Minority stressors, protective factors and mental health outcomes in lesbian, gay and bisexual people in the UK

Abstract

Two cross-sectional survey studies were conducted to examine the relationships between minority stressors, protective factors and mental health outcomes in lesbian, gay and bisexual people (LGB) in the United Kingdom (UK). A convenience sample of 156 LGB people in the UK participated in Study 1. Multiple regression analyses showed that victimization and sexuality-related identity threat were positively associated with anxiety and that identity resilience, social support and degree of outness were negative correlates; and that rejection was positively associated with depression while identity resilience and social support were negative correlates. In Study 2, based on a convenience sample of 333 gay men, our structural equation model showed that ethnic minority status, lower identity resilience and higher identity threat were associated with greater distress; ethnic minority status was associated with less social support and more internalized homonegativity; being single was associated with less social support and more internalized homonegativity; identity resilience was positively associated with social support and negatively associated with internalized homonegativity; identity threat was associated with less social support and more internalized homonegativity; internalized homonegativity was negatively associated with social support; and social support was negatively associated with distress while internalized homonegativity was positively associated with distress. Findings show differential effects of particular stressors on particular mental health outcomes in LGB people and the significance of promoting identity resilience, social support and degree of outness as protective factors. KeywordsMinority stress; identity resilience; identity threat; internalized homonegativity; social support; mental health stressors and protective factors relate to particular mental health outcomes and how they operate collectively as part of a social psychological system of factors determining psychological health. In two survey studies, we focus on the social psychological determinants of three mental health outcomes: distress, anxiety and depression. Minority stress and identity processesThe two studies reported in this article are guided by a theoretical framework consisting of minority stress theory (Meyer, 2003) and identity process theory (IPT) (Breakwell, 2015; Jaspal & Breakwell, 2014).Minority stress theory postulates that, as stigmatized minorities, LGB people are exposed to distal stressors, which are external and directed at them by other people, and proximal stressors, which are internal processes arising primarily through exposure to distal stressors. Exposure to these stressors has been found to undermine mental health (Meyer, 2003). Yet, the theory also posits that factors, such as access to social support, can operate protectively against these stressors and minimize their capacity to undermine mental health (Feinstein et al., 2014). In Study 1, we focus on the associations with anxiety and depression of dista...

‘Bigotry is all around us, and we have to deal with that’: Exploring LGBTQ+ young people’s experiences and understandings of health inequalities in North East England.

“…In relation to formal healthcare settings, participants of the wider research project that this paper draws from have highlighted the negative impacts of limitations of child and adolescent mental health services (CAMHS), particularly increasing waiting times, on the young people who try to engage with them (Holding et al, 2022). Our participants argued that CAMHS are not serving LGBTQ þ young people appropriately, despite their increased risk of mental health problems (Carlile, 2020;Jaspal et al, 2022;Westwood et al, 2020). Further, adults in positions of authority acting in discriminatory ways compounded mental and emotional distress.…”

“…Lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual/agenderþ (LGBTQ þ hereafter) people report poorer health and worse experiences of healthcare than the general population (McDermott, Gabb, et al, 2021;Carlile, 2020;Westwood et al, 2020;Gnan et al, 2019;Jaspal et al, 2022). In line with a social determinants of health (SDH) perspective, this paper looks beyond the healthcare setting to view health as situated within wider complex health systems, by reflecting on injustices that result from power imbalances and unequal access to resources and reduced opportunities to lead healthier lives (Marmot et al, 2020).…”

Chemsex, Identity and Sexual Health among Gay and Bisexual Men

“…Proximal stressors reflect the individual's internal response to these events, such as internalized homonegativity, that is, the acceptance of negative social representations of their sexual orientation. It has been found that these distinct types of stressors may contribute differently to depressive and anxious symptomatology in sexual minorities [52,53]. In order to understand how and why particular types of stressors affect mental health, it is important to understand the individual's sense of identity.…”

“…This has conversely been a key focus of identity process theory. Jaspal and colleagues [44,52] have shown that minority stressors that cause identity threat, that is, those that succeed in curtailing feelings of self-esteem, self-efficacy, positive distinctiveness and self-efficacy, tend to be associated with greater levels of distress, anxiety and depression. It seems important, therefore, to measure not only reported exposure to stressors and which ones but also the ways in which they impact on identity processes in gay and bisexual men.…”

“…Chronic prejudice due to one's sexual orientation (and its corollary, internalized homonegativity) can lead to feelings of distress, which reflects poor mental health [52]. Chronic prejudice not only increases the risk of internalized homonegativity, whereby gay and bisexual men may find it difficult to develop, sustain and nurture intimate relationships, but also stimulates fear of rejection.…”