Proximal Minority Stress, Psychosocial Resources, and Health in Sexual Minorities

Abstract

Although minority stress processes of internalized stigma and anticipated discrimination are related to poor mental and physical health, limited research has explored mechanisms through which they become related. Uncovering mechanisms could provide additional points of intervention to improve sexual minority health. Using data from 218 sexual minorities (gay, lesbian, and bisexual individuals) who participated in an online study, we examined the indirect explanatory role of reduced psychosocial resources (social support, self-compassion, selfesteem) in the link between proximal minority stress (concealment, internalized stigma, anticipated discrimination) and health outcomes (psychological distress, self-reported health). Results revealed proximal minority stress processes were indirectly associated with self-reported health through reduced social support, and indirectly associated with psychological distress through reduced self-compassion and self-esteem. Findings highlight the compromised psychosocial resources that explain how minority stressors become linked with health. Interventions aimed at improving resources may be avenues for improving sexual minority health.Gay, lesbian, and bisexual individuals (i.e., sexual minorities) experience worse mental health (e.g., depression, anxiety, substance use) and physical health outcomes and behaviors (e.g., asthma, obesity, smoking, some cancers) than heterosexuals (Williams & Mann, 2017). A contributor to sexual minority health is minority stress (Meyer, 2003), or stigma and resulting processes due to minority sexual identity. Limited work has identified mechanisms that link proximal minority stress processes of concealment, internalized stigma, and anticipated discrimination to health. Uncovering mechanisms could provide points of intervention to improve health. The present study examined psychosocial resources (social support, self-compassion, self-esteem) that may be compromised due to

The Benefits and Challenges of Health Disparities and Social Stress Frameworks for Research on Sexual and Gender Minority Health

“…As a result, the majority of research on stigma and its impact on sexual and gender minority health has utilized within‐group designs. This approach is useful in understanding the association between stigma and health (e.g., Lewis et al., ; Scandurra, Amodeo, Valerio, Bochicchio, & Frost, ; Williams, Mann, & Fredrick, ), but lacks the ability to examine the extent to which stigma explains a given health disparity (Schwartz & Meyer, ).…”

Commentary on: Sexual and Gender Minority Health Disparities as a Social issue: How Stigma and Intergroup Relations Can Explain and Reduce Health Disparities

“…These definitions, point to aspects that must be evident for us to use the terminology of stigma. The current volume deploys these definitions (see Williams & Mann, ), especially the social psychological definition that focuses on situational contexts as this formulation is particularly useful for identifying ways that stigma might be mitigated by altering contextual circumstances and situational cues (Lewis, Winstead, Mason, & Lau‐Barraco, ; Scandurra, Amodeo, Valerio, Bochicchio, & Frost, ; Williams, Mann, & Fredrick, ). A particularly strong example evident in this is reflected in the work of Fingerhut and Abdou () who marshal stereotype threat theory and its emphasis on situational cues to conjure ways in which health care access and encounters might be improved for LGBT groups.…”

“…() identified six dimensions of stigma—origins, course, concealability, peril, disruptiveness, and aesthetic qualities. The current volume makes use of these dimensions in its focused examination of LBGT stigma, making particular use of the concealability dimension which is, for example, linked to other constructs in a proximal minority stress approach (Williams et al., ). The six dimensions of Jones et al.…”

“…For example, Williams et al. () use measures of anticipated rejection, internalized stigma and concealment to show how these factors influence health indirectly through psychosocial resources social support, self‐esteem, and self‐compassion. Lewis et al.…”

“…The minority stress formulation is strongly represented in this volume—in fact 9 of the 11 articles in the volume cite Meyer's () Psychological Bulletin article. But just as many of the papers in the volume use minority stress theory they also reflect on its utility by building evidence relevant to its validity (see especially Bouris & Hill, ; Lewis et al., ; Scandurra et al., ; Williams et al., ). And Bouris and Hill () elaborate minority stress theory by conceptualizing the mother‐adolescent relationship as a key “promotive” resource that modifies minority stress processes.…”