Multiple Minority Research Articles

Individual and Familial Risk and Promotive Factors for Substance Use Among Multiracial American Young Adults

Background: Multiracial American adults have the highest rates of binge drinking and illicit drug use of all racial groups, yet little is known about the risk and promotive factors that contribute to their substance use. Objectives: This study examines how individual factors (i.e., shifting racial expressions, perceived racial ambiguity, creating third space, self-esteem, depression) and family cohesion relate to substance use among 574 Multiracial young adults in the United States (Mage = 19.87). Results: Findings suggested that Multiracial young adults who reported higher scores on perceived racial ambiguity, self-esteem, and depression had a higher likelihood of drinking to feel drunk and binge drinking, while more family cohesion with their first primary caregiver was associated with a lower likelihood of drinking to feel drunk. Perceived racial ambiguity was also associated with a higher likelihood of illicit drug use, while family cohesion with their second primary caregiver was associated with a lower likelihood of illicit drug use. Multiracial young adults with White ancestry were more likely to drink to feel drunk than Multiple Minority Multiracials, but there were no differences between groups in binge drinking or illicit drug use. Conclusions: In sum, the unique racialized experiences, mental health, and family relationships of Multiracial Americans may play a role in substance use.

Fostering Inclusivity in PM&R: A National Survey.

There is a persistent underrepresentation of women and multiple ethnic minority groups among medical school and residency applicants and trainees, particularly in Physical Medicine and Rehabilitation (PM&R). There is limited information on what causes these demographic disparities in PM&R and on strategies to increase interest in the field. To address this gap and improve early recruitment efforts, the authors conducted the first-ever national survey to gather information on pre-medical students' perceived barriers to medical school admissions, career interests, perceptions of PM&R, and strategies to increase interest in PM&R. The survey received 1093 responses from 236 colleges with a diverse representation of participants, including 53.3% (n = 583) from historically underrepresented groups such as those Underrepresented in Medicine (URiM), and those from rural communities, and/or low socioeconomic backgrounds. Only 31.2% (n = 313) knew the existence of PM&R. However, 60.0% (n = 568) of respondents were interested in learning more about PM&R through shadowing a PM&R physician (82.2%, n = 780), attending workshops (75.9%, n = 720), and mentorship (58.9%, n = 559). The national survey revealed limited exposure to PM&R at the pre-medical level but a strong interest in dedicated mentorship and workshops, suggesting effective strategies to address underrepresentation.

A both/and approach to conceptualizing multiple minority stress in sexual and racial minorities.

A both/and approach to conceptualizing multiple minority stress in sexual and racial minorities.

Sexual Victimization Among Gay and Bisexual Emerging Adult Men: Multivariate Differences in Substance Use, Minority Stress and Relationship Characteristics

ABSTRACT This study documented between-group differences in factors associated with lifetime sexual victimization in a sample of young sexual minority men. Diverse samples of gay (N = 205, ageM = 24.33 years) and bisexual (N = 201, ageM = 23.31 years) men were recruited using the CloudResearch platform to assess recent experiences of intimate partner violence (IPV). Participants were categorized into four groups, cross-classified by dichotomous self-reports of (a) childhood sexual abuse (CSA) and (b) sexual IPV. Principal components analysis was used to reduce the number of variables associated with sexual IPV in three domains: Past-year substance use involvement, minority stress, and relationship characteristics, separately for each sample. Gay men reporting both CSA and sexual IPV reported significantly higher mean factor scores for a principal component with high loadings for recent substance use, daily discrimination, relational aggression and relational victimization, compared to other groups of gay men. Bisexual men who experienced sexual IPV reported significantly higher mean factor scores for a principal component with high loadings for five measures of minority stress, compared to counterparts with no history of sexual victimization. Adult sexual IPV among gay men reporting CSA appears to occur in conditions that include harmful substance use, daily discrimination experiences, and relationship violence. Sexual IPV among bisexual men is associated with multiple minority stressors. Our findings highlighted different patterns of risk factors for sexual IPV among sexual minority men, providing information for tailored risk reduction initiatives, including the need for trauma-informed services and specialized training for service providers.

