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Correlates of Internalized Homophobia in a Community Sample of Lesbians and Gay Men

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Abstract

Objective: To systematically assess internalized homophobia and its correlates among gay men and lesbians. Design: A measure of internalized homophobia (IHP) was administered to a community sample of lesbians and gay men, along with measures of psychological well-being, outness, and perceptions of community. Results and Conclusions: Women's IHP scores were significantly lower than those of men. For lesbians and gay men alike, internalized homophobia was associated with less self-disclosure to heterosexual friends and acquaintances and less sense of connection to the gay and lesbian community. Lesbians and gay men with the highest IHP scores also manifested significantly more depressive symptoms and higher levels of demoralization than others, and high-IHP men manifested lower self-esteem than other men. IHP scores were not associated with disclosure to parents or the recency of developmental milestones for either lesbians or gay men.
Correlates of Internalized Homophobia in a
Community Sample of Lesbians and Gay Men
Gregory M. Herek, Ph.D.
1
Jeanine C. Cogan, Ph.D.
1
J. Roy Gillis, Ph.D.
2
Eric K. Glunt, Ph.D.
1
1
Department of Psychology, University of California, Davis, CA, USA
2
Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
Journal of the Gay and Lesbian Medical Association, 1997, 2, 17-25.
Abstract
Objective: To systematically assess internalized
homophobia and its correlates among gay men and
lesbians. Design: A measure of internalized
homophobia (IHP) was administered to a community
sample of lesbians and gay men, along with measures
of psychological well-being, outness, and perceptions
of community. Results and Conclusions: Women’s
IHP scores were significantly lower than those of
men. For lesbians and gay men alike, internalized
homophobia was associated with less self-disclosure
to heterosexual friends and acquaintances and less
sense of connection to the gay and lesbian
community. Lesbians and gay men with the highest
IHP scores also manifested significantly more
depressive symptoms and higher levels of
demoralization than others, and high-IHP men
manifested lower self-esteem than other men. IHP
scores were not associated with disclosure to parents
or the recency of developmental milestones for either
lesbians or gay men.
INTRODUCTION
Like many other societies, the culture of the
United States is pervaded by heterosexism, an
ideological system that denies, denigrates, and
stigmatizes any nonheterosexual form of behavior,
identity, relationship, or community (1, 2). Most
children who grow up in the U.S. internalize societal
heterosexism from an early age. Consequently,
lesbians and gay men usually experience some degree
of negative feeling toward themselves when they first
recognize their own homosexuality in adolescence or
adulthood. This sense of what is usually called
internalized homophobia often makes the process of
identity formation more difficult and can pose
psychological challenges to gay men and lesbians
throughout life (3 - 8). In the course of recognizing
their homosexual orientation, developing an identity
based on it, and disclosing their orientation to others
— the process usually termed coming out — most
lesbians and gay men successfully overcome the
threats to psychological well-being posed by
internalized homophobia. They manage to reclaim
disowned or devalued parts of themselves,
developing an identity into which their sexuality is
well integrated (5).
Despite widespread recognition that internalized
homophobia represents an important challenge to gay
and lesbian mental health, few published empirical
studies have attempted to assess its prevalence or
identify its correlates (9). The available data suggest
that higher levels of internalized homophobia are
associated with lower self-esteem and greater
psychological distress, such as depression (9 - 14).
Internalized homophobia has also been found to
correlate with lower levels of self-disclosure about
one’s sexual orientation, or being out of the closet
(hereafter referred to as “outness”), and reduced
social support (9, 12, 15, 16). Findings in this area
are confounded, however, because the measures of
internalized homophobia used in these studies also
included items about outness and attitudes toward
social involvement with other gay people and the gay
community.
A striking limitation of previous empirical
investigations of internalized homophobia is that
nearly all of them have focused on men. We found
only two published studies that reported data on
internalized homophobia among lesbians. Bell and
Weinberg (17) reported that lesbians in their San
Francisco sample expressed somewhat less regret
than gay men about their homosexuality, and were
somewhat less likely to say that they would have
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liked a magic pill to make them heterosexual. Kahn
(18), using an original measure that appears to have
focused on acceptance of societal stereotypes about
lesbians (items and psychometric data were not
included in the published report), found that higher
levels of internalized homophobia were associated
with expressing more traditional attitudes toward
gender roles, feeling more intimidated by and less
individuated from one’s parents, and feeling less
comfortable about disclosing one’s lesbian identity to
others. Given widespread recognition of the
importance of internalized homophobia for lesbians
(6, 7), a clear need exists for empirical data in this
area.
