Introduction: Sexual minority emerging adults in Appalachia face multiple sources of stigma and discrimination.
Methods: We conducted four focus groups and five one-on-one interviews with sexual minority young adults and community stakeholders.
Results: Themes emerged from qualitative analysis: 1) Appalachian culture engenders discrimination and isolation; 2) A need to identify safe spaces; 3) Lack of access to identity-affirming health services; and 4) participants draw strength from limited but persistent resistance, advocacy, and visibility.
Conclusion: Sexual minority emegerging adults experience intersectional stigma in a socially conservative Appalachian setting. Attention to their unique experiences points towards specific service and community support needs.
Keywords: lived experience; qualitative; sexual orientation; thematic analysis; young adults.