Content uploaded by G. Tyler Lefevor
Author content
All content in this area was uploaded by G. Tyler Lefevor on May 25, 2021
Content may be subject to copyright.
Sexual Minorities who Reject an LGB Identity 1
SEXUAL MINORITIES WHO REJECT AN LGB IDENTITY
Sexual Minorities who Reject an LGB Identity: Who Are They and Why Does It Matter?
Christopher H. Rosik, Ph.D.1,2, G. Tyler Lefevor, Ph.D.3, & A. Lee Beckstead, Ph.D.4
1Link Care Center, Fresno, California, United States
2Department of Psychology, Fresno Pacific University
3Department of Psychology, Utah State University
4Salt Lake City, Utah, United States
Author Note
We have no known conflict of interest to disclose.
We gratefully acknowledge the work of Ron Schow, Maribeth Raynes, and Ty
Mansfield in survey design, recruitment, and feedback on earlier versions of this article.
Correspondence concerning this article should be addressed to Christopher H.
Rosik, Link Care Center, 1734 W. Shaw Ave, Fresno, CA 93711. Phone: (559) 439-2647
(x142). Fax: (559) 439-4712. Email: christopherrosik@linkcare.org
Sexual Minorities who Reject an LGB Identity 2
Abstract
Although some persons with minority sexual orientations do not identify as lesbian, gay, or
bisexual (LGB), Minority Stress Theory (Meyer, 2003) has largely been developed utilizing
LGB-identified samples. We examined a sample (n = 274) of sexual minorities with diverse
religious and sexual identity labels to determine if those rejecting versus adopting an LGB
identity were different in terms of religious, sexual, relational, and health characteristics. Results
suggested those who reject an LGB identity are more likely to be religiously active, full members
of their church, and highly intrinsic and theologically conservative in their religious viewpoint.
They further reported having slightly more lifetime heterosexual attractions, fantasies, and
behaviors, greater internalized homonegativity, and being more interested in having children and
a child-centered family life. They were also more likely to be single and celibate or in a
heterosexual relationship. Contrary to expectations, these differences were not associated with
health differences in depression, anxiety, and social flourishing. LGB-identified participants did
report higher life satisfaction than those rejecting an LGB identity, but this difference was not
interpretively meaningful when considered in reference to population norms. We conclude with a
discussion of the potential implications of our findings for research, legal and professional
advocacy, and clinical care.
Keywords: sexual identity, religion, health, LGBTQ, minority stress
Sexual Minorities who Reject an LGB Identity 3
Sexual Minorities who Reject an LGB Identity: Who Are They and Why Does It Matter?
Although many sexual minorities adopt a lesbian, gay, bisexual (LGB) identity, some persons
who experience same-sex attractions reject an LGB identity in favor of other descriptions for their
sexuality, such as “same-sex attracted” or “mostly heterosexual” (Lefevor et al., 2020). Because
research typically focuses on LGB-identified individuals, very little is known about those who reject
an LGB identity. In this study, we seek to identify characteristics of this group and how these
characteristics may distinguish them from sexual minorities who are LGB-identified. We also
examine to what extent these groups differ on several health measures and close with a discussion
about why our findings matter for this literature.
Implications of Minority Stress Theory for Rejecting an LGB Identity
Minority stress theory (MST) maintains that LGB persons experience stress associated with
their stigmatized social status and this stress is responsible for their increased risk for psychological
distress (Meyer, 2003). Meyer proposed a number of stress processes linked to LGB identity along a
distal-proximal continuum. Distal stressors are defined as objective events, such as violence or overt
acts of prejudice. Proximal stressors are defined as perceptions or appraisals of objective events,
including hypervigilance or internalized stigma. The present study focuses on three core proximal
stressors: expectations of rejection, concealment, and internalized homonegativity (IH). Research has
indicated that each of these proximal stressors are associated with adverse mental health outcomes
for sexual minorities in comparison to their heterosexual counterparts (Cohen et al., 2016; Newcomb
& Mustanski, 2010; Pachankis et al., 2020). Each of these may also have implications for sexual
minorities who do not identify as LGB.
Expectations of Rejection
Experiences of stigma and prejudice in one’s interactions can result in anticipating future
rejection and being sensitive and vigilant toward the interpersonal world (Feinstein et al., 2012).
Following MST, sexual minorities may reject an LGB identity label to manage stigma and
Sexual Minorities who Reject an LGB Identity 4
expectations of rejection in their environment. Heteronormative religious settings are a common
example of where such sexual identity rejection may occur.
Concealment
Concealment is an internal psychological-stress process whereby individuals hide their
stigmatized minority sexual identity due to feelings of guilt and shame and/or out of fear its
disclosure would cause them harm (Meyer, 2003; Pachankis et al., 2020). Within this framework,
sexual minorities who reject an LGB identity may do so to evade detection and potential negative
ramifications in non-affirming environments. Such consequences might include loss of a social
network, loss of social status, expulsion from a private school, and/or loss of church membership.
Internalized Homonegativity
Sexual minorities coping with stigma and prejudice may also internalize these experiences
and the accompanying negative beliefs, a stress-inducing process called internalized homonegativity
(IH) (Puckett et al., 2017; Szymanski et al., 2008). This internalization of negative beliefs may lead
sexual minorities to reject an LGB identity. Certain faith or political communities may, for example,
impart beliefs that the experience of same-sex attractions makes one morally deficient or mentally ill.
Religious Exposure and Proximal Stressors
A significant body of research has found religion, and particularly conservative religion, to
be associated with these proximal stressors. Generally, conservative or traditional religiosity has been
related to more homonegative beliefs, greater sexual minority identity concealment, and higher levels
of IH, all of which are in turn associated with poorer mental health outcomes (Crowell et al., 2015;
Newcomb & Mustanski, 2010; Pachankis, et al. 2020; Sowe et al., 2014; Stern & Wright, 2017).
