Advancing Research On LGBTQ Microaggressions A Psychometric Scoping Review of Measures Fisher2018

Journal of Homosexuality
ISSN: 0091-8369 (Print) 1540-3602 (Online) Journal homepage: http://www.tandfonline.com/loi/wjhm20
Advancing Research on LGBTQ Microaggressions: A

Psychometric Scoping Review of Measures
Colleen M. Fisher, Michael R. Woodford, Rachel E. Gartner, Paul R. Sterzing &

Bryan G. Victor
To cite this article: Colleen M. Fisher, Michael R. Woodford, Rachel E. Gartner, Paul R. Sterzing
& Bryan G. Victor (2018): Advancing Research on LGBTQ Microaggressions: A Psychometric
Scoping Review of Measures, Journal of Homosexuality, DOI: 10.1080/00918369.2018.1539581
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JOURNAL OF HOMOSEXUALITY
https://doi.org/10.1080/00918369.2018.1539581
Advancing Research on LGBTQ Microaggressions: A

Psychometric Scoping Review of Measures
Colleen M. Fisher, PhDa, Michael R. Woodford, PhDb, Rachel E. Gartner, MSWc,
Paul R. Sterzing, PhDc, and Bryan G. Victor, PhDd
a
School of Social Work, University of Minnesota, St. Paul, Minnesota, USA; bLyle S. Hallman Faculty of
Social Work, Wilfrid Laurier University, Kitchener, Ontario, Canada; cSchool of Social Welfare, University
of California, Berkeley, California, USA; dSchool of Social Work, University of Michigan, Ann Arbor,
Michigan, USA
ABSTRACT KEYWORDS
Understanding the nature and consequences of LGBTQ microag- Microaggressions;
gressions is critical to fostering equity and wellbeing among discrimination; LGBTQ;
sexual and gender minorities. Yet little guidance is available for sexual orientation; gender
identity; measurement;
researchers seeking psychometrically robust measures of subtle
reliability and validity;
LGBTQ slights, invalidations, and insults. To address this gap, we review
conducted a scoping review of multi-item quantitative measures
that included at least one question addressing LGBTQ microag-
gressions. This article reports the study characteristics and psy-
chometric properties of 27 original measures we identified and
their subsequent adaptations. The article concludes with an
assessment of strengths and limitations of LGBTQ microaggres-
sion measurement, highlighting aspects of measurement innova-
tion on which future researchers can build. As microaggressions
remain a powerful and underexplored mechanism of sexual and
gender minority oppression, this review will help to both advance
methodological quality in this critical research area and enhance
our understanding of how microaggressions manifest in the lives
of LGBTQ individuals.
Microaggressions are subtle slights, invalidations, and insults that target

individuals because of their actual or perceived membership in a margin-
alized group or groups (Nadal, Erazo, Schulman, Han, & Deutsch, 2017;
Pierce, Carew, Pierce-Gonzalez, & Wills, 1977; Sterzing, Gartner, Woodford,
& Fisher, 2017; Sue, 2010). Microaggressions tend to be unintentional and
unconscious, and they are often enacted by well-meaning individuals (Sue,
2010). Moreover, microaggressions can be manifested at both the interper-
sonal and environmental (e.g., public policies) levels (Sue, 2010). Core to
microaggressions are messages that denigrate, exoticize, and “other” their
targets; however, because microaggressions are often ambiguous, targeted
individuals and perpetrators alike may dismiss or minimize their potential
harm. When challenged, perpetrators often attempt to explain their
CONTACT Colleen M. Fisher cfisher@umn.edu School of Social Work, University of Minnesota, 269 Peters
Hall, 1404 Gortner Avenue, St. Paul, MN 55108, USA.
© 2018 Taylor & Francis Group, LLC
2 C. M. FISHER ET AL.
comments and/or actions as a joke or misunderstanding (Sue, 2010). Initially

conceptualized to refer to subtle forms of racism (Pierce, 1970), microaggres-
sions have been recently applied to other marginalized groups, including
lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals (Nadal,
2013; Nadal, Rivera, & Corpus, 2010; Nadal, Whitman, Davis, Erazo, &
Davidoff, 2016; Nadal et al., 2011).
Microaggressions are considered mechanisms of contemporary oppression
because of their ubiquity and chronicity (Sue, 2010). Consistent with minority
stress theory (Meyer, 2003), the impact of microaggressions can accumulate over
time and contribute to the development of mental health problems and other
negative outcomes among targeted groups (Sue, 2010), including sexual (e.g.,
lesbian, gay, bisexual) and gender (e.g., transgender, gender nonconforming)
minorities (see Nadal, 2013; Nadal et al., 2016; for reviews). For example,
microaggressions targeting sexual minorities—also referred to as heterosexist
microaggressions—have been associated with reduced self-acceptance and
greater psychological distress (Woodford, Kulick, Sinco, & Hong, 2014b), as
well as posttraumatic stress symptoms (Robinson, 2014). Additionally, micro-
aggressions targeting gender minorities—also referred to as cisgenderist micro-
aggressions—have been linked to emotional distress and disruption in
friendships (Galupo, Henise, & Davis, 2014). Qualitative research conducted
with lesbian, gay, and bisexual individuals (Nadal et al., 2011) and transgender
individuals (Nadal, Davidoff, Davis, & Wong, 2014) has documented negative
mental health reactions to microaggressions, similar to those found in quanti-
tative studies. Interestingly, both qualitative (Shelton & Delgado-Romero, 2013)
and quantitative (MacDonald, 2013) research findings have suggested that
sexual orientation microaggressions within the context of therapy can negatively
affect the therapeutic process and effectiveness. Other research has suggested
that encountering the microaggression “that’s so gay” in educational settings is
associated with low perceptions of belonging and increased physical health
concerns such as headaches and stomach problems (Woodford, Howell,
Silverschanz, & Yu, 2012). Workplace research examining heterosexism (using
a measure of microaggressive behaviors) has found it to be positively associated
with psychological distress, health-related problems, and job dissatisfaction
(Waldo, 1999). Thus understanding the nature and consequences of LGBTQ
microaggressions is critical to fostering equity and wellbeing among sexual and
gender minority individuals and communities.
Research on microaggressions, generally, has grown considerably over the
past decade. Yet concerns have been recently raised about the construct, both in
terms of conceptual clarity and the foundational research findings that speak to
its adverse mental health effects (Lilienfeld, 2017). Others have called for more
research on the nature and scope of microaggressions (specifically, racial micro-
aggressions; Wong, Derthick, David, Saw, & Okazaki, 2014) and have high-
lighted the importance of using reliable and valid measures when quantitatively
JOURNAL OF HOMOSEXUALITY 3
assessing microaggressions (Lau & Williams, 2010). Although Lilienfeld (2017)

questioned the use of the term microaggressions and its loose connection to the
extant aggression literature, he supported and called for more research on subtle
prejudice. He also invited researchers to strengthen the research base, particu-
larly the reliability and validity of subtle prejudice measures with a focus on
criterion-related validity and incremental validity. This scoping review aims to
identify the state of microaggression measurement to assist in addressing
Lilienfeld’s (2017) critique of microaggression research.
LGBTQ microaggressions and quantitative research

Empirical attention to LGBTQ-specific microaggressions has grown over the
past decade, particularly sexual orientation microaggressions (Sterzing et al.,
2017). This has included a number of quantitative studies addressing micro-
aggressions exclusively (e.g., Gartner & Sterzing, 2017; Woodford, Joslin,
Pitcher, & Renn, 2017; Woodford et al., 2014b), ones that examined related
forms of subtle discrimination (e.g., heterosexist harassment; Silverschanz,
Cortina, Konik, & Magley, 2008), and other studies using global measures of
LGBTQ discrimination that include both subtle and blatant forms (e.g.,
Gattis, Woodford, & Han, 2014).
Parallel to microaggressions targeting other marginalized communities
(Lau & Williams, 2010), the study of LGBTQ microaggressions began with
several key qualitative studies (Nadal et al., 2014, 2011; Platt & Lenzen, 2013).
Findings from these qualitative studies have shaped subsequent research on
LGBTQ microaggressions, including the development of quantitative mea-
sures to assess their prevalence and covariates. While more qualitative
research is still needed (e.g., to explore experiences of LGBTQ people with
intersecting minority identities; Nadal et al., 2016), quantitative research—
including the development and use of psychometrically sound measures—
remains critically important to understanding microaggressions. Quantitative
research allows researchers to both capture the experiences of large groups of
participants to examine the prevalence and incidence of microaggressions
and to understand microaggressions’ statistical associations with negative
mental and behavioral health outcomes (Lau & Williams, 2010). Further,
consistent with minority stress theory (Meyer, 2003), large-scale quantitative
studies can also increase our insight into individual- and group-level forms of
coping to promote wellbeing in the context of LGBTQ microaggressions.
Researchers interested in the quantitative assessment of LGBTQ microag-
gressions often turn to existing studies when selecting measures. Because of
the increasing number of quantitative studies on LGBTQ microaggressions
and related constructs, numerous measures are available. Yet although it is
well understood that using psychometrically robust measures is a cornerstone
of high-quality quantitative research (Carmines & Zeller, 1979; Singleton &
Straits, 2017), little guidance is available to LGBTQ microaggression

