Gun Violence Exposure, Social Safety, and Cognitive Health Among Sexual and Gender Minority Populations in the United States: A Systematic Review
Garima Siwach, Circe Le CompteBackground
Sexual and gender minority (SGM) populations experience disproportionately high rates of gun violence, hate crimes, and intimate partner violence, yet the cognitive consequences of these exposures have not been systematically reviewed. Despite strong evidence that chronic stress and trauma can disrupt neurobiology, no prior review has focused on the relationship between gun violence and related violence or discrimination exposures and cognitive function among SGM populations in the United States.
Objectives
To synthesize available research on how gun violence and related violence or discrimination exposures relate to cognitive function across the life course among SGM populations in the United States, using minority stress theory and Social Safety Theory to interpret observed patterns and mechanisms.
Methods
A systematic review of PubMed, Scopus, Web of Science, PsycINFO, and Google Scholar was conducted for studies published between 2000 and 2026, following PRISMA 2020 guidelines. Eligible studies included SGM populations, assessed violence or discrimination exposure, and reported cognitive or neurocognitive outcomes. Quantitative, qualitative, and mixed-methods designs were included, and narrative synthesis was used because of heterogeneity in exposures, measures, and analytic approaches.
Results
Forty studies met inclusion criteria (total N = 148,963 participants). Across study designs, gun violence and related violence or discrimination exposures were generally associated with poorer cognitive outcomes, including lower global cognitive scores, faster cognitive decline, and more subjective cognitive complaints. Depression, PTSD, sleep disruption, and social isolation emerged as key mediating pathways in observational analyses.
Conclusions
Gun violence exposure and related violence and discrimination appear to be important and potentially modifiable determinants of cognitive health disparities among SGM populations in the United States. These findings support the need for SGM-affirming, trauma-informed cognitive health interventions and policies that reduce firearm violence and structural stigma. Addressing gun violence alongside minority stress, social isolation, and sleep disruption may help protect cognitive health in this structurally marginalized population, although causal pathways remain to be established in prospective studies.