However, this literature also largely relied upon LGB-identified samples and, as a consequence, may
have limited validity for non-LGB-identified conservatively religious sexual minorities (Szymanski
et al., 2008). For example, rejection of an LGB identity may limit exposure to proximal stressors
Sexual Minorities who Reject an LGB Identity 5
within conservative religious communities and promote access to social connection within these
groups, both of which could reduce associations with negative health outcomes.
Although Meyer (2003) theorized sexual minorities who did not adopt an LGB identity
would not be subject to proximal stressors, to our knowledge this has not been tested among sexual
minorities who reject an LGB identity. From our perspective, individuals experiencing same-sex
attractions in a conservative religious setting may not be concealing a sexual identity, but certainly
are concealing the presence of sexual attractions whose behavioral enactment would be strictly
prohibited. This could promote fears of rejection and internalized negativity. Our study thus
presumes these stressors are real for sexual minorities who reject an LGB identity, though further
research with such a focus is certainly desirable.
Possibly motivated and undergirded by religious norms, rejection of an LGB identity would
also appear to signal a lack of identity integration and self-acceptance, which is viewed in many
sexual minority developmental models and LGB-affirmative therapies as the culmination of the
coming out process (e.g., McCormick & Baldridge, 2019; Fassinger & Miller, 1996). The minority
stress processes resulting in a disruption of LGB identity formation would be expected to result in
mental health disparities between sexual minorities who have integrated their LGB identity as
compared to those who have rejected it.
Although MST has been helpful in understanding the experiences of many sexual minorities,
it was ultimately developed to describe the experiences of LGB-identified sexual minorities. As such,
it may have limited applicability to sexual minorities who reject an LGB identity, particularly those
in conservative religious contexts. The present study examines sexual minorities who reject an LGB
sexual identity label in comparison to those who are LGB identified. In light of the research on
minority stress and mental health outcomes, we sought to (a) understand who rejects a sexual
minority identity status and (b) determine if this rejection is associated with measures of mental
health.
Sexual Minorities who Reject an LGB Identity 6
Method
Survey Design
Participants were asked to take part in a survey that was designed to identify important
aspects of life and relationships for those who experience (or have experienced) same-sex attractions
(SSA) and identify as LGB, heterosexual, other sexual identities, or who reject a label, and were
involved in one of four relationship options (i.e., single and celibate; single and non-celibate;
heterosexual, mixed-orientation relationship; same-sex relationship). Participants completed the
survey through a website designed for the survey (4OptionsSurvey.com). A description of the survey
can be found in (Lefevor et al., 2019).
Data Collection and Recruitment
We obtained approval from the Idaho State Institutional Review Board prior to commencing
this study. Data collection occurred over a 10-month period from September, 2016 to June, 2017.
This involved invitations through (a) news media in Utah; (b) email lists, Facebook groups, and
conventions; (c) psychological associations and support networks; and (d) mental health providers.
Organizations and networks utilized for recruitment ranged from those religiously and/or
conservative oriented (e.g., North Star, Alliance for Therapeutic Choice and Scientific Integrity,
People Can Change) to those formally LGB-affirming (e.g., American Psychological Association’s
Society for the Psychological Study of Sexual Orientation and Gender Diversity, the LGBTQ-
affirmative Psychotherapist Guild of Utah, and the National Association for Social Work). Complete
details about participant recruitment can be found in (Lefevor et al., 2019). The present study was
conducted mostly by individuals who have experienced SSA or identify as LGB. In addition, some
members of the research team hold leadership roles in conservative organizations such as North Star
and The Alliance for Therapeutic Choice and Scientific Integity. This representation may have
encouraged non-LGB-identified participants to believe their perspectives would be represented and
Sexual Minorities who Reject an LGB Identity 7
understood. Indeed, 120 (43.8%) participants reported rejecting an LGB identity and 79 (28.8%)
participants identified as theologically conservative.
To be included in analyses, participants must have (a) been at least 18 years of age, (b)
experienced SSA at some point in their life, (c) identified their relationship status, and (d) completed
the first two sections of the survey, which took approximately one hour to complete. More details
about recruitment and makeup of the full sample can be obtained from Lefevor et al. (2019).
Participants
A total of 1499 respondents completed all mandatory questions. Our focus for this study was
on participants who had never identified as Mormon and rejected or adopted an LGB identity (n =
274) as Mormon participants have been analyzed elsewhere (Lefevor et al., 2020). The average age
of these participants was 42.3 (SD = 14.8). In terms of gender, 62 participants identified as women,
209 as men, and 14 used other descriptors (e.g., transman, gender fluid, genderqueer). Our sample
was primarily White (n = 227) and educated, with 75.2% (n = 206) earning at least a bachelor’s
degree.
Measures
The survey included both measures specifically created for this study as well as preexisting
measures and was designed to provide data to inform several studies. The present research
incorporated the variables described below. Differences in sample sizes for some of these variables
occurred due to the exclusion of “not applicable” responses when it was inappropriate to incorporate
these responses into the measure.
Demographics
We included single item measures of age, education (a 6-point Likert scale from “Less than
high school degree” to “Graduate degree”), race (0 = White, 1 = All others), and gender (1 =
Female, 2 = Male, 3 = Others). The LGB and non-LGB participants did not differ in level of
education or racial distribution, but the non-LGB group was older (M = 44.98, SD = 14.64) than the
Sexual Minorities who Reject an LGB Identity 8
LGB group (M = 39.9, SD = 14.52) (t(272) = 2.87, p < .01, d = .35). In addition, the LGB-identified
group contained more women (n = 39) than the non-LGB identified (n = 18) (X2(2) = 9.98, p < .007,
Cramer’s V = .19).
