Archives of Sexual Behavior (2020) 49:2259–2263
The Rejection Sensitivity Model: Sexual Minority Adolescents
LauraBaams1· WouterJ.Kiekens2· JessicaN.Fish3
Received: 13 October 2019 / Revised: 18 October 2019 / Accepted: 19 October 2019 / Published online: 29 October 2019
© The Author(s) 2019
Theoretical and empirical integration of the rejection sen-
sitivity (RS) model to sexual minority people is one of the
few attempts to extend existing theoretical frameworks that
explain mental health disparities for this population, namely
the minority stress framework (Meyer, 2003) and its exten-
sions (Hatzenbuehler, 2009; Testa, Habarth, Peta, Balsam,
& Bockting, 2015). Theoretical origins of RS are rooted in
the desire to understand how rejection from signiﬁcant oth-
ers aﬀects subsequent other close relationships (Downey &
Feldman, 1996). This was later extended to conceptualize
rejection based on membership of a stigmatized group and
modiﬁed to understand sexual orientation-related RS among
sexual minorities (Dyar, Feinstein, Eaton, & London, 2016;
Pachankis, Goldfried, & Ramrattan, 2008). Feinstein (2019)
brings new life to this adapted application by grounding and
integrating the basic tenets of sexual orientation-related RS
alongside a critical health compromising process of minority
stress: vigilance. Meyer theorized vigilance as a core form of
proximal minority stressors and explains that “LGB people
learn to anticipate—indeed, expect—negative regard from
members of the dominant culture. To ward oﬀ potential nega-
tive regard, discrimination, and violence, they must be vigi-
lant” and this vigilance is “related to feared possible (even if
imagined) negative events” (Meyer, 2003, p. 680–681). Fein-
stein explains that existing theoretical frameworks (Hatzen-
buehler, 2009; Meyer, 2003) mention vigilance and RS as
important processes, but lack a comprehensive integration of
these concepts. Given that schemas for RS are formed early in
the life course, we focus on the applicability to sexual minority
adolescents, and other marginalized groups.
How Rejection Sensitivity Might Expand
Understandings ofLGBTQ Adolescent
Overwhelmingly, research testing the negative impacts of
minority stress among sexual minority adolescents has focused
on mental health, and more speciﬁcally depression and suici-
dality. With good reason, studies show that sexual minority
adolescents experience depression (Lucassen, Stasiak, Samra,
Frampton, & Merry, 2017) and suicidality (Salway etal., 2019)
at much higher rates than heterosexual adolescents, sometimes
as young as age 11 (La Roi, Kretschmer, Dijkstra, Veenstra, &
Oldehinkel, 2016). A smaller subsection of this research has
enumerated anxiety as a correlate of minority stress (Jones,
Robinson, Oginni, Rahman, & Rimes, 2017). The RS frame-
work presented by Feinstein (2019) includes “anxiety” as an
important feature of RS: To “anxiously expect rejection” is
distinct from expecting rejection in the absence of anxiety or
fear. This is a crucial distinction, because it is the anxiety that
accompanies these expectations which activate RS as a detri-
mental process for sexual minority adolescents’ mental health.
The integration of the RS framework may also increase
understanding of other important consequences of diﬀerential
anticipatory emotions of rejection, namely anger and aggres-
sion. We may, for example, see diﬀerent associations between
RS and externalizing or internalizing behaviors as a result of
anticipatory responses that reﬂect anger relative to anxiety. In a
study among lesbian and bisexual women, for example, results
showed that drinking expectancies of aggression and anger
This commentary refers to the article available at https ://doi.
