Abstract
Many individuals who identify as lesbian, gay, bisexual, queer, and with other non-heterosexual orientations (LGBQ+) experience stigma, prejudice, and/or discrimination because of their sexuality. According to minority stress and identity development theories, these experiences can contribute to difficulties with self-acceptance of sexuality. Lower self-acceptance is considered a risk factor for adverse mental health outcomes. The current review aims to investigate whether self-acceptance of sexuality is associated with minority stressors or difficulties with mental health in LGBQ+ individuals, as well as whether there are differences in self-acceptance between different sexual orientations. Five bibliographic databases were searched. Thirteen studies were identified which used quantitative methodology to investigate associations between self-acceptance, minority stressors, and/or mental health within LGBQ+ samples, or differences in self-acceptance between different sexual orientations. The results from these cross-sectional studies suggested that lower self-acceptance of sexuality was associated with higher levels of self-reported minority stressors, including a lack of acceptance from friends and family, a lack of disclosure to others, and internalized heterosexism. Lower self-acceptance of sexuality was associated with poorer mental health outcomes, including greater global distress, depression symptoms, and lower psychological well-being. There was no significant relationship with suicidality. Studies also found that LGBQ+ individuals had lower general self-acceptance compared to heterosexual participants, bisexual individuals had lower sexuality self-acceptance compared to lesbian/gay individuals, and lesbian women had lower sexuality self-acceptance compared to gay men. Given the potential importance of self-acceptance for LGBQ+ populations, further research is required with more robust methodology. Self-acceptance could be a potential target in clinical interventions for LGBQ+ individuals.
Highlights
Many individuals who identify as lesbian, gay, bisexual, queer, and with other non-heterosexual orientations (LGBQ+) experience stressors within societal contexts which privilege heterosexuality as the normal and preferred sexual orientation (Meyer, 2003)
This review aims to answer the following questions: (1) Is self-acceptance of sexuality or general self-acceptance statistically associated with minority stress and mental health or well-being in LGBQ+ individuals, and (2) Are there statistical differences in general or sexuality self-acceptance between different sexual orientations? This review will include an assessment of methodological quality to assess the included studies’ design, reporting, and attempts to reduce bias, to inform conclusions
Most papers were excluded at this stage because they did not include measures of self-acceptance, or there was no quantitative analysis investigating the relationship between self-acceptance and mental health outcomes or minority stressors, despite including these outcomes within separate analyses
Summary
Many individuals who identify as lesbian, gay, bisexual, queer, and with other non-heterosexual orientations (LGBQ+) experience stressors within societal contexts which privilege heterosexuality as the normal and preferred sexual orientation (Meyer, 2003). Meyer’s minority stress theory proposes that this chronic exposure to minority stressors is responsible for the observed increased risk of mental health difficulties in sexual minority populations compared to their heterosexual peers (Ross et al, 2018; Semlyen, King, Varney, & Hagger-Johnson, 2016). Consistent with this suggestion, previous evidence suggests that increased levels of minority stressors in LGBQ+ populations are negatively associated with mental well-being (Burton, Marshal, Chisolm, Sucato, & Friedman, 2013; Gnan et al, 2019; Meyer, 2003; Pitoňák, 2017).
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