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Minority Stress and Mental Health in Gay Men
Abstract
This study describes stress as derived from minority status and explores its effect on psychological distress in gay men. The concept of minority stress is based on the premise that gay people in a heterosexist society are subjected to chronic stress related to their stigmatization. Minority stressors were conceptualized as: internalized homophobia, which relates to gay men's direction of societal negative attitudes toward the self; stigma, which relates to expectations of rejection and discrimination; and actual experiences of discrimination and violence. The mental health effects of the three minority stressors were tested in a community sample of 741 New York City gay men. The results supported minority stress hypotheses: each of the stressors had a significant independent association with a variety of mental health measures. Odds ratios suggested that men who had high levels of minority stress were twice to three times as likely to suffer also from high levels of distress.
... In this regard, various personal, cultural, and social variables were identified in previous studies as protective or risk factors against homophobia. It is also important to mention the minority stress model, based on the social stress theory, which posits that stress can be influenced not only by personal events but also by the social environment (Meyer, 2003) According to this model, discrimination and prejudice rooted in the stigmatization of identity (e.g., race, gender, and sexuality) comprise a powerful and persistent source of stress (Meyer, 1995). Thus, according to the minority stress model, individuals belonging to a minority social group, such as sexual minorities, experience elevated level of stress due to their social position (Meyer, 2003), and this stress that may span multiple generations (Meyer, 2003). ...
The present study aimed to examine some potential predictors of homophobia
against lesbians and gay individuals. Our sample comprised 722 heterosexual
participants aged 18–74, mostly women (self-reported gender; 224 men and
498 women) with various educational backgrounds (i.e., High School, Bachelor’s,
and Master’s degrees). Participants filled in self-reported scales measuring
sexual orientation beliefs (incremental vs. entity views), religiosity, social media
use, and perceived gender-transcendent social roles. Correlation analyses and
multiple regression models were computed separately for men and women. For
all participants, homophobia against lesbians (HAL) was negatively associated
with participants’ age, religiosity, and gender-transcendent social roles and
positively with incremental views about sexuality. However, only in the case of
women was HAL positively related to social media use. Next, for both men and
women, homophobia against gay individuals (HAG) was negatively related to age,
religiosity, and gender-transcendent social roles. However, only in the case of
women, HAG was positively related to social media use online and incremental
views about sexuality. In the case of men, the most significant predictor of HAL
was the perceived gender-transcendent social roles and HAG – perceived genderlinked social roles. For women, perceived gender-linked social roles were the
most significant predictor of both HAL and HAG. Results are discussed regarding
their use for interventions aimed at reducing homophobia among heterosexual
individuals.
... Minority stress theory [31] suggests that TNB people likely experience increased socio-environmental stressors that can lead to substance use as a coping mechanism [32,33]. Both external and internal stressors, such as violence and internalized stigma, may induce psychological distress and lead to substance use [33][34][35]. Experiencing violence and stigma are associated with increased use of tobacco, alcohol, and nonmedical prescription drugs among TNB populations [22,[36][37][38][39], giving credence to this theory. However, stigmas and gender norms affect separate sub-groups of TNB people differently due to varied experiences of gender identity and expression, cultural norms, health systems, socio-economic realities, and geographic location [40,41]. ...
Background
Transgender and non-binary (TNB) people are at high risk of substance misuse compared to cisgender individuals. Few studies have described substance use among non-binary people, and many studies have focused solely on samples from Western countries. In this global study of TNB people, we sought to identify intra-group differences, risk factors, and COVID-related changes in the use of tobacco, alcohol, and cannabis.
Methods
We used cross-sectional data from 926 TNB users of the Hornet app across 76 countries between October and November 2020. Participants self-reported the use of tobacco, alcohol, and cannabis in the past 6 months and any changes in use during the pandemic. We generated descriptive statistics and used logistic regression to assess substance use between TNB subgroups, identify risk factors for each substance by gender identity, and identify changes in substance use before and during the pandemic.