Religiousness
We utilized four common indicators of religiousness. Church/religious activity was measured
on a 5-point Likert scale from 1 = More than once per week to 5 = Stopped attending/not applicable.
This variable was transformed so that higher scores would indicate greater religious activity. Current
church/religious statuses examined were “full member,” alienated from membership (e.g., probation,
disfellowshipped, excommunicated, resigned), and “disinterested/not applicable.” Many options for
religious views were offered to participants, and categories employed were (a) “theologically
conservative, traditional, or orthodox”; (b) “theological moderate”; (c) “theological
liberal/progressive”; (d) “other religious views” (e.g., “theologically heterodox” and “spiritual but
not religious”); and (e) “non-religious or anti-religious.” Intrinsic Religiosity (IR) was measured by
the statement, “My whole approach to life is based on my religion/spirituality” (Gorsuch &
McPherson, 1989). This item utilized a 7-point Likert scale format from 1 = Strongly disagree to 7 =
Strongly agree.
Relationships
We assessed relationship contexts using four measures. Participants indicated whether they
were (a) single and celibate; (b) single and not celibate; (c) in a heterosexual, mixed-orientation
relationship; or (d) in a same-sex relationship. Participants’ history of heterosexual marriage was
assessed with the question, “Have you ever been in a heterosexual marriage?”, with response options
of (a) currently in a heterosexual marriage, (b) divorced or separated, (c) widowed, (d) never, and (e)
other. Due to low frequencies, widowed participants were included in the “other” category.
Participants were also asked about the importance they place on having children and living a child-
centered life now or in the future. Responses ranged from 1 = Not important to me to 4 = Very
Sexual Minorities who Reject an LGB Identity 9
important to me. Degree of social support was assessed with the question, “I meet my needs for
connection, intimacy, and mutual understanding” rated on a 7-point Likert scale anchored by 1 =
Never to 7 = Always.
Sexuality
Sexuality-related variables included Kinsey (Kinsey et al., 1948) lifetime ratings of sexual
behaviors, attractions, and fantasies utilizing a 7-point Likert scale ranging from 1 = Exclusively
heterosexual with no homosexual to 7 = Exclusively homosexual with no heterosexual. Two
participants who reported no lifetime experience of same-sex attractions, behaviors, and fantasies and
were removed from the sample before our analyses. IH was assessed using the three-item internalized
homonegativity subscale from the Lesbian, Gay, and Bisexual Identity Scale (Mohr & Kendra,
2011). The authors report an internal consistency of .86 and a test-retest reliability of .92. Cronbach’s
alpha for the present study was .90. This scale is in line with the original conceptualization of IH
(Puckett et al., 2017), including the item, “If it were possible, I would choose to be straight.” Total
scores could range from 3 to 21, with higher scores signaling greater IH. Participants also indicated
the degree of conflict between religious and sexual identities with the single item, “I feel resolved
about my sexuality and religious issues.” IH and identity resolution were both measured on a 7-point
Likert scale ranging from 1 = Strongly disagree to 7 = Strongly agree.
Sexual Identity Labeling
Participants were asked about their current sexual identity and given 28 options from which
to choose. They also indicated their degree of rejection of an LGB identity or acceptance of it
through the question, “I am open/out about my rejection of the gay/lesbian/bisexual identity (mark
N/A if you identify as gay/lesbian/bisexual).” Degree of openness about LGB identity rejection
ranged from 1 = Never to 7 = Always. Participants who indicated rejection of an LGB identity
regardless of their degree of outness about it were grouped (n = 120) and compared with participants
identifying as LGB (n = 154), resulting in a final sample of 274.
Sexual Minorities who Reject an LGB Identity 10
Not surprisingly, there were significant differences between the groups regarding their
current sexual identity (X2(17) = 103.68, p < .001, Cramer’s V = .62. Despite indicating that they
rejected an LGB identity, 17 participants also reported an LGB identity. After deliberation, we
decided to include these individuals with those who rejected an LGB identity.
Health Indicators
Depression. Current depression was measured using the Patient Health Questionnaire (PHQ-
9; Kroenke et al., 2001). The PHQ-9 has good concurrent validity with the Short Form-20 (SF-20)
and diagnosis of major depressive disorder (Kroenke et al., 2001). Total scores could range from 4 to
36 with higher scores reflecting greater depression. Cronbach’s alpha for the present study was .91.
Anxiety. Current anxiety was measured using the Generalized Anxiety Disorder 7-item
(GAD-7) scale (Spitzer et al., 2006). The GAD-7 has good concurrent validity with the SF-20 and
diagnosis of generalized anxiety disorder (Spitzer et al., 2006). Total scores could range from 4 to 28
with higher scores indicating greater anxiety. Cronbach’s alpha for the present study was .91.
Flourishing. Psychosocial flourishing was measured using the Flourishing Scale (Diener et
al., 2009), an 8-item measure of self-perceived success in areas such as relationships, purpose, and
optimism rated on a 7-point Likert scale with anchors of 1 = Strongly disagree to 7 = Strongly agree.
Total flourishing scores could range from 8 to 56 with higher scores indicating greater flourishing.
The Flourishing Scale is psychometrically validated and is comparable to other measures of
psychosocial well-being. Cronbach’s alpha for this present study was .93.
Life Satisfaction. Life satisfaction was assessed with the five-item Satisfaction with Life
Scale (SWLS; Diener et al., 1985). Participants indicated agreement with statements on a 7-point
Likert scale ranging from 1 = Strongly disagree to 7 = Strongly agree. Total life satisfaction scores
could range from 5 to 35 with higher scores signaling greater life satisfaction. Cronbach’s alpha for
the present study was .89.