researchers—including the scope of measures available, their characteristics
and psychometric properties (e.g., reliability, validity), and their evolution
and modification in subsequent studies.
A recent review of measures assessing discrimination against sexual mino-
rities found that the psychometric properties of existing scales were ques-
tionable in terms of both validity and reliability (Morrison, Bishop,
Morrison, & Parker-Taneo, 2016). Although this study is a useful resource
for researchers, it focused on sexual orientation discrimination generally and
thus did not explicitly search for microaggression measures or measures of
related concepts. Furthermore, Morrison et al. (2016) did not include mea-
sures assessing gender minority microaggressions. Because microaggressions
occur more frequently than blatant forms of discrimination (Rankin, Weber,
Blumenfeld, & Frazer, 2010; Woodford, Han, Craig, Lim, & Matney, 2014a;
Woodford et al., 2014b; Yost & Gilmore, 2011) and contribute to health
disparities for sexual and gender minorities (Woodford et al., 2014a, 2014b),
selecting the most rigorous instruments for analyzing the nature and con-
sequences of LGBTQ microaggressions is paramount to addressing these
critical issues. To effectively answer calls to strengthen microaggression
research (e.g., Lau & Williams, 2010; Lilienfeld, 2017), researchers must
employ the most robust measures possible. At present, no review exists of
quantitative measures that specifically assess sexual and gender minority
microaggressions.
To address this gap, we conducted a scoping review of quantitative measures
of LGBTQ microaggressions. The current study (1) reports the psychometric
characteristics of each identified measure; (2) describes the evolution of mea-
sures that were subsequently adapted, including details of how each was mod-
ified; and (3) offers recommendations for advancing research on LGBTQ
microaggressions. As LGBTQ microaggressions remain a critical mechanism
of sexual and gender minority oppression, this psychometric scoping review will
help to guide future researchers in finding the best measures for their projects,
thereby advancing methodological quality in this critical research area.
Methods
Scoping reviews have become increasingly popular as a means of knowledge
synthesis, which allow researchers to explore concepts, evidence, and poten-
tial gaps in the literature in a particular field (Colquhoun et al., 2014). The
approach for the current scoping review was informed by Arksey and
O’Malley’s (2005) five-stage methodology, which lays out a systematic pro-
cess for searching the academic and gray literature, synthesizing findings, and
increasing the replicability of the study. The five stages are (1) identifying the
research questions, (2) identifying relevant studies, (3) study selection, (4)
charting the data, and (5) collating, summarizing and reporting the results
(Arksey & O’Malley, 2005). In terms of the distribution of work, the last
author identified the relevant studies, while the first four authors and a
trained research assistant worked to select eligible studies, to chart the data,
and to collate, summarize, and report the results. Discrepancies in coding
were resolved through dialogue and consensus among the entire study team
during regular meetings.
Document identification
Following the specific aims of our study, to better understand the psycho-
metric properties of measures that fully or partially measure LGBTQ micro-
aggressions, we first identified relevant documents (Arksey & O’Malley,
2005). The research team in consultation with a social science librarian
identified the terms and search strategy. The search had three categories of
terms: (1) population (i.e., sexual and/or gender minorities), (2) discrimina-
tion (which included search terms such as “heterosexism,” “homonegativ*,”
and “transphobi*”), and (3) subtle/covert (e.g., terms such as “microaggress*”
or “incivility” or “covert”). We used combinations of terms from each of the
three categories to search prominent databases (an appendix containing all
search terms and specifications is available from the authors). Databases that
index a high rate of social science and health-related journal articles, dis-
sertations, and reports were selected (e.g., PsycINFO, Social Services
Abstracts, ProQuest Dissertations); these databases were searched using two
database aggregators: ProQuest and EbscoHost. In addition, PubMed was
searched independently using the same search specifications. The search was
undertaken on November 16, 2016.
When searching in ProQuest, we used the advanced search interface that
allowed us to identify documents that contained our terms anywhere in the
document text, including title, abstract, references, and keywords, and to
select the following source types given our intent to include both academic
and gray literature: books, dissertations and theses, other sources, reports,
scholarly journals, trade journals, and working papers. Filters were not set for
EbscoHost and PubMed searches. Searches were exported from the database
aggregators as generic text files and document metadata (i.e., title, abstract,
journal, year of publication). BibWrangleR software package for R (Victor,
Perron, & Yochum, 2015) was used to convert files into an analyzable data
frame for review. These initial searches produced 562 unique documents.
During the screening process, Morrison and colleagues’ (2016) psycho-
metric review of sexual orientation discrimination measures was identified.
That study searched the academic literature to identify general measures of
LGB discrimination (i.e., not limited to blatant or subtle forms of discrimi-
nation). Because of its relevance to our own scoping review, we manually
reviewed the study’s reference list to identify any documents that met our
inclusion criteria but were not identified in our original search (n = 9; for
example, a scale that included an microaggression item among a majority of
blatant discrimination items). Further, during the review process we recog-
nized instances in which we did not have the documents presenting original
scales although we had captured studies in our search that reused or adapted
an original scale (e.g., an original measure published in a dissertation may
have been less discoverable than its more recent adaptation published in a
journal article). In these cases, we identified the documents that contained
the original publication of the scales and, if they met our inclusion criteria,
included them in our scoping review (n = 3).
Selecting documents for inclusion

The research team established a set of criteria to screen identified documents
for inclusion in the study. To be included, the document needed to report
empirical findings from a study using (1) quantitative methods; (2) a sample
including sexual and/or gender minorities; and (3) multi-item scale(s) with at
least one item inquiring about experiencing LGBTQ microaggressions. We
were specifically interested in scales assessing microaggressive behaviors or
incidents; therefore, we excluded scales that only addressed opinions related
to heterosexism and ones that only included items addressing an individual’s
psychological, affective, or behavioral response(s) to LGBTQ microaggres-
sions (e.g., Stigma Consciousness Questionnaire for Gay Men and Lesbians;
Pinel, 1999). Scales that did not reference sexual orientation or gender
identity in items or stem sentences but were about microaggressions gener-
ally were included only if respondents were able to attribute the incident to
their sexual orientation and/or gender identity and this attribution was part
of the scale scores. An example is the Everyday Discrimination Scale, which
asks respondents to indicate how frequently they experience various discri-
minatory behaviors and to indicate the perceived cause by selecting from an
array of social identities (e.g., ancestry, gender, sexual orientation; Williams,
Yu, Jackson, & Anderson, 1997). Some researchers have used this scale with
LGBTQ populations (e.g., Durso & Meyer, 2013), but the tendency has been
to simply report scores on the discrimination scale and the frequency that
each identity was endorsed. While it does provide valuable insight into the
experiences of LGBTQ people, this approach does not specifically capture
heterosexist/cisgenderist discrimination, but rather general discrimination.
Given the focus of our review, we excluded these generic discrimination
measures. When the information provided in a document was not sufficient
for assessing whether inclusion criteria had been met, we requested a copy of
the scale from the document authors. Two documents were removed prior to
screening based on insufficient information to assess adherence to inclusion
criteria. For dissertations that were later published as articles, we used the
dissertation version for our study.
We used a two-stage process to screen each document for inclusion: (1)
title and abstract review, and (2) full text review. Each document was
randomly assigned to two members of the research team to review at both
stages. If both of the assigned reviewers agreed, then the document was
included or excluded accordingly. Discrepancies in reviewer decisions were
resolved through consensus among the entire research team. These screening
stages resulted in 126 publications for measurement extraction. To be as
inclusive as possible, when the same measure was used in two or more
publications from the same dataset, we included each publication in our
review. An appendix containing the consort diagram that details each step of
the search and screening process is available from the authors.
Charting the data