Results
Most TNB participants used tobacco (53.7%, n = 498) and alcohol (66.3%, n = 614). Non-binary participants had increased odds of using cannabis (adjusted odds ratio: 1.62, 95% CI 1.03, 2.55) compared to transfeminine participants. Participants’ geographic region of residence was most associated with higher substance use, compared to other potential factors. Most participants reported increases in at least one substance during COVID-19 (54.2%, n = 276 of 518 responses).
Conclusions
In this global TNB sample, we found that substance use varied by gender identity, and changes in substance use during the pandemic varied by TNB sub-groups. We join researchers calling for gender-specific tailoring of substance-related services for TNB clients and urge further studies with greater inclusion and disaggregation of non-binary and transmasculine individuals to support better-informed analysis of transgender health.
Actualmente, la automedicación es un enigma para el sistema de salud y sus miembrosprofesionales, debido a que su origen y resolución son complicados, al igual que los beneficios yperjuicios de donde de esta práctica diaria emergen. Objetivo: determinar las características ycomportamientos que llevan a los usuarios hacia la automedicación para concientización propia delos lectores del presente artículo. Materiales y métodos: Estudio no experimental de tipodescriptivo, prospectivo, transversal, observacional y bibliográfico, aplicando una encuesta duranteel período mayo – septiembre de 2020. La selección de la población fue por muestreo sistemático.Participaron 60 usuarios de la ciudad de Portoviejo, Ecuador. Resultados: El 70% mujeres y 30%hombres. El 40%. 25 – 31 años adultos jóvenes, 35% del rango de edad entre 18 – 24 años y porúltimo el límite de 32 años en adelante 25%. El 70% asume haber consumido medicamentos estosúltimos meses. El tipo de medicamentos que se consume frecuentemente son los analgésicos(diclofenaco, paracetamol) 75%, antinflamatorios (ibuprofeno) 20% y antibióticos (Amoxicilina,ciprofloxacino, cefalexina, azitromicina) 5%. La frecuencia de consumo de antimicrobianos es 82%de al menos una vez al mes, 11% de 2 o 3 veces por semana y todos los días 7%. El 45% seautomedican por los motivos de que cuentan con escaso tiempo para ir al médico, 33% paradificultad del acceso al servicio de salud 22% para una existencia de mala calidad para atención alservicio de salud. Para el 92% no es seguro automedicarse. El 80% menciona que losantimicrobianos si producen resistencia. En el 60% revelan que cuando sienten que presentan síntomas de malestar, Si acude al médico. El 64% consideró que no continuará automedicándose. El78% si acostumbran leer los insertos que hay dentro de las cajas de los productos médicos, 22% no.El 53% reveló que recomienda medicación a otra persona o familiar y 47% personas no. Y para el100% automedicarse si es dañino para la salud. Conclusiones: Existe un alto porcentaje derecomendación de medicamentos hacia otras personas y de frecuente consumo, los analgésicos.
La homofobia es y ha sido una de las problemáticas más comunes alrededor del mundo. Poresta razón el objetivo del artículo es concientizar a la sociedad en torno a la lucha contra lahomofobia promoviendo el respeto hacia todas las personas sin importar su género o suorientación sexual.La homofobia se ve representada a través de actitudes y comportamientos discriminatoriosen contra de la comunidad LGBTI, estas conductas tienen un efecto directo en estacomunidad ya que la mayoría de estos son rechazados y marginados, violentando susderechos.Se realizó un estudio de carácter descriptivo y de corte longitudinal, en el que se aplicó unaencuesta de 10 preguntas a una muestra de 50 personas con el fin de comprender elconocimiento de la sociedad relacionado al tema de la homosexualidad y homofobia. Con los resultados se evidencio que a pesar que la mayoría tiene conocimiento sobre este temano se absuelve a las personas de sufrir bullying por tener una orientación sexual diferente.Las personas que han sufrido de ataques homofóbicos tienen problemas al desarrollarsesocialmente, sentimentalmente y sexualmente, también tienden a tener adicciones asustancias ilegales, a aceptar maltratos, burlas y ofensas debido a su baja autoestima,muchas han terminado en el suicidio debido a la discriminación. Por esta razón se debefomentar el respeto y la tolerancia en todos los espacios, desde el hogar, planteleseducativos y laborales promoviendo los derechos de todas las personas sin distinción.