One of the challenges for research on
internalized homophobia is how to operationalize the
construct. Although mental health practitioners and
researchers generally agree about the broad definition
of internalized homophobia — that is, negative
feelings about one’s own homosexuality — they vary
widely in their specific conceptualizations and
operationalizations of this construct (9). Thus,
internalized homophobia has been operationalized
not only as dislike of one’s own homosexual feelings
and behaviors, but also as hostile and rejecting
attitudes toward other gay people, denigration of
homosexuality as an acceptable lifestyle,
unwillingness to disclose one’s homosexuality to
others, perceptions of stigma associated with being
homosexual, and acceptance of societal stereotypes
about homosexuality (9, 11, 15, 16, 18 - 20). As
Shidlo (9) noted, many of these constructs might
better be regarded as correlates of internalized
homophobia rather than manifestations of it.
To avoid this problem, the present study
employed Martin’s measure of internalized
homophobia, which represents a fairly narrow
definition of the construct (19, 20). The items focus
primarily on dissatisfaction with being homosexual
and desiring to become heterosexual. Thus, in
contrast to multidimensional approaches (9, 15, 16),
Martin’s instrument does not equate internalized
homophobia with other phenomena such as
reluctance to disclose one’s sexual orientation to
others. It thereby avoids a possible confound that
would be introduced by treating interpersonal
disclosure as both a component of internalized
homophobia and a correlate of it.
We sought to document the relationship of
internalized homophobia to psychological well-being,
identity integration, and community perceptions in a
nonclinical sample. We recruited lesbians and gay
men at a community event in Sacramento (CA),
assuming that they generally represented well-
functioning individuals with a gay or lesbian identity
sufficiently integrated to allow them to attend the
event. Because such individuals are likely to have
generally positive feelings about their homosexual
orientation, we hypothesized that most members of
the sample would manifest no internalized
homophobia or very low levels of it. To the extent
that internalized homophobia was observed,
however, we expected that it would be associated
with lower levels of psychological well-being, less
openness about one’s sexual orientation, less sense of
community involvement, and a heightened sense of
being stigmatized as a consequence of a homosexual
orientation.
METHOD
Sample and Procedure
Participants were 75 women and 75 men
recruited at a large lesbian/gay/bisexual street fair in
Sacramento (CA). Attendance at the festival was
estimated by organizers to have exceeded 4000. The
research team rented a booth at the fair, from which
participants were recruited. Volunteers were paid $5,
offered a soft drink, and provided space in a shady
area to complete the questionnaire, which required
approximately 40 minutes. Of the 150 questionnaires,
3 were discarded because of excessive amounts of
missing data. This left 147 questionnaires, 74 from
women and 73 from men. Because a small number of
respondents did not answer all of the questions, ns
differ slightly for the various measures reported
below.
Measures
Only the measures relevant to the present paper
are described here. Additional information about the
questionnaire has been reported elsewhere (21).
Internalized homophobia. Internalized
homophobia was assessed with a 9-item measure
adapted for self-administration from interview items
developed by Martin and Dean (19). Following
Meyer (20), we refer to these items as the IHP scale.
The IHP items were originally derived from the
diagnostic criteria for ego-dystonic homosexuality
contained in the Diagnostic and Statistical Manual
(22). Previous research has indicated that the self-
administered version of the IHP scale has acceptable
internal consistency and correlated as expected with
relevant measures (23). Items were administered with
a 5-point response scale, ranging from disagree
strongly to agree strongly. For the present sample, α
= .71 for women and .83 for men. The IHP items are
reprinted in the Appendix.
Psychological well-being. Three aspects of
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psychological well-being were assessed. Depressive
symptoms during the previous 30 days were assessed
with the 20-item Center for Epidemiologic Studies
Depression scale, or CES-D (24; α = .93 for women
and .94 for men). To maintain consistency
throughout the questionnaire, CES-D items were
administered with a 5-point response scale (rather
than the 4-point scale on which scale norms are
based). The response alternatives were never, almost
never, sometimes, fairly often, very often. Using the
same response format, a 23-item version of the
demoralization scale of the Psychiatric Epidemiology
Research Instrument, or PERI (25), was also
administered (α = .94 for both women and men).
Self-esteem was assessed with Rosenberg’s (26) 10-
item scale (α = .89 for women and .91 for men).
Disclosure of sexual orientation. Outness was
assessed with three questions about the extent to
which respondents had disclosed their sexual
orientation to current heterosexual friends,
heterosexual friends known prior to coming out, and
heterosexual casual acquaintances. Each question
was accompanied by a 10-point rating scale ranging
from out to none of them to out to all of them. The
rating scales were summed and divided by the
number of items to yield a mean scale score (α = .82
for women and .87 for men). Respondents also were
asked whether they had come out to either their
mother or their father.
Perceptions of community. The extent to which
respondents perceived their membership in the gay or
lesbian community as an important component of
their identity was assessed with a 10-item measure of
collective self-esteem adapted from Luhtanen and
Crocker (27; α = .84 for women and .82 for men).