University students who were men who had sex with men (MSM) in Sichuan, China had a higher prevalence of insomnia and probable depression than their non-MSM counterparts: mediation via emotional dysregulations

BackgroundMen who have sex with men studying in universities (MSM-US) frequently face multiple sexual minority stressors that potentially lead to maladaptive emotional regulations and mental problems. This study compared the prevalence of depression/insomnia between MSM-US and non-MSM male university students (NUS) and hypothesized that the potential differences would be mediated via emotional dysregulation styles (rumination and catastrophizing).MethodsThe study design was a cross-sectional study. NUS were recruited from a university-based survey using cluster sampling in three universities in China from June to October 2018, while MSM-US from the same university-based survey and the other community-based survey using convenience sampling. The effective samples size was 2,531 (292 MSM-US and 2,239 NUS). Structural equation modeling (SEM) was performed.ResultsMSM-US had significantly higher prevalence of both probable depression (55.1% versus 35.7%; OR = 4.85, 95% CI: 3.38–6.94) and moderate-to-severe clinical insomnia (17.3% versus 4.1%; OR = 2.21, 95% CI: 1.73–2.83) than NUS. MSM-US were also more likely than NUS to use emotional dysregulation styles (rumination/catastrophizing), which were correlated with probable depression/insomnia (r = 0.17 to 0.31). In the SEM, the differences in depression/insomnia between MSM-US and NUS were partially mediated by the latent variable of emotional dysregulation (rumination and catastrophizing), with effect sizes of 55.0% for probable depression and 33.6% for insomnia, respectively.ConclusionsDepression and insomnia were prevalent among male university students in Sichuan, China. Furthermore, MSM-US were at increased risk than NUS for both mental problems; emotional dysregulation partially explained such differences. Future studies are warranted to confirm the findings, develop tailored interventions to address general and MSM-specific stressors and reduce rumination and catastrophizing, and examine whether similar patterns exist in other sexual minority groups.

Group-swinging as a strategic approach to curating multiple minority identities online: A study of lesbian gamers

Building upon platform-swinging, this study introduces the concept of identity-driven “group-swinging” within a single platform, focusing on how users with multiple minority identities strategically curate corresponding identities through this process. Collecting all created and engaged posts ( n = 31,084) from 102 lesbian gamers in both lesbian gamer and female gamer groups, this research utilizes structural topic modeling to delineate their productive and consumptive curation across different groups. The results indicate that lesbian gamers often prioritize discussions on women and queer issues within the female gamer community while presenting a more gamer-centric identity in the lesbian gamer community. Group-swinging emerges as an optimal strategy for exploring a balance between belongingness and distinctiveness, enabling lesbian gamers to navigate their multiple minority identities effectively. This study enriches the understanding of identity curation and optimal distinctiveness theory, offering plausible strategies for the online resilience of marginalized groups within the polymedia context.

Gender Nonconformity, Minority Stress, and Psychological Distress Among Sexual Minority Adolescents.

Purpose: Sexual minority adolescents (SMAs) have disproportionate experiences of mental health symptoms during adolescence, and minority stress contributes to mental health inequities among SMAs. Gender nonconformity (GNC) could place SMAs at higher risk for minority stress and subsequent mental health symptoms. The current study was designed to examine associations between GNC, minority stress, and psychological distress among SMAs. Method: SMAs ages 12-17 years (n = 455; mean age = 15.52 years) in the United States completed a cross-sectional online survey from February to July 2022, including measures of GNC, peer victimization, family rejection, negative expectations, negative disclosure experiences, internalized homonegativity, and psychological distress. We conducted path analysis to examine associations between GNC, minority stressors, and psychological distress, including indirect effects of GNC on psychological distress via minority stress. Results: In multivariable path analysis adjusted for demographic characteristics, GNC was associated with higher levels of peer victimization and negative expectations and lower internalized homonegativity among SMAs. Higher levels of peer victimization and negative expectations were associated with higher psychological distress. GNC was indirectly related to higher levels of psychological distress via higher peer victimization. Conclusions: The current study is the first to document associations between GNC and multiple minority stress experiences among SMAs, and GNC was indirectly related to psychological distress among SMAs via peer victimization. Although all SMAs would benefit from interventions designed to reduce peer victimization and increase their capacity to cope with minority stress, such interventions may be particularly beneficial for SMAs who are gender nonconforming.

