Sexual Orientation Microaggressions Research Articles

Sexual Orientation Microaggression Rating Scale (SOMRS): Development and association with alliance ruptures.

Sexual minority clients report experiencing frequent microaggressions during therapy, however, therapists may not recognize those microaggressions or may be reluctant to self-report them. The main aim of the present study was thus to develop an observational measure of in-session therapist-committed microaggressions related to the sexual orientation of sexual minority individuals (e.g., those who identify as lesbian, gay, bisexual, or queer). The present study further examined the association between therapist-committed sexual orientation microaggressions and ruptures in the therapeutic alliance. We hypothesized that clinically significant microaggressions would be positively associated with withdrawal ruptures in the alliance. The sample consisted of 44 gay and bisexual men who participated in a cognitive behavioral treatment designed to reduce depression, anxiety, human immunodeficiency virus-transmission-risk behaviors, and substance use. An observer-based coding measure designed for this study, the Sexual Orientation Microaggression Rating Scale (SOMRS), was utilized to capture sexual minority microaggressions in the initial sessions of treatment. Good interrater reliability was achieved for the SOMRS. Microaggressions were coded in 34% of the sessions. Within the subset of sessions with coded microaggressions, a significant association was found between withdrawal ruptures and microaggression significance ratings. The SOMRS holds potential for supporting research on microaggression as well as future efforts to help clinicians recognize and repair in-session behaviors that negatively impact sexual minority clients. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

How Do Intimate Partner Violence, Outness, and Community Connection Relate to Minority Stressors for Men Who Have Sex with Men?

Intimate partner violence (IPV) is a pervasive issue among men who have sex with men (MSM). However, IPV has long been conceptualized as abuse between a male perpetrator and a female victim, leaving gaps in the literature on the unique impacts IPV victimization has for both male victims and victims in same-sex relationships. This study examines relationships between IPV and negative minority stress experiences specific to LGBTQ individuals: overt experiences of homophobia, sexual orientation microaggressions, and internalized homophobia. Participants (N = 168) were recruited through three popular MSM networking applications (i.e., Grindr, Jack'd, and Scruff. Most were recruited from one state in the southeastern United States. Ordinary Least Squares regressions were used to examine IPV as a predictive factor in three separate models, all of which controlled for age, race, outness, and gay community connection (GCC). IPV victimization is associated with increased levels of experiences of overt homophobia, homophobic microaggressions, and internalized homophobia for MSM. Outness, or being open with the people in one's life about one's MSM identity, is associated with lower levels of both sexual orientation microaggressions and internalized homophobia. GCC is also associated with lower levels of internalized homophobia. Results from this study show that IPV victimization is related to minority stressors for MSM. These findings support the existence of unique elements of IPV for LGBTQ victims, specifically MSM. Implications for IPV researchers and service providers are discussed, including the importance of the protective role of outness and GCC against some minority stressors.

Interpersonal and environmental microaggressions & depression: Thai LGBQ+ perspectives

Microaggressions, which are subtle verbal and non-verbal insults or denigrations, have been identified as prevalent experiences among LGBQ+ populations, often resulting in adverse mental health outcomes. In the Thai context, little research has explored the impact of both types of microaggressions on depression among LGBQ+ individuals. This study aimed to investigate the relationship between interpersonal (INMG) and environmental microaggressions (ENMG) and depressive symptoms among Thai LGBQ+ individuals. A sample of 307 Thai LGBQ+ participants was surveyed using the Thai Sexual Orientation Microaggressions Scale and the PHQ-9 for depressive symptoms. Hierarchical regression analyses were employed to determine the unique effects of interpersonal and environmental microaggressions on depression, controlling for sociodemographic variables and internalized heterosexism (IHP). Both INMG (β = .172, p = 0.008) and ENMG (β = .173, p = 0.007) were significant predictors of depressive symptoms, accounting for approximately 24.2% of the variance. When introduced into the model, they accounted for a significant ΔR2 of 0.079 (p < 0.001). After controlling for sociodemographics and IHP, these microaggressions contributed significantly to the explanation of depressive symptoms, emphasizing their key role in influencing the mental health of LGBQ+ individuals in Thailand. Interpersonal and environmental microaggressions impose unique mental health challenges on Thai LGBQ+ individuals. These findings accentuate the pressing need for interventions tailored to the cultural and regional contexts within Thailand. Furthermore, the research underscores the importance of acquiring a holistic understanding of the LGBQ+ experience, advocating for a more systematic exploration across Thailand's varied geographical landscapes to offer comprehensive solutions.