Background
Little information is available on the association between gender nonconformity during adolescence and subsequent mental health. While the distress related to gender nonconformity may be socially produced rather than attributed to individual-level factors, further research is needed to better understand the role of psychosocial factors in this context.
Method
We analyzed data from the Tokyo Teen Cohort, obtained through random sampling of adolescents born between 2002 and 2004. We used inverse probability weighting to examine the association of gender nonconformity at ages 12 and 14 as a time-varying variable with subsequent mental health at age 16, while accounting for time-fixed and time-varying confounders. Furthermore, we used a weighting approach to investigate the mediating role of modifiable psychosocial factors in this association, addressing exposure-mediator and mediator–mediator interactions.
Results
A total of 3171 participants were analyzed. Persistent gender nonconforming behavior at ages 12 and 14 was associated with subsequent depression ( β = 2.02, 95% confidence interval [CI] 0.85 to 3.19) and psychotic experiences ( β = 0.33, 95% CI 0.14 to 0.52) at age 16. The results remained robust in sensitivity analyses. Approximately 30% of the association between gender nonconformity and depression was consistently mediated by a set of psychosocial factors, namely loneliness, bullying victimization, and relationships with mother, father, and friends.
Conclusions
Persistent gender nonconformity during adolescence is associated with subsequent mental health. Psychosocial factors play a vital mediating role in this association, highlighting the essential need for social intervention and change to reduce stigmatization and ameliorate mental health challenges.
Child sexual abuse (CSA) is pervasive internationally, and has significant impacts on victim-survivors into adulthood. The most appropriate way to address this problem is prevention and early intervention of perpetration. Stigma experienced by people with paedophilia (PWP) is associated with refusal to seek and engage in therapeutic care, and nonadherence to treatment plans. Fear of rejection or unfair practice by healthcare professionals is a specific barrier. This scoping review aims to examine stigmatisation of individuals with a sexual interest in children or adolescents (paedophilia), and how stigma may impact (a) the help-seeking behaviour and disclosure, and (b) treatment professionals' willingness to treat this population. The influence of stigma on therapeutic outcomes and effectiveness was further explored to illuminate barriers and facilitators to treatment for PWP. In line with the Systematic Reviews and Meta-Analysis for Scoping Review (PRISMA-ScR) guidelines, relevant databases were searched (e.g., PsycInfo, EbscoHost) and screened independently. Eligible studies were focused on the impact of stigma on help-seeking and disclosure, published between 2000 and 2022, and English-language. Themes reflect experiences of internalised stigma, public and familial stigmatisation, professional stigma, and how these function as barriers to accessing help or disclosing one's sexual attraction to informal (e.g., close friends, family) and formal (e.g., mental health professionals, GPs, religious leaders) supports. As demonstrated by the papers reviewed, there is a clear and timely need for increased intervention and treatment. Specialist training for treatment professionals is needed to improve service accessibility and competences in treating clients who disclose this attraction. http://mc.manuscriptcentral.com/sajrt Sexual Abuse F o r P e e r R e v i e w Abstract Child sexual abuse (CSA) is pervasive internationally, and has significant impacts on victim-survivors
Lesbian, Gay, Bisexual, Transgender and Queer Access to Mental Health Services.