Associations of Minority Stressors, Alcohol Use Disorder, Resilience, and HIV Testing Self-Efficacy Among Community-Based Black Men Who Have Sex with Men in a Southern U.S. City: A Causal Mediation and Moderation Analysis

Background: Black men who have sex with men (BMSM) face multiple minority stressors (e.g., homophobia, racism, and presumed HIV status) that may indirectly erode their confidence in pursuing HIV testing uptake through exacerbating alcohol use disorder (AUD). Objectives: Using cross-sectional data from 203 community-based BMSM (71.4% as homosexual with a mean age of 26 years) living in a Southern US city, we conducted a causal mediation and moderation analysis to investigate in/direct pathways linking minority stressors, AUD risk, and self-efficacy of HIV testing, including how resilience may moderate these associations. Results: Our mediation analysis revealed that AUD risk accounted for 32.1% of the total effect of internalized homonegativity (βtotal effect = -0.424; SE=0.071; p<0.001), 28.6% of the total effect of experienced homophobia (βtotal effect = -0.684; SE=0.122; p<0.001), and 15.3% of the total effect of perceived HIV stigma (βtotal effect = -0.361; SE=0.164; p<0.05) on HIV testing self-efficacy. Resilience significantly moderated the associations of experienced homophobia (β = -0.049; SE=0.011; p<0.001), internalized homonegativity (β = -0.065; SE=0.027; p<0.01), and perceived HIV stigma (β = -0.034; SE=0.013; p<0.05) with AUD risk. Resilience also significantly moderated the associations of experienced homophobia (β = -0.073; SE=0.021; p<0.01), internalized homonegativity (β = -0.082; SE=0.012; p<0.001), perceived HIV stigma (β = -0.037; SE=0.039; p<0.05), and AUD risk (β = -0.021; SE=0.015; p<0.05) with HIV testing self-efficacy. Conclusions: Our study provides important implications in identifying multilevel sources for building resilience among BMSM to buffer the effects of minority stress on AUD risk and improve HIV testing outcomes.

Brick by brick bias: Arab Muslim experience of intersectionality in housing

ABSTRACT The study presented in this paper examined intersectional discrimination against individuals with multiple minority identities in the housing market, specifically those identifying as Arab Muslims. By sending inquiries from three fictitious applicants – a Swedish Christian, an Arab Christian, and an Arab Muslim – to 1,200 landlords in Sweden, we analyzed differences in landlord responses. Results showed the Swedish Christian received the most positive replies, followed by the Arab Christian, with the Arab Muslim receiving the fewest. The study underscores the compounded discrimination faced by those with multiple minority identities and challenges the conflation of ethnic and religious identities in prior research.

Mind the Gap: Sexual Orientation Wage Gaps for Non-White and Immigrant Minorities in the United States

ABSTRACT A growing body of literature has found that sexual orientation and gender impact labor market outcomes, including earnings. This literature generally finds that gay and bisexual men earn less than heterosexual men. Despite being the highest earners among women, lesbians earn less than heterosexual men, and bisexual women earn the least. Far less research has explored intersectional disadvantages/advantages of being a lesbian, gay, or bisexual (LGB) individual and belonging to other minority groups. Using data from the 2013 to 2018 US National Health Interview Survey, this paper explores whether being an LGB racial minority or LGB immigrant results in cumulative earning disadvantages/advantages. This study finds that regardless of race or immigrant status, gay men’s earnings did not statistically differ from white/US-born heterosexual men’s earnings. For white and US-born women, their earnings followed the same pattern, with lesbians earning the most, followed by heterosexual women, then bisexuals; however, for nonwhite women, bisexuals earned the most and lesbians earned the least. The results for immigrant sexual minorities were not statistically significant. These findings suggest that disadvantage/advantage is multilayered—sexual minorities who occupy multiple minority positions may experience different levels of disadvantage/advantage.