Sample items include “I’m glad I belong to the
lesbian/bisexual [for men: gay/bisexual] community”
and “My membership in the lesbian/bisexual
[gay/bisexual] community is an important reflection
of who I am.” Respondents’ perceptions of stigma in
the Sacramento area were assessed with a 7-item
measure of perceived stigma (α = .89 for women and
.83 for men). Sample items include “Most people in
the Sacramento area think less of a person who is
lesbian/bisexual [gay/bisexual]” and “Most people in
the Sacramento area willingly accept a
lesbian/bisexual woman [gay/bisexual man] as a
close friend.” For both measures, items were
administered with a 5-point response scale, ranging
from disagree strongly to agree strongly. The
complete set of items for both scales is reproduced
elsewhere (23).
Developmental milestones. Because internalized
homophobia is widely considered to be more
prevalent among individuals who have recently come
out, we assessed the recency of key developmental
milestones. We asked respondents how old they were
when each of the following events occurred: they
were first sexually attracted to a person of their same
sex; they had a sexual experience leading to orgasm
with a person of the same sex; they first decided for
themselves that they were lesbian, gay, or bisexual;
and they first disclosed their homosexuality or
bisexuality to another person. From these data, we
computed the amount of time that had elapsed since
each milestone by subtracting the respondent’s age
when the event occurred from their current age. If
higher levels of internalized homophobia were found
to be associated with the recency of one or more of
these milestones, we planned to control statistically
for that variable.
Demographic variables. We also assessed the
following demographic variables: gender, race and
ethnicity, age, educational level, income in the
previous year, current employment status, marital and
parental status, and relationship status. In addition,
sexual orientation was assessed by asking
respondents to select one of four alternatives to
describe themselves: lesbian or gay; bisexual, mostly
lesbian/gay; bisexual, mostly heterosexual;
heterosexual or straight.
RESULTS
Sample Characteristics
Except as noted below, gender differences were
not observed in demographic characteristics. The full
sample (n = 147) was predominantly White (82%),
with another 7% Latino, 1% African American, 2%
Asian/Pacific Islander, and 1% Native American. The
remaining 7% classified themselves as “other,” most
of them reporting mixed ancestry. Most respondents
(86%) identified their sexual orientation as lesbian or
gay, with another 14% identifying as bisexual.
Respondents ranged in age from 16 to 68 years (M =
33 years). The sample was highly educated, with 47%
having earned a bachelor’s or higher degree. Only
8% had not completed any formal education beyond
high school. Respondents’ median annual income
was in the range of $15,000 - $25,000. Twenty-five
percent reported earning $35,000 or more, whereas
35% reported income of $15,000 or less. Women
were more likely than men to report that they were
currently working at a job for pay (85% versus 72%;
chi-square (1, N = 145) = 3.82, p = .05). Most
respondents (78%) had never been married
heterosexually, but 19% had once been married, and
one respondent was currently married. One-tenth of
the respondents had at least one child. A majority
Page 4
(60%) reported that they were currently in a long-
term, committed relationship.
Internalized Homophobia
Men scored significantly higher than women on
the IHP measure, and bisexuals scored significantly
higher than homosexuals (Ms = 14.79 for gay men,
19.91 for bisexual men, 11.68 for lesbians, and 16.87
for bisexual women). Analysis of variance (ANOVA)
yielded significant main effects for sex (F (1, 138) =
14.66, p < .001) and sexual orientation (F (1, 138) =
15.89, p < .001). The sex-by-orientation interaction
effect was not significant. As expected, most
respondents scored at the lower extreme of the IHP
scoring continuum. One-half of the lesbian
respondents scored 9 or 10, whereas one-half of the
gay male respondents scored between 9 and 13 (the
theoretical range for scores was from 9 to 45).
Bisexuals’ scores were somewhat less skewed:
Median scores were 17 for bisexual women and 19
for bisexual men. Because of the differences between
bisexuals and homosexuals in their scores on the IHP
scale, and because of the relatively small number of
bisexuals in the sample, the remaining analyses were
conducted only for respondents who identified
themselves as gay or lesbian.
The skewed distribution and constricted range
of lesbians’ and gay men’s scores on the IHP
measure, although anticipated, nevertheless created a
problem for statistical analysis because it was likely
to deflate correlation coefficients between the IHP
scale and other measures. Recognizing that this
problem, coupled with our relatively small sample
size, could obscure relationships among the variables
of interest, we used two strategies in subsequent
statistical analyses. First, we assessed zero-order
correlations between IHP scores and the variables
related to developmental milestones, psychological
well-being, outness, and perceptions of community.
Because these analyses utilize the full range of
information provided by the continuous variables,
they are useful in identifying subtle covariations
between IHP scores and the other constructs.
Second, we used ANOVA to compare the
minority of respondents who scored extremely high
(for this sample) on IHP with the other respondents.
For these comparisons, a respondent was considered
a high IHP scorer if she or he had marked “agree” or
“strongly agree” to at least one of the 9 IHP items (ns
= 15 women and 27 men, or approximately one-third
of the sample). The remaining respondents — those
who had marked “strongly disagree,” “disagree,” or
“neither agree nor disagree” to all 9 IHP items —
were classified as low IHP scorers (ns = 51 women
and 33 men, or approximately two-thirds of the
sample). As expected, mean IHP scores differed
significantly between those in the low-scoring group
(mean IHP = 10.22 for women and 11.62 for men)
and those in the high-scoring group (mean IHP =
17.00 for women and 18.69 for men; for the main
effect for IHP scores, F = 73.36, p < .001).
