Spiritual Pathways to Aging and Emotional Well-Being through Indigenous Cultural Generativity Among Native American LGBTQ+ and Two-Spirit People

Background and Purpose: This study examined how Indigenous cultural generativity and spirituality influence emotional well-being among Native American Two-Spirit and LGBTQ+ (Native 2S/LGBTQ+) people. Although Native 2S/LGBTQ+ communities experience disproportionate mental health challenges, emerging research suggests that Indigenous cultural generativity and spirituality may serve as key sources of strength and healing. We also explored whether age moderates these relationships. Methods: We conducted a secondary data analysis of the HONOR Project (R0165871), the largest cross-sectional study of Native 2S/LGBTQ+ health to date (N = 447). Using path analysis testing, we tested whether spirituality mediated the association between Indigenous cultural generativity and emotional well-being, and whether age moderated this indirect pathway. Results: Indigenous cultural generativity was significantly associated with emotional well-being, with evidence of full mediation through spirituality (indirect effect β = 0.12, p = .002). Age significantly moderated the pathway linking generativity to spirituality (β = 0.03, p = .038), with Native 2S/LGBTQ+ participants aged 50 years and older demonstrating a pattern consistent with a stronger indirect effect (β = 0.12) compared to those under 50 (β = 0.09), indicating that spirituality played a more pronounced role in linking Indigenous cultural generativity to emotional well-being among Native 2S/LGBTQ+ Elders. Conclusions and Implications: These findings underscore the importance of Indigenous cultural generativity and spirituality as potential protective factors for emotional well-being among Native 2S/LGBTQ+ people. Efforts to strengthen intergenerational connections and embed cultural and spiritual practices into health and aging services hold promise for promoting emotional-wellbeing, particularly among Native 2S/LGBTQ+ Elders.