Family Support, Outness, and Psychological Well-Being in LGBTQ+ Adult Children of Immigrants

Researchers have documented mental health issues of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) populations. Those with multiple minority identities may face greater mental health concerns due to minority stress. Little research has examined the mental health of LGBTQ+ adult children of immigrants. The objective of this study was to determine if family support, as measured by interpersonal and environmental microaggressions and microaffirmations, predicted levels of outness and levels of psychological well-being in LGBTQ+ adult children of immigrants and to assess whether family support was a moderator in the relationship between outness and well-being. 109 participants completed an online survey that included three measures and demographic information. Multiple regression showed that family support did not predict outness in LGBTQ+ adult children of immigrants, but environmental microaffirmations predicted psychological well-being and environmental microaggressions moderated the relationship between outness and psychological well-being. We discuss implications for helping professionals and future directions for research.

Perceived discrimination and youth vaping: The role of intersectional identities

IntroductionElectronic cigarettes (also termed e-cigarette or vapes) often contain nicotine, an addictive psychoactive substance, which can have harmful effects during adolescence. Frequent experiences of discrimination are one risk factor shown to increase susceptibility to tobacco use, especially for individuals that identify as a social minority. Applying Intersectionality Theory, this research examined the relationship between youth experiences of discrimination and vape use at the intersection of race/ethnicity and sexual orientation. MethodCross-sectional survey data from 4747 youth (ages 12–17) that participated in the 2022 Teens, Nicotine, and Tobacco Project (TNT) online survey were used to evaluate the impact of discrimination on vape use for lesbian, gay, bisexual, and/or queer/questioning (LGBQ+) youth of color. ResultsMultivariable regression analyses showed that identifying as both a sexual and racial/ethnic minority was a risk factor for experiencing discrimination. Frequent discrimination and reporting discrimination due to sexual orientation was associated with a greater likelihood of ever and current vaping. Path models supported that discrimination mediated the relationship between intersectional identity and vape use. LGBQ+ youth of color reported more frequent discrimination, which was associated with a greater likelihood of ever/current vape use. ConclusionsIntersectionality Theory aids in understanding how discrimination can exacerbate tobacco-related disparities for youth with multiple minority identities. Findings corroborate the importance of measuring discrimination in public health surveys. Effective tobacco interventions could incorporate strategies to cope with discrimination-related stress.

Does the approach used to measure sexual identity affect estimates of health disparities differently by race? A randomized experiment from the National Survey of Family Growth

The inclusion of “something else” as a response option for survey questions about sexual identity has been shown to significantly moderate estimated differences between sexual identity subgroups in the distributions of various health outcomes in national health surveys, specifically for substance use/misuse and reproductive health. This moderation effect may be larger depending on the respondent's race, possibly due to the intersectionality of multiple minority identities and compounding minority stressors. To test this hypothesis, we conducted secondary analyses of data from five consecutive years of the National Survey of Family Growth (2015–2019) [n = 18,903 (8510 males, 10,393 females)] in the United States, where respondents were randomly assigned to receive either a four-category version of the sexual identity question that included “something else” as a response option along with lesbian/gay, bisexual, and heterosexual, or a three-category version that omitted “something else.” We focused on model-based estimates of distributions of health outcomes across subgroups defined by both race and sexual identity and tested the race moderation hypothesis using three-way interactions involving sexual identity, question type received (four-category vs. three-category), and race (Black, White, and other). Based on this randomized experiment, we found evidence of significant differences between the four-category and three-category question versions of sexual identity, in terms of the associations between sexual identity and several health outcomes, along with moderation of these differences by the respondent's race. For some outcomes, such as wanting a child or another child, the magnitudes of the estimated sexual identity differences among racial minority individuals, specifically between bisexual and heterosexual women, were sensitive to the measurement of sexual identity. These results further suggest a need for improved sexual minority measurement, especially among racial minorities. These differences were also mostly found among women, suggesting further intersectionality of groups exposed to specific stressors.