Internalized Homophobia and Developmental
Milestones
The mean age for first attraction to a member of
the same sex was 11.5 for females and 10.3 for
males. Mean age for first orgasm with a person of the
same sex was 20.2 for females and 17.7 for males.
On average, females first identified themselves as
lesbian or bisexual at age 20.2, whereas men did so at
age 18.7. Mean age for first disclosure of one’s
sexual orientation was 20.5 for females and 21.2 for
males. No significant correlations were observed
between IHP scores and age at these milestone
events, current age, or number of years since the
milestone event. Therefore, we did not control for
these variables in subsequent analyses.
______________________________
Insert Tables I and II about here
______________________________
Internalized Homophobia and Psychological Well-
Being
As shown in Table I, gay men’s IHP scores
were significantly correlated with depressive
symptoms, demoralization, and self-esteem. To the
extent that gay men manifested higher levels of
internalized homophobia, they tended to report more
depressive symptoms, more demoralization, and less
self-esteem. The correlation coefficients for lesbians
were not statistically significant.
When extremely high scorers were compared to
other respondents (Table II), lesbians and gay men
alike manifested significant differences in depression
and demoralization. On the CES-D, Table II shows
that high-IHP men scored approximately 9 points
higher than low-IHP men, whereas high IHP-lesbians
scored approximately 4 points higher than low-IHP
lesbians. On the PERI demoralization scale, high-IHP
women and men alike scored approximately 9 points
higher than their low-IHP counterparts. A sex-by-IHP
group interaction was not observed for either the
CES-D or PERI demoralization scale.
For self-esteem, the same pattern emerged for
gay men but not lesbians. As shown in Table II, gay
men in the high IHP group scored more than 4 points
lower than low-IHP men on the self-esteem measure,
whereas lesbians in the two groups did not differ in
self-esteem scores. Although the pattern of self-
esteem scores in Table II suggests that the significant
Page 5
difference occurred only among gay men, a
significant sex-by-IHP group interaction was not
detected, possibly because of the relatively low
statistical power for the analysis as result of the small
sample size.
Internalized Homophobia and Disclosure of Sexual
Orientation
As shown in Table I, IHP scores were
negatively correlated with outness to friends among
lesbians and gay men alike. Table II shows that high-
IHP women and men scored approximately 1 point
lower (less disclosure) on the measure of outness to
friends than their low-IHP counterparts.
Most of the respondents reported that their
sexual orientation was known to their mother (88%
of lesbians, 78% of gay men) or their father (71% of
lesbians and 69% of gay men). The majority of gay
men (66%) and lesbians (71%) alike said that both
parents knew about their sexual orientation.
Respondents were somewhat more likely to report
that they had directly disclosed their sexual
orientation to their mother (84% of the women and
87% of the men who said their mother knew) than
their father (60% of the women and 66% of the men
who said that their father knew); however, the
difference was not statistically significant. Fewer
than one-tenth of the lesbians (8%) and one-fifth of
the gay men (19%) said that neither parent knew
about their sexual orientation. IHP scores did not
systematically vary according to whether respondents
reported that a parent knew about their sexual
orientation, or whether they had directly disclosed to
either parent.
Internalized Homophobia and Perception of
Community
As shown in Table I, IHP scores were
negatively correlated with collective self-esteem for
both women and men, indicating that respondents felt
less connected to the lesbian, gay, and bisexual
community to the extent that they experienced higher
levels of internalized homophobia. This pattern is
replicated in the comparison of high- and low-IHP
respondents in Table II. Perceptions of stigma were
only slightly correlated with IHP scores, as shown in
Table I. However, Table II indicates that individuals
with the highest IHP scores were significantly more
likely than other respondents to perceive that the
local climate was hostile to gay men and lesbians;
this pattern was more pronounced for men than for
women.
1
1
A separate report on data obtained with the present
sample pointed out the relationship between criminal
DISCUSSION
As expected, higher levels of internalized
homophobia were associated with less openness
about one’s sexual orientation and less sense of
belonging to the gay and lesbian community (Tables I
and II). The highest IHP scorers also manifested more
depressive symptomatology and demoralization than
low scorers (Table II). High IHP scores were also
associated with lower self-esteem, but this pattern
seemed to hold primarily for gay men.
