national studies to better understand the aging experience on a global level and the effects of various policies. “Natural experiments”, arising from policy change or regional differences, may provide another powerful approach for examining mechanisms affecting the health of SGM older adults. Applicants are encouraged to leverage NIA’s investment in data infrastructure and publicly available datasets. (See NIA’s Office of Research Resources.)

Areas of programmatic interest to NIA include but are not limited to:

  • Studies examining interpersonal processes, and the situational contexts that influence them, and lead to positive and healthy relationships in adulthood and older age. NIA is especially interested in research that can identify causal mechanisms accounting for links between marital status, long-term romantic partnerships, and health.
  • Studies examining how factors such as social identity, intersectionality, positionality, and stigma impact interpersonal interactions, well-being, and health in later life.
  • Causes and consequences of self-disclosing sexual orientation and gender identity in mid-late life and older age to families, intimate partners, employers, health care practitioners, and institutions.
  • Studies of unique caregiving needs of older SGM individuals, especially, for individuals with Alzheimer’s disease and related dementias and their families (of origin and chosen).
  • Interventions to promote healthy aging and reduce health disparities for SGM adults. NIA encourages a mechanism-focused approach to intervention development as promoted by the NIH Science of Behavior Change and the NIH Stage Model. NIA also supports pragmatic trial development (see "Introduction to pragmatic clinical trials").
  • Data infrastructure and method development to support studies of older SGM adults, including development of representative population cohorts of older SGM adults with adequate sample size to study issues of intersectionality, and the addition of cohort-sensitive SGM measures to existing studies. This includes the development of novel recruitment strategies and methods and approaches for identifying and assessing unique issues and needs of older SGM adults.

NIAAA seeks innovative applications in the areas of:

  • Epidemiological research that examines patterns of risk, morbidity and mortality related to alcohol use disorders (AUDs) in SGM populations, including studies of 1) risk and protective factors for heavy (including binge) drinking and AUDs; 2) correlates of underage drinking and related problems among SGM populations; 3) factors that influence transitions into and out of problem drinking patterns across the lifespan among SGM populations; and 4) the consequences, for drinking and related problems, that may be attributable to the combination of racial/ethnic minority status in addition to SGM status.
  • Etiological or mechanistic research—including human laboratory-based research—examining how biological, behavioral, social, and/or environmental factors contribute to drinking-related outcomes for SGM populations.
  • Research leading to interventions to ameliorate drinking and related problems in SGM populations, including formative research to identify and develop appropriate intervention content as well as pilot testing of interventions to establish feasibility, acceptability, and preliminary efficacy.
  • Design, implementation and evaluation of preventive and/or treatment interventions that address AUDs and related problems and that are appropriate to the needs of SGM populations. Such projects may extend to evaluations of screening, assessment, brief interventions, and referral to alcohol treatment; to other individual-level preventive approaches, such as protective strategies; studies that assess drinking prevention approaches that enlist families or peers (online or offline); studies that focus on the effects of community/institutional-level alcohol policies for preventing drinking and related problems among SGM populations; and studies that look at alcohol treatment efficacy among SGM populations.

Areas of programmatic interest to NIAID include but are not limited to:

  • Research on all areas of HIV infection, including developing and testing preventive HIV vaccines, and other prevention strategies, and new treatments for HIV infection and AIDS-associated opportunistic infections
  • Basic and applied research to better understand, treat, and ultimately prevent other infectious, immunologic, and allergic diseases.
  • Training and career development (e.g. T, F, and K) applications from rural and urban institutions that may have underserved SGM populations.

The mission of NIAMS is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. NIAMS also conducts and supports basic research on the normal structure and function of bones, joints, muscles, and skin. Basic research involves a wide variety of scientific disciplines, including immunology, genetics, molecular biology, structural biology, biochemistry, physiology, virology, and pharmacology. Clinical research areas include rheumatology, orthopaedics, dermatology, metabolic bone diseases, heritable disorders of bone and cartilage, inherited and inflammatory muscle diseases, and sports and rehabilitation medicine. NIAMS also seeks studies that include sufficient numbers of SGM individuals to enable robust sub-group analyses. Clinical trials designed to answer specific questions about the safety, tolerability, efficacy, effectiveness, clinical management, and/or implementation of pharmacologic, behavioral, biologic, surgical, or device (invasive or non-invasive) interventions will only be supported by NIAMS if submitted to a NIAMS clinical trials-specific FOA. A current list of active NIAMS clinical trials FOAs is available at https://www.niams.nih.gov/grants-funding/conducting-clinical-research/grants. For information regarding NIAMS supported scientific areas/programs and contacts, please see:https://www.niams.nih.gov/grants-funding/supported-scientific-areas.