Social stress can be caused by many factors. The United Nations Convention on the Rights of Persons with Disabilities (CRPD) highlights many social stressors disabled people experience in their daily lives. How social stressors experienced by disabled people are discussed in the academic literature and what data are generated influence social-stressor related policies, education, and research. Therefore, the aim of our study was to better understand the academic coverage of social stressors experienced by disabled people. We performed a scoping review study of academic abstracts employing SCOPUS, the 70 databases of EBSCO-HOST and Web of Science, and a directed qualitative content analysis to achieve our aim. Using many different search strategies, we found few to no abstracts covering social stressors experienced by disabled people. Of the 1809 abstracts obtained using various stress-related phrases and disability terms, we found a bias towards covering disabled people as stressors for others. Seventeen abstracts mentioned social stressors experienced by disabled people. Fourteen abstracts flagged “disability” as the stressor. No abstract contained stress phrases specific to social stressors disabled people experience, such as “disablism stress*” or “ableism stress*”. Of the abstracts containing equity, diversity, and inclusion phrases and policy frameworks, only one was relevant, and none of the abstracts covering emergency and disaster discussions, stress-identifying technologies, or science and technology governance were relevant. Anxiety is one consequence of social stressors. We found no abstract that contained anxiety phrases that are specific to social stressors disabled people experience, such as “ableism anxiety”, “disablism anxiety” or “disability anxiety”. Within the 1809 abstract, only one stated that a social stressor is a cause of anxiety. Finally, of the abstracts that contained anxiety phrases linked to a changing natural environment, such as “climate anxiety”, none were relevant. Our study found many gaps in the academic literature that should be fixed and with that highlights many opportunities.
Recent research shows that the crucial factor determining the rejection of former mental patients is their behavior rather than their stigmantized status. The study reported here, based on a vignette experiment (with a design that varies patient status with the nature of behavior), challenges this conclusion. Like previous research, it indicates that a simple assessment of labelings shows little effect on a social distance scale. However, when a measure of perceived dangerousness of mental patients is introduced, strong labeling effects emerge. Specifically, the data reveal that the lable of "previous hospitalization" fosters high social distance among those who perceive mental patients to be dangerous and low social distance among those who do not see patients as a threat. It appears that past investigators have missed these effects because they have averaged excessively lenient responses with excessively rejecting ones. This suggests that labels play an important role in how former mental patients are p...
Although several psychological theories predict that members of stigmatized groups should have low global self-esteem, empirical research typically does not support this prediction. It is proposed here that this discrepancy may be explained by considering the ways in which membership in a stigmatized group may protect the self-concept. It is proposed that members of stigmatized groups may (a) attribute negative feedback to prejudice against their group, (b) compare their outcomes with those of the ingroup, rather than with the relatively advantaged outgroup, and (c) selectively devalue those dimensions on which their group fares poorly and value those dimensions on which their group excels. Evidence for each of these processes and their consequences for self-esteem and motivation is reviewed. Factors that moderate the use of these strategies and implications of this analysis for treatment of stigmas are also discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This article describes some of the major psychosocial challenges faced by lesbian and gay male survivors of hate crimes, their significant others, and the gay community as a whole. When an individual is attacked because she or he is perceived to be gay, the negative mental health consequences of victimization converge with those resulting from societal heterosexism to create a unique set of problems. Such victimization represents a crisis for the individual, creating opportunities for growth as well as risks for impairment. The principal risk associated with anti-gay victimization is that the survivor's homosexuality becomes directly linked to her or his newly heightened sense of vulnerability. The problems faced by lesbian and gay male victims of sexual assault, and the psychological impact of verbal abuse also are discussed. Suggestions are offered to assist practitioners in helping the survivors of anti-gay hate crimes.
Thomas Scheff's labeling approach to mental illness is based on reactions of other to "residual rule-breaking." This article develops a theory of self-labeling processes to account for the unexplained phenomenon of voluntary treatment seeking. By taking the role of the generalized other, individual can assess the meaning of their impulses and actions. When individuals observe themselves frequently or persistently breaking "residual rules," they attribute disturbance to themselves and may seek professional help. Drawing from Hochschild and Pugliesi, the article reconceptualized " residual rule-breaking" as violations of feeling or expression norms. When individuals are unable to manage or transform deviant feelings, self-attributions of disturbance should result. The conditions under which feeling management attempts are likely to fail and result in self-attributions of disturbance are outlined in the context of a more general theory of emotional processes. Some conditions under which labeling by others ma...