Data Analysis
Sexual Minorities who Reject an LGB Identity 11
All analyses were conducted using SPSS Statistics 25. Univariate analyses supported the
linearity and normality of all our continuous variables. All variables were within the acceptable range
with skewness less than 2 and kurtosis less than 5 (West et al., 1995). These impressions were
confirmed by examination of residuals. Independent-samples t-tests were used for group comparisons
on continuous variables. Cohen’s d was obtained as the effect size statistic and interpreted according
to his recommendations (Cohen, 1992). Chi-square statistics were employed for analyses of
comparisons for nominal variables. Due to the number of comparisons, we used an alpha of .01 to
control for Type I error.
Results
Univariate statistics and participant characteristics for the full sample are presented in Table
1. Results for group comparisons between LGB-identified and LGB-rejecting participants are
examined below.
Religion, Relationships, and Sexuality
Tables 2 and 3 display the significant findings for differences between participants who adopt
versus reject an LGB identity as pertains to religiousness, relationships, and sexuality. Religiously,
sexual minority individuals who rejected an LGB identity tended to be more active in and full
members of their church as well as more highly intrinsic and conservative in their religious viewpoint
than those who identified as LGB, with effect sizes in the medium to large range. In terms of the
relationship variables, those rejecting an LGB identity tended to place a greater emphasis on having
family and children and were more likely to be single and celibate than participants who identified as
LGB, with effect sizes in the medium range. The groups did not differ in the degree they felt their
needs for connection and intimacy were being met, though there was a trend in the direction of LGB
participants (M = 4.91, SD = 1.80) feeling more connected than those who rejected an LGB identity
(M = 4.33, SD = 2.01)(X2(269) = 2.47, p = .013, d = .30). There was not a significant difference in
participants’ history of involvement in a heterosexual marriage/relationship, although there was a
Sexual Minorities who Reject an LGB Identity 12
trend suggesting that those rejecting an LGB identity may be more likely to have been involved in a
heterosexual marriage/relationship than LGB participants (X2(3) = 9.61, p < .05, Cramer’s V = .19).
Regarding sexuality, participants who rejected an LGB identity reported greater IH and lower
Kinsey lifetime attraction ratings (i.e., more heterosexual attractions, fantasies, and behaviors) than
the LGB participants, with effect sizes being large for IH and medium for the Kinsey ratings. In post
hoc analyses, we noted within the LGB-identified group the association between IH and depression
(r(154) = .21, p = .01) diminished slightly when controlling for religious activity (r(154) = .18, p <
.02). However, among participants rejecting an LGB identity, the association between IH and
depression (r(120) = .33, p < .001) increased when religious activity was controlled (r(120) = .46, p
< .001), suggesting IH and religious activity may operate differently for these groups in relation to
health outcomes. The Kinsey ratings indicate that participants who reject an LGB identity label
reported on average somewhat more heterosexual attractions, though both groups described
themselves as predominantly experiencing same-sex attractions (SSA).
Participants who reject an LGB identity (M = 5.40, SD = 1.81) did not differ from the LGB
group (M = 5.50, SD = 1.65) in terms of the degree of resolution of conflict between their religious
and sexual identities (X2(232) = .48, p = .63, d = .06). On average, both groups reported moderate
agreement with having resolved these issues.
Health Indicators
For the most part, health indicators were not different between sexual minorities who adopted
or rejected an LGB identity. The LGB-identified participants and those rejecting an LGB identity
label reported similar levels of depression (M = 14.36, SD = 5.39 vs. M = 15.37, SD = 5.79,
respectively)(t(272) = -1.49, p = .14, d = .18), anxiety (M = 12.05, SD = 5.14 vs. M = 12.47, SD =
4.99)(t(272) = -.67, p = .50, d = .08), and flourishing (M = 47.37, SD = 7.72 vs M = 46.13, SD =
8.75)(t(272) = 1.25, p = .21, d = .15). However, we did find that participants identifying as LGB
reported greater life satisfaction than those rejecting an LGB identity, with a medium effect size.
Sexual Minorities who Reject an LGB Identity 13
As a check on our findings, we reran our analyses after removing the 17 participants who
indicated an LGB identity earlier in the survey and later indicted rejecting such an identity. The
removal of these individuals did not substantially alter our results. In fact, subsequent effect sizes
increased modestly, although their strength did not change in terms of conventional interpretive
guidelines. These may be individuals less dogmatic about their rejection of an LGB identity, but
whatever the reasons for their manner of responding, their inclusion with other participants who
reject an LGB identity appears empirically justifiable.
Discussion
We examined a theologically diverse sample of sexual minorities to determine how those
who reject an LGB identity may differ from those who have adopted an LGB identity and how the
two groups compare in terms of health indicators. Our findings are generally consistent with a recent
study on Mormon sexual minorities (Lefevor et al., 2020) and suggest that significant differences
exist between the two groups; however, these differences do not appear to translate into health
disparities.
Who Rejects an LGB Identity?
Participants who rejected an LGB label were significantly more conservatively religious than
LGB-identified participants. They were also more likely to be single and not sexually active or in a
heterosexual relationship and place a greater emphasis on raising children than those identifying as
LGB. These values and relational choices likely reflect the heteronormative environment of
conservative religious communities. Participants who rejected an LGB label also reported more
lifetime heterosexual attractions, fantasies, and behaviors than LGB-identified participants. These
sexual experiences may undergird the difference between these groups in their involvement in and
aspirations for heterosexual marriage and a child-centered family life. Nonetheless, we note that both
groups indicated a primarily same-sex sexual orientation.