A Conditional Process Analysis of Microaffirmations, Microaggressions, and Mental Health Among Thai Sexual Minorities

ABSTRACT Sexual orientation (SO) microaggressions contribute to mental health issues among sexual minorities. Microaffirmations may mitigate these effects, with internalized heterosexism and SO concealment proposed as mediators. A community sample of 307 Thai sexual minorities completed measures assessing SO microaggressions, microaffirmations, internalized heterosexism, SO concealment, and mental health concerns. Serial mediation analysis using Hayes’ PROCESS macro model 6 tested indirect effects through proposed mediators. Conditional process analysis using PROCESS model 85 examined the moderating role of microaffirmations. These models tested hypothesized moderated serial mediation relationships among study variables. SO microaggressions had a total effect on mental health concerns, directly and indirectly through increased SO concealment. The internalized heterosexism → SO concealment sequence mediated this relationship. Microaffirmations moderated the direct microaggressions-mental health link, reducing this association at higher levels of microaffirmations. The full model accounted for 31.6% of the variance (R2 = 0.316) in mental health concerns. The Johnson-Neyman technique identified 0.613 as the microaffirmations value above which the effect of SO microaggressions on mental health was no longer significant. Findings elucidate mechanisms linking SO microaggressions to mental health issues and microaffirmations’ protective role among Thai sexual minorities. These results could inform efforts to mitigate minority stress impacts.

Sexual orientation-based microaggressions and cannabis use outcomes among sexual minority individuals: The impact of negative affect and coping-motivated cannabis use

IntroductionSexual minority individuals report significantly more cannabis use and problems than their heterosexual peers, possibly due to their frequent experiences with sexual orientation-based microaggressions. As a result, sexual minority individuals may turn to cannabis use to cope with the negative affect associated with these experiences. No known studies have tested this hypothesis; therefore, the current study tested if sexual orientation microaggressions are positively associated with negative affect (anxiety and depression), cannabis coping motives, and cannabis-related outcomes (frequency, problems); if coping motives are positively associated with cannabis-related outcomes; and if negative affect and cannabis use to cope with negative affect serially mediate the relation between sexual orientation microaggressions and cannabis-related outcomes. MethodsSexual minority undergraduate students who reported cannabis use in the past three months (N = 328; 71.3 % cis-female) completed an online survey. ResultsMicroaggressions were significantly positively correlated with anxiety, depression, coping-motivated cannabis use, cannabis-related problems, non-sexual orientation-related stress, and overt sexual orientation-based discrimination. Additionally, after controlling for non-sexual orientation-related stress and overt sexual orientation-based discrimination, microaggressions were indirectly positively related to cannabis use frequency and problems via the sequential effects of negative affect and coping motives. This relation remained significant when examining negative affect specific to sexual orientation microaggressions and cannabis use to cope with this microaggressions-specific negative affect. ConclusionsResults highlight the adverse impact of sexual orientation microaggressions in terms of negative affect and negative cannabis-related outcomes.

Psychometric Exploration of the Swedish Translation of the Sexual Orientation Microaggressions Scale (SOMS), and a Commentary on the Validity of the Construct of Microaggressions

ABSTRACT The aim of the present study was to assess the psychometric properties of a Swedish translation of the Sexual Orientation Microaggressions Scale (SOMS) in a convenience sample of 267 Swedish LGB+ people (Mean age = 36.41). Testing suggested some strengths in terms of factor structure and 2-week test-retest reliability (ICC > .79). Also, internal consistency (α = .80–.91) and convergent validity were supported for most subscales. However, the Assumption of Deviance subscale was associated with low response variability and internal consistency (α = .35), and the correlational pattern between the Environmental Microaggressions subscale and mental health variables diverged from the overall trend. Furthermore, measurement invariance between homo- and bisexual participants was not supported for most subscales, and although microaggressions would be theoretically irrelevant to a small comparison sample of heterosexual people (N = 76, Mean age = 40.43), metric invariance of the Environmental Microaggressions subscale was supported in comparison to LGB+ people. We argue that these limitations suggest a restricted applicability of the SOMS in a Swedish context, and this has consequences for the definition and operationalization of the construct of microaggressions as a whole. Therefore, more research on the latent properties of microaggressions in Swedish as well as in other contexts is required.

