Original Article

Associations between Sexual Minority Identities, Heterosexism, Identity Concealment, and Depression in Lesbian, Gay, and Bisexual Emerging Adults: Adjusting for the Effects of General Stressors

Authors: Claire Hsieh, BS, Ruby Charak, PhD, Gisselle Razo, BS, Jennifer Tabler, PhD, Rachel M. Schmitz, PhD

Abstract

Objectives: Lesbian, gay, and bisexual (LGB) individuals experience stressors distinctively tied to their sexual identities, such as externalized and internalized heterosexism and identity concealment, which are correlated with increased psychological distress, including depression. The present study examined the variance in depression scores resulting from heterosexism, LGB identity concealment, and minority sexual identities, after adjusting for race/ethnicity and interpersonal violence victimization experiences.

Methods: Participants were 277 LGB emerging adults 18 to 29 years old (mean 25.39, standard deviation 2.77; 46 lesbian women, 71 gay men) recruited from an online platform.

Results: Nearly 41% reported moderate to severe depression symptoms. A two-step hierarchical regression model examining the effect of sexual minority stressors, heterosexism, LGB identity concealment, and minority sexual identity on depression after controlling for childhood maltreatment and face-to-face intimate partner violence types was significant. Bisexual women (vs gay men), those with greater exposure to heterosexism, and those with a greater degree of identity concealment experienced significantly higher scores on depression. In addition, being a person of color (including identifying as Hispanic), exposure to childhood maltreatment, and experiencing psychological intimate partner violence significantly predicted increases in depression scores.

Conclusions: Findings emphasize the importance of assessing minority stressors and taking them into account when providing clinical interventions to LGB individuals.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull 2003;129:674–697.
 
2. Schmitz RM, Charak R. “I went into this as one person, and then came out a totally different person”: Native LGBTQ2S+ young adults’ conceptions of trauma. J Interpers Violence 2022;37:NP3293-NP3319.
 
3. King M, Semlyen J, Tai SS, et al. A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry 2008;8:70.
 
4. Cochran SD, Sullivan JG, Mays VM. Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States. J Consult Clin Psychol 2003;71: 53–61.
 
5. Szymanski DM, Gupta A. Examining the relationship between multiple internalized oppressions and African American lesbian, gay, bisexual, and questioning persons’ self-esteem and psychological distress. J Couns Psychol 2009;56:110–118.
 
6. Russell ST, Fish JN. Mental health in lesbian, gay, bisexual, and transgender (LGBT) youth. Annu Rev Clin Psychol 2016;12:465–487.
 
7. Meidlinger PC, Hope DA. Differentiating disclosure and concealment in measurement of outness for sexual minorities: The Nebraska Outness Scale. Psychol Sex Orientat Gend Divers 2014;1:489–497.
 
8. Bosson JK, Weaver JR, Prewitt-Freilino JL. Concealing to belong, revealing to be known: classification expectations and self-threats among persons with concealable stigmas. Self Identity 2012;11:114–135.
 
9. Villarreal L, Charak R, Schmitz RM, et al. The relationship between sexual orientation outness, heterosexism, emotion dysregulation, and alcohol use among lesbian, gay, and bisexual emerging adults. J Gay Lesbian Ment Health 2020;25:1–22.
 
10. Friedman MS, Marshal MP, Guadamuz TE, et al. A meta-analysis of disparities in childhood sexual abuse, parental physical abuse, and peer victimization among sexual minority and sexual nonminority individuals. Am J Public Health 2011;101:1481–1494.
 
11. Sterzing PR, Hong JS, Gartner RE, et al. Child maltreatment and bullying victimization among a community-based sample of sexual minority youth: the meditating role of psychological distress. J Child Adolesc Trauma 2016;9:283–293.
 
12. Corliss HL, Cochran SD, Mays VM. Reports of parental maltreatment during childhood in a United States population-based survey of homosexual, bisexual, and heterosexual adults. Child Abuse Neglect 2002;26:1165–1178.
 
13. Stoddard JP, Dibble SL, Fineman N. Sexual and physical abuse: a comparison between lesbians and their heterosexual sisters. J Homosex 2009;56:407–420.
 
14. Charak R, Villarreal L, Schmitz RM, et al. Patterns of childhood maltreatment and intimate partner violence, emotion dysregulation, and mental health symptoms among lesbian, gay, and bisexual emerging adults: a three-step latent class approach. Child Abuse Neglect 2019;89:99–110.
 
15. Messinger AM. Invisible victims: same-sex IPV in the National Violence Against Women Survey. J Interpers Violence 2010;26:2228–2243.
 
16. Walters ML, Chen J, Breiding MJ. The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 findings on victimization by sexual orientation. https://www.cdc.gov/violenceprevention/pdf/nisvs_sofindings.pdf. Accessed August 19, 2023.
 
17. Trujillo O, Cantu JI, Charak R. Unique and cumulative effects of intimate partner cybervictimization types on alcohol use in lesbian, gay, and bisexual emerging adults. Cyberpsychol Behav Soc Netw 2020;23:743–751.
 
18. Balsam KF, Lehavot K, Beadnell B, et al. Childhood abuse and mental health indicators among ethnically diverse lesbian, gay, and bisexual adults. J Consult Clin Psychol 2010;78:459–468.
 
19. Ramirez JL, Paz Galupo M. Multiple minority stress: the role of proximal and distal stress on mental health outcomes among lesbian, gay, and bisexual people of color. J Gay Lesbian Ment Health 2019;23:145–167.
 
20. Ryan C, Huebner D, Diaz RM, et al. Family rejection as a predictor of negative health outcomes in White and Latino lesbian, gay, and bisexual young adults. Pediatrics 2009;123:346–352.
 
21. Bostwick WB, Hughes TL, Steffen A, et al. Depression and victimization in a community sample of bisexual and lesbian women: an intersectional approach. Arch Sexual Behav 2018;48:131–141.
 
22. Buhrmester M, Kwang T, Gosling SD. Amazon’s Mechanical Turk: a new source of inexpensive, yet high-quality, data? Perspect Psychol Sci 2011;6:3–5.
 
23. Arnett JJ, Zukauskiene R, Sugimura K. The new life stage of emerging adulthood at ages 18-29 years: implications for mental health. Lancet Psychiatry 2014;1:569–576.
 
24. Bernstein DP, Stein JA, Newcomb MD, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl 2003;26:169–190.
 
25. Straus MA, Douglas EM. A short form of the Revised Conflict Tactics Scales, and Typologies for Severity and Mutuality. Violence Victims 2004; 19:507–520.
 
26. Balsam KF, Beadnell B, Molina Y. The Daily Heterosexist Experiences Questionnaire. Meas Eval Couns Dev 2013;46:3–25.
 
27. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16:606–613.
 
28. Kerr DL, Santurri L, Peters P. A comparison of lesbian, bisexual, and heterosexual college undergraduate women on selected mental health issues. J Am Coll Health 2013;61:185–194.
 
29. Cochran BN, Peavy KM, Robohm JS. Do specialized services exist for LGBT individuals seeking treatment for substance misuse? A study of available treatment programs. Subst Use Misuse 2007;42:161–176. .
 
30. Pachankis JE, Hatzenbuehler ML, Rendina HJ, et al. LGB-affirmative cognitive-behavioral therapy for young adult gay and bisexual men: a randomized controlled trial of a transdiagnostic minority stress approach. J Consult Clin Psychol 2015;83:875–889.
 
31. Linehan M. DBT Skills Training Manual, 2nd ed. New York: Guilford Press; 2015.