Abstract
Two cross-sectional survey studies were conducted to examine the relationships between minority stressors, protective factors and mental health outcomes in lesbian, gay and bisexual people (LGB) in the United Kingdom (UK). A convenience sample of 156 LGB people in the UK participated in Study 1. Multiple regression analyses showed that victimization and sexuality-related identity threat were positively associated with anxiety and that identity resilience, social support and degree of outness were negative correlates; and that rejection was positively associated with depression while identity resilience and social support were negative correlates. In Study 2, based on a convenience sample of 333 gay men, our structural equation model showed that ethnic minority status, lower identity resilience and higher identity threat were associated with greater distress; ethnic minority status was associated with less social support and more internalized homonegativity; being single was associated with less social support and more internalized homonegativity; identity resilience was positively associated with social support and negatively associated with internalized homonegativity; identity threat was associated with less social support and more internalized homonegativity; internalized homonegativity was negatively associated with social support; and social support was negatively associated with distress while internalized homonegativity was positively associated with distress. Findings show differential effects of particular stressors on particular mental health outcomes in LGB people and the significance of promoting identity resilience, social support and degree of outness as protective factors.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Almeida, J., Johnson, R. M., Corliss, H. L., Molnar, B. E., & Azrael, D. (2009). Emotional distress among LGBT youth: The influence of perceived discrimination based on sexual orientation. Journal of Youth and Adolescence, 38(7), 1001–1014. https://doi.org/10.1007/s10964-009-9397-9
Alvarez-Galvez, J., & Rojas-Garcia, A. (2019). Measuring the impact of multiple discrimination on depression in Europe. BMC Public Health, 19, 435. https://doi.org/10.1186/s12889-019-6714-4
American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association Publications. https://doi.org/10.1176/appi.books.9780890425596
Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). American Journal of Preventive Medicine, 10(2), 77–84.
Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society Series B (Methodological), 57, 289–300. https://doi.org/10.1111/j.2517-6161.1995.tb02031.x
Breakwell, G. M. (2015). Coping with threatened identities. Routledge.
Breakwell, G. M. (2021). Identity resilience: Its origins in identity processes and its role in coping with threat. Contemporary Social Science, 16(5), 573–588. https://doi.org/10.1080/21582041.2021.1999488
Breakwell, G. M., & Jaspal, R. (2021a). Coming out, distress and identity threat in gay men in the United Kingdom. Sexuality Research & Social Policy. https://doi.org/10.1007/s13178-021-00608-4
Breakwell, G. M., & Jaspal, R. (2021b). Identity change, uncertainty and mistrust in relation to fear and risk of COVID-19. Journal of Risk Research, 24(3-4), 335–351. https://doi.org/10.1080/13669877.2020.1864011
Breakwell, G. M., Fino, E., & Jaspal, R. (2022). The identity resilience index: Development and validation in two UK samples. Identity: An International Journal of Theory and Research, 22(2), 166–182. https://doi.org/10.1080/15283488.2021.1957895
Cohen, S., Mermelstein, R., Kamarck, T., & Hoberman, H. (1985). Measuring the functional components of social support. In I. G. Sarason & B. R. Sarason (Eds.), Social support: Theory, research and application (pp. 73–94). Martinus Nijhoff.
Feinstein, B. A. (2020). The rejection sensitivity model as a framework for understanding sexual minority mental health. Archives of Sexual Behavior, 49(7), 2247–2258. https://doi.org/10.1007/s10508-019-1428-3
Feinstein, B. A., Wadsworth, L. P., Davila, J., & Goldfried, M. R. (2014). Do parental acceptance and family support moderate associations between dimensions of minority stress and depressive symptoms among lesbians and gay men? Professional Psychology: Research and Practice, 45(4), 239–246. https://doi.org/10.1037/a0035393
Fritz, M. S., & Mackinnon, D. P. (2007). Required sample size to detect the mediated effect. Psychological Science, 18(3), 233–239. https://doi.org/10.1111/j.1467-9280.2007.01882.x
Frost, D., & Meyer, J. (2009). Internalized homophobia and relationship quality among lesbians, gay men, and bisexuals. Journal of Counseling Psychology, 56(1), 97–109. https://doi.org/10.1037/a0012844
Garnets, L. D., Herek, G. M., & Levy, B. (2003). Violence and victimization of lesbians and gay men: Mental health consequences. In L. D. Garnets & D. C. Kimmel (Eds.), Psychological perspectives on lesbian, gay, and bisexual experiences (pp. 188–206). Columbia University Press.