The NICHD supports biological, behavioral, and clinical research related to conception and pregnancy, normal and abnormal development in childhood, reproductive health, population dynamics across the lifespan, and rehabilitation medicine (https://www.nichd.nih.gov/grantsfunding/opportunities-mechanisms/areas-research/Pages/default.aspx). Research projects considered by funding by NICHD must fall within the scientific missions of the twelve Scientific Branches of the NICHD Division of Extramural Research (DER) or the National Center for Medical Rehabilitation Research (NCMRR). Information about those scientific missions and program staff contacts may be found on the web pages for the DER scientific branches at: http://www.nichd.nih.gov/about/org/der/branches/Pages/index.aspx and the NCMRR at: http://www.nichd.nih.gov/about/org/ncmrr/Pages/overview.aspx. Potential applicants are strongly encouraged to read these webpages for any updates in response to recent scientific advances or emerging public health topics. NICHD encourages applications that address its extramural program priorities and will consider how well research projects align with one or more of those priorities when making award decisions. A detailed list of NICHD high priority research areas may be found at https://www.nichd.nih.gov/grants-funding/opportunities-mechanisms/areasresearch/Pages/priorities.aspx

Areas of programmatic interest to NIDA include but are not limited to:

  • Innovative drug abuse epidemiology, prevention, and health services research among SGM populations;
  • Translational research that applies findings from epidemiology, cognitive science, neuroscience, and other sciences to develop and test novel prevention interventions among SGM populations;
  • Treatment development research and testing for substance use disorders, including behavioral treatments, among SGM populations;
  • Vulnerability to addiction and biological etiology among SGM populations;
  • Behavioral and cognitive mechanisms and consequences of substance or polysubstance use among SGM populations.

Areas of programmatic interest to NIDCR include but are not limited to:

  • Research on craniofacial skeletal tissue homeostasis, injury, and repair in the presence of hormone therapy
  • Epidemiologic research on the prevalence and unmet dental, oral, and/or craniofacial needs of SGM individuals, e.g., oral cancers, oral complications of HIV/AIDS, orofacial trauma
  • Research identifying explanatory mechanisms of oral health disparities of SGM individuals or populations
  • Research to reduce oral health disparities for SGM individuals or populations, targeting individual, family, community, provider, health system, and/or policy levers of change

NIDDK supports medical research and research training and dissemination of science-based information on diabetes and other endocrine and metabolic diseases; digestive diseases, nutritional disorders, and obesity; and kidney, urologic, and hematologic diseases, to improve people’s health and quality of life.

Areas of programmatic interest to NIEHS include but are not limited to:

  • Studies to better understand the impact of environmental exposures, such as endocrine disrupting chemicals, on gonadal development and other hormonal systems that affect sexual development
  • Development of resources, approaches, and technologies that will promote research on environmental conditions that effect the health of sexual and gender minority populations

Areas of programmatic interest to NIMH include:

  • Identification of mutable and mechanistic causes of disparities in mental health-related clinical (including suicide thoughts and behaviors) and functional outcomes (including Severe Mental Illness) from which interventions targeting health equity can be developed and tested. This could include interventions at the individual, family, provider, clinic or system-level, based on the empirical evidence for the contributing factor(s). Descriptive studies of the prevalence and characteristics of mental disorders in SGM individuals are considered low priority. For more details on NIMH support for intervention studies, please see: https://www.nimh.nih.gov/funding/opportunities-announcements/clinical-trials-foas/index.shtml.
  • Studies of how non-mental health specialty settings (e.g., SGM social or support groups, human resources or employee assistance programs, educational settings, etc.) can contribute to and support screening, referral, diagnosis and treatment or prevention of mental illness and suicide behavior in SGM populations.
  • The development and testing of stigma reduction interventions and/or interventions that address social cultural barriers that not only change knowledge/attitudes/beliefs but also lead to behavior change (by consumers or providers) or structural change (at the clinic or system level) that improves access, engagement, retention, treatment adherence, quality of care and mental health outcomes (including suicide risk) for SGM across the life course.
  • Studies proposing to adapt/augment interventions for SGM from racial or ethnic minority groups should provide an empirical basis for the need for intervention tailoring and how it is expected to achieve equity in mental health-related outcomes among those groups.
  • Studies to better understand disparities in HIV rates and outcomes among SGM living with HIV and how to mitigate them as well as a better understanding of the factors impeding scale up of efficacious HIV prevention interventions for SGM and the development of approaches to address these barriers.

