Enacted and Anticipated Stigma Are Associated With Mental Ill-Health Among LGBT+ People in Malaysia: A Brief Report

Abstract

This brief report contributes crucial empirical evidence to the fledgling literature on mental health status and minority stressors among LGBT+ people in Malaysia, where LGBT+ identities remain criminalized by laws. Drawing data from the 2023 Kami Survey (n= 640), we explore the associations between enacted stigma (measured using the Experiences of Discrimination Scale [EDS]), proximal stressors including anticipated stigma (negative future expectations) and internalized LGBT-phobia, and mental health variables (depression, nonsuicidal self-injury [NSSI], suicidal ideation, and suicide attempts). Participants who were Malay or Indigenous in the Malay Peninsula (compared with Chinese), questioning sexual orientation (compared with gay or lesbian participants), trans men, trans women, or nonbinary participants (compared with cis men), and intersex individuals (compared with those without intersex characteristics) scored significantly higher on the EDS. Multivariate regression analyses, adjusting for demographic characteristics, revealed that enacted stigma predicted elevated risks of depressive symptoms, NSSI, and suicide attempts. Furthermore, negative future expectations were significantly associated with increased risks of NSSI and suicidal ideation. Our findings provide preliminary support for the minority stress model in Malaysia, emphasizing the need to eradicate systemic and institutional injustices promoting enacted stigma and stressful environments for LGBT+ people. Further longitudinal research is warranted to complement our cross-sectional findings by exploring the nuanced impacts of different forms of enacted stigma and proximal stressors on LGBT+ mental health, specifically within the LGBT-criminalization context of Malaysia and broader Southeast Asia.