Once the final sample of publications (n = 109) was determined, data were
extracted with a focus on measure characteristics, psychometric properties,
and any adaptations made to original measures. For every measure, we
recorded (1) the name of the measure (or construct assessed, if no name
was assigned); (2) the number of items; (3) the name and number of items
for any subscales; (4) if the measure addressed discrimination targeting
sexual orientation and/or gender identity; and (5) if the measure examined
microaggressions only (labeled micro) or included items assessing microag-
gressions and more blatant forms of discrimination (labeled global). We also
extracted information about the sample characteristics: sample size, mean
age, race (as percent people of color), sexual orientation (as percent sexual
minority), gender identity (as percent gender identity minority), and sex/
gender (as percent women or female depending on study reporting).
The psychometric properties of each measure were then extracted. Our
first step was an examination of internal consistency (e.g., Cronbach’s alpha)
and any other types of scale reliability. For validity, only procedures explicitly
presented by the publications’ authors as measures of validity were recorded.
For example, studies that reported correlations between measures but did not
discuss them in the context of validity testing were not coded as having tested
for construct or criterion-related validity. We gathered information on (1)
face validity, or the extent to which the questions make sense at face value,
(2) content validity, or the extent to which the items represent all facets of the
construct as assessed by substantive experts, (3) construct validity, or how
well the measure assesses what it is designed to measure (including discri-
minant, convergent, and known-group), (4) criterion-related validity, or how
well the developed measure maps on to some set standard or criterion
(including concurrent, predictive, and incremental), and (5) factor structure,
or tests of measure dimensionality (including exploratory and confirmatory

factor analysis; DeVellis, 2012; Singleton & Straits, 2017).
We also recorded how many times a measure was used in our publication
sample, including the number of subsequent adaptations of each original
measure. For adapted measures, we assessed modifications based on either
the authors’ descriptions of changes or on our own evaluation when details
were not provided in the publication. These included, but were not limited
to, changes in response options, adjustments in reference (target) group or
timeframe, and addition, removal, and adjustment of any items. Trends in
adaptation were also noted for measures with extensive use (e.g., changing
item wording and/or adding or adjusting language to be inclusive of different
sexual and/or gender minority populations). Finally, similar to the original
measures, details of each adapted measure were recorded, including sample
characteristics and psychometric properties.
Results
Overview of original measures
As detailed in Table 1, our review resulted in the identification of 27 original
measures, with 16 of these measures assessing microaggressions and/or subtle
forms of discrimination exclusively and 11 global measures assessing both
blatant and subtle forms of discrimination. The first measure in our review
was published by Waldo in 1997, but the majority of measures (n = 20)
emerged over the last 8 years (i.e., since 2010). The number of items per
measure ranged from 2 to 135 (x = 24.0, SD = 27.7). Thirteen measures were
multidimensional, with the number of subscales ranging from 2 to 13 (x
= 4.5, SD = 3.4), although not all subscales tapped into microaggressions.
Overall, the measures assessed the following eight microaggression-related
dimensions: (1) direct versus indirect (i.e., witnessed) interpersonal discrimi-
nation; (2) environmental (e.g., public policies) discrimination; (3) different
timeframes (e.g., experiences in past 6 months vs. lifetime); (4) affective
impact; (5) multiple or intersecting marginalized identities; (6) different
contexts (e.g., education, workplace); (7) different types of perpetrators
(e.g., family, heterosexual friends, LGBTQ community); and (8) thematic
content (e.g., assumption of sexual pathology, exoticization).
Sample characteristics of original measures

Sample sizes ranged from 25 to 5,766 participants (x = 653.1, SD = 1,110.8),
across the 27 original measures (see Table 1). The sample mean age ranged
from 16.8 to 41.1 years old, including adolescent to young adult samples (≤25
y/o: 7 publications) and adult-only samples (>25 y/o: 18 publications). Sexual
Table 1. Sexual orientation and gender identity microaggression measure characteristics.
Total
Instrument Name # Target Statusa
(original author) Items Subscales [# items] DiscriminationFormb Sample Characteristicsc Reliabilityd Validitye
Heterosexist Harassment, Rejection 14 (1) Harassment & Rejection [7], SO (n = 124) Total: α = .90 FACT
& Discrimination Scale [HHRD] (2) Workplace & School Global Age: x= 41 (SD 10) (1) α = .89,
(Szymanski, 2006) Discrimination [4], 10% POC; 100% SM; (2) α = .84,
(3) Other Discrimination [3] 100% F (3) α = .78
Workplace Heterosexist Experiences 22 (1) Direct [15] SO S1 (n = 180)f Total: α = .93 FACT
Questionnaire [WHEQ] (Waldo, 1999) (2) Indirect [7] Global Age: x= 38 (SD 8); (1) α = n.r.g
10% POC; 100% SM; 46% W (2) α = n.r.
S2 (n = 107)
Age: x= 39 (SD 11);
7% POC; 100% SM; 35% W
Homonegative Microaggressions Scale 135 (1) HMS Current: Past 6 mo. [45] SO S1 (n = 28) Total: n/ag CONT,
[HMS] (Wright & Wegner, 2012) (2) HMS Past: Since Growing Up [45] Micro Age: x= 27 (SD 6); (1) α = .94, CONS,
(3) HMS Impact [45] 36% POC; 100% SM; 46% F (2) α = .95, CRIT
S2 (n = 120) (3) α = .96
Age: x= 34 (SD 12);
14% POC; 100% SM; 44% F
Heterosexist Harassment Scale [HHS] 8 n/a SO (n = 1634) α = .85 n.r.
(Silverschanz, 2006)h (separated into 2 subscales in Micro Age: x= 24 (SD n.r.);
subsequent publication) 9% POC; 9% SM; 55% F
Daily Heterosexist Experiences 50 (1) Gender Expression [6] SO S1 (n = 119) Total: α = .92 CONS,
Questionnaire [DHEQ] (2) Vigilance [7], (3) Parenting [6] Global Age: x= 39 (SD 11); 48% POC; (1) .86, (2) .86, CRIT,
(Balsam et al., 2013) (4) Discrimination/Harassment [6] 100% SM; 14% GIM; 41% F (3) .83, (4) .85, FACT
(5) Vicarious Trauma [6] S2 (n = 900) (5) .82, (6) .79,
(6) Family of Origin [6] Age: x= 34 (SD 11); 31% POC; (7) .79, (8) .87,
(7) HIV/AIDS [5], 100% SM; 12% GIM; 57% F (9) .76
(8) Victimization [5], S3 (n = 1217)
(9) Isolation [4] Age: x= 37 (SD 12); 33.3% POC;
100% SM; 16% GIM; 51% F

(Continued )
9
10
Table 1. (Continued).
Total
LGBQ Microaggressions on Campus 20 (1) Interpersonal [15], SO S1 (n = 14); Age: x= 22 (SD 4); 24% Total: α = n.r. FACE,
Scale [LGBQ-MCS] (2) Environmental [5] Micro POC; (1) α = .94, CONT,
(Woodford et al., 2015a) 100% SM; 14% GIM; 36% F/W (2) α = .81 CONS,
S2 (n = 281); Age: x= 24 (SD n.r.); FACT
24% POC; 100% SM; 0% GIM; 58%
C. M. FISHER ET AL.
W
S3 (n = 580); Age: x= 23 (SD 6);
29% POC; 100% SM; 3% GIM; 54%
W
LGBT People of Color 18 (1) POC Heterosexism [6], SO, GE/GI S1 (n = 53); Age: x= 36 (SD 10); Total: α = .92 CONS,
Microaggressions Scale (2) LGBT Racism [6], Micro 100% POC; 100% SM/GIM; (1) α = .81, CRIT
[LGBT-PCMS] (Balsam et al., 2011) (3) LGBT Relationship Racism [6] S2 (n = 266); Age: x= 32 (SD 10); (2) α = .89,
100% POC; 100% SM; 9% GIM; 55% (3) α = .83
F
S3 (n = 297); Age: x= 33 (SD 10);
87% POC; 100% SM; 11% GIM; 50%
W
Experiences of Homophobic 11 n/a SO (n = 912) α = .75 n.r.
Discrimination [EHD] Global Age: x= 31 (SD n.r.);
(construct measured) 100% POC; 100% SM; 0% F
Díaz et al., 2001)
Gay and Lesbian 49 (1) Couples Issues [4], SO S1 (n = 32); Age: x= 35 (SD n.r); Total: α = n.r. CONT,
Oppressive Situation Inventory- (2) Dangers to Safety [5], Global 25% POC; 100% SM; 41% W (1) α = .63, CONS,
Frequency [GALOSI-F] (3) Exclusion, Rejection, & S2 (n = 607); Age: x= 32 (SD 14); (2) α = .77, CRIT,
(Highlen et al., 2000) Separation [9], (4) Internalized 19% POC; 100% SM; 39% W (3) α = .87, FACT
Homonegativity [10], S3 (n = 293); Age: x= 33 (SD 14); (4) α = .88,
(5) Restricted Opportunities & 27% POC; 100% SM; 41% W (5) α = .69,
Rights [3], (6) Stigmatizing & (6) α = .85,
Stereotyping [11], (7) Verbal (7) α = .77
Harassment & Intimidation [7]
(Continued )
Total
Anti-Bisexual Experiences Scale [ABES; 17 (1) Sexual Orientation Instability [8] SO S1 (n = 699); Age: x= 32 (SD 11); S1: LG: α = .94 CONT,
ABES-LG; ABES-H] (2) Sexual Irresponsibility [4] Micro 21% POC; 100% SM; 2% GIM; 59% S2: LG: α = .95 CONS,
(Brewster & Moradi, 2010) (3) Interpersonal Hostility [5] W Test-Retest FACT
S2 (n = 176); Age: x= 34 (SD 14); r = .77-.89
20% POC; 100% SM; 11% GIM; 60%
W
Victimization Catalog 76 (1) Hostile Treatment [24] SO (n = 1039) n/a n.r.
(Bachmann & Simon, 2014) (2) Discrimination Incidents [52] Global Age: x= 38 (SD 11); (index/count)
100% SM; 0% W
Sexual Orientation Stigma 8 n/a SO (n = 200) α = .93 n.r.
(construct measured) (Bruce, Stall, Global Age: x= 21 (SD 2)
Fata, & Campbell, 2014) 75% POC; 100% SM; 0% F
Perceived Homophobia among 11 (1) General Community [4] SO (n = 1196) (1) n/a, count CONT
General Community, Heterosexual (2) Heterosexual Friends [3] Global Age: x= 36 (SD n.r.); (2) α = .87,
Friends & Family [PHGGHFF] (3) Family [4]i 100% POC; 100% SM; 0% W (3) α = .82
(constructs measured)
(Choi et al., 2013)
Schedule of 18 n/a SO (n = 449) α = .93 n.r.
Homophobic Events (Fingerhut, Global Age: x= 33 (SD 12);
Peplau, & Gable, 2010)j 15% POC; 100% SM; 44% W
Homophobic Discourse (construct 2 n/a SO (n = 5766) n.r. n.r.
measured) (Peter, Taylor, & Micro Age: x= 17 (SD n.r.);
Chamberland, 2015) 28% POC; 28% SM; 40% F
Two-Spirit 32 n/a SO, GE/GI (n = 221) α = .96 n.r.
Microaggression Scale (Town, 2014) Micro Age: x= 39 (SD n.r.);
100% POC; 100% SM; 0% F
Sexual Orientation Microaggressions 9 n/a SO (n = 76) α = .84 n.r.
in Psychotherapy Scale Micro Age: x= 37 (SD n.r.);
(MacDonald, 2013)k 21% POC; 100% SM; 7% GIM; 69% F
Measure of Heterosexist 20 n/a SO (n = 25) α = .90 n.r.