Sexual Minorities who Reject an LGB Identity 14
We found also that both groups reported feeling moderately resolved about any conflicts
between their sexuality and religious issues. Both groups also reported similar degrees of social
support and age. These findings contrast with expectations that those rejecting an LGB identity may
be less developed in their sexual identity than LGB individuals and hence be expected to eventually
adopt an LGB identity (Fassinger & Miller, 1996). Rather, it seems more probably likely that the
rejection of an LGB identity by these sexual minorities reflects the congruence between their
conservatively religious values, their sexual experiences, and their ability to meet needs for
connection, intimacy, and mutual understanding within their conservatively religious community
(Barringer & Gay, 2017).
In keeping with our view that religiously active sexual minorities who reject an LGB identity
are still subject to the proximal stressors of Minority Stress Theory, we found IH to be significantly
greater among participants who rejected an LGB identity than for those LGB identified. However, in
contrast to our expectations, for the most part this was not associated with worse reported health (see
also Barnes & Meyer, 2012). This may be due to the buffering effects on minority stress processes of
social support and connection within religious communities (Barringer & Gay, 2017). Exposure to
proximal stressors within conservative religious communities may additionally be mitigated by the
rejection of an LGB identity, which in turn could reduce associations with negative health outcomes.
Additionally, it is possible among some of those rejecting an LGB identity that our measure of IH,
which prioritizes a heterosexual identity, may reflect principled religious conviction more than
health-diminishing shame or self-loathing (Hallman et al., 2018).
We did not find that participants who rejected an LGB identity had significantly worse levels
of depression, anxiety, and psychosocial flourishing than those who were LGB identified. Assuming
sexual minorities who reject an LGB identity are indeed subject to proximal sexual minority
stressors, this seems at odds with minority stress and sexual identity theories that assume adoption of
an LGB identity is the healthiest pathway of sexual minority identity development. This plausibly
Sexual Minorities who Reject an LGB Identity 15
could be the result of the underrepresentation in research of sexual minorities who reject an LGB
identity or are otherwise living within conservatively religious communities, a problem we discuss
below. Nevertheless, these participants did report less life satisfaction than LGB-identified
participants. This finding suggests that real stresses remain for sexual minorities who are active in
conservative religious environments that may not be completely mitigated by the social capital
available within these communities. No doubt leaders and members within these religious traditions
can do more to promote emotional and relational thriving among sexual minorities in their
communities.
It is also important to situate contextually the health findings within population norms. Means
for both groups were in the moderately severe range (i.e., 15-20) for depression (Kronke et al., 2001)
and in the moderate clinical range (i.e., 10-14) for anxiety (Spitzer et al., 2006). Despite these health
findings, results for psychosocial flourishing indicated both groups were experiencing slightly above
average levels of flourishing (Diener et al., 2009). Life satisfaction was slightly below the non-
clinical sample average (i.e., 25; Diener et al., 1985) for participants rejecting an LGB identity,
whereas the LGB-identified participants reported average life satisfaction levels. However, both
groups are classifiable within the “slightly satisfied” range (Pavot & Diener, 1993); therefore, this
difference may not be interpretively meaningful. These findings may suggest that, regardless of
identity choice and although minority stress negatively impacts the emotional health of these sexual
minorities, both groups find ways to live equally flourishing and satisfying lives within their
respective religious or LGB communities. Minority stress processes not specific to conservatively
religious environments may be dominant in the depression and anxiety findings; alternatively, sexual
orientation minority stresses unique to LGB communities may be roughly as harmful to sexual
minorities as minority stresses deriving from conservatively religious contexts. It is also possible
non-sexual orientation related stress processes common to both groups are important in explaining
the emotional distress of our sample. Further research is needed to clarify these important questions.
Sexual Minorities who Reject an LGB Identity 16
Implications for Research, Advocacy, and Clinical Care
Our findings have several implications for understanding sexual minorities who reject an
LGB identity. We briefly address three intersecting areas of concern related to research and
advocacy, clinical care, and the need for profession-wide ideological diversity.
Our findings for sexual minorities who reject an LGB identity seem to go against the
scholarly consensus and conventional wisdom pertaining to those who experience SSA but remain in
conservative religious faith communities. Contrary to expectations that severe minority stresses
within heteronormative religious contexts and a concomitant arrested sexual identity development
would be associated with greater adverse health, we found no significant or interpretively meaningful
health differences between those rejecting or adopting an LGB identity. This may have been a
function of sociopolitically diversifying our research team to gain the trust of and have access to
conservative sexual minority networks that have large numbers of individuals who reject an LGB
identity. We suspect our findings would not be so surprising if research in this area was regularly
conducted outside the LGB networks and venues more easily accessed by researchers whose values
and beliefs align with those they study. To put it another way, when studies utilize LGB self-identity
as the sexual minority inclusion criterion, they exclude those sexual minorities rejecting an LGB
identity by definition and render these individuals invisible.
This potentially serious limitation of the research literature has implications for legal and
mental health advocacy, particularly where legislative and policy initiatives impact sexual minorities
and their conservative religious communities (Rosik, 2017). Caution should be exercised not to
assume theories and constructs derived from LGB samples can be easily generalized to sexual
minorities who do not share such an identity (Lefevor et al., 2020). Similarly, using studies limited to
or dominated by LGB-identified persons alienated from or uninterested in traditional faith
communities (e.g., Dehlin et al., 2015; Hamilton & Gross, 2013; Ryan et al., 2020; Sowe, Brown et
al., 2014; Sowe, Taylor et al., 2017) as a basis for laws or advocacy efforts that impact sexual
Sexual Minorities who Reject an LGB Identity 17
minorities in traditional religious settings may be a dubious practice (e.g., advocating the curtailment
of religious freedoms to promote LGB well-being; Sowe, Taylor, et al., 2017). Legal opinions as well
as official pronunciations and clinical guidance from professional associations in this arena need to
be primarily grounded in population-based samples able to identify sexual minorities who reject LGB
labels or samples purposefully recruiting sexual minorities not LGB identified. Furthermore, mental
health professionals encountering sexual minority clients who are (or are not) embedded within
conservative religious communities should not assume their rejection of an LGB identity label
inhibits their ability to live healthy, meaningful, and satisfying lives.
