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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.
... This ongoing homophobia, bullying, discrimination and peer/familial rejection results in the development of mental scars that ultimately manifest as mental illnesses. The ongoing stressors encountered by sexual minority individuals form the basis of the Minority Stress theory that states that LGBTQIA+ individuals encounter various stressors that accumulate, producing poor mental health (Meyer, 1995). This is one possible explanation as to the mental health disparities seen in sexual and gender minorities when compared to their heterosexual counterparts (Meyer, 1995). ...
... The ongoing stressors encountered by sexual minority individuals form the basis of the Minority Stress theory that states that LGBTQIA+ individuals encounter various stressors that accumulate, producing poor mental health (Meyer, 1995). This is one possible explanation as to the mental health disparities seen in sexual and gender minorities when compared to their heterosexual counterparts (Meyer, 1995). To cope with mental health issues, stigma, or prejudice, many LGBTQIA+ people often turn to unhealthy coping mechanisms, so to lessen the daily pressure exerted on their mental health and wellbeing. ...
Background: Research has consistently shown increased drug use among lesbian, gay, bisexual, transgender, intersex, queer/questioning, and asexual (LGBTQIA+) individuals. This is particularly the case among LGBTQIA+ adolescents. Substance use within this vulnerable community can propagate mental health issues leading to psychiatric disorders, self-harm and even suicide. Therefore, the objective of this scoping review was to evaluate the determinants of drug use among LGBTQIA+ adolescents. Methods: A comprehensive search of mainly primary research was conducted using several databases. Peer-reviewed articles published between 2018 and 2023 were included. The scoping review was conducted using the framework outlined by Joanna Briggs Institute (JBI) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses- Extension for Scoping Reviews (PRISMA-ScR) statement. Results: A total of 29 articles (including 400194 participants) were included in the analysis. The articles reported that the main determinants of drug use among LGBTQIA+ adolescents include homelessness, peer-peer interactions, mental health, and protective factors. The articles reported that mental health issues, which are mainly triggered by rejection, were the main determinants of drug use among LGBTOIA+ adolescents. Conclusion: Findings from this scoping review provide relatively reliable evidence that homelessness, mental health, peer-peer interactions, and protective factors are the main determinants of illicit drug use among LGBTQ+ adolescents. Rigorous studies that include large sample sizes, and systematic reviews are needed to further confirm these findings and assist in developing interventions to combat the unusually high level of drug use among this group.
... Partner relational problems are a "human heritage" that pertain to all sexual orientations and to every kind of romantic relationship. However, as anticipated, minority stress (Meyer 1995) can complicate these relationships and obstruct their resolution. Psychiatrists and mental health professionals need to understand the role of minority stress in gay and lesbian psychological and relational development. ...
... Minority stress-based models (Meyer, 1995) posit that minoritized individuals may be at risk for worse mental health and substance-related outcomes due to greater exposure to stressors associated with minority/marginalized status such as race-based discrimination (i.e., racism). Consistent with these models, some Black Americans may use cannabis (and continue to use cannabis despite cannabis-related problems) to cope with negative emotions experienced after experiencing structural and/or interpersonal racism. ...
Black Americans who use cannabis appear at greater risk for negative cannabis-related outcomes, and cannabis use is more common among individuals who smoke cigarettes. Race-based health disparities concerning cannabis outcomes indicate a need to identify psycho-socio-cultural factors that may play a role in cannabis use and related problems among Black Americans to inform prevention and treatment efforts. Minority stress-based models posit that stressors such as racism increase negative emotions, which may be associated with using substances such as cannabis to cope with negative emotions. Yet, no known research has directly assessed whether negative emotions experienced in response to racism play a role in cannabis-related behaviors. Participants were 254 (50.2% female) Black Americans who endorsed current cigarette smoking and were aged 18–73 (M = 42.1, SD = 14.1). Participants completed an online survey regarding their experiences with racism, smoking, and cannabis-related behaviors. Negative emotions in response to racism were assessed via the Racial Trauma Scale (RTS). Experiencing more frequent racism was related to greater RTS and cannabis-related problems. When entered simultaneously, frequency of racism was related to more cannabis-related problems via RTS, but not anxiety or depression broadly. Racism was related to more cannabis problems via the sequential effects of RTS and a greater quantity of cannabis used. These data indicate that the experience of negative emotions that occur after experiencing racism may play an important role in cannabis misuse among Black Americans.