Microaggressions Micro Age: x= 34 (SD 14)
(Oshi-Ojuri, 2013) 100% POC; 100% SM; 100% F
11
(Continued )
12
Total
LGBT Minority Stress Measure 25 (1) Identity Concealment [4] SO, GE/GI (n = 640); Age: x= n.r.; Total α = .87 CONS,
[LGBT-MSM] (Outland, 2016) (2) Everyday Discrimination/ Global 18% POC; 100% SM; 20% GIM; 36% (1) α = .81, CRIT,
Microaggressions [4] F (2) α = .73, FACT
(3) Rejection Anticipation [4] (3) α = .84,
C. M. FISHER ET AL.
(4) Discrimination Events [4] (4) α = .75,

(5) Internalized Stigma [3] (5) α = .88,
(6) Victimization Events [3] (6) α = .82,
(7) Community Connectedness [3] (7) α = .82
Avoidance Behaviors [AB] 3 n/a SO (n = 530); Age: n.r.; α = .89 FACT
(construct measured) (Hong, Micro 26% POC; 100% SM; 3% GIM; 54% F
Woodford, Long, & Renn, 2016)
Gendered Heterosexism (construct 8 n/a SO (n = 83); Age: x= 20 (SD 2); α = .84 n.r.
measured) (Friedman, 2008) Global 40% POC; 100% SM; 0% GIM; 100%
F
Environmental Microaggressions [EM] 8 (1) Distal [3] SO (n = 187); Age: x= 21 (SD 2) Total: α = n.r. FACT
(Woodford et al., 2015c) (2) Proximal [5] Micro 23% POC; 100% SM; 0% GIM; 55% (1) α = .68,
W (2) α = .65
Sexual Orientation Microaggression 19 n/a SO S1 (n = 204); Age: 20–24; n.r. CONS,
Inventory [SOMI] (Swann, Minshew, Micro 87% POC; 97% SM; 56% F CRIT
Newcomb, & Mustanski , 2016) S2 (n = 340); Age: 17–21;
82% POC; 99.7% SM; 0% F
Types of Everyday Transphobic 11 n/a GE/GI (n = 4115) n.r. n.r.
Discrimination Micro Age: x= 38 (SD 13);22% POC;
(Miller & Grollman, 2015)l 79% SM; 100% GIM; 61% TW
Gender-nonconformity Harassment 3 n/a GE/GI S1 (n = 400)f; Age: 19–74; α = .79 n.r.
(Konik & Cortina, 2008) Micro 8% POC; 6% SM; 55% F
S2 (n = 229); Age: 19–70;
11% POC; 100% SM; 0% GIM; 65% F
(Continued )
Total
Microaggressions 36 (1) Assumption of Universal GE/GI (n = 255); Age: 18–44; n.r. n.r.
(construct measured) Transgender Experience; (2) Micro 18% POC; 87% SM;
(Johnson, 2014) Discomfort/disapproval…m,n 100% GIM; 21% W, 31% TF
Sexual Orientation Discrimination 16 n/a SO (n = 223); Age: x= 28 (SD 8) α = .74 n.r.
Scale [SOD]o Truong, 2010) Micro 100% POC; 100% SM; 0% W
Notes:
a
SO = Measure targets sexual orientation discrimination; GE/GI = Measure targets gender expression and/or gender identity discrimination.
b
Micro = Only microaggressions assessed ; Global = Both subtle and blatant discrimination assessed.
c
Race/Ethnicity: POC = People of Color (non-White); Sexual Orientation: SM = Sexual Minority (non-heterosexual); Gender Identity: GIM = Gender Identity Minority (non-cisgender);
Sex/Gender: F = Female/W = Women-identified (per terminology used in each article); For studies with 100% GIM samples, we report % with TransWomen (TransW) and other
Gender Nonconforming (GNC) identities.
d
All alphas reported are Internal Consistency Reliability and represent total scale scores unless otherwise indicated.
e
FACE = Face Validity, CONT = Content Validity, CONS = Construct Validity (includes: discriminant, convergent, known-group), CR = Criterion-Related Validity (includes concurrent,
predictive, incremental), FACT = Factor Structure (includes: EFA and CFA testing).
f
S1 and S2 were collected at different recruitment sites and combined into a single analytic sample; demographics not reported.
g
n/a = not applicable, n.r. = not reported.
h
Includes 3 items from Waldo’s (1999) Workplace Heterosexist Experiences Questionnaire and modified for a university setting + 5 new items.
i
Treated as separate scales (i.e., never summated into an overall measure).
j
Schedule of Racist Events scale (Landrine & Klonoff, 1995) was reworded to apply to discrimination based on sexual orientation.
k
Adapted the Racial Microaggressions in Counseling Scale (Constantine, 2007).
l
Authors created sub-scales from the National Trans Survey (which did not originally identify any sub-scales).
m
Continued: (3) Endorsement of Gendernormative and Binary Culture or Behaviors; (4) Use of Transphobic and/or Incorrectly Gendered Terminology; (5) Denial of Existence of
Transphobia; (6) Assumption of Sexual Pathology or Abnormality; (7) Denial of Bodily Privacy; (8) Exoticization; (9) Other; (10) Expecting Clients to Provide Education; (11) Omitting
Gender Matters from the Therapeutic Conversation; (12) Physical Threat or Harassment; (13) Denial of Individual Transphobia.
n
Number of items not identified by subscale.
o
Modified version of Meyer, Schwartz, and Frost (2008) “Experiences of Everyday Discrimination” measure, which adapted a measure by Williams et al. (1997) to include sexual
orientation.
13
minorities only (21 publications) were the primary target population, fol-
lowed by combined sexual and gender minorities (four publications) and
gender minorities only (two publications). Approximately 70% (15 out of 21)
of the sexual minority-only publications failed to report if they included or
excluded gender minority participants. Twelve publications provided sample
percentages on gender minorities: 0% (three publications), 3% to 20% (seven
publications), and 100% (two publications). Seventeen publications used
mixed sex/gender samples—females/women accounting for 21% to 69% of
the overall sample—with 10 publications using single sex/gender samples:
sexual minority females/women (three publications), sexual minority males/
men (six publications), and heterosexual and sexual minority males/men
(one publication). Lastly, the majority of publications included samples
with less than 30% participants of color: 7% to 15% (five publications),
16% to 30% (10 publications), 31% to 75% (five publications), and 86% to
100% non-White individuals (seven publications).
Psychometric properties of original measures