Minority stressors and suicidal ideation in sexual minority individuals across adulthood.

Suicidal ideation occurs at relatively high rates among adults identifying as sexual minorities compared to those identifying as heterosexual, and minority stress is one explanation for this disparity. Minority stress is known to associate with increased suicidal ideation, but research on how minority stress associates with suicidal ideation in sexual minority adults across the adult lifespan is lacking. Data were collected online from 284 sexual minority adults ranging in age from 18 to 85. Participants were recruited from Prolific and completed self-report measures assessing past-month suicidal ideation and multiple sexual minority stressors. The minority stressors of acceptance concerns, concealment motivation, and difficulty processing one's identity were positively correlated with likelihood of past-month suicidal deation. Age moderated the relationship between two minority stressors and suicidal ideation: identity uncertainty and internalized homonegativity. These relationships were only significant among older adults, compared to middle-age and younger adults. Specific internalized minority stressors about one's sexual identity were significantly associated with past-month suicidal ideation for older adults. More research is needed on how minority stress impacts recent suicidal ideation for sexual minority adults across the lifespan.

Designing pareto-optimal selection systems for multiple minority subgroups and multiple criteria.

Currently used Pareto-optimal (PO) approaches for balancing diversity and validity goals in selection can deal only with one minority group and one criterion. These are key limitations because the workplace and society at large are getting increasingly diverse and because selection system designers often have interest in multiple criteria. Therefore, the article extends existing methods for designing PO selection systems to situations involving multiple criteria and multiple minority groups (i.e., multiobjective PO selection systems). We first present a hybrid multiobjective PO approach for computing selection systems that are PO with respect to (a) a set of quality objectives (i.e., criteria) and (b) a set of diversity objectives where each diversity objective relates to a different minority group. Next, we propose three two-dimensional subspace procedures that aid selection designers in choosing between the PO systems in case of a high number of quality and diversity objectives. We illustrate our novel multiobjective PO approaches via several example applications, thereby demonstrating that they are the first to reveal the complete gamut of eligible PO selection designs and to faithfully capture the Pareto trade-off front in case of more than two objectives. In addition, a small-scale cross-validation study confirms that the resulting PO selection designs retain an advantage over alternative designs when applied in new validation samples. Finally, the article provides a link to an executable code to perform the new multiobjective PO approaches. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of Multiple Minority Statuses: An Examination of Violent Victimization, Police Reporting and Perception of Police Bias

Individuals who identify as belonging to multiple marginalized groups experience disproportionate violent victimization yet are reluctant to inform the police following an incident. Perceptions of the police as biased may influence whether victims report. This study examines low socio-economic and sexual orientation/gender-identity (SOGI) minority statuses on experiencing violent victimization, reporting to the police and perceived police bias as a reason for not reporting. Multivariate logistic regressions were applied to National Crime Victimization Survey data. Low-income, SOGI respondents reported greater odds of experiencing violent victimization but lower odds of reporting to the police. An increase in the odds of perceiving the police as biased was found among victims who did not report. Results suggest greater work to improve the strained relationships between the police and minority communities.

Queer Experience in Turkey

This study explores the possibility of critical agency of queer subjects in Turkey in terms of challenging and subverting normative structural constraints. These constraints are attested through expansive use of the concept of habitus including class, gender, family, ethnicity and religion. Our field study in which in-depth interviews have been conducted detected two types of habitus in the life experiences of queer subjects: critical and conservative. While the former enables critical agency, the latter undermines this possibility. On this ground, it is argued that exhibiting critical habitus appears to be the precondition of performing critical agency. We conclude that having multiple minority identities, education, and involvement in organizations develop a critical habitus enhancing critical queer agency.

