LGBTQ individuals’ lived experiences of hypervigilance.

Abstract

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are at risk for poorer health outcomes in part because of stigma, discrimination, victimization, and resulting trauma and stress. Stigmarelated stress can lead to hypervigilance, or a chronic and pervasive state of alertness and readiness to respond to potential threats in the environment. The current study is one of the first to explore LGBTQidentified individuals' lived experiences of hypervigilance. In a brief online format, participants (N = 245) completed demographic items and were asked to describe their experiences of hypervigilance and its impact on their lives. Participants reported over 30 negative emotions that accompanied hypervigilance; anxiety, fear, and exhaustion were the most common. Negative emotional reactions occurred in public and private settings and with family, coworkers, strangers, and others perceived to be prejudiced. Participants self-monitored and socially withdrew in efforts to protect themselves from stress and risk of harm. Service providers and researchers should assess hypervigilance in LGBTQ individuals and examine the impact on health and well-being while working to combat stigma and advocate for protective and equitable social policies. Public Significance StatementLesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals described their lived experience of hypervigilance, a chronic and pervasive stress response to direct and indirect experiences of stigma and discrimination.They were hypervigilant for potential harm as they interacted in public and private and when interacting with certain family members, coworkers, community members, and strangers they perceived to be prejudiced against LGBTQ people. Hypervigilance was often accompanied by negative emotions and social avoidance/isolation.

A measure of hypervigilance in LGBTQ-identified individuals.

“…The term hypervigilance has been used in past studies of LGBTQ-identified individuals; however, more attention is needed to define and operationalize the term as it applies specifically to LGBTQ-identified individuals. The current study suggests a factor structure and measure of hypervigilance in LGBTQ-identified individuals consistent with previous qualitative findings (Rostosky et al, 2021) and the conceptual dimensions of studies of hypervigilance in non-LGBTQ samples. The findings of the present study expand our understanding of the domains of hypervigilance experienced by LGBTQ-identified individuals and their relative associations with psychological health outcomes.…”

“…We followed steps recommended by Boateng et al (2018) for scale construction and planned analyses. Item statements were created based on qualitative data provided by Rostosky et al (2021). The qualitative data were read for common statements associated with the themes of where (in what locations or settings) and around whom hypervigilance occurred, and the specific hypervigilant behaviors participants reported.…”

“…A qualitative study focused on exploring hypervigilance in an LGBTQ sample (Rostosky et al, 2021) found that hypervigilance was experienced around family, coworkers, strangers, and people perceived to be prejudiced or anti-LGBTQ (such as conservatives). Participants in the study reported hypervigilance in several locations or settings, such as at work, or in rural areas, bars and restaurants, conservative religious spaces or institutions, and public restrooms.…”

“…Recent qualitative work suggests that hypervigilance in LGBTQ-identified individuals is a complex concept with multiple dimensions. These dimensions include feelings of hypervigilance in public and private spaces and when around family, coworkers, strangers, and others who are perceived to be prejudiced; and behavioral responses such as self-monitoring and social withdrawal (Rostosky et al, 2021). The current study constructed statements reflecting these dimensions to create an LGBTQ-specific measure of hypervigilance.…”

Monitoring patients’ sexual orientation and gender identity: Can we ask? Should we ask? How do we ask?

“…1 We know that LGBT+ individuals may have encountered accumulative experiences of stigma and discrimination across their lives, which can have a negative impact on their health and can even have some bearing on their life expectancy. 2 The fear of stigma and discrimination can also impact on LGBT+ people accessing timely healthcare. Furthermore, there are barriers in our healthcare systems that increase these health inequities.…”