The gender differences observed in the present
study suggest that lesbians may experience
internalized homophobia to a lesser extent than gay
men, and that internalized homophobia may be less
closely linked to self-esteem for lesbians than it is for
gay men. Such a pattern might be explained with
reference to empirical studies of heterosexuals’
attitudes toward homosexuality, which have
repeatedly shown that heterosexual men’s attitudes
toward gay men are more negative than their attitudes
toward lesbians or heterosexual women’s attitudes
toward either gay men or lesbians (28, 29). Because
gay men and lesbians typically are subjected to the
same socialization processes as their heterosexual
counterparts, it is reasonable to expect that their
internalization of attitudes toward homosexuality
would mirror that of heterosexuals. That is, (gay)
men might be expected to internalize greater hostility
toward (their own) male homosexuality relative to
(lesbian) women’s internalization of hostility toward
(their own) lesbianism. This conclusion, however,
must be qualified by two important considerations.
First, the data reported here were collected from
a convenience sample that is not representative of a
larger population. Because they were recruited at an
event celebrating the local gay and lesbian
community, participants in the present study were
probably higher in self-acceptance and community
involvement than many other lesbians and gay men.
victimization — especially hate crime victimization
— and psychological distress (21). To control for the
possible effects of victimization on the outcome
variables discussed in the present paper, we
replicated the ANOVAs reported in Table II in a
series of analyses of covariance with hate crime
victimization and other criminal victimization
entered as covariates (0 = never victimized, 1 =
victimized at least once). The pattern of significant
results was the same as in Table II, indicating that
the relationships between internalized homophobia
and self-esteem, depressive symptoms, and the other
variables remained significant even when the effects
of criminal victimization were statistically controlled.
Page 6
The lesbians recruited for the present sample simply
may have not manifested sufficient variation in their
IHP scores to permit adequate assessment of the
relationships of IHP to mental health variables. This
possibility is suggested by the fact that a majority of
the lesbians scored at or only slightly above the
minimum possible score on the IHP measure. A
similar pattern might not have been observed in a
different sample of women recruited from the same
community.
A second possibility is that the observed
difference between lesbians and gay men reflects
limitations of the instrument. Shidlo (9), for example,
suggested that the IHP may not be sufficiently
sensitive to detect low or moderate levels of
internalized homophobia. Perhaps even more relevant
to the present discussion, the IHP scale was first
developed in a study of gay men (19, 20), and may be
less suitable for assessing internalized homophobia
among lesbians. Such a limitation might result from
item content, such as the IHP’s inclusion of several
items that express the desire to stop being
homosexual or to develop heterosexual attractions.
These items suggest a conceptualization of sexuality
in dichotomous terms, with respondents expected to
manifest sexual attraction to either one sex or the
other. Such a polarized construction of sexual
orientation may be more applicable to men’s
experiences than to those of women (30, 31).
That lesbians in the present sample experienced
greater fluidity in their sexual orientation than the
men is indicated by their responses to a question
about how much choice they felt that they had about
their sexual orientation. Regardless of whether they
were gay or bisexual, men were more likely than
women to respond that they had “no choice at all.”
The difference was statistically significant for
homosexual respondents (80% of gay men felt they
had no choice, compared to 62% of lesbians; chi-
square (2, N = 125) = 6.13, p < .05). For bisexuals,
the pattern was similar (67% of men versus 25% of
women), but not statistically significant.
Before drawing conclusions about differences
in internalized homophobia between lesbians and gay
men, therefore, additional data should be collected
from larger and more diverse samples. Ideally, such
samples will be more racially and ethnically diverse
than the present sample, and will include more
women and men who are in the closet. Researchers
should also consider comparing the measure
employed in the present study with one or more other
measures of internalized homophobia (e.g., 9, 15,
16), recognizing that those measures encompass
broader conceptualizations of internalized
homophobia than does the IHP.
It is also important to recognize that the
correlational findings presented here do not reveal a
causal direction in the relationships among variables.
Internalized homophobia may indeed be an
underlying cause of psychological distress.
Alternatively, it may be indirectly related to
depression because it contributes to social isolation
(as a result of non-disclosure and lack of community
involvement), which can lead to feelings of
loneliness and depression. Yet another possibility is
that psychological distress leads to feelings of
dissatisfaction with many aspects of oneself,
including one’s sexual orientation.
Regardless of the causal relationships, the
correlational patterns reported here for a nonclinical
sample are consistent with observations by many gay-
affirmative clinicians and theorists (4, 5, 7, 8). They
suggest that practitioners should recognize the
likelihood that clients who have negative feelings
about their homosexuality are also likely to be more
in the closet and less integrated into a gay social
network than other gay people. In addition, such
clients may be at heightened risk for depression and,
in the case of gay men, low self-esteem. Conversely,
therapists should also consider the possibility that
clients who present with depressive symptoms may
also have heightened levels of internalized
homophobia.
ACKNOWLEDGMENTS
The research described in this article was
supported by a grant to the first author from the
National Institute of Mental Health (R01 MH50185).
The authors thank Camille Barber, Fred Fead,
Clarmundo Sullivan, David Webb, and David Welton
for their assistance in data collection, and Mary Ellen
Chaney and Rebecca Hill for their administrative
support. We also acknowledge the generous
assistance of the late John Martin in the earliest
stages of planning for this project. Requests for
reprints should be sent to Gregory Herek, Psychology
Department, University of California, One Shields
Avenue, Davis, CA 95616, USA.