* Laura Baams
1 Department ofPedagogy andEducational Sciences,
University ofGroningen, Grote Rozenstraat 38,
2 Department ofSociology/Interuniversity Center forSocial
Science Theory andMethodology, University ofGroningen,
3 Department ofFamily Science, School ofPublic Health,
University ofMaryland, CollegePark, MD, USA
2260 Archives of Sexual Behavior (2020) 49:2259–2263
were associated with alcohol abuse and dependency, whereas
expecting that drinking will help you forget your worries when
depressed was associated with heavy episodic drinking (Fish
& Hughes, 2018). Research investigating victimization and
bullying (Lereya, Copeland, Zammit, & Wolke, 2015) may
beneﬁt from testing the role of diﬀerent anticipatory emotions
as these might inﬂuence outcomes of aggression (anticipation
of anger) relative to poor mental health (anticipation of anxi-
ety). Aligning with Feinstein’s (2019) framework, we might
hypothesize that some adolescents who are rejected may be
more likely to respond with aggression. For example, a study
among Minnesotan adolescents showed that sexual minority
adolescents were more likely to be both victims and perpe-
trators of bullying behaviors than their heterosexual peers
(Eisenberg, Gower, McMorris, & Bucchianeri, 2015). At
the same time, there could be positive, adaptive features of
anticipation of anger in response to rejection: Shared anger
may bring about and strengthen community, activism, civic
engagement, and other forms of resilience among sexual
minority adolescents through, for example, Gender and Sex-
uality Alliances in schools (Poteat, Scheer, Marx, Calzo, &
Yoshikawa, 2015). Youth may also anticipate and cope with
negative experiences by hyper-engaging in school (Watson
& Russell, 2016). Whether anxious or angry expectations of
rejection bring about mental and behavioral problems, or posi-
tive change, likely depends on the context in which the rejec-
tion takes place and the support sexual minority youth might
ﬁnd in other contexts. Importantly, the distinction between
these anticipatory emotions in relation to externalizing and
internalizing behaviors may also require diﬀerent intervention
strategies (e.g., targeting anger versus targeting youth anxiety).
Critical Developmental Periods forRejection
Research shows that sexual orientation disparities in victimiza-
tion are evident at young ages, well before many adolescents
acknowledge an awareness of their sexual orientation (Mar-
tin-Storey & Fish, 2019; Mittleman, 2019). Might these early
experiences of rejection become part of the learning history
that sets an early precedent for elevated sexual orientation-spe-
ciﬁc RS across the life course? Further, considering the declin-
ing age of coming out for adolescents, experiences with rejec-
tion and internalization of negative messaging around sexual
minority identity may come at a younger age than previous
generations, when both mental health (Russell & Fish, 2019)
and RS are more vulnerable to these unique social stressors.
According to Feinstein (2019), the cognitive social
learning history of sexual minority individuals might also
include vicarious experiences of rejection that impact their
own RS (e.g., witnessing victimization or hearing nega-
tive messages about sexual minority individuals in media).
Although media has become more inclusive of sexual (and
gender) diversity, debates around marriage equality, bath-
room access, and conversion therapy might also portray
negative views of sexual and gender diversity. Thus, in
addition to witnessing hate crimes, (social) media portray-
als of violence against sexual minority individuals might
impact young people’s anxious expectations of the world
(Paterson, Brown, & Walters, 2019). A parallel process can
be observed in children and youth of color, who experience
vicarious racism negatively impacting various health out-
comes (Heard-Garris, Cale, Camaj, Hamati, & Dominguez,
2018). Importantly, vicarious experiences may be more or
less impactful depending on when they occur in the life
course, in that contemporary cohorts of sexual minority
youth may be uniquely inﬂuenced by the negative politi-
cal rhetoric in ways that alter their RS and hypervigilance
across the life course. In fact, some might argue that the
degree to which contemporary youth engage in new media
may make this cohort of sexual minority youth particularly
susceptible to RS, and the negative mental health conse-
With rapid changes in social attitudes toward sexual and
gender diversity, research has increasingly included a focus on
cohort diﬀerences among sexual minority people. Our focus
on adolescence is in part due to the developmental stage and
its importance for the development of RS, but also because
contemporary sexual minority adolescents grow up in a social
environment that is unique from older cohorts of sexual
minority adults—and its impact on their lived experience
and health will likely play out in unforetold ways across their
life course. For example, in a study examining experiences of
discrimination across the life course, gay and bisexual men
in their 40s and 50s evidenced the highest rates of perceived
discrimination relative to lesbian, gay, and bisexual adults of
other ages (both older and younger). Rice, Fish, Russell, and
Lanza (2019) attributed this anomoly to the fact that these
men would have been in their late teens and early 20s during
the AIDS epidemic, therefore (potentially) heightening these
men’s perceptions of discrimination. We imagine, given the
tenets of RS, that these men might have altered attributions of
potentially neutral or ambiguous stimuli and elevated RS given
the social stigma they experienced during this contentious
time in history. Growing attention for cohort diﬀerences in
perceptions of discrimination and compromised health might
foreshadow how diﬀerent cohorts have unique RS-inducing
experiences, and therefore unique health consequences.
