Stress, Stigma, and Sexual Minority Status: The Intersectional Ecology Model of LGBTQ Health

Abstract

One of the four overarching goals of Healthy People 2020 is to achieve health equity, eliminate health disparities, and improve the health of all groups, including the health of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) populations. In 2011, the Institute of Medicine (IOM) released a report that drew attention to the unique health disparities experienced by sexual minorities and underscored the need for a comprehensive approach to sexual minority health research. This article proposes a new model of LGBTQ health to help measure, explore, explain, and predict the impact of sexual minority status on health outcomes. The Intersectional Ecology Model of LGBTQ Health (IEM) demonstrates how the relentless hypervigilance of LGBTQ individuals in a heteronormative society impacts health outcomes through the primary vehicles of stigma and chronic, elevated stress. The purpose of the IEM is to guide future research and enhance public health practice for LGBTQ populations.

Methamphetamine Use and Sexual Risk Behaviors among Men Who Have Sex With Men in a Mexico‐US Border City

“…27 Another theoretical model, the Intersectional Ecology Model of LGBTQ Health, addresses the impact stigma from the dominant culture, from other minorities, and within sexual minority groups on various aspects of the lives of sexual minorities. 28 The sexual minorities experience chronic stressors such as failing to fulfill societal expectations, bearing with the negative attitudes of society, and maintaining nondisclosure of sexual orientation, which lead to the internalization of negative attitudes and affects the mental and physical health of this group. 27 Racial/ethnic disparities in HIV prevalence have been linked to discrimination and an increase in high-risk sexual ties.…”

“…Of the 100 male participants, 92 had sex in the past 12 months, and of those 19 (20.7%) were MSM. Median (Q1, Q3) age was 28.5 (28,35) years (≥21 eligibility), the majority of participants were single or never married (59.8%) and born in Mexico (77.2%) while close to half crossed the border into the United States in the past 12 months (45.7%) or specifically into El Paso (44.6%) in the past 12 months. In terms of meth use initiation, the median (Q1, Q3) age for first time use of meth was 18 (16,21) years.…”

“Civil rights? Yeah, right!”: Reflections on legislative changes from older sexual and gender minorities in Aotearoa New Zealand

“…Research indicates that sexual and gender minorities experience stigma, discrimination, and abuse at higher rates than heterosexual and cisgender individuals (Adams, Dickinson, & Asiasiga, 2013;Hash & Rogers, 2013;Mink, Lindley, & Weinstein, 2014). For older sexual and gender minorities, there are additional, unique, challenges that their older heterosexual and cisgender peers do not face.…”

The Cuban Health Paradigm: An Exploratory Analysis Through LGBTQ and HIV/AIDS Individual Perspectives

“…It is widely understood that minority health is generally worse than the general population, a fact which some attribute to minority stress, economic oppression, diminished social capital and many other factors. 2…”

“…24 Being denied the ability to live authentically, marry the person you love, hold a job openly, and live without fear of physical threat, increases the prevalence of mental and physical illness. 25 "LGBTQ individuals experience many of the same stressors (stressful stimulus) as anyone else-but they also experience a distinguishable set of stressors that are unique to or pronounced in sexual minorities." 26 These stressors include homophobia and harassment, isolation and loneliness, shame, stigma, hiding and guilt, and threat of violence or abuse.…”