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Page 9
Table I
Correlations of Internalized Homophobia (IHP) Scores for Gay Men and Lesbians
Gay Men Lesbians
___________________________________________________________________________
Depressive Symptoms (CES-D) .268* .054
(n = 56) (n = 58)
Demoralization .397** .196
(n = 58) (n = 61)
Self-esteem -.447** -.097
(n = 56) (n = 62)
Outness to Friends -.336** -.302*
(n = 58) (n = 65)
Collective Self-esteem -.384** -.465**
(n = 57) (n = 65)
Perceived Stigma .117 .143
(n = 57) (n = 65)
___________________________________________________________________________
Note. Variations in n are due to missing data on one of the two correlated variables.
a
p < .05
b
p < .01
Page 10
Table II
Mean Scores for Gay Men and Lesbians High and Low in Internalized Homophobia (IHP)
Gay Men Lesbians
High IHP Low IHP High IHP Low IHP
___________________________________________________________________________
Depressive Symptoms 30.28 21.50 28.31 24.33
(CES-D)
a
(sd = 16.25) (sd = 12.43) (sd = 16.37) (sd = 14.03)
(n = 25) (n = 32) (n = 13) (n = 46)
Demoralization
b
27.88 18.36 29.00 20.60
(sd = 17.84) (sd = 11.91) (sd = 18.68) (sd = 14.34)
(n = 26) (n = 33) (n = 14) (n = 48)
Self-esteem
c
39.58 44.06 42.54 42.72
(sd = 8.76) (sd = 6.24) (sd = 8.31) (sd = 6.84)
(n = 26) (n = 32) (n = 13) (n = 50)
Outness to Friends
d
4.70 5.63 4.89 5.89
(sd = 2.83) (sd = 2.95) (sd = 2.62) (sd = 2.35)
(n = 27) (n = 33) (n = 15) (n = 51)
(table continues)
Page 11
Table II (continued)
Gay Men Lesbians
High IHP Low IHP High IHP Low IHP
___________________________________________________________________________
Collective Self-esteem
e
38.79 41.67 41.00 44.18
(sd = 6.57) (sd = 6.15) (sd = 7.18) (sd = 4.53)
(n = 24) (n = 33) (n = 15) (n = 50)
Perceived Stigma
f
24.38 20.03 21.60 20.43
(sd = 5.69) (sd = 5.43) (sd = 7.31) (sd = 5.79)
(n = 26) (n = 32) (n = 15) (n = 51)
___________________________________________________________________________
Note. Variations in n are due to missing data on one of the two variables used in the ANOVA.
a
Main effect for IHP: F (1, 112) = 5.346, p < .05.
b
Main effect for IHP: F (1, 117) = 9.092, p < .01.
c
Main effect for IHP: F (1, 117) = 3.332, p < .10.
d
Main effect for IHP: F (1, 122) = 3.436, p < .10.
e
Main effect for IHP: F (1, 118) = 6.937, p = .01. Main effect for Sex: F (1, 118) = 8.155, p < .01.
f
Main effect for IHP: F (1, 120) = 6.443, p < .05.
Page 12
Appendix
Internalized Homophobia Scale Items
1. I often feel it best to avoid personal or social involvement with other lesbian/bisexual
women.
2. I have tried to stop being attracted to women in general.
3. If someone offered me the chance to be completely heterosexual, I would accept the chance.
4. I wish I weren’t lesbian/bisexual.
5. I feel alienated from myself because of being lesbian/bisexual.
6. I wish that I could develop more erotic feelings about men.
7. I feel that being lesbian/bisexual is a personal shortcoming for me.
8. I would like to get professional help in order to change my sexual orientation from
lesbian/bisexual to straight.
9. I have tried to become more sexually attracted to men.
_____________________________________________________________________________
Note. Items are presented with wording for female respondents. For male respondents, the terms
lesbian, men, and women were changed to gay, women, and men, respectively (23).
... Due to the influx of anti-LGBTQ+ legislative policies, it is necessary to explore the impact of discrimination related to LGBTQ+ individuals at a societal level, specifically when there is risk for the internalization of that negativity (Herek et al., 1998). Internalized LGBTQ+ negativity has been conceptualized as selfhating which then may extend to hating others who hold LGBTQ+ identities (Herek et al., 1998). ...
... Due to the influx of anti-LGBTQ+ legislative policies, it is necessary to explore the impact of discrimination related to LGBTQ+ individuals at a societal level, specifically when there is risk for the internalization of that negativity (Herek et al., 1998). Internalized LGBTQ+ negativity has been conceptualized as selfhating which then may extend to hating others who hold LGBTQ+ identities (Herek et al., 1998). This concept of internalized LGBTQ+ negativity has been associated with higher levels of psychological distress (Walch et al., 2016). ...