2261Archives of Sexual Behavior (2020) 49:2259–2263
Sociocontextual Perspectives onRejection
Existing theoretical frameworks, including the current RS
framework, pay little attention to the context in which people
develop RS or experience early rejection. As Feinstein (2019)
outlines, context matters both for the occurrence and salience
of rejection and may impact the development of RS. In addi-
tion, experiencing rejection in spaces that are thought to be
“safe” might have a stronger impact on RS than experiencing
rejection in historically unaccepting spaces. For example,
when bisexual individuals experience rejection in the LGBTQ
community, this may impact their RS to a larger extent than
when they experience rejection in historically heterosexual
spaces (Bostwick & Hequembourg, 2014). Additionally, expe-
riencing RS in “safe” spaces might elicit diﬀerent anticipatory
emotions (e.g., anxiety, anger) compared to experiencing RS
in more traditionally unaccepting spaces. Further, many sex-
ual minority adolescents experience victimization in multiple
contexts: their family home, school, or in public (Goldbach
& Gibbs, 2017). Experiences in one context might translate
to elevated RS in other contexts. For RS in particular, it is
important to attend to multiple intersecting contexts and how
experiences with rejection in one context does not preclude
the experience of rejection in another, and may even set in
motion the development of “generalized” RS, because it likely
manifests as the result of experiences across multiple contexts.
Alternatively, sexual minority adolescents might also gradu-
ally select more supportive social environments (i.e., friends,
LGBTQ community) limiting experiences with rejection
and increasing positive and supportive experiences (Cohen,
Padilla, & Aravena, 2006).
Applicability toOther Marginalized/
Preliminary research on RS supports the notion that pro-
cesses of RS explain the associations between minority
stress and health outcomes, and that this mechanistic pro-
cess holds for diﬀerent sexual minority subgroups (e.g.,
men/women, monosexual/bisexual sexual minority people;
Feinstein, 2019), which is what one hopes to see when the-
ory building. However, Feinstein reﬂects on how anxious
expectations of rejection might diﬀer when we account for
intersections with gender, race/ethnicity, and age, and that
cues triggering anxious expectations may be diﬀerent from
cues triggering angry expectations among speciﬁc groups.
A focus on intersecting experiences of rejection is crucial
in understanding the development of RS for many sexual
minority youth. That is, sexual minority youth of color likely
develops RS related to two social statuses: sexual orientation-
related RS from society in general, as well as race/ethnicity-
related RS from both society in general, but also within the
LGBTQ community, whereas White sexual minority people
likely do not experience RS related to racial/ethnic identity.
Along these same lines, however, RS related to diﬀerent iden-
tities—such as a racial/ethnic identity—may also cultivate
unique strategies to combat the negative inﬂuence of rejec-
tion, staving oﬀ RS. For example, parents of youth of color
often engage in conversations around race-related experi-
ences, including race-related rejection (i.e., family racial/eth-
nic socialization practices), which has been shown to have
positive eﬀects for mental health and academic achievement
among youth of color (Hughes etal., 2006). It could be that
these strategies to address race-related rejection could help
sexual minority youth of color cope with sexual orientation-
related rejection. Thus, intersectional views on the devel-
opment of RS could provide new perspectives on “multiple
minority stressors” and how these experiences are linked to
resilience, but also compromised mental health.
