Exploring Discrimination and Mental Health Disparities Faced By Black Sexual Minority Women Using a Minority Stress Framework

Abstract

Black sexual minority women are triply marginalized due to their race, gender, and sexual orientation. We compared three dimensions of discrimination—frequency (regularity of occurrences), scope (number of types of discriminatory acts experienced), and number of bases (number of social statuses to which discrimination was attributed)—and self-reported mental health (depressive symptoms, psychological well-being, and social well-being) between 64 Black sexual minority women and each of two groups sharing two of three marginalized statuses: (a) 67 White sexual minority women and (b) 67 Black sexual minority men. Black sexual minority women reported greater discrimination frequency, scope, and number of bases and poorer psychological and social well-being than White sexual minority women and more discrimination bases, a higher level of depressive symptoms, and poorer social well-being than Black sexual minority men. We then tested and contrasted dimensions of discrimination as mediators between social status (race or gender) and mental health outcomes. Discrimination frequency and scope mediated the association between race and mental health, with a stronger effect via frequency among sexual minority women. Number of discrimination bases mediated the association between gender and mental health among Black sexual minorities. Future research and clinical practice would benefit from considering Black sexual minority women's mental health in a multidimensional minority stress context.

Pathways to Hazardous Drinking Among Racially and Socioeconomically Diverse Lesbian Women

“…It may be that these women make distinctions between sources of discrimination and do not experience their racial minority status as contributing to discrimination due to their sexual orientation. Consistent with this finding, Calabrese et al (2015) found that Black and White lesbian women did not significantly differ in reported sexual minority discrimination. On the other hand, our single item discrimination measure may have limited our ability to capture variability in perceived discrimination, thus attenuating the association between race and sexual minority discrimination.…”

“…In fact, in a recent meta-analysis, minority statuses of race, sex, and sexual orientation were each associated with poorer psychological well-being. Also, Black sexual minority women compared to White sexual minority women, reported more discrimination, which was then associated with poorer well-being (Calabrese, Meyer, Overstreet, Hale, & Hansen, 2015). Also, Black lesbian, gay, bisexual and transgender (LGBT) individuals may experience more psychological distress and emotional disorders (Balsam, Molina, Beadnell, Simoni, & Walters, 2011; King et al, 2008; O'Donnell, Meyer, & Schwartz, 2011) than White LGBT individuals.…”

Sexual orientation differences in functional limitations, disability, and mental health services use: Results from the 2013–2014 National Health Interview Survey.

“…Over the years, the MSM has received substantial empirical support, particularly when predicting sexual orientation-related disparities in mental health morbidity (Cochran, 2001; Cochran & Mays, 2009; Eldahan et al, 2016; Feinstein et al, 2012; Hatzenbuehler, 2009; Lehavot & Simoni, 2011; McCabe, Bostwick, Hughes, West, & Boyd, 2010; Meyer, 2003; Meyer, Schwartz, & Frost, 2008; Pachankis, Rendina, et al, 2015; Ueno, 2010). However, the MSM is less robust at explaining frequently observed patterns of gender (Cochran, Bandiera, & Mays, 2013; Cochran & Mays, 2013) or racial/ethnic (Bostwick, Boyd, Hughes, West, & McCabe, 2014; Bostwick, Meyer, et al, 2014; Calabrese, Meyer, Overstreet, Haile, & Hansen, 2015) differences within the LGB population. For example, although the MSM predicts that the double marginalization of sexual and racial/ethnic minority status should result in greater mental health disparities among LGB persons of color, current evidence is not fully supportive of this prediction (Bostwick, Meyer, et al, 2014; Calabrese et al, 2015; Cochran, Mays, Alegria, Ortega, & Takeuchi, 2007).…”

“…However, the MSM is less robust at explaining frequently observed patterns of gender (Cochran, Bandiera, & Mays, 2013; Cochran & Mays, 2013) or racial/ethnic (Bostwick, Boyd, Hughes, West, & McCabe, 2014; Bostwick, Meyer, et al, 2014; Calabrese, Meyer, Overstreet, Haile, & Hansen, 2015) differences within the LGB population. For example, although the MSM predicts that the double marginalization of sexual and racial/ethnic minority status should result in greater mental health disparities among LGB persons of color, current evidence is not fully supportive of this prediction (Bostwick, Meyer, et al, 2014; Calabrese et al, 2015; Cochran, Mays, Alegria, Ortega, & Takeuchi, 2007). …”

Meta-Perceptions of Others’ Attitudes Toward Bisexual Men and Women Among a Nationally Representative Probability Sample

“…Stigma negatively affects the health and well-being of socially marginalized groups (Calabrese, Meyer, Overstreet, Haile, & Hansen, 2015; Cook, Juster, Calebs, Heinze, & Miller, 2017; Hatzenbuehler & McLaughlin, 2014; Hatzenbuehler, Phelan, & Link, 2013; Rendina et al, 2017). Researchers have quantified the stigmatization of marginalized groups by administering validated surveys to assess the prevalence of negative attitudes toward members of socially stigmatized groups (Helms & Waters, 2016; Herek, 2002).…”