Gilbert, P., & Allan, S. (1998). The role of defeat and entrapment (arrested flight) in depression: An exploration of an evolutionary view. Psychological Medicine, 28(3), 585–598. https://doi.org/10.1017/s0033291798006710
Hart, T. A., Noor, S. W., Vernon, J., Kidwai, A., Roberts, K., Myers, T., & Calzavara, L. (2018). Childhood maltreatment, bullying victimization, and psychological distress among gay and bisexual men. Journal of Sex Research, 55(4-5), 604–616. https://doi.org/10.1080/00224499.2017.1401972
Herek, G. M., Gillis, J. R., & Cogan, J. C. (2009). Internalized stigma among sexual minority adults: Insights from a social psychological perspective. Journal of Counseling Psychology, 56, 32–43. https://doi.org/10.1037/a0014672
Hoy-Ellis, C. P., & Fredriksen-Goldsen, K. I. (2016). Lesbian, gay, & bisexual older adults: Linking internal minority stressors, chronic health conditions, and depression. Aging & Mental Health, 20(11), 1119–1130. https://doi.org/10.1080/13607863.2016.1168362
Jaspal, R. (2015). The experience of relationship dissolution among British Asian gay men: Identity threat and protection. Sexuality Research & Social Policy, 12(1), 34–46. https://doi.org/10.1007/s13178-014-0175-4
Jaspal, R. (2018). Enhancing sexual health, self-identity and wellbeing among men who have sex with men: A guide for practitioners. Jessica Kingsley Publishers.
Jaspal, R. (2019). The social psychology of gay men. Palgrave. https://doi.org/10.1007/978-3-030-27057-5
Jaspal, R., & Breakwell, G. M. (Eds.). (2014). Identity process theory: Identity, social action and social change. Cambridge University Press. https://doi.org/10.1017/CBO9781139136983
Jaspal, R., Lopes, B., & Rehman, Z. (2021). A structural equation model for predicting depressive symptomatology in black, Asian and minority ethnic lesbian, gay and bisexual people in the UK. Psychology and Sexuality, 12(3), 217–234. https://doi.org/10.1080/19419899.2019.1690560
Jaspal, R., Assi, M., & Maatouk, I. (2022). Coping styles in heterosexual and non-heterosexual students in Lebanon: A cross-sectional study. International Journal of Social Psychology, 37(1), 33–66. https://doi.org/10.1080/02134748.2021.1993117
Jolley, D., & Jaspal, R. (2020). Discrimination, HIV conspiracy theories and pre-exposure prophylaxis acceptability in gay men. Sexual Health, 17(6), 525–533. https://doi.org/10.1071/SH20154
Katz-Wise, S. L., & Hyde, J. S. (2012). Victimization experiences of lesbian, gay, and bisexual individuals: A meta-analysis. Journal of Sex Research, 49(2-3), 142–167. https://doi.org/10.1080/00224499.2011.637247
Kaysen, D. L., Kulesza, M., Balsam, K. F., Rhew, I. C., Blayney, J. A., Lehavot, K., & Hughes, T. L. (2014). Coping as a mediator of internalized homophobia and psychological distress among young adult sexual minority women. Psychology of Sexual Orientation and Gender Diversity, 1(3), 225–233. https://doi.org/10.1037/sgd0000045
Khanolkar, A. R., Bolster, A., Tabor, E., Frost, D. M., Patalay, P., & Redclift, V. (2022). Lived experiences and their consequences for health in sexual and ethnic minority young adults in the UK – A qualitative study. University College London.
Kline, R. B. (2005). Principles and practices of structural equation modeling. Guilford Press.
