Minority stress and mental and sexual health: Examining the psychological mediation framework among gay and bisexual men.

Schwartz, Danielle R.; Stratton, Natalie; Hart, Trevor A.

doi:10.1037/sgd0000180

Cited by 68 publications

(79 citation statements)

References 76 publications

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“…As mentioned above, starting from a clinical view of stress and with the aim of extending the MST, the PMF was postulated as a theoretical framework to better understand psychological pathways that link minority stressors to negative health outcomes. Previous studies have empirically supported the validity of the PMF, both in LG [ 28 , 29 ] and transgender and gender nonconforming [ 30 , 31 , 32 ] people.…”

Section: Introductionmentioning

confidence: 96%

Parenting Desire and Minority Stress in Lesbians and Gay Men: A Mediation Framework

Amodeo

Esposito

Bochicchio

et al. 2018

IJERPH

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Despite the rapid increase in lesbian and gay (LG) people who desire and decide to become parents, LG childless individuals may encounter serious obstacles in the parenthood process, such as minority stress. Notwithstanding, the psychological processes by which prejudice events might affect the desire to become parents are still understudied. As an extension of the minority stress theory, the psychological mediation framework sheds light on these psychological processes, as it encompasses a more clinical view of stress. Within this framework, the current study aimed at assessing the role of prejudice events in affecting parenting desire in 290 childless Italian LG individuals (120 lesbians and 170 gay men), as well as the role of internalized heterosexism and sexual orientation concealment in mediating the relationship between prejudice events and parenting desire. The results suggest that only in lesbians prejudice events were negatively associated with parenting desire, and that sexual orientation concealment and internalized heterosexism were also negatively associated with parenting desire. Furthermore, sexual orientation concealment, and not internalized heterosexism, mediated the relationship between prejudice events and parenting desire in lesbians, but not gay men. The findings have important implications for clinical practice.

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Section: Introductionmentioning

confidence: 96%

Parenting Desire and Minority Stress in Lesbians and Gay Men: A Mediation Framework

Amodeo

Esposito

Bochicchio

et al. 2018

IJERPH

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“…Recent works have supported the PMF within sexual minority populations, including lesbian, gay, and bisexual cisgender people [ 29 , 30 ]. On the contrary, only a few studies have applied the PMF to the TGNC population.…”

Section: Introductionmentioning

confidence: 99%

Internalized Transphobia, Resilience, and Mental Health: Applying the Psychological Mediation Framework to Italian Transgender Individuals

Scandurra

Bochicchio

Amodeo

et al. 2018

IJERPH

103

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Transgender and gender nonconforming (TGNC) people are a highly-stigmatized population. For this reason, they might internalize society’s normative gender attitudes and develop negative mental health outcomes. As an extension of the minority stress model, the psychological mediation framework sheds light on psychological processes through which anti-transgender discrimination might affect mental health. Within this framework, the current study aimed at assessing in 149 TGNC Italian individuals the role of internalized transphobia as a mediator between anti-transgender discrimination and mental health, considering resilience as the individual-level coping mechanism buffering this relationship. The results suggest that both indicators of internalized transphobia (i.e., shame and alienation) mediate the relationship between anti-transgender discrimination and depression, while only alienation mediates the relationship between anti-transgender discrimination and anxiety. Furthermore, the results suggest that the indirect relation between anti-transgender discrimination and anxiety through alienation is conditional on low and moderate levels of resilience. Findings have important implications for clinical practice and psycho-social interventions to reduce stigma and stress caused by interpersonal and individual stigma.

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“…[ 46 ] Several potential mechanisms for these relationships have been described, including emotional dysregulation, anxiety, and depression. [ 13 , 46 – 48 ] Despite low levels of internalized homophobia in our cohort (represented by low MAGI-MSV scores), the overall levels of self-reported lifetime discrimination were high (59%). These findings underscore the role of broader social forces in driving health outcomes in MSM, as abundantly illustrated in literature from diverse global settings,[ 49 , 50 ] and highlight the need for advocacy and structural change as part of a combination HIV prevention approach.…”

Section: Discussionmentioning

confidence: 78%

High prevalence of syndemic health problems in patients seeking post-exposure prophylaxis for sexual exposures to HIV

et al. 2018

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IntroductionThe standard clinical approach to non-occupational HIV post-exposure prophylaxis (nPEP) focuses on biomedical aspects of the intervention, but may overlook co-occurring or ‘syndemic’ psychosocial problems that reinforce future vulnerability to HIV. We therefore sought to determine the prevalence of syndemic health problems in a cohort of Ontario nPEP patients, and explored the relationship between syndemic burden and HIV risk.MethodsBetween 07/2013-08/2016, we distributed a self-administered questionnaire to patients presenting to three clinics in Toronto and Ottawa seeking nPEP for sexual HIV exposures. We used validated screening tools to estimate the prevalence of depression (CES-D score ≥16), harmful alcohol use (AUDIT ≥8), problematic drug use (DUDIT ≥6 men/≥2 women), and sexual compulsivity (SCS ≥24) among men who have sex with men (MSM) respondents. In exploratory analyses, we examined the relationships between syndemic conditions using univariable logistic regression models, and the relationship between syndemic count (total number of syndemic conditions per participant) and HIV risk, as estimated by the HIRI-MSM score, using linear regression models.ResultsThe 186 MSM included in the analysis had median age 31 (IQR = 26–36), including 87.6% having a college/undergraduate degree or higher. Overall, 53.8% screened positive for depression, 34.4% for harmful alcohol use, 30.1% for problematic drug use, and 16.1% for sexual compulsivity. Most participants (74.2%) had at least one syndemic condition and 46.8% had more than one. Exploratory analyses suggested positive associations between depression and harmful alcohol use (OR = 2.11, 95%CI = 1.13, 3.94) and between harmful alcohol use and problematic drug use (OR = 1.22, 95%CI = 0.65, 2.29). Syndemic count was associated with increased HIRI-MSM risk scores in univariable (2.2, 95%CI = 1.0, 3.3 per syndemic condition) and multivariable (2.1, 95%CI = 0.6, 3.6) linear regression models.ConclusionsThe prevalence of syndemic conditions in MSM seeking nPEP for sexual exposure is alarmingly high, and is associated with underlying HIV risk. Routine screening for these conditions may identify opportunities for intervention and could alleviate future vulnerability to HIV.

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Minority stress and mental and sexual health: Examining the psychological mediation framework among gay and bisexual men.

Cited by 68 publications

References 76 publications

Parenting Desire and Minority Stress in Lesbians and Gay Men: A Mediation Framework

Parenting Desire and Minority Stress in Lesbians and Gay Men: A Mediation Framework

Internalized Transphobia, Resilience, and Mental Health: Applying the Psychological Mediation Framework to Italian Transgender Individuals

High prevalence of syndemic health problems in patients seeking post-exposure prophylaxis for sexual exposures to HIV

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