Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence.

Abstract

In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress-explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.The study of mental health of lesbian, gay, and bisexual (LGB) populations has been complicated by the debate on the classification of homosexuality as a mental disorder during the 1960s and early 1970s. That debate posited a gay-affirmative perspective, which sought to declassify homosexuality, against a conservative perspective, which sought to retain the classification of homosexuality as a mental disorder (Bayer, 1981). Although the debate on classification ended in 1973 with the removal of homosexuality from the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM;American Psychiatric Association, 1973), its heritage has lasted. This heritage has tainted discussion on mental health of lesbians and gay men by associating-even equating-claims that LGB people have higher prevalences of mental disorders than heterosexual people with the historical antigay stance and the stigmatization of LGB persons (Bailey, 1999).However, a fresh look at the issues should make it clear that whether LGB populations have higher prevalences of mental disorders is unrelated to the classification of homosexuality as a mental disorder. A retrospective analysis would suggest that the attempt to find a scientific answer in that debate rested on flawed logic. The debated scientific question was, Is homosexuality a mental disorder? The operationalized research question that pervaded the debate was, Do homosexuals have high prevalences of mental disorders? But the research did not accurately operationalize the scientific question. The question of whether homosexuality should be considered a mental disorder is a question about classification. It can be answered by debating which behaviors, cognitions, or emotions should be considered indicators of a mental disorder (American Psychiatric Association, 1994). To use postmodernist understanding of scientific knowledge, such a debate on classification concerns the social construction of mental disorder-what we as a society and as scientists agree are abnormal behaviors, cognitions, and emotions. The answer, therefore, depends on scientific and social consensus that evolves and is subject to the vicissitudes ...

Sexual Minority Status and Violence Among HIV Infected and At-Risk Women

“…Bisexual identity may be associated with unique stresses, multiple marginalization, and limited support. [52][53][54] Childhood sexual abuse also emerged as an important predictor of abuse; this is in line with previous studies, which found that women abused as children were twice as likely to experience violence as adults, 4 and may support the importance of early interventions. 55 There are several limitations to this study.…”

Risk Factors for Non-Suicidal Self-Injury Among Trans Youth

“…The minority stress model described by Meyer [42] explains that stress which particular minority groups (such as lesbian, gay, bisexual and trans people) can experience are due to the relationship between minority and dominant values which results in conflicts with their social environment. This model suggests that stress in specific minority groups can largely be explained by stressors induced by a hostile, transphobic culture, which often results in a lifetime of harassment, abuse, victimization and discrimination [43]. This explains why levels of transphobia were predictive of psychopathology and were more common among the NSSI group.…”

Health Disparities Among Common Subcultural Identities of Young Gay Men: Physical, Mental, and Sexual Health

“…Specifically, men indicated whether they were currently receiving treatment for depression or anxiety or both. Experiences related to stigma are closely linked with the mental health of gay men (Meyer, 2003). In addition to assessing mental health directly, we included five items for variables that tend to be stigma-related among gay men.…”