Lee, J. H., Gamarel, K. E., Bryant, K. J., Zaller, N. D., & Operario, D. (2016). Discrimination, mental health, and substance use disorders among sexual minority populations. LGBT Health, 3(4), 258–265. https://doi.org/10.1089/lgbt.2015.0135
Legate, N., Ryan, R. M., & Weinstein, N. (2012). Is coming out always a “good thing”? Exploring the relations of autonomy support, outness, and wellness for lesbian, gay, and bisexual individuals. Social Psychological and Personality Science, 3(2), 145–152. https://doi.org/10.1177/1948550611411929
Liang, Z., & Huang, Y. T. (2021). "strong together": Minority stress, internalized homophobia, relationship satisfaction, and depressive symptoms among Taiwanese young gay men. Journal of Sex Research. https://doi.org/10.1080/00224499.2021.1947954
Lopes, B., & Jaspal, R. (2022). Identity processes and psychological wellbeing upon recall of a significant ‘coming out’ experience in lesbian, gay and bisexual people. Journal of Homosexuality. https://doi.org/10.1080/00918369.2022.211153
Maatouk, I., & Jaspal, R. (2022). Internalized sexual orientation stigma and mental health in a religiously diverse sample of gay and bisexual men in Lebanon. Journal of Homosexuality. https://doi.org/10.1080/00918369.2022.2030617
Marston, E. G., Hare, A., & Allen, J. P. (2010). Rejection sensitivity in late adolescence: Social and emotional sequelae. Journal of Research on Adolescence, 20(4), 959–982. https://doi.org/10.1111/j.1532-7795.2010.00675.x
Marteau, T. M., & Bekker, H. (1992). The development of a six-item short-form of the state scale of the Spielberger State–Trait Anxiety Inventory (STAI). British Journal of Clinical Psychology, 31(3), 301–306. https://doi.org/10.1111/j.2044-8260.1992.tb00997.x
McConnell, E. A., Birkett, M. A., & Mustanski, B. (2015). Typologies of social support and associations with mental health outcomes among LGBT youth. LGBT Health, 2(1), 55–61. https://doi.org/10.1089/lgbt.2014.0051
McDonald, K. (2018). Social support and mental health in LGBTQ adolescents: A review of the literature. Issues in Mental Health Nursing, 39(1), 16–29. https://doi.org/10.1080/01612840.2017.1398283
Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. https://doi.org/10.1037/0033-2909.129.5.674
Meyer, I. H. (2015). Resilience in the study of minority stress and health of sexual and gender minorities. Psychology of Sexual Orientation and Gender Diversity, 2(3), 209–213. https://doi.org/10.1037/sgd0000132
Meyer, I. H., & Dean, L. (1998). Internalized homophobia, intimacy, and sexual behavior among gay and bisexual men. In G. M. Herek (Ed.), Stigma and sexual orientation: Understanding prejudice against lesbians, gay men, and bisexuals (pp. 160–186). Sage Publications, Inc. https://doi.org/10.4135/9781452243818.n8
Moeller, R. W., Seehuus, M., & Peisch, V. (2020). Emotional intelligence, belongingness, and mental health in college students. Frontiers in Psychology, 11, 93. https://doi.org/10.3389/fpsyg.2020.00093
Mohr, J., & Fassinger, R. (2000). Measuring dimensions of lesbian and gay male experience. Measurement and Evaluation in Counseling and Development, 33(2), 66–90. https://doi.org/10.1080/07481756.2000.12068999
Mustanski, B., Andrews, R., & Puckett, J. A. (2016). The effects of cumulative victimization on mental health among lesbian, gay, bisexual, and transgender adolescents and young adults. American Journal of Public Health, 106(3), 527–533. https://doi.org/10.2105/AJPH.2015.302976
Negele, A., Kaufhold, J., Kallenbach, L., & Leuzinger-Bohleber, M. (2015). Childhood trauma and its relation to chronic depression in adulthood. Depression Research and Treatment. https://doi.org/10.1155/2015/650804
Outland, P. L. (2016). Developing the LGBT stress measure. Unpublished MSc dissertation. Colorado State University https://mountainscholar.org/handle/10217/176760
Puckett, J. A., Levitt, H. M., Horne, S. G., & Hayes-Skelton, S. A. (2015). Internalized heterosexism and psychological distress: The mediating roles of self-criticism and community connectedness. Psychology of Sexual Orientation and Gender Diversity, 2(4), 426–435. https://doi.org/10.1037/sgd0000123
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. https://doi.org/10.1177/014662167700100306
Ragins, B. R. (2004). Sexual orientation in the workplace: The unique work and career experiences of gay, lesbian and bisexual workers. In J. J. Martocchio (Ed.), Research in personnel and human resources management (pp. 35–129). Elsevier Science/JAI Press. https://doi.org/10.1016/S0742-7301(04)23002-X