Developing and Validating Thai Sexual Orientation Microaggression and Microaffirmation Scales

ABSTRACT Mental health disparities exist for sexual minority populations globally. Microaggressions and microaffirmations related to sexual orientation may negatively or positively impact well-being. Culturally validated tools are needed to assess these constructs among LGBQ+ (lesbian, gay, bisexual, queer/questioning) individuals in Thailand’s high-context culture. This study aimed to develop and validate the Thai Sexual Orientation Microaggressions Scale (T-SOMG) and the Thai Sexual Orientation Microaffirmations Scale (T-SOMF) to quantify experiences among LGBQ+ Thais. A mixed-methods approach was utilized. Initial scale items were derived from a literature review, expert consultation, and interviews with LGBQ+ Thais. Exploratory factor analysis (n = 164) refined the item pools. Confirmatory factor analysis (n = 200) confirmed the factor structures. Reliability and validity were examined. The final 18-item T-SOMG contained two subscales—Interpersonal and Environmental Microaggressions. The 13-item T-SOMF contained Interpersonal and Environmental Microaffirmations subscales. All scales demonstrated good model fit, reliability, convergent validity, and discriminant validity. The T-SOMG and T-SOMF are culturally valid tools for assessing microaggressions and microaffirmations among LGBQ+ Thais. These localized scales can enable research on factors impacting LGBQ+ well-being. Further validation in diverse samples is warranted.

Experiences with sexual orientation microaggression in mental health services in Israel

Introduction Little is known about the experiences of LGBTQ+ identifying professionals working in mental health services. Method This study analyzed 14 in-depth interviews conducted with LGB identifying professionals working in mental health services in Israel. Results Analysis of the interviews identified six unique forms of sexual orientation microaggressions: (1) Pathologizing LGBTQ+ identities; (2) Messages of concealment; (3) Lack of recognition; (4) Organizational positioning as experts of “gayness”; (5) Heteronormative compliments; and (6) Invasiveness. Conclusion We argue that actions should be taken by mental health services to reduce the unique sexual orientation microaggressions identified in this study.

Sexual stigmas among lesbian, gay, and bisexual individuals with problematic internet use and depression.

Sexual stigma causes psychological distress among lesbian, gay, and bisexual (LGB) individuals. LGB individuals are more likely to exhibit both problematic Internet use (PIU) and significant depression than are heterosexual individuals. Whether the severities of sexual stigma varied among LGB individuals with various statuses of comorbid PIU and depression warrants study. The present study aimed to investigate the differences in the experiences of familial sexual stigma (FSS), internalized sexual stigma (ISS), and sexual orientation microaggressions (SOMs) among LGB individuals with various statuses of comorbid PIU and depression. In total, 1,000 self-identified LGB young adult individuals participated in the study. The level of PIU was assessed using the Chen Internet Addiction Scale, depression was assessed using the Center for Epidemiological Studies-Depression Scale, the experience of FSS was assessed using the Homosexuality-Related Stigma Scale, the experience of ISS was assessed using the Measure of Internalized Sexual Stigma for Lesbians and Gay Men, and the experience of sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory. The differences in the levels of FSS, ISS, and SOMs among the four groups [i.e., the groups with both PIU and depression (comorbid group), only depression, only PIU, and neither PIU nor depression (neither group)] were investigated using multivariate analysis of covariance. The results indicated that LGB individuals with comorbid PIU and depression reported higher levels of ISS and SOMs than did those with depression only and PIU only, respectively. Moreover, LGB individuals with PIU or significant depression had higher levels of FSS and SOMs than did those with neither PIU nor depression. The results of this study supported that the experiences of FSS, ISS, and SOMs were significantly associated with various levels of PIU and depression in LGB individuals.

Effects of gender nonconformity and biological sex on the relationship between sexual orientation microaggressions and anxiety and depressive symptoms among lesbian, gay, and bisexual Taiwanese young adults: A moderated-moderation study