Ethno-racial variations in mental health symptoms among sexually-active gay, bisexual, and other men who have sex with men in Vancouver, Canada: a longitudinal analysis

BackgroundMinority stress from racism and heterosexism may uniquely interact to impact the mental health of racialized sexual minorities. We examined variations in anxiety and depressive symptoms by reported by ethno-racial identity among gay, bisexual, and other men who have sex with men (gbMSM) in Vancouver, Canada.MethodsWe recruited gbMSM aged ≥ 16 years from February 2012 to February 2015 using respondent-driven sampling (RDS). Participants completed computer assisted self-interviews (CASI) at enrollment and every 6 months until February 2017. We examined factors associated with moderate/severe anxiety and depression scores (> 10) on the Hospital Anxiety and Depression Scale (HADS) and differences in key explanatory variables including sociodemographic, psychosocial, and substance use factors. We used multivariable mixed effects models to assess whether moderate/severe scores were associated with ethno-racial identity across all visits.ResultsAfter RDS-adjustment, of 774 participants, 79.9% of participants identified as gay. 68.6% identified as white, 9.2% as Asian, 9.8% as Indigenous, 7.3% as Latin American, and 5.1% as other ethno-racial identities. Participants contributed a median of 6 follow-up visits (Q1-Q3: 4–7). In the multivariable analysis, Asian participants had decreased odds of moderate/severe anxiety scores compared to white participants (aOR = 0.39; 95% CI: 0.18–0.86), and Latin American participants had decreased odds of moderate/severe depression scores compared to both white (aOR = 0.17; 95% CI: 0.08–0.36) and Asian (aOR = 0.07; 95% CI: 0.02–0.20) participants.ConclusionAsian and Latino gbMSM reported decreased mental health symptoms compared to white participants. Asian and Latino gbMSM in Vancouver appear to manage multiple minority stressors without adversely affecting their mental health.

Conceptualizing rural Appalachian LGBTQ+ through the IS-WEL wellness lens: implications for Clinical practice and advocacy

ABSTRACT Rural Appalachian LGBTQ+ individuals experience discrimination and hardships due to cultural factors and multiple minority identities. A recent rise in anti-LGBTQ+ legislation in Appalachian states highlights the continued need to prepare counselors to support and advocate for rural Appalachian LGBTQ+ clients. As wellness is central to the counseling profession, this article explores current research and conceptualizes rural Appalachian LGBTQ+ individuals’ experiences through the Indivisible Self (IS-WEL) wellness lens and discusses implications for practice and advocacy.

A systematic review of psychosocial challenges for MSM living with HIV among diverse and intersecting minorities

Men who have sex with men (MSM) living with HIV have been studied extensively for stigmatization and inequitable factors affecting well-being. Although intersecting factors are acknowledged in some studies, they are rarely discussed in the context of health implications among multiple minority identities. This leaves psychosocial research outputs to focus their efforts among less stigmatized MSM groups, white men, while disregarding specific issues among historically marginalized MSM-related identities (e.g., racialized, Indigenous, and aging populations). As per the 95-95-95 goals set by the Joint United Nations Programme on HIV and AIDS, this systematic review covers psychosocial protective and risk factors experienced by HIV-positive MSM while also considering other intersecting identities. Following a standardized search inquiry, 2,139 records were identified and narrowed down to 24 peer-reviewed articles which were systematically reviewed. Psychological and social protective factors are contextually described. Some risk factors such as co-occurring stigmas, psychological distress, exposure to violence, and trauma among diverse MSM can potentiate greater risk-taking behaviours associated with HIV transmission among HIV-positive men. These findings highlight factors that contribute to resilient pathways among racialized minorities and other intersections among MSM while also examining specific psychological stressors. Tailored interventions and care for minorities with intersecting identities, with a focus on co-occurring stigmas, are crucial to ensure the well-being of diverse HIV-positive MSM and reduce HIV transmission. We propose an adaptation to the minority stress model to refine available tools and provide future studies with more accurate depictions of the lived experiences among diverse MSM.