Randall, A. K., & Bodenmann, G. (2017). Stress and its associations with relationship satisfaction. Current Opinion in Psychology, 13, 96–106. https://doi.org/10.1016/j.copsyc.2016.05.010
Russell, S. T., Ryan, C., Toomey, R. B., Diaz, R. M., & Sanchez, J. (2011). Lesbian, gay, bisexual, and transgender adolescent school victimization: Implications for young adult health and adjustment. The Journal of School Health, 81(5), 223–230. https://doi.org/10.1111/j.1746-1561.2011.00583.x
Sattler, F. A., & Christiansen, H. (2017). How do discrepancies between victimization and rejection expectations in gay and bisexual men relate to mental health problems? Frontiers in Psychology, 8, 857. https://doi.org/10.3389/fpsyg.2017.00857
Schmidt, N. B., Richey, J. A., Zvolensky, M. J., & Maner, J. K. (2008). Exploring human freeze responses to a threat stressor. Journal of Behavior Therapy and Experimental Psychiatry, 39(3), 292–304. https://doi.org/10.1016/j.jbtep.2007.08.002
Sommantico, M., De Rosa, B., & Parrello, S. (2018). Internalized sexual stigma in Italian lesbians and gay men: The roles of outness, connectedness to the LGBT community, and relationship satisfaction. Journal of Sex & Marital Therapy, 44(7), 641–656. https://doi.org/10.1080/0092623X.2018.1447056
Sosoo, E. E., Bernard, D. L., & Neblett, E. W. (2020). The influence of internalized racism on the relationship between discrimination and anxiety. Cultural Diversity & Ethnic Minority Psychology, 26(4), 570–580. https://doi.org/10.1037/cdp0000320
Tabachnick, G. B., & Fidell, S. L. (2001). Using multivariate statistics (Fourth ed.). Allyn & Bacon.
Whitman, C. N., & Nadal, K. L. (2015). Sexual minority identities: Outness and well-being among lesbian, gay, and bisexual adults. Journal of Gay & Lesbian Mental Health, 19(4), 370–396. https://doi.org/10.1080/19359705.2015.1038974
Whitton, S. W., Dyar, C., Newcomb, M. E., & Mustanski, B. (2018). Romantic involvement: A protective factor for psychological health in racially-diverse young sexual minorities. Journal of Abnormal Psychology, 127(3), 265–275. https://doi.org/10.1037/abn0000332
Whitton, S. W., Godfrey, L. M., Crosby, S., & Newcomb, M. E. (2020). Romantic involvement and mental health in sexual and gender minority emerging adults assigned female at birth. Journal of Social and Personal Relationships, 37(4), 1340–1361. https://doi.org/10.1177/0265407519898000
Wilkerson, J. M., Schick, V. R., Romijnders, K. A., Bauldry, J., Butame, S. A., & Center, M. (2017). Social support, depression, self-esteem, and coping among LGBTQ adolescents participating in hatch youth. Health Promotion Practice, 18(3), 358–365. https://doi.org/10.1177/1524839916654461
Williamson, I. R. (2000). Internalized homophobia and health issues affecting lesbians and gay men. Health Education Research, 15(1), 97–107. https://doi.org/10.1093/her/15.1.97
Wilson, C., & Cariola, L. A. (2020). LGBTQI+ youth and mental health: A systematic review of qualitative research. Adolescent Research Review, 5, 187–211. https://doi.org/10.1007/s40894-019-00118-w
Yarns, B. C., Abrams, J. M., Meeks, T. W., & Sewell, D. D. (2016). The mental health of older LGBT adults. Current Psychiatry Reports, 18(6), 60. https://doi.org/10.1007/s11920-016-0697-y
Authors’ Contribution Statement
RJ designed Study 1 and conducted the analysis for Study 1. RJ and GMB designed Study 2. BL conducted the analysis for Study 2. RJ, BL and GMB wrote the manuscript.
Data
The data are available on Brighton Research Data, the University of Brighton’s data repository, at the following link: https://researchdata.brighton.ac.uk/id/eprint/293
Funding
The studies received no funding.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethics Approval
Ethical approval was obtained from Nottingham Trent University’s Schools of Business, Law and Social Science Ethics Committee.
Consent
Participants received a detailed participant information sheet, an online consent form and a full debrief after completing the study. They provided consent to participate and for the results to be published.
Competing Interests
The Authors have no competing interests to declare.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Jaspal, R., Lopes, B. & Breakwell, G.M. Minority stressors, protective factors and mental health outcomes in lesbian, gay and bisexual people in the UK. Curr Psychol 42, 24918–24934 (2023). https://doi.org/10.1007/s12144-022-03631-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12144-022-03631-9