Twenty-three publications (85%) reported internal consistency reliability for
their total scale score and/or subscales (see Table 1). The Anti-Bisexual
Experience Scale (ABES; Brewster & Moradi, 2010) was the only measure
in our review to report any reliability testing beyond internal consistency:
test-retest (r = .77 to .89) at a two-week follow-up. The majority of single-
dimension measures (12 out of 14) reported internal consistency reliability,
with Cronbach’s alphas ranging from .74 to .96. Six publications (out of 13)
indicated their multidimensional measure could be summated or averaged
into a total scale score, with five of these measures being psychometrically
appropriate (i.e., not a count of experiences) for internal consistency testing.
For the scales reporting a total score, Cronbach’s alphas ranged from .87 to
.93, with their subscales ranging from .73 to 89. The seven remaining multi-
dimensional measures had Cronbach’s alpha values ranging from .63 to .96
on their subscales. It is important to note that four of these seven publica-
tions failed to report if their multidimensional measures could be combined
into a total scale score (i.e., Brewster & Moradi, 2010; Highlen, Bean, &
Sampson, 2000; Johnson, 2014; Woodford, Paceley, Kulick, & Hong, 2015c).
Only 13 publications, specifically two single-dimension and 11 multidimen-
sional measures, reported any validity testing. As shown in Table 2, factor
structure was the most common form of validity testing (nine measures),
followed by construct (eight measures), criterion-related (six measures), content
(five measures), and face (one measure). The Heterosexist Harassment Rejection
and Discrimination Scale (HHRDS; Szymanski, 2006), LGBQ Microaggressions
on Campus Scale (LGBQ-MCS; Woodford, Chonody, Kulick, Brennan, & Renn,
2015a), and ABES (Brewster & Moradi, 2010) were the only three
Table 2. Summary of validity testing for the 27 original measures (by publication year).
Measure Subscales FACE CONT CRIT CONS FACT EFA CFA EFA + CFA
WHEQ (Waldo, 1999) 2 X X
GALOSI-F (Highlen et al., 2000) 7 X X X X X
HHRDS (Szymanski, 2006) 3 X X X X
ABES (Brewster & Moradi, 2010) 3 X X X X X X
LGBT-PCMS (Balsam et al., 2011) 3 X X
HMS (Wright &Wegner, 2012) 3 X X X
DHEQ (Balsam et al., 2013) 9 X X X X
PHGCHFF (Choi et al., 2013) 3 X
EM (Woodford et al., 2015c) 2 X X
LGBQ-MCS (Woodford et al., 2015a) 2 X X X X X X X
AB (Hong et al., 2016) 1 X X
LGBT-MSM (Outland, 2016) 7 X X X X
SOMI (Swann et al., 2016) 1 X X
Total - 1 5 6 8 9 7 5 3
multidimensional scales to conduct an EFA and CFA to both explore and

confirm their measure’s factor structure.
Woodford and colleagues’ (2015a) publication on the LGBQ-MCS was the
only one to report on all five types of validity. They consulted professionals
working with LGBTQ university students, LGBTQ students, and an expert in
LGBTQ discrimination to assess face and content validity. They conducted
exploratory and confirmatory factor analyses and also examined construct
and criterion-related validity using a range of measures.
Other researchers engaged in relatively extensive validity testing but did
not examine factor structure. Wright and Wegner (2012) evaluated the
content validity of their proposed 30-item scale by consulting with experts
and through a survey (inclusive of open-ended questions related to the
themes addressed in the survey) conducted with 28 LGB people. Criterion-
related validity (convergent and discriminant) of the revised scale was
assessed by examining associations between their subscales and discrimina-
tion measures and between participants’ subscale scores and self-esteem and
LGB-identity indicators (i.e., internalized feelings and identity development
process). Choi and colleagues (2013) described their process of developing a
“culturally sensitive and psychometrically valid” instrument that involved
focus groups, in-depth individual interviews, and extensive pre-testing of
preliminary measures with sexual minority men of color, followed by formal
psychometric testing. Balsam and colleagues (2011) tested the construct
validity of the LGBT People of Color Microaggressions Scale (LGBT-
PCMS) and its subscales by examining correlations with psychological indi-
cators (e.g., perceived stress), lifetime LGBT discrimination items (e.g., “life
would be different), and LGBT-identity indicators (e.g., internalized homo-
negativity). They also tested differences between groups, such as men versus
women.
Adaptions of original measures

Eight of the original measures were adapted across 65 total publications.
Forty publications used an adapted version of the HHRDS (Szymanski,
2006). As shown in Table 3, the most common modification to the
HHRDS measure was changing item wording and/or adding or removing
items to be inclusive of different sexual and/or gender minority populations:
lesbians and bisexual females (eight publications); gay and bisexual males
(four publications); LGB or LGBQ males and females (23 publications); and
LGBTQ and trans* persons (five publications). Changing the response
options was the next most common modification, including removing
“more than 70% of the time” from the original response option of “the
event happened almost all the time; more than 70% of the time” (12 pub-
lications) and updating the response scale to 0 (never) to 6 (almost every
week; one publication). The remaining modifications involved changing the
original reference period (i.e., past year) to the past 6 months or lifetime
(four publications), using only one or two of the three available subscales
(three publications), and repeating items to assess both heterosexual and
sexual minority perpetrators (one publication). The majority of the
HHRDS adaptations (36 out of 40) reported internal consistency reliability,
with Cronbach’s alpha values ranging from .74 to .96. Only one publication
(Friedman, 2008) reported any validity testing, namely factorial validity using
EFA to support their modified version of the HHRDS.
As shown in Table 4, the Workplace Heterosexist Experiences
Questionnaire (WHEQ; Waldo, 1999) was the next most frequently adapted
measure (10 publications), followed by the Heterosexist Harassment Scale
(HHS; Silverschanz, 2006; five publications), Daily Heterosexist Experiences
Questionnaire (DHEQ; Balsam, Beadnell, & Molina, 2013; three publica-
tions), Homonegative Microaggressions Scale (HMS; Wright & Wegner,
2012; three publications), Experiences of Homophobic Discrimination
(EHD; Diaz, Ayala, Bein, Henne, & Marin, 2001; two publications), LGBQ-
MCS (Woodford et al., 2015a; one publication), and LGBT-PCMS (Balsam
et al., 2011; one publication). Table 4 details the range of modifications (e.g.,
target group; reference period; response options) made across these seven
measures. The majority of these adaptations (22 out of 25 publications)
reported internal consistency reliability: Cronbach’s alpha values ranged
from .61 to .95. No other forms of reliability testing were reported. Only 4
of the 25 publications reported any validity testing on these modified mea-
sures. In relation to the WHEQ, Leskinen (2012) tested for construct validity,
while Brewster, Velez, DeBlaere, and Moradi (2012) conducted an EFA and
found support for direct and indirect (i.e., witnessed, overheard) subscales of
cisgenderism in the workplace. Woodford, Kulick, and Atteberry (2015b)
conducted a principal components analysis to examine the factor structure of
Table 3. Published modifications to the Heterosexist Harassment, Rejection, and Discrimination Scale [HHRDS] (Szymanski, 2006).
Instrument Modifications Study N Sample Demographicsa Reliabilityb Validityc
a
Reference group & Beaber (2008) 226 Age: x= 30 (9) α = .91 n.r.
question wording 26% POC; 100% SM; 100% F
inclusive of Bisexual Szymanski and Meyer (2008) 91 Age: x= 35 (11) α = .83 n.r.
women (Lesbian & 100% POC; 100% SM; 100% F
Bisexual female Lambe (2013)c,d 203 Age: x= 32 (8) L&G: α = .87 n.r.
samples) – all studies; 18% POC; 100% SM; 100% F Het: α = .87
Removed “more than 70% Age: x= 33 (11)
of the time” from last DeBlaere et al. (2014) 134 100% POC; 100%SM; 100% F n.r. n.r.
a Age: x= 34 (14)
response option;
Szymanski and Henrichs-Beck 473 19% POC; 100%SM; 100% F α = .91 n.r.
Changed reference period
(2014)b
(past 6 months);b
Age: x= 32 (13)
Used selected subscales Szymanski, Dunn, and Ikizler (2014) 761 18% POC; 100% SM; 100% F α = .90 n.r.
(Harassment & Age: x= 29 (9)
Rejection);c Watson, Grotewiel, Farrell, Marshik, 243 17% POC; 100% SM; 100% F n.r. n.r.
Repeated question series to and Schneider (2015)a
assess experiences with Age: x= 33 (13)
two perpetrator groups Szymanski, Ikizler, and Dunn (2016) 540 18% POC; 100% SM; 100% F α = .91 n.r.
(L&G, Heterosexuals)d
Reference group & Kleiman, Spanierman, and Smith 180 Age: x= 20 (2) α = .86 n.r.
question wording (2015) 0% POC; 46% SM; 2% GNC; 0% F
inclusive of sexual Schwartz, Stratton, and Hart (2016)a 471 Age: x= 35 (12) α = .93 n.r.
minority men (Gay & 41% POC; 100% SM; 2% GNC 0% F
Bisexual male samples) Szymanski (2009) 210 Age: x= 36 (15) α = .91 n.r.
—all studies; 15% POC; 100% SM; 0% F
Removed “more than 70% Szymanski and Ikizler (2013) 203 Age: x= 31 (12) α = .90 n.r.
of the time” from last 18% POC; 100% SM; 0% F
response optiona
(Continued )
17
18