NIMH also seeks studies that:

  • Include sufficient numbers of SGM individuals to enable robust sub-group analyses.
  • Conduct secondary data analyses to identify strategies for improving the quality of mental health care for SGM individuals.

Areas of programmatic interest to NINDS include but are not limited to:

  • Research on health disparities in SGM populations relevant to neurological disorders that fall within the scientific mission of the NINDS (https://www.ninds.nih.gov/About-NINDS/Who-We-Are/Mission).
  • Research on the effects of exogenous hormone use among transgender and/or intersex individuals on neurological function and neurological disorders.
  • Research on risk factors for neurological disorders in SGM populations.

Inquiries

Please direct all inquiries to:

Jennifer Alvidrez, PhD
National Institute on Minority Health and Health Disparities (NIMHD)
Telephone: 301-594-9567
Email: jennifer.alvidrez@nih.gov

Della B. White, PhD
National Center for Complementary & Integrative Health (NCCIH)
Telephone: 301-827-6358
Email: Della.White@nih.gov

Elizabeth Perruccio, PhD
National Cancer Institute (NCI)
Telephone: 240-276-6178
Email: liz.perruccio@nih.gov

Christine Gatlin, Ph.D.
National Human Genome Research Institute (NHGRI)
Telephone: 301-480-2280
Email: gatlincl@mail.nih.gov

Brad Newsome, PhD
National Heart, Lung, and Blood Institute (NHLBI)
Telephone: 301-827-8170
Email: brad.newsome@nih.gov

Melissa S. Gerald, PhD
National Institute on Aging (NIA)
Telephone: 301-496-3136
Email: melissa.gerald@nih.gov

Robert C. Freeman, PhD
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Telephone: 301-443-8820
Email: rfreeman@mail.nih.gov

Philip Renzullo, PhD, MPH
National Institute of Allergy and Infectious Diseases (NIAID)
Telephone: 240-627-3041
Email: prenzullo@niaid.nih.gov

Heiyoung Park, PhD
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Telephone: 301-594-3507
Email: Heiyoung.Park@nih.gov

Regina Bures, PhD
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Telephone: 301-496-9485
Email: regina.bures@nih.gov

Jeffrey Schulden, MD
National Institute on Drug Abuse (NIDA)
Telephone: 301-402-1526
Email: schuldenj@nida.nih.gov

Dena Fischer, DDS, MSD, MS
National Institute of Dental and Craniofacial Research (NIDCR)
Telephone: 301-594-4876
Email: dena.fischer@nih.gov

Tamara Bavendam, MD, MS
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Telephone: 301-594-4733
Email: bavendamtg@mail.nih.gov

Thaddeus Schug, PhD
National Institute of Environmental Health Sciences (NIEHS)
Telephone: 984-287-3319
Email: schugt2@niehs.nih.gov

Tamara Lewis-Johnson, MBA, MPH
National Institute of Mental Health (NIMH)
Telephone: 301-594-7963
Email: tamara.lewisjohnson@nih.gov

Amelie Gubitz, PhD
National Institute of Neurological Disorders and Stroke (NINDS)
Telephone: 301-496-5680
Email: gubitza@ninds.nih.gov

Kate Winseck, MSW
Office of Disease Prevention (ODP)
Telephone: 301-827-5583
Email: winseckk@mail.nih.gov

Victoria Cargill, MD, MSCE, AAHIVS
Office of Research on Women’s Health (ORWH)
Telephone: 301-435-0971
Email: cargillv@od.nih.gov

Karen L. Parker, PhD, MSW
Sexual & Gender Minority Research Office (SGMRO)
Telephone: 301-451-2055
Email: Klparker@mail.nih.gov