At the broadest level, our findings highlight the value of ideological diversity for developing
a more comprehensive understanding of sexual minorities. When legal and mental health associations
become too tribal (Clark & Winegard, 2020), there is a risk certain groups and perspectives will be
overlooked, as may have been the case with sexual minorities who reject an LGB identity. As
Chambers et al. (2013) warned, “To the extent that social scientists operate under one set of
assumptions and values, and fail to recognize important alternatives, their scientific conclusions and
social-policy recommendations are likely to be tainted” (p. 148). We hope our experience with an
ideologically diverse research team exemplifies the benefits of such an endeavor and encourages
legal and mental health professionals to prioritize sociopolitical diversity as a diversity dimension in
their research and advocacy.
Limitations
Some limitations of our study should be noted. The study’s cross-sectional nature does
not allow for a determination of causation in our findings. It is possible that participant
characteristics between sexual minorities rejecting versus adopting an LGB identity promote
well-being and do so in different ways. It is also possible preexisting levels of well-being lead to
specific differences in certain participant characteristics (e.g., less depression enables greater
Sexual Minorities who Reject an LGB Identity 18
religious activity among those rejecting LGB identity and less religious activity among those
who identify as LGB).
Many of our variables were single-item measures, which is common for exploratory
research but precludes our ability to establish their psychometric properties. This limitation also
suggests caution in interpreting our findings, although single-item measures are common in the
sexual orientation literature and have not prevented other studies from being widely cited (e.g.,
Dehlin et al., 2015; Ryan et al., 2020).
Our sample consisted primarily of white men and hence may not generalize to women
and racial minorities. Finally, we utilized theological identification to discern conservative faith
communities among participants. Although this assumption is sensible, it is possible religious
viewpoint may not be an exact indicator of the degree to which a participant’s religious
community is affirming or rejecting of an LGB identity.
Conclusion
We examined a sample of sexual minorities with diverse religious and sexual identity labels
to determine if those rejecting versus adopting an LGB identity were different in terms of religious,
sexual, relational, and health characteristics. Results suggested those who reject an LGB identity are
more likely to be religiously active, hold full membership in their church, and be highly intrinsic and
theologically conservative in their religious viewpoint. They further report slightly more
heterosexual attractions and behaviors, greater internalized homonegativity, and more interest in
raising children. They also were more likely to be single and celibate or in a heterosexual
relationship. Contrary to our expectations from minority stress and sexual identity development
theories, these differences were not associated with differences in experiences of depression, anxiety,
and social flourishing, nor were they related to interpretively meaningful differences in life
satisfaction. These findings seem to be at odds with conventional wisdom and underscore the
Sexual Minorities who Reject an LGB Identity 19
importance of pursuing sociopolitical diversity among researchers and the populations they study as
well as its value for ensuring appropriate legal advocacy and clinical care.
Sexual Minorities who Reject an LGB Identity 20
References
Barnes, D. M., & Meyer, I. H. (2012). Religious affiliation, internalized homophobia, and mental
health in lesbians, gay men, and bisexuals. American Journal of Orthopsychiatry, 82, 505-
515. http://doi.org/10.1111/j.1939-0025.2012.01185.x
Barringer, M. N., & Gay, D. A. (2017). Happily religious: The surprising sources of happiness
among lesbian, gay, bisexual, and transgender adults. Sociological Inquiry, 87, 75-96.
http://doi.org/10.1111/soin.12154
Chambers, J. R., Schlenker, B. R., & Collisson, B. (2013). Ideology and prejudice: The role of value
conflicts. Psychological Science, 24(2), 140-149. http://doi.org/10.1177/0956797612447820.
Clark, C. J., & Winegard, B. M. (2020). Tribalism in war and peace: The nature and evolution of
ideological epistemology and its significance for modern social sciences. Psychological
Inquiry, 31(1), 1-22. http://doi.org/10.1080/1047840X.2020.1721233
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155-159. doi: 10.1037/0033-
2909.112.1.155
Cohen, J. M., Feinstein, B. A., Rodriguez-Seijas, C., Taylor, C. B., & Newman, M. G. (2016).
Rejection Sensitivity as a Transdiagnostic Risk Factor for Internalizing Psychopathology
Among Gay and Bisexual Men. Psychology of Sexual Orientation and Gender Diversity,
3(3), 259-264. http:/doi.org/10.1037/sgd0000170
Crowell, K. A., Galliher, R., Dehlin, J., & Bradshaw, W. S. (2015). Specific aspects of minority
stress associated with depression among LDS affiliated non-heterosexual adults. Journal of
Homosexuality, 62, 242-267. http://doi.org/10.1080/00918369.2014.969611
Dehlin, J. P., Galliher, R. V., Bradshaw, W. S., Hyde, D. C., & Crowell, K.A. (2015). Sexual
orientation change efforts among current or former LDS church members. Journal of
Counseling Psychology, 62, 95-105. http://doi.org/10.1037/cou0000011
Sexual Minorities who Reject an LGB Identity 21
Diener, E., Emmons, R. A., Larsen, R J., & Griffin, S. (1985). The satisfaction with life scale.