... We then aimed to bridge the gap in previous literature that has demonstrated the relationship between internalized LGBTQ+ negativity and resilience (Herek et al., 1998) and assess whether this relationship translates to LGBTQ+ cancer survivors. We hypothesized that: ...
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Approximately 1.3 million cancer survivors may identify as lesbian, gay, bisexual, transgender or another sexual or gender expansive identity (LGBTQ+). Psychological distress is prominent among cancer survivors. Resilience is the ability to cope and or grow from adversity. Resilience diminishes psychological distress for non-LGBTQ+ cancer survivors. It is unclear if this is consistent among LGBTQ+ cancer survivors. With the rise of anti-LGBTQ+ legislation in the United States, understanding how internalizing LGBTQ+ negativity impacts psychological distress is salient for LGBTQ+ cancer survivors. Self-esteem has been strongly related to resilience, and determining if this translates to LGBTQ+ cancer survivors helps demonstrate a mechanism that may bolster resilience within this population. Using a nationally distributed web-based survey sample of 60 LGBTQ+ cancer survivors (M = 42.15, SD = 13.19), we conducted a stepwise linear regression to develop the most parsimonious model for predicting resilience. The predictive model was significant and accounted for 32% of the variance in resilience, F(2, 57) = 15.08, p < .001, R² = .32; anxiety, t = −4.01, B = −0.44, p < .001, 95% CI [−.50, −.17]; and self-esteem, t = 3.01, B = 0.33, p = .004, 95% CI [.16, .79] were found to be significant predictors of resilience. This study is a promising step to identifying how resilience uniquely impacts LGBTQ+ cancer survivors.
... Internalized homophobia was assessed using the Internalized Homophobia Scale (Herek et al., 1998), a unidimensional nine-item self-report scale used to measure internalized negative attitudes and beliefs about SMM. Items were rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). ...
... Example items include "I often feel it best to avoid personal or social involvement with other gay/bisexual males" and "I have tried to stop being attracted to males in general." In the original study, Herek et al. (1998) reported strong internal consistency (α = .83) for men in their sample of sexual minority individuals. ...
... Similar studies have reported Cronbach's α values greater than or equal to .70 (Lewis et al., 2003;Meyer, 1995). Internalized homophobia scores have been positively correlated with increased depression symptoms, lower self-esteem, and increased anxiety symptoms (Herek et al., 1998;Igartua et al., 2003;Newcomb & Mustanski, 2010). In the present study, internal consistency was high, α = .91. ...
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Latino and Black sexual minority men (SMM) are at elevated risk of cigarette use compared to their heterosexual and White SMM counterparts. Internalized homophobia may affect substance use disparities. However, the research linking internalized homophobia and substance use has been inconsistent. The purpose of the present study was to clarify the association between internalized homophobia and daily cigarette use by testing the roles of internalized racism and ethnic identity acceptance as potential moderators of this link. This study collected data from 165 Black and/or Latino SMMs across the United States (Mage = 23.72, SD = 3.85) as part of a larger study. Data were collected from December 2020 to February 2021 via Qualtrics Panels. Zero-inflated Poisson regression was conducted to examine the association between internalized homophobia and daily cigarette use and whether internalized racism and/or ethnic identity acceptance would moderate the association between internalized homophobia and daily cigarette use. Internalized homophobia was negatively associated with daily cigarette use; however, this association was significantly moderated by internalized racism and ethnic identity acceptance. Simple slope analyses revealed that low levels of internalized racism and high levels of ethnic identity acceptance attenuated the positive association between internalized homophobia and daily cigarette use. At low levels of ethnic identity acceptance, the positive association between internalized homophobia and daily cigarette use was strengthened. This research aids in contextualizing the association between internalized homophobia and daily cigarette use among Latino and Black SMM. Implications for smoking treatment and prevention programs are discussed.
... Internal consistency for the composite score was acceptable (α = .96). The Internalized Homophobia Scale (Herek et al., 1998) is a nineitem self-report measure of internalized sexual minority stigma adapted from an interview by Martin and Dean (1987). Participants respond to items (e.g., I would like to get professional help in order to change my sexual orientation to straight) on a scale from 1 (never) to 4 (often). ...
... Previous literature suggests sexual orientation concealment is sometimes associated with disordered eating and body image concerns (Convertino et al., 2021), though the effect size is smaller for sexual orientation concealment compared to internalized stigma. Sexual orientation concealment is interrelated with internalized SM stigma (Herek et al., 1998(Herek et al., , 2015, these relations may be better modeled as a process rather than a concomitant occurrence, which was beyond the capabilities of the modeling used in the present study, which conserves statistical power. Fourth, we used a lifetime measure of racial/ethnic discrimination, which is less temporally aligned with the framing of the SM stressors in the study, which makes it difficult to determine the salience of recency of racial/ethnic discrimination in relation to ED symptoms rather than cumulative experiences. ...