White racism has influenced theory and practice in psychiatry and allied fields. Psychiatrists have largely ignored the interactionist approach, as expounded by Sullivan and Rush, in analyzing Negroes within their respective societies. Rather, in the vein of Freudian preoccupation with unconscious motivation, abnormal behavior and what is considered innate individual differences, psychiatrists have arrived at broad generalizations of individual and group behavior based on past histories and present conditions of mentally disturbed, maladaptive patients. Psychiatrists have drawn upon theories of genetic, physiological, and psychological determinism to reinforce the myth of black inferiority. The mental health professions must reexamine the impact of racist thinking, past and present, on the disciplines dealing with human behavior--especially psychiatry. They must do some basic rethinking in areas such as recruitment and training of black psychiatrists, the referral procedure of white psychiatrists, research, and upgrading of patient services in the black community. (Author/SB)
Developed a community-based sample of 746 20–70 yr old homosexual men from the New York City population, using a combination of (1) recruitment from sources within the gay community and (2) personal referral by Ss recruited through these sources. S population was comparable to randomly drawn San Francisco samples (e.g., W. Winkelstein et al; 1987) in terms of age, race, and degree of "being out of the closet." Although sample selection using conventional probability techniques should be the method of choice, a reasonably representative sample appears to have been assembled in the absence of a citywide sampling frame, a door-to-door enumeration, or a random-digit dialing screening procedure. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A review of the literature on the relation of life events, stress, and illness shows the clear recognition that illness onset is the outcome of multiple characteristics of the individual interacting with interdependent factors in the individual's social context, in the presence of a disease agent. The conceptual model is comprehensive, multicausal, and interactive; empirical designs should consider this complexity. Crucial in the process of measuring relationships between change in life events and illness onset are the psychometric properties of the measures used and the method of data collection that is employed. The importance of (a) thorough conceptualization and sampling, (b) multidimensional scaling of item samples to identify common dimensions of life events, (c) determination of the true variance and stability of the measures over a variety of populations is stressed. In retrospective studies, important sources of error in measuring life events are selective memory, denial of events, and overreporting to justify an illness. In prospective studies, the subjective evaluation of the significance of a life event to a respondent has been neglected. It is concluded that improvement in data analytic procedures remains a major challenge for life events investigators. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
To assess stress — the demands placed on the individual by his or her environment — life-event checklists and lists of daily hassles have been widely used. Such instruments are intended to reflect harmful, threatening, or challenging aspects of the environment, but they are likely to be strongly influenced by characteristics of the respondent, especially the personality disposition of neuroticism. Individuals high on this dimension perceive life as stressful, cope poorly, are dissatisfied with social supports, have low psychological well-being, and make more somatic complaints. Relations among these variables may be due to the common influence of neuroticism rather than processes of stress and coping. Longitudinal designs and objective outcome measures can reduced the confounding effect of neuroticism. By including measures of neuroticism in their designs, researchers can increase their understanding of the mutual roles of stress and personality in determining mental and physical health. By measuring neuroticism in their clients, stress management practitioners can gain insight into the reports of stressful events and conditions their clients make.
This report describes progress made to date on a study of the impact of the AIDS epidemic on the gay community of New York City. Using a model of the life stress process described by Barbara Dohrenwend and her colleagues, the AIDS epidemic was conceptualized as a community stressor resulting in two key stress-inducing events: death of loved ones due to AIDS and potential illness and death of oneself due to infection with human immunodeficiency virus (HIV). It was hypothesized that these stressors would be significantly related to three domains of health outcomes: sexual behavior, drug and alcohol use, and psychological distress. Descriptive trends over time are provided for both the health outcome variables and the stressor variables. Cross-sectional analyses for 3 years of data provide evidence in support of the main hypothesis. The implications of these findings are discussed from the standpoints of methodology, public health, and the psychology of stress processes in community settings.