Journal of Personality Assessment, 49, 71-75. http://dx.doi/10.1207s15327752jpa4901_13
Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi, D. W., Oishi, S., & Biswas-Diener, R. (2009).
New measures of well-being. In E. Diener (Ed.), Assessing well-being (pp. 247-266). New
York, NY: Springer.
Fassinger, R. E., & Miller, B. A. (1996). Validation of an inclusive model of sexual minority identity
formation on a sample of gay men. Journal of Homosexuality, 32, 53-78.
http://doi.org/10.1300/Jo82v32n02_04
Feinstein, B. A., Goldfried, M. R., & Davila, J. (2012). The relationship between experiences of
discrimination and mental health among lesbians and gay men: An examination of
internalized homonegativity and rejection sensitivity as potential mechanisms. Journal of
Consulting and Clinical Psychology, 80, 917-927. http://dx.doi.org/10.1037/a0029425
Gorsuch, R. L., & McPherson, S. E. (1989). Intrinsic/Extrinsic measurement: I/E revised and single-
item scales. Journal for the Scientific Study of Religion, 28, 348-354.
Hallman, J. M., Yarhouse, M. A., & Suarez, E. C. (2018). Shame and psychosocial development in
religiously affiliated sexual minority women. Journal of Psychology and Theology, 46, 3-21.
http://doi.org/10.1177/0091647117748450
Hamilton, R., & Gross, A. M. (2013). Role of religious attendance and identity conflict in
psychological well-being. Journal of Religion and Health, 52, 817-827.
http://doi.org/10.1007/s10943-011-9513-4
Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. (1948). Sexual behavior in the human male.
Philadelphia, PA: W.B. Saunders.
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). Validity of a brief depression severity
measure. Journal of General Internal Medicine, 16, 606-613.
http://doi.org/10.1046/j.15251497.2001.016009606.x
Sexual Minorities who Reject an LGB Identity 22
Lefevor, G. T., Beckstead, A. L., Shcow, R. L., Raynes, M., Mansfield, T. R., & Rosik, C. H. (2019).
Satisfaction and health within four sexual identity relationship options. Journal of Sex &
Marital Therapy, 45(5), 355-369. https://doi.org/10.1080/0092623X.2018.1531333
Lefevor, G. T., Sorrell, S. A., Kappers, G., Plunk, A., Schow, R. L., Rosik, C. H., & Beckstead, A. L.
(2020). Same-sex attracted, not LGBQ: The associations of sexual identity labeling on
religiousness, sexuality, and health among Mormons. Journal of Homosexuality, 67(7), 940-
964. https://doi.org/10.1080/00918369.2018.1564006
McCormick, A., & Baldridge, S. (2019). Family Acceptance and Faith: Understanding the
Acceptance Processes of Parents of LGBTQ Youth. Social Work & Christianity, 46(1), 32-
40.
Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual
populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674-97.
http://doi.org/10.1037/0033-2909.129.5.674
Mohr, J. J., & Kendra, M. S. (2011). Revision and extension of a multidimensional measure of sexual
minority identity: The Lesbian, Gay, and Bisexual Identity Scale. Journal of Counseling
Psychology, 58, 234-45. http://doi.org/10.13072/midss.150
Newcomb, M. E., & Mustanski, B. (2010). Internalized homophobia and internalizing mental health
problems: A meta-analytic review. Clinical Psychology Review, 30, 1019-1029.
http://doi.org/10.1016/j.cpr.2010.07.003
Pavot, W., & Diener, E. (1993). Review of the Satisfaction With Life Scale. Psychological
Assessment, 5(2), 164-172. http://doi.org/10.1037/1040-3590.5.2.164
Pachankis, J. E., Mahon C.P., Jackson S.D., Fetzner B.K., & Bränström R (2020). Sexual orientation
concealment and mental health: A conceptual and meta-analytic review. Psychological
Bulletin, 146(10), 831-871. http://doi.org/10.1037/bul0000271
Puckett, J. A., Newcomb, M. E., Garofalo, R., & Mustanski, B. (2017). Examining the conditions
Sexual Minorities who Reject an LGB Identity 23
under which internalized homophobia is associated with substance use and condomless sex in
young MSM: The moderating role of impulsivity. Annals of Behavioral Medicine, 51, 567-
577. http://doi.org/10.1007/s12160-017-9878-0
Rosik, C. H. (2017). Sexual orientation change efforts, professional psychology, and the law: A brief
history and analysis of a therapeutic prohibition. BYU Journal of Public Law, 32(1), 47-88.
Retrieved from https://digitalcommons.law.byu.edu/jpl/vol32/iss1/3/
Ryan, C., Toomey, R. B., Diaz, R. M., & Russell, S.T. (2020). Parent-Initiated sexual orientation
change efforts with LGBT adolescents: Implications for young adult mental health and
adjustment. Journal of Homosexuality, 67(2), 159-173.
http://doi.org/10.1080/00918369.2018.1538407
Sowe, B. J., Brown, J., & Taylor, A. J. (2014). Sex and the sinner: Comparing religious and
nonreligious same-sex attracted adults on internalized homonegativity and distress. American
Journal of Orthopsychiatry, 84(5), 530-544. http://dx.doi.org/10.1037/ort00000021
Sowe, B. J., Taylor, A. J., & Brown, J. (2017). Religious anti-gay prejudice as a predictor of mental
health, abuse, and substance use. American Journal of Orthopsychiatry, 87, 690–703.
http://doi.org/10.1037/ort0000297
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing
generalized anxiety disorder. Archives of Internal Medicine, 166, 1092-1097.