BackgroundSexual orientation microaggressions (SOMs) may negatively affect lesbian, gay, and bisexual (LGB) individuals' mental health. However, the moderating effects of gender nonconformity and biological sex on the relationship between SOMs and anxiety and depressive symptoms has never been examined. We evaluated the moderating effect of gender nonconformity on the association of SOMs with anxiety and depressive symptoms among LGB young male and female adults. We hypothesized that the associations of SOMs with anxiety and depressive symptoms weakened with increasing gender nonconformity among gay and bisexual men but strengthened with increasing gender nonconformity among lesbian and bisexual women. MethodsIn total, 1000 self-identified LGB young adult individuals participated in the study. The experience of sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory, anxiety was assessed using the State subscale on the State-Trait Anxiety Inventory, and depression was assessed using the Center for Epidemiological Studies-Depression Scale. The two-way moderation models stratified by sex examined the moderating effects of gender nonconformity on the association between SOMs and anxiety symptoms in the male and female participants. The three-way moderated moderation models were used to determine whether gender nonconformity and sex jointly moderated the associations between SOMs and anxiety and depressive symptoms. ResultsIn the two-way moderation models stratified by sex, gender nonconformity exerted opposite moderating effects on the association between SOMs and anxiety and depressive symptoms in the male and female participants. For the male participants, the association between SOMs and anxiety (β = −0.08) and depressive symptoms (β = −0.09) weakened with increasing gender nonconformity. For the female participants, the association between SOMs and anxiety (β = 0.08) and depressive symptoms (β = 0.13) strengthened with increasing gender nonconformity. The three-way moderated moderation models further confirmed that sex moderated the moderating effects of gender nonconformity on the associations between SOM and anxiety (β = −0.16, p = .047) and depressive symptoms (β = −0.22, p < .001). LimitationThe cross-sectional study design limited the inferences that could be made concerning the temporal relationship between SOMs and mental health problems. ConclusionsThe association between SOMs and anxiety and depressive symptoms weakened with increasing gender nonconformity in gay and bisexual men, whereas the association between SOMs and anxiety and depressive symptoms strengthened with increasing gender nonconformity in lesbian and bisexual women.

Minority Stress and Intimate Partner Violence among Sexual and Gender Minorities assigned Female at Birth.

Sexual and gender minorities assigned female at birth (SGM-AFAB) experience high rates of intimate partner violence (IPV). Using multiwave longitudinal data, the present study tested the following associations of minority stress and IPV among SGM-AFAB: concurrent within-person (i.e., whether changes in minority stress co-occur with changes in IPV), prospective within-person (i.e., whether changes in minority stressors precede changes in IPV), and between-persons (i.e., whether individuals who experience more minority stress, on average, experience more IPV). Data were from Waves 1-7 (spanning 3.5 years) of a longitudinal cohort study of 488 young SGM-AFAB. At each wave, participants reported on SGM victimization, sexual orientation microaggressions, internalized heterosexism, and five types of IPV for up to three partners in the past six months. Controlling for other minority stress experiences, microaggressions showed concurrent within-person associations with two types of IPV victimization (psychological and coercive control) and three types of IPV perpetration (psychological, physical, and sexual), and between-persons associations with psychological IPV victimization and coercive control victimization and perpetration. Microaggressions also had a significant prospective within-persons association with SGM-specific IPV perpetration. SGM victimization showed no unique within-person associations with IPV but, between-persons, was associated with all types of IPV victimization (except coercive control), and psychological and sexual IPV perpetration. Internalized heterosexism was not associated with any IPV outcome. Minority stress, particularly distal stressors, appear to contribute to risk for IPV among SGM-AFAB. Clinicians working with SGM-AFAB individuals in relationships may benefit from screening for experiences of minority stress.

Discrimination and sleep disturbance: How is substance use a mediator for sexual minority men?

ABSTRACT Discrimination plays a role in sleep disturbance for sexual minority men (SMM). Coping with discrimination through substance use may impact this relationship. Therefore, the current study aims to understand how substance use may mediate the relationship between microaggressions and sleep. In 2020, SMM were recruited for an online survey. Participants responded to items about sleep disturbance, sexual orientation microaggressions, and recent substance use. Multivariate regressions investigated the association of microaggressions with sleep disturbance and if substance use mediates this relationship. Microaggressions were associated with both sleep disturbance and substance use. The final model was significant, and a Sobel test indicated that substance use partially mediates the relationship between microaggressions and sleep disturbance. These findings build evidence that increased substance use due to discrimination is contributing to increased sleep disturbance. Social workers should prioritize assessing experiences of discrimination to identify risk for substance use and sleep disturbance.

Discrimination and sleep disturbance: how is substance use a mediator for sexual minority men?