e
Reference group & Breslow et al. (2015)a, 552 Age: x= 26 (10); 26% POC; α = .89 n.r.
question wording 93% SM; 16% TransF; 39% GNC
inclusive of Trans* Drazdowski et al. (2016) 200 Age: x= 30 (10); 100% POC; α = .85 n.r.
individuals (LGBTQ and 98% SM; 15% GIM; 0% F (each subscale)
Trans* samples)—all Outland (2016)a 583 Age: x= n.r.; 18% POC; n.r. n.r.
studies; 100% SM; 12% GIM; 36% F
Removed “more than 70% Sutter and Perrin (2016) 200 Age: x= 30 (10); 100% POC; n.r. n.r.
of the time” from last 98% SM; 15% GIM; 53% F
C. M. FISHER ET AL.
response option;a Velez, Breslow, Brewster, Cox, and 304 Age: x= 25 (7); 27% POC; α = .89 n.r.
Added/removed items Foster (2016)a,e 90% SM; 100% GIM; 0% F
(1 removed, 1 added)e
Reference group & Friedman (2008)f 83 Age: x= 19 (2) α = .87 FACT
question wording 40% POC; 100% SM; 100% F
inclusive of LGB or Szymanski and Gupta (2009) 178 Age: x= 29 (8) α = .95 n.r.
LGBQ individuals (men 100% POC; 100% SM; 48% F
& women samples)— St. Pierre and Senn (2010) 280 Age: x= n.r. α = .92 n.r.
all studies; 9% POC; 100% SM; 64% F
Removed “more than 70% Szymanski and Sung (2010) 144 Age: x= 31 (9); 100% POC; α = .91 n.r.
of the time” from last 100% SM; 4% GIM; 57% F
response option;a Lehavot and Simoni (2011)a 1381 Age: x= 34 (12) α = .90 n.r.
Changed reference 26% POC; 100% SM; 100% F
period (lifetime);b Corpus (2012)b 167 Age: x= n.r. α = .92 n.r.
Used selected subscales 100% POC; 100% SM; 100% F
(Harassment & Feinstein, Goldfried, and Davila 467 Age: x= 31 (12) α = .93 n.r.
Rejection);c,a (Workplace (2012) 24% POC; 100% SM; 47% F
& School Discrimination; Fritz (2012)c,a 188 Age: x= n.r.; 37–42% POC; α = .82 n.r.
Other Discrimination);c,b 77% SM; 2–10% GIM; 0–90% Fd
Modified response set Bandermann and Szymanski (2014) 423 Age: x= 33 (15); 18% POC; α = .90 n.r.
(0 = Never in past year to 100% SM; 6% GIM; 52% F
6 = Almost every week);f Cogger (2014)a 371 Age: x= 30 (10); 22% POC; α = .92 n.r.
100% SM; 8% GIM; 93% F
Denton, Rostosky, and Danner 564 Age: x= 35 (13) α = .92 n.r.
(2014)a 16% POC; 100% SM; 48% F
Feinstein, Wadsworth, Davila, and 414 Age: x= 31 (12) α = .94 n.r.
Goldfried (2014) 21% POC; 100% SM; 48% F
(Continued )
cb
Mereish (2014) 155
Age: x= 41 (16) α = .95 n.r.
31% POC; 100% SM; 100% F
Brewster, Velez, Foster, Esposito, 143 Age: x= 39 (15); 29% POC; α = .90 n.r.
and Robinson (2016)a 100% SM; 15% GIM; 36% F
Detwiler (2015) 189 Age: x= 60 (8); 10% POC; α = .88 n.r.
100% SM; 41% GIM; 62% F
Figueroa and Zoccola (2015)b 277 Age: x= n.r. α = .89 n.r.
22% POC; 100% SM; 47% F
Liao, Kashubeck-West, Weng, and 265 Age: x= 34 (13); 21% POC; α = .78-.86 n.r.
Deitz (2015) 100% SM; 6% GIM; 56% F (for 3 subscales)
Mason and Lewis (2015)a,b 164 Age: x= n.r. α = .76-.81 n.r.
38% POC; 100% SM; 100% F (for 3 subscales)
Mereish and Poteat (2015) 719 Age: x= 42 (15); 38% POC; α = .95 n.r.
100% SM; 3% GIM; 55% F
Sandil, Robinson, Brewster, Wong, 142 Age: x= 32 (8); 100% POC; α = .89 n.r.
and Geiger (2015)a 100% SM; 3% GIM; 30% F
Velez, Breslow, Brewster, Cox, and 173 Age: x= 31 (11); 100% POC; α = .90 n.r.
Foster (2016)a 100% SM; 7% GIM; 43% F
Szymanski and Mikorski (2016) 361 Age: x= 28 (13); 25% POC; α = .89 n.r.
100% SM; 11% GIM; 59% F
Wright (2016) 232 Age: x= 31 (14); 25% POC; α = .88 n.r.
100% SM; 8% GIM; 34% F
Notes:
a
Race/Ethnicity: POC = People of Color (non-White); Sexual Orientation: SM = Sexual Minority (non-heterosexual); Gender Identity: GIM = Gender Identity Minority (non-cisgender);
b
c
FACE = Face Validity, CONT = Content Validity, CONS = Construct Validity (includes: discriminant, convergent, known-group), CRIT = Criterion-Related Validity (includes: concurrent,
d
Demographic characteristics (race, gender identity, sex) were presented by sexual orientation sub-group rather than for overall sample.
19
20
Table 4. Published modifications to other sexual orientation and gender identity microaggression measures.
Workplace Heterosexist Experiences Questionnaire [WHEQ]
(Waldo, 1999) Modified in 10 publications
Changed reference period from 24 to 12 months Smith and Ingram 97 Age: x= 34.7 (10); 18% POC; 100% SM; 41% α = .92 n.r.
(2004) F
Carter II, Mollen, 165 Age: x= 37.9 (SD 12.2); 24.2% POC; 100% α = .93 n.r.
and Smith (2014) SM; 39.4% F
Reed and Leuty 135 Age: x= 32.8 (SD 10.9); 29.6% POC; 100% α = .89 n.r.
C. M. FISHER ET AL.
(2016) SM; 50.3% F