http://doi.org/10.1001/archinte.166.10.1092
Stern, S., & Wright, A. J. (2017). Discrete effects of religiosity and spirituality on gay identity and
self-esteem. Journal of Homosexuality, 65, 1071-1092.
https://doi.org/10.1080/00918369.2017.1368769
Szymanski, D. M., Kashubeck-West, S., & Meyer, J. (2008). Internalized heterosexism:
Measurement, psychosocial correlates, and research directions. The Counseling Psychologist,
36, 525-574. http://doi.org/10.1177/0011000007309489
Sexual Minorities who Reject an LGB Identity 24
West, S. G., Finch, J. F., & Curran, P. J. (1995). Structural equation models with nonnormal
variables: Problems and remedies. In R. H. Hoyle (Ed.), Structural equation modeling:
Concepts, issues and applications (pp. 56-75). Newbery Park, CA: Sage.
Sexual Minorities who Reject an LGB Identity 25
Table 1
Participant Characteristics
Characteristic M SD Characteristic M SD
Age
42.11
14.72
Importance of Children
2.35
1.41
Education
4.89
1.24
Internalized Homonegativity
9.77
5.96
Religious Activity
1.91
1.78
Depression
14.80
5.58
Intrinsic Religiousness
5.22
1.96
Anxiety
12.22
5.05
Kinsey Lifetime Rating
5.50
1.52
Psychosocial Flourishing
46.82
8.20
Identity Resolution
5.45
1.72
Life Satisfaction
23.28
7.00
Characteristic n % Characteristic n %
Religious Affiliation Sexual Identity
None/Unaffiliated
93
33.9
Lesbian or Gay
96
35.0
Catholic
40
14.6
Same-Sex/Gender Attracted
41
15.0
Evangelical Protestant
32
11.7
Heterosexual with SSA
30
10.9
Baptist
15
5.5
No Option/More than One Applies
23
8.4
Jehovah’s Witness
12
4.4
Bisexual
13
4.7
Judaism
12
4.4
Homosexual
13
4.7
Methodist
11
4.0
Heterosexual/Straight Bisexual
12
4.4
Pentecostal
11
4.0
Do Not Use a Label
12
4.4
Exploring Options
11
4.0
Queer
8
2.9
Other
38
13.5
Other
26
9.5
Religious Viewpoint Race
Theology Conservative
79
28.8
White/Caucasian
227
82.8
Spiritual/Not Religious
36
13.1
Multi-Ethnic/None Apply
13
4.7
Theology Heterodox
28
10.2
Latina(o)/Hispanic/American
12
4.4
Atheist
25
9.1
Black/African-American
9
3.3
Theology Liberal
22
8.0
Middle Eastern/M.E. American
5
1.8
Theology Moderate
20
7.3
Asian/Asian American
4
1.5
Non-Religious
17
6.2
South Asian
3
1.1
Agnostic
15
5.5
Native American/American Indian
1
.4
Others
32
11.8
Heterosexual Marriage Status Relationship Status
Never Married
194
70.8
Single and Celibate
83
30.3
Currently Married
47
17.2
Same-Sex Relationship/Marriage
78
28.5
Divorced/Separated
24
8.8
Single, Not Celibate
59
21.5
Other
5
1.8
Heterosexual Relation/Marriage
54
19.7
Widowed
4
1.5
Current Church/Religious Status
Full Member
133
48.5
Not Applicable
63
23.0
Disinterested
49
17.9
Resigned
20
7.3
Plan to Leave
4
1.5
Formal Probation
3
1.1
Excommunicated
2
.7
Note. N = 274 except for Intrinsic Religiousness (N = 233), Kinsey Ratings (N = 264), Identity Resolution (N = 235), and Importance of
Children (N = 262). Smaller N’s due to Not Applicable responses being excluded.
Sexual Minorities who Reject an LGB Identity 26
Table 2
Significant Group Differences Between Participants Identifying as LGB and Those Rejecting an
LGB Identity
_____LGB ___ __Reject LGB___
Variable n M SD n M SD t Cohen’s d
Religious Activity 154 1.38 1.70 120 2.58 1.64 -5.88** .72
Intrinsic Religiousness 116 4.68 2.04 106 5.80 1.70 -4.67** .60
Children/Family Important 154 2.10 1.32 120 2.68 1.45 -3.40** .42
Kinsey Lifetime Attraction 152 5.82 1.33 112 5.06 1.64 4.02** .51
Internalized Homonegativity 154 7.58 5.05 120 12.58 5.87 -7.42** .91
Life Satisfaction 154 24.29 6.94 120 21.98 6.89 2.75* .33
Key: * p < .01. ** p < .001. Unequal variances not assumed for Intrinsic Religiousness,
Children/Family Important, Kinsey Rating, and Internalized Homonegativity.
Sexual Minorities who Reject an LGB Identity 27
Table 3
Significant Frequency Differences Between Participants Identifying as LGB and Those Rejecting an LGB Identity
Variable Category % LGB % Reject LGB X2 Cramer’s V
Religious Viewpoint
Conservative
13.0%
49.2%
50.50*
.43
Moderate
5.2%
10.0%
Liberal/Progressive
12.3%
5.0%
Other
40.3%
20.0%
Non- or Anti-Religious
31.2%
15.8%
Church Status
Full Member
33.1%
68.3%
40.23*
.38
Alienated from Church
16.0%
3.3%
Not Interested/Applicable
50.6%
28.3%
Relationship Status
Single & Celibate
18.8%
45.0%
41.90*
.39
Single Not Celibate
26.6%
15.0%
Mixed Orientation Relationship
14.3%
26.7%
Same-Sex Relationship
40.3%
13.3%
Key: * p < .001.