ABSTRACT Discrimination plays a role in sleep disturbance for sexual minority men (SMM). Coping with discrimination through substance use may impact this relationship. Therefore, the current study aims to understand how substance use may mediate the relationship between microaggressions and sleep. In 2020, 239 SMM were recruited for an online survey. Participants responded to items about sleep disturbance, sexual orientation microaggressions, and recent substance use. Multivariate regressions investigated the association of microaggressions with sleep disturbance, and if substance use mediates this relationship. Microaggressions were associated with both sleep disturbance and substance use. The final model was significant and a Sobel test indicated that substance use partially mediates the relationship between microaggressions and sleep disturbance. These findings build evidence that increased substance use due to discrimination is contributing to increased sleep disturbance. Social workers should prioritize assessing experiences of discrimination to identify risk for substance use and sleep disturbance.

Chinese Sexual Minority Students Experiencing Microaggressions: Implications for Sexuality Education.

The sexual prejudice faced by sexual minorities or lesbian, gay, bisexual, and questioning/queer (LGBQ) students has been studied extensively around the world in the last two decades; however, it has only recently received attention from Hong Kong Chinese society, specifically in relation to this subtle form of prejudice. In the last decade, there has been an increase in the amount of literature examining the experiences of individuals encountering sexual orientation microaggressions, which are defined as discrimination or sexual prejudices manifested in subtle forms, particularly when directed toward socially marginalized groups, such as sexual minority students. The current study used a qualitative descriptive approach and semi-structured interviews to explore the themes of sexual orientation microaggressions experienced by Chinese sexual minority students. Several contextual themes to categorize microaggressions emerged: (1) the approval of heteronormative culture; (2) the use of heterosexist languages; (3) the assumption of sexual abnormality; and (4) the allowing of institutionally endorsed microaggressions. The results suggest that sexual minority students in Hong Kong experience diverse forms of microaggression in schools. The implications for the need to support LGBQ students are discussed, especially in addressing sexuality education in schools and the training of school professionals.

Minority Stress, Identity Conflict, and HIV-Related Outcomes Among Men Who Have Sex with Men, Transgender Women, and Gender Nonbinary People of Color.

Purpose: This study investigated conflict between sexual orientation and racial/ethnic identities as a mechanism linking minority stress to HIV-related outcomes among men who have sex with men (MSM), transgender women and gender nonbinary (TGN) people of color (POC). Methods: We tested longitudinal mediation models with sexual orientation microaggressions, internalized heterosexism (IH), and sexual orientation concealment at Time 1, and pre-exposure prophylaxis (PrEP) use and number of condomless anal sex (CAS) partners at Time 3, mediated by identity conflict at Time 2. Participants were 337 MSM and TGN POC. Data were collected in Chicago, Illinois, from September 2018 to February 2021. Results: Indirect associations of IH and sexual orientation concealment, respectively, at Time 1 with CAS partners at Time 3 through identity conflict at Time 2 were significant. Mediation models with sexual orientation microaggressions as the predictor and PrEP use as the outcome were not significant. Conclusion: Minority stress may contribute to identity conflict and increase CAS by isolating MSM and TGN POC from sexual and gender minority communities, thus restricting access to safer sex resources, and by increasing psychological distress and decreasing self-care (e.g., condom use).

Problematic Smartphone Use and Its Associations with Sexual Minority Stressors, Gender Nonconformity, and Mental Health Problems among Young Adult Lesbian, Gay, and Bisexual Individuals in Taiwan.

Smartphones are a necessity for many people; however, problematic smartphone use (PSU) may negatively influence people’s mental health. Using multivariate linear regression analysis, the study examined the associations of sexual minority stressors [namely perceived sexual stigma from family members, sexual orientation microaggressions (SOMs), and internalized sexual stigma] and gender nonconformity with PSU severity as well as the associations of PSU with depression and anxiety in young adult lesbian, gay, and bisexual (LGB) individuals. This cross-sectional survey study recruited 1000 young adult LGB individuals (500 men and 500 women). PSU severity was assessed using the Smartphone Addiction Inventory. The experiences of perceived sexual stigma from family members, SOMs, and internalized sexual stigma and the levels of gender nonconformity, depression, and anxiety were assessed. The results indicated that perceived sexual stigma from family members, SOMs, internalized sexual stigma in the dimensions of social discomfort and identity and gender nonconformity were significantly associated with PSU severity in LGB individuals. Moreover, PSU was significantly associated with depression and anxiety in LGB individuals. The findings highlight the significance of developing strategies for the prevention and early detection of PSU and sexual minority stress in LGB individuals.

The role of alcohol demand on daily microaggressions and alcohol use among emerging adult bisexual+ women.