12-month reference period; added 1 item McConnell (2004) 213 Age: x= 36.2 (SD 10.1); 15.6% POC; 100% α = .93 n.r.
SM; 47.9% F
12-month reference period; 8-item version (5 original items + 3 Konik (2005) Analytic Age: x= 45 (SD n.r.) Analytic sample: 36.4% α = 80 n.r.
new heterosexist harassment items; 2 items removed in sample: SM; 58.2% W
analysis); Response set (1 = never, 2 = once or twice, 629
3 = > twice); Modified response stem & options to match
other measures
Konik and Cortina S1: 1337 S1: Age: x= 45 (SD n.r.); 8% POC; 6% SM; α = 80 n.r.
(2008) S2: 218 55% F S2: Age: x= 40 (SD n.r.) 11% POC;
100% SM; 0% GIM; 65% F
Modifications not explained Kelleher (2009) 301 Age: x= 20.8 (SD 2.5) 99% SM; 6% GIM; 25% n.r. n.r.
F
12-month reference period; 15-item version (8 items from Konik Leskinen (2012) 425 Age: x= 41 (SD n.r.) 44% POC; 100% W α = 90 CONS
& Cortina, 2008 + 7 new items); Likert-type response set
(1 = never; 5 = many times)
Changed target group to Trans*; EFA resulted in 2 subscales: (1) Brewster et al. 263 Age: x= 38.3 (SD 13.5) 14% POC; 89% SM; Direct: α = .92 FACT
Direct, 15 items; (2) Indirect, 6 items (2012) 100% GIM; 44% TransW, 31% other non- Indirect: α = .91
men
12-month reference period; 8-item version (5 original university- Rabelo and Cortina S1: 55 S1: Age: x= 43.5 (10.8) 10.9% POC; 100% α = .79 n.r.
relevant items + 3 new workplace heterosexism items); (2014) S2: 212 SM; 45.5% F S2: Age: x= 40.4 (10.9); 11.3%
Question stem & response set modified to match other POC; 100% SM; 0% GIM; 67% F
measures
Heterosexist Harassment Scale [HHS] (Silverschanz, 2006)
Modified in 5 publications
(Continued )
Used 5 of 8 items; Identified two sub-scales: (1) Ambient Silverschanz et al. 3128
Age: x= 23 (SD n.r.) 10% POC; 11%SM; 49% n.r. n.r.
Heterosexist Harassment [AHH; 3 items] (2) Personal (2008) F
Heterosexist Harassment [PHH; 2 items]
Used only AHH [3 items]; Modified stem, item wording [2 Swank, Woodford, 1538 SM: Age x= 23.3 (SD 5.2) 16.2% POC; 3.5% SM students: α = .81 n.r.
selected items], response set (0 = none, 1 = once, 2 = 2–3 and Lim (2013) (17.7% GIM; 66.5% F H Youth: Age: x= 22.8 (SD 6.0) Heterosexual
times, 3 = 4–9 times, 4 = 10+); Modified reference period SM) 20.9% POC; .2% GIM; 62.1% F students: α = .78
(“past 12 months (or since at the university, if < 12 months);”
Added 1 item
Used both AHH & PHH [3 items each, constructed to be parallel]; Woodford et al. 2428 SM: Age x= 23.3 (SD 5.2) 26.1% POC; 66.9% n.r. n.r.
Modifications to stem, item wording, response set, and (2014a) F H: Age: x= 23.1 (SD 5.9) 28.4% POC; 59.9%
reference period (see Swank et al., 2013 above); Added 1 item. F
Used both AHH [4 items] & PHH [3 items]; Modifications to stem, Woodford and 381 Age x= 23.4 (SD 5.3) 22.8% POC; 100% SM; α = .61 n.r.
item wording, response set, and reference period (see Swank Kulick (2015) 67.2% F
et al., 2013 above); Added 2 items.
Used PHH [3 items]; Modifications to stem, item wording, Woodford et al. 326 Age: x= 23.5(SD 5.3) 21.2% POC; 100% SM; α = .62 FACT
response set, and reference period (see Swank et al., 2013 (2015b) 2.5% GIM; 68.7% F
above); Added 1 item
Homonegative Microaggressions Scale [HMS] (Wright &
Wegner, 2012) Modified in 3 publications
Used 6-month [42 items]; To improve relevance for LBQ women, Gottlieb (2015) 155 Age: 18–54 16.1% POC; 100% SM; 100% W Overall α = .93 n.r.
modified item wording for study population; deleted 5 items;
added 2 items
Developed a four-factor scale F1 Assumed Deviance, F2 Second Wegner (2014) S1: 120 S1: Age: x= 24 (SD 12) 14%POC; 100% SM; Total: α = .95 (1) FACT
Class Citizen F3 Assumption of Gay Culture, F4 Stereotypical S2:302 44% F S2: Age: x= 31 (SD 10) 29% POC; α = .85 (2) α = .83 (3) (S1: EFA
Knowledge and Behavior; 27 items; Past 6 months only 100% SM; 45%F α = .82 (4) α = .76 S2: CFA)
Used Wegner’s (2014) abbreviated version of the HMS (27 items); Whicker (2016) 179 Age: x= 34.6(SD 14.2) 11.2% POC; 100% SM; (1) α = .90 (2) α = .92 n.r.
Assessed (1) current [past 6 months], (2) past [lifetime], and 0% F/W (3) α = .95
(3) impact; Only included current in final analysis
Daily Heterosexist Experiences Questionnaire [DHEQ]

(Balsam et al., 2013) Modified in 3 publications
(Continued )
21
22
Used one subscale [Family Rejection]; 6-point response set Zimmerman, 843 Age: x= 21.4 (SD 2.1) 45.8% POC; 100% SM; Time 1 α = .81 Time 2 n.r.
[never to almost everyday]; eliminated reference period Darnell, Rhew, Lee, 100% W α = .82
and Kaysen (2015)
Used 6 trans*-related subscales identity [gender expression, Lehavot, Simpson, 212 Age: x= 49.3 (SD 14.9) 10.4% POC; 100% α = .93 n.r.
vigilance, discrimination/harassment, vicarious trauma, family and Shipherd GIM; 88.7% TransW4
C. M. FISHER ET AL.
of origin, isolation] (2016)

Used 3 subscales (1) gender expression (2) discrimination/ Tebbe and Moradi 335 Age: x= 25.2 (SD 6.6) 18.2% POC; 93.7 SM; (1) α = .73 (2) α = .82 n.r.
harassment, (3) victimization; modified item wording for study (2016) 100% GIM; 32.8% TransW, 38.2% GNC (3) α = .62
population
Experiences of Homophobic Discrimination [EHD] (Diaz et al.,
2001) Modified in 2 publications
Used 8 of 11 items Bruce et al. (2014) 200 Age: x= 20.9 (SD 2.1) 76.5% POC; 100% SM; Overall α = .93 n.r.
0% W
Modified Response set to Yes/No Finneran and 1575 Age: 15-> 50 36.8% POC; 100% SM; 0% F α = 0.71 n.r.
Stephenson (2014)
LGBQ Microaggressions on Campus Scale [LGBQ-MCS]
(Woodford et al., 2015a) Modified in 1 publication
Used (1) Interpersonal Microaggressions sub-scale; created (2) Hong et al. (2016) 530 Age: n.r. 26% POC; 100% SM; 3% GIM; 54% (1) α = .95 (2) α = .77 (1) n.r.
ambient heterosexism scale [using 3 Environmental W (2) n.r.
Microaggressions subscale items)
LGBT People of Color Microaggressions Scale [LGBT-PCMS]
(Balsam et al., 2011) Modified in 1 publication
Modified response options (never happened – almost all of the Szymanski and 144 Age: x= 30.7 (SD 8.6) 100% POC; 100% SM; (1): α = .88 (2) α = .75 n.r.
time) & reference period [past year] Sung (2010) 4% GIM; 57% F (3) α = .83
Notes:
a
Race/Ethnicity: POC = People of Color (non-white); Sexual Orientation: SM = Sexual Minority (non-heterosexual); Gender Identity: GIM = Gender Identity Minority (non-cisgender);
b
c
FACE = Face Validity, CONT = Content Validity, CONS = Construct Validity (includes: discriminant, convergent, known-group), CRIT = Criterion-Related Validity (includes concurrent,
the Personal Heterosexist Harassment subscale, which they adapted from

Silverchanz et al.’s (2008) HHS. Lastly, Wegner (2014) conducted an EFA
and CFA on the current subscale (i.e., past 6 months) of the HMS (Wright &
Wegner, 2012), resulting in a 27-item scale (reduced from 45 items).
Discussion
This psychometric scoping review identified 27 original measures. Of these
measures, 16 exclusively measured LGBTQ microaggressions, while the
others were global measures containing items addressing both microaggres-
sive and blatant discrimination. Our findings suggest that while a consider-
able number of measures are now available to researchers interested in the
quantitative assessment of LGBTQ microaggressions, the extent to which the
psychometric properties of these measures have been tested is highly variable.
Thus while researchers may increasingly recognize the importance of asses-
sing these subtle minority stressors, either specifically or as part of broader
discrimination constructs, the rigor with which they are measured may call
resultant claims about their prevalence and impact into question. Lilienfeld
(2017) recently raised this measure validity issue when expressing concern
about the state of microaggression research, calling on researchers to ensure
that measures are psychometrically robust and that claims about microag-
gressions’ effects are thoroughly tested. While the vast majority of researchers
with articles included in this sample reported the internal consistency of their
original scales, fewer than half of the measures in the current review reported
any type of validity testing.
Reliability
Assessing internal consistency is a critical component of measurement devel-
opment as this provides evidence of the homogeneity of items meant to
reflect the intended latent construct (DeVellis, 2012). The original microag-
gression-specific measures we identified, with few exceptions (i.e., Woodford
et al., 2015a), reported internal consistency reliability that exceeded the
commonly accepted alpha level of .70. This was also the case for the global
measures and/or their subscales (exception: Highlen et al., 2000).
Among our sample, only one study tested another type of reliability: test-
retest (Brewster & Moradi, 2010). Test-retest reliability is challenging to
assess for several reasons, such as contaminated responses at the retest
because participants previously completed the measures and the timing of
the retest (DeVellis, 2012). Brewster and Moradi (2010) conducted their
retest two weeks after the initial test and found evidence supporting the
test-retest reliability of their measure. Test-retest reliability may be particu-
larly difficult to assess for LGBTQ microaggressions and global
discrimination measures as these measures intend to capture participants’

