Effects of Minority Stress on Lesbian, Bisexual, Transgender, and Queer People of Color Julia Leschi
Research has repeatedly found that members of oppressed social groups (e.g., sexual or racial/ethnic minorities) have worse mental health outcomes than their dominant counterparts (Dhejne et al., 2016; Hendricks & Testa, 2012; Meyer, 2003; Paradies et al., 2015; Pieterse et al., 2012; Williams & WilliamsMorris, 2000). For example, African American adults are 20% more likely to report high levels of psychological distress than White adults, while Latina teenagers are more likely to attempt suicide than their non-Hispanic White counterparts (Centers for Disease Control and Prevention [CDC], 2019). Similarly, lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults are three times more likely to report suicidal ideation than heterosexual adults (CDC, 2016), with 40% of transgender adults having attempted suicide in their lifetime, compared to 5% of the general population (James et al., 2016). Minority stress theory has been applied to explain these differences, positing that stigma, prejudice, and discrimination directed at minority groups create a hostile and stressful environment which leads to mental health problems (Meyer, 2003). Minority stress includes distal stressors (e.g., workplace and housing discrimination, microaggressions), objective events that are visible in the environment to an outside observer, and proximal stressors (e.g., self-stigma, identity concealment, expectation of rejection), which arise secondary to distal ones and have been defined as the internalization of negative messaging and attitudes projected by others (Hendricks & Testa, 2012; Meyer, 2003; Ramirez & Paz Galupo, 2019). Although the literature on minority stress has mostly focused on LGBTQ, as well as ethnic and racial minority (i.e., people of color) , individuals (Paradies et al., 2015; Pieterse et al., 2012), it has typically explored the relation between a single minority identity and poor mental health outcomes. Less attention has been given to how minority stress affects LGBTQ individuals who also belong to racial/ethnic minority groups. Some have hypothesized that the intersection of these two identities amplifies the risks of exposure to discrimination leading to minority stress and, therefore, alters the processes through which one is affected by it; however, others suggest this intersection might lead to resilience as a result of LGBTQ people of color’s prior experiences with discrimination (Ching et al., 2018; Ramirez & Paz Galupo, 2019; Rodriguez-Seijas et al., 2019; Rosenfield, 2012). Hence, the present literature review explored the following question: How does minority stress impact the mental health of LGBTQ people of color? Excess Risks and Mental Health Outcomes Having multiple minority identities exposes LGBTQ people of color to both racist and heterosexist microaggressions, 24
leaving them susceptible to excess minority stress (Balsam et al., 2011; Szymanski & Sung, 2010). This specific vulnerability has been termed the “double-jeopardy” hypothesis, which posits that the intersection of two marginalized identities leads to a double health disadvantage (Dowd & Bengston, 1978). Research studying LGBTQ people of color has found that they suffer from negative mental health outcomes such as general psychological distress, increased anxiety, and depressed mood at a higher rate than their heterosexual and cisgender counterparts (Diaz et al., 2001; Szymanski & Sung, 2010). Such outcomes are seen as a consequence of social discrimination, unique tensions between their sexual/gender identity, and the perceived heterosexist and cissexist norms of their ethnic or racial community (Consolacion et al., 2004; Diaz et al., 2001; Szymanski & Sung, 2010). Indeed, minority stress factors can be perceived differently based on one’s own cultural beliefs and the messaging from one’s environment (Ramirez & Paz Galupo, 2019; Sarno et al., 2015). Presently, LGBTQ people of color report being discriminated against in both of their communities, having to deal with heterosexism, homophobia, or transphobia within their racial/ethnic groups, while dealing with racism and fetishization in LGBTQ spaces (i.e., social and political spaces catering specifically to an LGBTQ population; Balsam et al., 2011; Consolacion et al., 2004; McConnell et al., 2018; Ramirez & Paz, 2019; Szymanski & Sung, 2010). LGBTQ spaces give queer individuals the opportunity to be true to themselves, as well as find support and community; however, when LGBTQ people of color experience racism in these spaces, they are isolated from a source of support more accessible to White LGBTQ people (Gieseking, 2016). Additionally, queer people of color face communityspecific struggles in their home environments, such as clashes between traditional cultural norms and queer identity (Balsam et al., 2011; Ching et al., 2018; Noyola et al., 2020). These situations can trigger a conflict in allegiance, which has been defined as a perceived incompatibility between one’s racial and ethnic and sexual orientation identities, and leads to psychological distress (Sarno et al., 2015). Specifically, conflicts in allegiances are positively correlated with experiences of racism in LGBTQ spaces and heterosexism from family (Sarno et al., 2015), highlighting the negative effects of this double-sided rejection. Moreover, conflict in allegiance levels are highest among those with high racial/ethnic behavioral engagement and low sexual orientation behavioral engagement, leaving them more likely to suffer from poor mental health (Sarno et al., 2015). This suggests that strong identification and engagement with the LGBTQ community could mediate the extent to which distress caused by conflicts in allegiances develop (Ching et al., 2018; Sarno et al., 2015).