Objective: Bisexual women drink more and have more alcohol consequences than heterosexual and lesbian women. This higher risk may in part be attributable to sexual orientation microaggressions. Drinking to cope motivations and alcohol demand may influence the association between microaggressions and alcohol use. The present study used a daily diary design to examine the association between microaggressions and same-day alcohol use (yes/no, quantity) and consequences, and if drinking to cope and alcohol demand moderate this association among bisexual+ (i.e., bi+) women. Method: Participants were 103 emerging adult bi+ women who completed a baseline assessment, including an alcohol purchase task to measure alcohol demand. Subsequently, participants reported their experiences of microaggressions, alcohol use, and alcohol consequences for 28 days. Multilevel model analyses were conducted. Results: Microaggressions were associated with a higher likelihood to drink and greater same-day alcohol use and consequences. The association between microaggressions and alcohol quantity was stronger for those who had a lower price associated with the highest expenditure (lower P max). For those who would stop drinking at lower price values (lower breakpoint), reported spending less overall on alcohol (lower O max), and had lower P max values, microaggressions were associated with more consequences. For those with higher breakpoint, O max, and P max microaggressions were not associated with consequences. Conclusions: Microaggressions may have a deleterious impact on alcohol use and consequences for bi+ women, particularly for those with lower alcohol demand. Clinicians should encourage bi+ clients to consider how microaggressions influence their drinking and support clients to engage in positive coping skills. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Sexual Orientation Microaggression Inventory Short Form (SOMI-SF): Validation in Three Samples of Racially/Ethnically Diverse Sexual Minority Youth.

The Sexual Orientation Microaggression Inventory (SOMI) has been used to measure sexual orientation-based microaggression experiences. However, at 19 items, the SOMI may be difficult to fit into survey batteries where microaggressions are not the primary predictor or the time researchers have with each participant is very limited. We sought to identify an eight-item short form of the SOMI (SOMI-SF) in a sample of sexual minority (SM) youth (N = 879) and confirm the validity and reliability of the SOMI-SF by administering both versions to separate cohorts of male-assigned (N = 533) and female-assigned (N = 430) at birth SM youth. Data was collected from April 2018 to May 2020. We found high reliability (α > 0.80) and validity (significant association with SM victimization, depression symptoms, anxiety symptoms, and internalized stigma) in all three samples for the SOMI-SF. For researchers looking to conserve time and limit burden, the SOMI-SF is a high quality option for measuring sexual orientation microaggressions. The greater ease of administering the SOMI-SF means that sexual orientation microaggressions can be measured in a greater number of contexts. With a growing literature linking these experiences to poorer health outcomes for SM populations, measuring these experiences quickly and accurately can improve our understanding of the mechanisms creating those links and impact policy necessary to alleviate them.

Transcending Pathological Accommodation: An Intersubjective Self Psychology Approach to Affirmative Therapy

Minority stress, including that experienced by sexual minority (SM) individuals, has been studied extensively in social and developmental contexts. Still, sexual orientation microaggressions (i.e., exposure to frequent heterosexist/homophobic language) can persist within the family structure. The focus of this paper is on the internalization of these experiences and the deleterious impact they could have on identity and developed systems of pathological accommodation, referring to attempts at rejecting one’s sexual identity to achieve acceptance from parents. A composite case is presented to demonstrate the effects of persistent discriminatory events within the family structure; this serves as a set of model scenes, that in aggregate, can lead to internalized homophobia. This paper explores a treatment process that integrates concepts of intersubjective self psychology and affirmative therapy to arrive at a theoretical approach that helps to mitigate internalized homophobia as can be present in gay identifying male clients.

Microaggressions and Health Outcomes among Racially and Ethnically Diverse Bisexual Women

This study assessed the relationship between microaggressions and health outcomes among bisexual women. Participants came from the Women’s Daily Experiences Study, a mixed method study of bisexual women recruited in Chicago (N = 112). Using cross-sectional data, we tested bivariate and multivariate associations of lifetime and past year sexual orientation microaggressions with depression, anxiety, self-assessed mental and physical health, and substance use. We also tested relationships between intersectional microaggressions, related to racial and sexual minority identities, and health outcomes among a sub-sample of women of color (n = 64). The majority of participants reported experiences of microaggressions in their lifetime and in the past year. Multivariate analyses revealed significant associations between lifetime and past year sexual orientation microaggressions, mental health and substance use. Among bisexual women of color, intersectional microaggressions were significantly associated with higher levels of depression, anxiety, and poorer self-assessed mental health. Implications and future directions are discussed.