experiences with everyday mistreatment which is not necessarily a stable
phenomenon (Nadal et al., 2010; Sue, 2010). Thus changes in discrimination
scores may actually reflect changes in the frequency participants experience
discrimination, yet test-retest validity would be poor in such cases (DeVellis,
2012). For example, respondents’ circumstances may change between the test
and retest period, such as from a high-microaggression environment to a
low-microaggression environment, making test-retest difficult to establish
without additional documentation of environmental and situational factors
simultaneously assessed. It was notable that no studies in this review con-
ducted split-half reliability tests; future research should explore this option
particularly when discrimination measures contain a large number of items.
Validity
Consistent with Morrison et al.’s (2016) review of global LGB discrimination
measures, our study reported a substantial lack of validity testing for mea-
sures of LGBTQ microaggressions. Without adequate validity testing, the
extent to which a named microaggression measure actually assesses micro-
aggressive experiences remains unknown (Singleton & Straits, 2017), and
researchers risk misclassifying experiences or failing to capture the breadth
of the experience under investigation.
Although the importance of face validity has been questioned by some
scholars (DeVellis, 2012), ensuring that a measure at least seems to assess the
intended phenomenon is a valuable initial step, as is the process of assessing
content validity by engaging experts and potential respondents. Both of these
were notably absent for the overwhelming majority of measures reviewed in
this study, however. With respect to the studies that examined criterion-
related validity, predictive validity was the only form examined. No study
examined incremental validity, which is a form of validity that Lilienfeld
(2017) emphasized as being necessary to substantiate claims about the effects
of microaggressions. Simply put, incremental validity involves testing “the
extent to which [the new measure] contributes meaningful information
above and beyond extant measures (Lilienfeld, 2017, p. 157, citing Meehl,
1959; Sechrest, 1963). Testing this form of validity for microaggression
measures is particularly important given theoretical claims about their
unique effects. Future research is needed to integrate incremental validity
testing into their psychometric testing of LGBTQ microaggressions measures.
The lack of thorough testing leaves the field of microaggressions research
open to the critique that the construct is under-conceptualized, lacking in the
measurement rigor to advance this area of inquiry (Lilienfeld, 2017).
Another notable finding from this scoping review was the virtual absence
of validity testing among the adapted versions of the original measures.
Issues with validity stemming from the original measures, as described above,
are compounded when these scales are adapted in subsequent studies without
undergoing psychometric testing. Even in cases where the validity of an
original scale was established, subsequent modifications (e.g., revising ques-
tion wording or response option) can alter question meaning and interpreta-
tion and thus nullify the psychometric testing performed on the original
measure. Although the considerable modifications to original measures
observed in this review suggests that researchers are readily adapting avail-
able measures to meet study, population, and contextual needs—presumably
a sign of a dynamic and growing field of research—the consequence of this
approach is that the overwhelming majority of current quantitative research
on LGBTQ microaggressions has been carried out using unvalidated
measures.
Adaptations
In addition to concerns about the lack of robust psychometric testing for
adapted measures, we noted that the term adapted itself ranged in meaning
from a small number of modifications (e.g., changes to reference period only)
to numerous changes (e.g., changing stem, item wording, response set,
reference period, and adding new items). This wide spectrum of adaptation
raises the question of what constitutes a measure that has been modified but
retains sufficient characteristics to reflect the original instrument and what
indicates modifications substantive enough that the measure should be
understood as an entirely new scale—and thus require full psychometric
testing. The second challenge in this area was that many adaptations were
not clearly described in the literature. We sought adapted measures when
possible and used all available details in each publication but noted the
persistent challenge that many adapted measures were simply not thoroughly
explained.
Limitations
This review has several limitations. First, measures published after November
16, 2016, were not included, nor were measures that lacked sufficient details
about the items in the identified document or in cases when the original scale
was not available (including from authors, when contacted). Thus the review
is not necessarily exhaustive of all existing measures. Second, because of the
constantly evolving language used to describe sexual and gender minorities
and related systems of oppression, our search terms may have failed to
capture all articles in this area leading to the unintentional exclusion of
some measures. Hence, selection bias may have impacted review findings.
Third, we relied on the information reported by authors, including details
about validity and reliability results. With respect to validity, we identified

studies that examined associations between the extracted measure and other
variables (e.g., depression, anxiety) that could be reflective of construct and/
or criterion-related validity (DeVellis, 2012); however, these were not inter-
preted as tests of validity for this review unless explicitly described as such by
the authors. We recommend that readers interested in these measures con-
sult original articles to determine if they consider these tests evidence of
validity. Fourth, in terms of adapted measures, it was not always clear how an
original measure had been modified. When possible, we assessed modifica-
tions by comparing the adapted measure with its original, but we acknowl-
edge that we may not have appropriately assessed such measures in our
review when information was lacking. Finally, given that our scoping review
aimed to identify available measures and their psychometric characteristics,
the study did not assess the procedures by which each measure was devel-
oped or the theoretical frameworks that guided each measure’s development.
Addressing this area, the extent to which both sexual and gender minority
individuals were included in measurement development (e.g., through focus
groups or community boards) and development of measures for multiple
languages are important areas of research for future reviews.
Conclusion
Microaggressions derive much of their power as a minority stressor from
their chronicity and ambiguity (Sue, 2010; Woodford et al., 2014b). These
factors often incite vigilance, distrust, and stress among LGBTQ individuals
across contexts such as the workplace, college campuses, the home, or when
seeking mental or physical health care (Sue, 2010; Woodford et al., 2014b,
2015b). The ubiquitous nature of microaggressions may also make them
particularly challenging to evaluate with cross-sectional research designs;
however, with emerging studies speaking to their negative association with
self-esteem and sexual minority identity development (Wright & Wegner,
2012) and positive association with anxiety, depressive symptoms, and sui-
cidality (Ratliff, Sterzing, & Gartner, Under Review; Woodford et al., 2014b),
it is crucial that researchers and clinicians address the pressing issue of
microaggressions measurement (Lilienfeld, 2017). The growing field of
LGBTQ microaggressions research has made significant strides, presenting
important opportunities to advance our understanding of these everyday
discriminatory experiences.
The current psychometric scoping review synthesized the depth, breadth,
and rigor of measurement tools available to LGBTQ microaggression
researchers. This review identified important gaps in measurement of
LGBTQ microaggressions broadly but also raises issues regarding the applic-
ability of measures for specific LGBTQ subpopulations. Some groups (e.g.,
individuals identifying as genderqueer or those with multiple minority sta-

tuses) have notably fewer tools available to assess their experiences. The
practice of adapting measures designed for lesbian women and/or gay men
by simply changing out identity terms most likely fails to capture the unique,
thematic content of microaggressions specific to these subpopulations. At
present, our review revealed only one measure designed to assess microag-
gressions from the LGBTQ community and their racial and ethnic minority
community (i.e., LGBT People of Color Microaggressions Scale; Balsam et al.,
2011).
Additionally, this psychometric scoping review highlights aspects of measure-
ment innovation on which future researchers can build. Measure adaptations
demonstrate that researchers are interested in assessing LGBTQ microaggres-
sions with new populations and within new contexts. The evolution of measure-
ment represents an opportunity to examine and extend existing theoretical
frameworks used to explain microaggressions, including their causes, intersec-
tional experiences, and consequences, for LGBTQ individuals. Practitioners who
work with LGBTQ individuals can also benefit from measurement innovation:
as researchers continue to create more rigorous, contextually relevant measures
LGBTQ microaggressions, they increase the likelihood of them being used in
practice environments. For example, “gold standard” microaggression measures
could be more consistently used to assess subtle LGBTQ discrimination in
middle and high schools, universities, workplace settings, and family systems.
This move from research to practice has the potential to shed light on LGBTQ
microaggressions that, by definition, are often unseen, unacknowledged, and
isolating social experiences. As microaggressions remain a powerful and under-
explored mechanism of oppression, this study helps to both advance methodo-
logical quality in this critical research area and enhance our understanding of
how microaggressions manifest in the lives of sexual and gender minorities.
Disclosure statement
No potential conflict of interest was reported by the authors.
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Advancing Research on LGBTQ Microaggressions: A

Colleen M. Fisher, Michael R. Woodford, Rachel E. Gartner, Paul R. Sterzing &

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Advancing Research on LGBTQ Microaggressions: A

Microaggressions are subtle slights, invalidations, and insults that target

comments and/or actions as a joke or misunderstanding (Sue, 2010). Initially

assessing microaggressions (Lau & Williams, 2010). Although Lilienfeld (2017)

LGBTQ microaggressions and quantitative research

Straits, 2017), little guidance is available to LGBTQ microaggression

Selecting documents for inclusion

Charting the data

or tests of measure dimensionality (including exploratory and confirmatory

Sample characteristics of original measures

100% SM; 16% GIM; 51% F

Measure of Heterosexist 20 n/a SO (n = 25) α = .90 n.r.

(4) Discrimination Events [4] (4) α = .75,

Psychometric properties of original measures

multidimensional scales to conduct an EFA and CFA to both explore and

Adaptions of original measures

Instrument Modifications Study N Sample Demographicsa Reliabilityb Validityc

(2016) SM; 50.3% F

Daily Heterosexist Experiences Questionnaire [DHEQ]

of origin, isolation] (2016)

the Personal Heterosexist Harassment subscale, which they adapted from

discrimination measures as these measures intend to capture participants’

about validity and reliability results. With respect to validity, we identified

individuals identifying as genderqueer or those with multiple minority sta-

adults. Measurement and Evaluation in Counseling and Development, 46(1), 3–25.

sexual minority individuals. Journal of Counseling Psychology, 62(2), 226. doi:10.1037/

Oshi-Ojuri, M. F. (2013). A quantitative look at the impact of microaggressions on the

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