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Drawing from intersectionality and minority stress theory, we examined the main and interaction effects of racial/ethnic discrimination, intraminority, and sexual minority stress on changes in disordered eating over the course of a month. Participants were 186 U.S. sexual minority men (SMM). Most participants (n = 139) reported a marginalized racial/ethnic identity (i.e., SMM of Color). Participants completed self-report measures at baseline and at 1 month follow-up. SMM of Color reported greater purging and muscle building than non-Latine White SMM. Our primary analyses revealed that the interaction effects between racial/ethnic discrimination and sexual minority stressors predicted increases in excessive exercise, binge eating, purging, and muscle building, such that at high levels of sexual minority stress, racial/ethnic discrimination predicted increases in disordered eating. However, for excessive exercise, at low levels of internalized stigma, experiences of racial/ethnic discrimination predicted increases in excessive exercise. Results from this study provide several targetable stress processes that may be used to guide the prevention and treatment of disordered eating in men with multiple marginalized identities. Our findings reinforce the necessity for culturally responsive/affirming care that recognizes the impacts of multiple identities and their respective experiences in the development and maintenance of disordered eating.
... The nine-item IHP Scale (Herek et al., 1998) examines personal endorsement of sexual orientation stigma within one's self-concept on a 5-point Likert scale (1 = disagree strongly, 5 = agree strongly). The IHP has demonstrated adequate internal consistency (α = .71-.85) and convergent validity with anxiety, depression, and self-esteem across various sexual minority groups (Herek et al., 1998). ...
... The nine-item IHP Scale (Herek et al., 1998) examines personal endorsement of sexual orientation stigma within one's self-concept on a 5-point Likert scale (1 = disagree strongly, 5 = agree strongly). The IHP has demonstrated adequate internal consistency (α = .71-.85) and convergent validity with anxiety, depression, and self-esteem across various sexual minority groups (Herek et al., 1998). The internal consistency of the scale in the present study was good (α = .83). ...
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Borderline personality disorder (BPD) is a psychological condition associated with significant impairments in psychosocial functioning. Sexual minority individuals, such as those identifying as lesbian, gay, and bisexual, are at elevated risk for BPD. Experiences of invalidation are strongly associated with BPD and commonly reported by sexual minorities. However, little research has examined how different forms of invalidation, including sexual minority stigma, confer risk for BPD, particularly in diverse and resource-limited contexts. We examined associations between experiences of parental invalidation, sexual orientation microaggression, internalized homophobia, and BPD symptoms among 130 lesbian, gay, and bisexual adults in Malaysia, where sexual minority identities remain highly stigmatized. In addition, we investigated whether self-compassion serves a protective role. Participants were recruited from the community and completed online questionnaires assessing the above constructs. Results from hierarchical linear regressions indicated that experiences of parental invalidation and sexual orientation microaggression (but not internalized homophobia) were associated with more severe BPD symptoms. Self-compassion did not moderate these associations but was independently associated with less severe BPD symptoms, above and beyond experiences of invalidation. Our findings provide further evidence for the key role of environmental invalidation in conferring risk for BPD among sexual minorities and suggest potentially important implications for understanding and treating BPD.
... Regarding enacted SMS, three studies reported adapting items from Díaz et al. (2001) and two studies reported utilizing the lifetime victimization scale from Fredriksen-Goldsen and Kim (2017). Regarding internalized SMS, three studies reported utilizing a version of the internalized homophobia (IHP) scale-two utilizing the full 9-item IHP (see Herek et al., 1997;Martin and Dean, 1987;Meyer, 1995) and one utilizing the revised 5-item IHP-R (Herek, 2009)-and two studies reported adapting items from the Nungesser homosexual attitudes inventory (Nungesser, 1983). ...
... Findings were synthesized in total and, to explore heterogeneity, for each minority stressor-stimulant pair. frequency (Martin and Dean, 1987;Meyer, 1995;Herek et al., 1997); analyzed as a composite continuous predictor single item with the following response scale: "0 (never), 2 (once or twice), 3 (monthly), 4 (weekly), and 6 (daily or almost daily)" (p. 988); analyzed as three continuous outcomes stimulant type Random-intercept mixed-effects linear regressions of internalized SMS on each outcome with psychological distress, age, gender, race/ethnicity, sexual orientation, and time point as covariates; no association observed for any stimulant type ...
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... The Internalised Homophobia Scale (IHP) was adapted from an interview (see Martin and Dean 1988) to a self-report measure by Herek et al. (1998). The self-report IHP is a 9-item self-report measure that assesses internalised stigma related to one's sexual orientation (i.e., discomfort with one's own sexual orientation). ...
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... These appraisals may be derived, in part, from the extent to which the identities are evaluated as positive or negative in specific social contexts (e.g., Clark and Clark 1947;Herek et al. 1998). For instance, in the U.S., maleness, Whiteness, high socioeconomic status, and heterosexuality are generally valued, whereas femininity, racial and ethnic minority group membership, low socioeconomic status, and same-sex attraction are generally devalued (Fiske et al. 2002;Szymanski and Moffitt 2012). ...
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