The influence of structural stigma and rejection sensitivity on young sexual minority men's daily tobacco and alcohol use

Abstract

Stigma occurs at both individual and structural levels, but existing research tends to examine the effect of individual and structural forms of stigma in isolation, rather than considering potential synergistic effects. To address this gap, our study examined whether stigma at the individual level, namely gay-related rejection sensitivity, interacts with structural stigma to predict substance use among young sexual minority men. Sexual minority (n = 119) participants completed online measures of our constructs (e.g., rejection sensitivity). Participants currently resided across a broad array of geographic areas (i.e., 24 U.S. states), and had attended high school in 28 states, allowing us to capture sufficient variance in current and past forms of structural stigma, defined as (1) a lack of state-level policies providing equal opportunities for heterosexual and sexual minority individuals and (2) negative state-aggregated attitudes toward sexual minorities. To measure daily substance use, we utilized a daily diary approach, whereby all participants were asked to indicate whether they used tobacco or alcohol on nine consecutive days. Results indicated that structural stigma interacted with rejection sensitivity to predict tobacco and alcohol use, and that this relationship depended on the developmental timing of exposure to structural stigma. In contrast, rejection sensitivity did not mediate the relationship between structural stigma and substance use. These results suggest that psychological predispositions, such as rejection sensitivity, interact with features of the social environment, such as structural stigma, to predict important health behaviors among young sexual minority men. These results add to a growing body of research documenting the multiple levels through which stigma interacts to produce negative health outcomes among sexual minority individuals.

Disparities in tobacco use by sexual orientation among high school students

“…Prospective data from the Growing Up Today Study found that sexual minority youth in the United States living in states with low structural stigma were less likely to report cigarette use in the past year . Furthermore, a recent study on the role of structural stigma on substance use among sexual minority youth found that exposure to structural stigma was significantly associated with daily cigarette use (Pachankis et al, 2014). According to survey selfreport data, LGB youth were more likely to have experienced sexual abuse, parental abuse, assault at school when compared to non-LGB peers (Saewyc et al, 2006;Bontempo and d'Augelli, 2002).…”

Discrimination, Mental Health, and Substance Use Disorders Among Sexual Minority Populations

“…Studies using diverse methodologies consistently attribute the source of sexual orientation-related mental health and substance use disparities in sexual minorities to disproportionate exposure to minority stress-the stress associated with stigma-related social disadvantage that compounds general life stress. 6,[11][12][13] According to this model, 6 minority stress emerges from stigmatizing societal structures-termed structural stigma 14 -that deny sexual minority individuals (i.e., those who identify as gay, bisexual, or lesbian or engage in same-sex sexual behavior) the same rights and opportunities afforded to heterosexuals. In addition, discrimination within families, religious communities, schools, and workplaces elevate stress and, therefore, the mental health and substance burden experienced by sexual minorities across the lifespan.…”

Comparison of Government and Non-Government Alcohol and Other Drug (AOD) Treatment Service Delivery for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community

“…LGBT people also experience unique challenges related to discrimination and stigma (Pachankis et al, 2014), victimization (Collier, van Beusekom, Bos, & Sandfort, 2013) 25 and physical abuse (Goldbach et al, 2014;Ignatavicius, 2013) that can negatively affect psychological well-being (see Flentje, Livingston, Roly, & Sorensen, 2015), and for which some persons use substances to help cope Williamson, 2000). It is well established that Q2 30 some of the most powerful institutions in society have historically rejected homosexuality, including various religions, health systems and the media (Meyer, 2013).…”