Stigma, Psychosocial Resources, and Health Among Sexual Minorities

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This study is aligned with the Institute of Medicine’s (IOM; 2011) recommendation for research to promote understanding of sexual minority health disparities. Specifically, the present study draws from two frameworks describing how stigma may manifest in negative health outcomes. First, Hatzenbueler’s (2009) model suggests mental health outcomes are influenced by group characteristics and stigma related stressors (e.g. prejudice, discrimination) that are mediated by psychological processes (e.g. coping strategies, cognitive processes) as well as group-specific processes (e.g. expectations of rejection, internalized stigma). Second, Frost’s (2011) model describes how stigma manifests as the experience of stigma (stress) as well as how intervening variables (e.g. coping strategies, meaning making) moderate health outcomes of stigma. Extending such work, this study adds to the literature explaining disparities among sexual minorities by examining multiple indicators of sexual stigma simultaneously, as they differently link to health outcomes of stress and self-reported health through psychosocial mechanisms of social support, self-compassion, and self-esteem. Moreover, this study will gauge if centrality of identity and level of “outness” plays a role in sexual minority health. Sample research questions addressed include: 1) Do different types of sexual stigma link with specific health outcomes and impaired psychosocial mechanisms? 2) Which psychosocial mechanisms are more strongly linked to health outcomes among sexual minorities? We collected data from 380 participants that self-identified as lesbian, gay, or bisexual through an online survey. Hierarchical multiple regression analyses examining sexual stigma, psychosocial resource mechanisms and health outcomes uncovered that public (p<.05) and self-stigma (p<.05) related to decreased social support, whereas discrimination (p.05) and self-stigma (p<.01) related to decreased self-compassion, and while discrimination (p<.01) and concealment (p<.05) related to decreased self-esteem. Moreover, discrimination related to both worse self-reported health (p<.05) and stress symptoms (p<.01). When psychosocial mechanisms were added sequentially to the model of health outcomes, results revealed that only decreased social support predicted worse self-reported health (p<.05). However, low levels of self-compassion (p<.001) and self-esteem (p<.001) predicted increased stress symptoms, contributing an additional 34% of explained variance in stress beyond stigma. Thus, findings revealed that differing types of sexual stigma matter for particular mechanisms that ultimately link to health outcomes, underscoring the strength in particular of sexually-based discrimination in health. Moreover, stress symptoms appeared particularly vulnerable with 53% of stress variance explained by sexual stigma, decreased resources, and identity factors such as centrality. This study also provided initial support for considering the resource of self-compassion as a mechanism in sexual minority health, which has not been examined previously in relation to sexual minorities, and which might be a target for intervention to improve health.


Johnson City, TN

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