Abstract

This study tested the mechanisms by which social stigma contributes to psychological distress in lesbian, gay, and bisexual individuals. A large community sample (N = 4248, M age = 29.9 years, 42.9% female, 57.1% male, 35.7% bisexual, 64.3% lesbian/gay, 9.9% non-white) was recruited using targeted and general advertisements for an online cross-sectional survey. Participants completed measures of childhood gender nonconformity, prejudice events, victimization, microaggressions, sexual orientation concealment, sexual orientation disclosure, expectations of rejection, self-stigma, rumination, and distress. Structural equation modeling was used to test the relationships between these variables in a model based upon minority stress theory and the integrative mediation framework with childhood gender nonconformity as the initial independent variable and distress (depression, anxiety, and well-being) as the final dependent variable. The results broadly support the hypothesized model. The final model had good fit χ2(37) = 440.99, p < .001, TLI = .96, CFI = .98, RMSEA = .05 [.05, .06] and explained 50.2% of the variance in psychological distress and 24.8% in rumination. Sexual orientation and gender had moderating effects on some individual paths. Results should be considered in the context of the cross-sectional nature of the data, which prevented tests of causality, and self-report measures used, which are vulnerable to bias. Findings indicate strong relationships between minority stressors and psychological distress in lesbian, gay, and bisexual individuals, which are partially accounted for by rumination. These results may inform the development of interventions that address the added burden of minority stress among lesbian, gay, and bisexual individuals.

Highlights

  • Compared to heterosexual individuals, lesbian, gay, and bisexual (LGB) individuals are at substantially greater risk of a range of common mental disorders (King et al, 2008; Plöderl & Tremblay, 2015; Ross et al, 2018; Semlyen, King, Varney, & HaggerJohnson, 2016)

  • Bonferroni adjusted t-tests were performed in order to determine whether bisexual individuals differed from lesbian/ gay individuals in anxiety, depression, well-being, and/or outness and whether women differed from men in anxiety, depression, well-being, and/or rumination (α = .05/8 = .006)

  • The victimization measure may not be cleanly tapping into its target construct, at least compared to the two other measures of prejudice events, which did not load onto expectations of rejection

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Summary

Introduction

Lesbian, gay, and bisexual (LGB) individuals are at substantially greater risk of a range of common mental disorders (King et al, 2008; Plöderl & Tremblay, 2015; Ross et al, 2018; Semlyen, King, Varney, & HaggerJohnson, 2016). In LGB individuals are over 1.5 times higher than they are for heterosexual individuals, both in a period of 12 months or across the lifetime (King et al, 2008). As LGB individuals make up approximately 3.5% of the population (Gates, 2011), this constitutes a significant public health burden. Minority stress theory includes four kinds of “stressors” unique to LGB individuals, which are broadly divided into “distal” and “proximal” stressors. Proximal stressors constitute the minority individual’s cognitive processes, self-concepts, coping

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