In addition, although Feinstein (2019) acknowledges the
applicability of the RS framework to diﬀerent genders, there
is currently very little research on the development of RS
among transgender and other gender minority adolescents.
Theoretical work on gender minority stress mentions nega-
tive expectations from the future as an important precursor of
vigilance (Rood etal., 2016; Testa etal., 2015) and suggests
that experiences with rejection and trauma in transgender
persons form a “trauma history” which then creates vigi-
lance similar to how it would in sexual minority populations
(Hendricks & Testa, 2012). However, because we currently
lack a measure of RS that is applicable to multiple groups and
groups with multiple minority identities, we have very little
knowledge of the experience and development of RS among
gender minority adolescents. Further, the emergence of new
identity labels among sexual and gender minority youth
(e.g., pansexual, genderqueer, gender nonbinary) underline
the need for measurement development for a diverse and
dynamic sexual and gender minority population (Galupo,
Ramirez, & Pulice-Farrow, 2017).
Feinstein (2019) broadly discusses currently available interven-
tions that target RS, such as cognitive behavioral therapy (CBT).
An alternative to CBT may be to target the memory bias—an
important aspect of RS—through trauma-informed care or eye
movement desensitization and reprocessing (EMDR) therapies
(Pantalone, Valentine, & Shipherd, 2017). However, a common-
ality among these psychological approaches is that they rely
on people ﬁnding their way to, and accessing, mental health
providers. Adolescents with high levels of RS might struggle
2262 Archives of Sexual Behavior (2020) 49:2259–2263
to do so, may not be out to parents, and might prefer not to
disclose their sexual orientation to health providers (Fuzzell,
Fedesco, Alexander, Fortenberry, & Shields, 2016). Similarly,
although people may suﬀer from mental health and substance
use disorders, relatively few people engage in formal counseling
or therapy (Lipari, Park-Lee, & Van Horn, 2016; SAMHSA,
2016). It is therefore necessary to understand how large-scale
intervention strategies might be developed or adapted to address
and intervene in RS processes for sexual minority youth.
Further, Feinstein (2019) and the RS literature, more broadly,
do not pay much attention to how RS might be prevented. For
example, rejection might occur in one context (e.g., school) but
if other contexts are supportive (e.g., home), the development
of RS might be slowed down or prevented. For sexual minority
adolescents, the school context might be particularly amenable
to change by implementing inclusive policies and programs
that reduce bullying and improve acceptance (Day, Ioverno, &
Russell, 2019). LGBTQ community centers (see Fish, Moody,
Grossman, & Russell, 2019; Williams, Levine, & Fish, 2019)
may also be uniquely positioned to deliver programs that
increase sexual minority youth’ self-esteem and develop cop-
ing strategies to address RS and the associated mental health
consequences. Additionally, psychoeducation and advocacy has
improved support and acceptance in the family context (Parker,
Hirsch, Philbin, & Parker, 2018), while medical systems might
beneﬁt from education and training to improve accessibility and
cultural competence (Bidell & Stepleman, 2017).
In addition to the applicability of the RS framework for sexual
minority individuals from various cohorts, the applicability of
this framework to diﬀerent sexual and gender minority popu-
lations remains to be seen. Research among diverse groups
of sexual and gender minority individuals should consider
important aspects of identity development, such as identity
centrality (Dyar etal., 2016). Although identity development
clearly plays a role in the development of RS, these mecha-
nisms are likely universal, whereas the trigger of RS is minor-
ity (or status)-speciﬁc. What Feinstein’s (2019) visioning does
is portray a close-up of one aspect of the minority stress frame-
work, which enables us to more rigorously test hypotheses
and improve the speciﬁcity of the minority stress framework.
By doing so, Feinstein oﬀers an example of what scholars can
do to continue to innovate minority stress theory and thereby
improve our understanding of how minority stress impacts
health and the ways we can disrupt this process.
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