Gender and sexual identity development (GSID) are formative tasks of adolescence and young adulthood. For LGBTQ2S+ individuals, these processes may be complicated by issues of safety, support, and access to resources. A potential avenue for identity experimentation is tabletop role-playing games (TRPGs), cooperative narrative games wherein players adopt fictional personas and describe their actions within a fantasy setting arbitrated by a facilitator. Previous studies provide indications of the significance of TRPGs to GSID but have generally been limited to small sample sizes and/or specific demographic subgroups that lack a specific inclusion of LGBTQ2S+ youth within their samples. The current study sought to address these gaps and investigate the role of TRPGs to GSID among LGBTQ2S+ individuals during adolescence and young adulthood by generating and analyzing a digital ethnography composed of anonymous online public posts ( N = 211) across four social media platforms authored by current self-identified LGBTQ2S+ youth and young adults, or self-identified LGBTQ2S+ adults retroactively reflecting on their youth and/or young adulthood ( N = 199). Thematic analysis revealed a range of themes highlighting the significance of TRPGs to GSID organized under five overarching categories: (a) Identity Expression, Exploration, and Experimentation through Role-Play; (b) Navigating Safety and Visibility; (c) Enactment and Embodiment of Possibility through Fantasy; (d) Agency, Power, and Resistance; and (e) Personal Significance and Impact to Life and Well-Being.
This paper presents findings from the qualitative portion of a larger mixed-methods study using thematic analysis with data from student focus groups focused on the experiences and mathematical identity of Queer-spectrum STEM students. Drawing on Nasir's identity resource constructs, this study sheds light on the material, relational, and ideational resources impacting Queer-spectrum students majoring in STEM. Four key findings emerged from the data: (1) smaller "safe spaces" within STEM environments fostered robust participation among Queer-spectrum students (2) resources supporting academic and social integration, such as Out in STEM, were crucial for empowerment and fostering a holistic sense of self, (3) peer and instructor relationships were crucial in fostering academic success but were often constrained in STEM settings resulting in limited role models and (4) the lack of positive ideational resources regarding normative STEM identities and historical discrimination contributed to a sense of exclusion among Queer-spectrum students. Efforts to diversify STEM must address these challenges by promoting supportive environments that value diverse identities. Future research should examine how identity resources are made available in diverse institutional contexts to better support Queer-spectrum students in developing robust math identities.
RESUMO Este artigo apresenta descobertas da parte qualitativa oriunda de um estudo mais abrangente que utilizou métodos mistos. Os resultados apresentados foram obtidos por meio de análise temática com dados de grupos focais de estudantes, para examinar as experiências e a identidade matemática de estudantes do espectro Queer em áreas de STEM (Ciência, Tecnologia, Engenharia e Matemática). Com base nos conceitos de recursos de identidade de Nasir, este estudo analisa os recursos materiais, relacionais e ideacionais que impactam os estudantes do espectro Queer em áreas de STEM. Quatro principais resultados emergiram dos dados coletados: (1) espaços menores e "seguros" dentro dos ambientes de STEM fomentaram uma participação robusta entre os estudantes do espectro Queer; (2) recursos que apoiam a integração acadêmica e social, como o Out in STEM [Assumide em STEM], foram cruciais para o empoderamento e para promover um senso de identidade holístico; (3) as relações com colegas e instrutores são essenciais para o sucesso acadêmico, mas frequentemente são limitadas nos contextos de STEM, resultando em poucos modelos de referência; e (4) a falta de recursos ideacionais positivos sobre identidades normativas em STEM e a discriminação histórica contribuíram para uma sensação de exclusão entre os estudantes do espectro Queer. Esforços para diversificar STEM devem abordar esses desafios, promovendo ambientes de apoio que valorizem identidades diversas. Pesquisas futuras devem examinar como os recursos de identidade são disponibilizados em contextos institucionais diversos para melhor apoiar estudantes do espectro Queer no desenvolvimento de identidades matemáticas sólidas.
Background
Black, Indigenous, and People of Color (BIPOC) racial/ethnic groups, sexual minorities (SM), and men have higher odds of smoking, less access to smoking cessation education and services, and lower smoking cessation rates than their white, heterosexual, and women counterparts. The purpose of this study is to examine the experiences of BIPOC gay men in accessing smoking cessation counseling from their healthcare providers and understand the facilitators and barriers to smoking cessation.
Methods
This study analyzed data from BIPOC gay men who smoke daily via social media and organizational listservs throughout the United States and conducted semi-structured individual qualitative interviews. Two trained coders used thematic analysis to analyze the data.
Results
Findings identified three overarching themes: 1) Sources of Information, 2) Facilitators and Barriers, and 3) Areas of Improvement for Smoking Cessation Counseling. Participants reported trusting advice from community members over healthcare providers regarding smoking cessation counseling. They also felt that the smoking cessation advice received from healthcare providers was, at times, confusing and inadequate. Identity concordance between patient and healthcare provider helped participants feel seen by their provider, which motivated them to engage in smoking cessation counseling. Finally, participants suggested improvements for smoking cessation counseling for BIPOC gay men such as integrating mental health support in smoking cessation services, accountability for patients, and providing harm reduction alternatives instead of smoking cessation only.
Conclusion
BIPOC gay men who smoke daily value the importance of receiving culturally adaptive and gender-affirming care from healthcare providers who share their identities when receiving smoking cessation and harm reduction counseling.
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.