Scholars have utilized the Minority Stress Model to explore external and internal stressors, coping mechanisms, social support and mental health outcomes for sexually marginalized populations. However, scarce studies examine Latinx sexually marginalized experiences and associations within the model. Thus, the goal of this study was to integrate sexually marginalized Latinx experiences in the Minority Stress Model. The theoretical frameworks utilized were Minority Stress Theory, Intersectionality and Experiential Theory rooted in the Couple and Family Therapy field. First, an explanation of the Minority Stress Model, influences of prominent Latinx cultural factors (i.e., tradition, familism, gender, and acculturation) in model processes, and a proposed Latinx Minority Stress Model is provided. Further, clinical implications are discussed through intersectional multicultural competency and Experiential Theory techniques. Second, a quantitative study with a sample comprised of 76 Latinx lesbian women in romantic relationships will be discussed. Regression analysis indicated that participants with family closeness and positive romantic relationship quality reported lower internalized heterosexism (i.e., internal stress). Additionally, higher internalized heterosexism outcomes predicted higher reports of anxiety and depression. Positive relationship quality perception also statistically mediated internalized heterosexist thoughts and depression. Implications for clinical work are discussed using Experiential Theory. Finally, research and clinical implications are examined through an integration of the proposed Latinx Minority Stress Model and quantitative analysis results. Limitations and future directions are discussed.

Lesbian, Gay, and Bisexual youth are at increased risk for the use of substances (Moon, Fornili & O’Briant, 2007; Remafedi, 1987), including cigarettes, alcohol, marijuana, cocaine, and ecstasy (Bontempo & D’Augelli, 2002; Corliss, Rosario, Wypij, Wylie, Frazier & Austin, 2010). Currently, no interventions exist designed to meet the needs of LGB adolescents (NREPP, 2011), and little theory exists to explain substance use by LG adolescents. To begin the process of developing tailored interventions, this three-study dissertation sought to: (1) explore the perspectives of LGB youth, and identify their perspectives on unique prevention development, (2) systematically review the empirical literature on culturally based risk factors in LGB youth and to identify most relevant salient themes for testing, and (3) explore the relationship between identified minority related stressors and substance use patterns in a large sample of LGB youth. Findings indicate that LGB adolescents have unique cultural experiences not captured in current prevention programming. Additionally, five constructs from minority stress are described, and their relationship to marijuana use is explained. Future research should focus on the development of better measurement instruments for minority stress in LGB adolescents and the exploration of its impact on behavioral health outcomes. / text

The purpose of this study was to explore the intersection of multiple minority identities in men who have sex with men (MSM) of color, focusing on the relationship between experiences of minority stress and negative health outcomes. Specifically, this study aimed to identify how minority stress levels in MSM of color impact the following negative health outcomes: poor mental health, substance abuse, and risky sexual behavior. The role of ethnic identity belonging and religious practice as potentially moderating the relationship between minority stress and negative health outcomes was further explored. A cross-sectional online survey was utilized to test the research questions. The sample consisted of 152 participants who identified as racial/ethnic minorities and MSM between the ages of 18 and 29. Direct effects of minority stress reflected in self-reports of Lesbian, Gay and Bisexual (LGB) victimization, internalized homophobia, and perceived ethnic discrimination on negative health outcomes were tested using analysis software IBM SPSS. The findings revealed that greater minority stress was associated only with increased mental health problems. As hypothesized, evidence emerged that ethnic identity belonging moderated the relationship between minority stress and both mental health and substance use outcomes, suggesting that ethnic identity belonging may serve as a protective factor for MSM of color. Under conditions of high minority stress, MSM of color with greater engagement with formal religious practice were associated with the highest negative mental health outcomes, whereas lower degrees of religious practice predicted better mental health outcomes. This study identified MSM of color to be at risk for poor mental health and has highlighted the importance of ethnic identity belonging as a potential buffer against mental health and substance use issues. Further research is necessary to determine whether religiosity serves as a protective factor or risk factor for MSM of color. These findings will help researchers to better understand MSM of color and may have a potential impact on prevention and intervention efforts by identifying risk and protective factors that help to explain the aversive effects of minority stress.

abstract: Lesbian, gay and bisexual (LGB) individuals are exposed to specific stressors due to their sexual minority status. One such stressor may result from the negative family reactions to one’s romantic partner. Encountering this stress may be especially harmful for LGB individuals’ emotional well-being, as it could be considered a “double rejection”: that of their partner and possibly their own sexual orientation. The stress surrounding family members’ negative attitudes about their partner may affect how one feels about their partner. Furthermore, there may be individual differences that affect how an individual may perceive and respond to this stress. Specifically, one’s attachment style could either exacerbate (anxious) or weaken (avoidant) the experiences of stress, which may influence the emotions they feel about their partner. Using 14-day daily diary data from 81 same-sex couples, the purpose of this study was to examine whether there was an association between daily perceptions of stress via negative family reactions to partner and negative partner-related emotions, and whether attachment insecurity (anxiety and avoidance) moderated this association. Individuals’ perceptions of stress via negative family reactions was found to be positively associated with their reports of negative emotions about one’s partner. Anxious and avoidant attachment did not moderate the association between perceptions of stress and negative emotions due to one’s partner. The finding suggests this specific stressor on negative emotions due to partner may be an intrapersonal process, in which case couple therapists can increase clients’ awareness of this stress and how it impacts their feelings towards their romantic partner. / Dissertation/Thesis / Masters Thesis Counseling Psychology 2017

abstract: Research has consistently shown that gay/lesbian/bisexual (GLB) or sexual minority youth are at an increased risk for adverse outcomes resulting from the stress caused by continual exposure to negative events (e.g., victimization, discrimination). The present study used a nationally representative sample of adolescents to test mechanisms that may be responsible for the differences in offending behaviors among sexual minority and heterosexual adolescents. Specifically, this study tested whether bisexual adolescents received less maternal support than did heterosexual adolescents because of their sexual orientation, thus increasing the likelihood that they run away from home. This study then examined whether the greater likelihood that bisexual adolescents running away would lead to them committing a significantly higher variety of income-based offenses, but not a significantly higher variety of aggression-based offenses. This study tested the hypothesized mediation model using two separate indicators of sexual orientation measured at two different time points, modeled outcomes in two ways, as well as estimated the models separately for boys and girls. Structural equation modeling was used to test the hypothesized direct and indirect relations. Results showed support for maternal support and running away mediating the relations between sexual orientation and offending behaviors for the model predicting the likelihood of committing either an aggressive or an income offense, but only for girls who identified as bisexual in early adulthood. Results did not support these relations for the other models, suggesting that bisexual females have unique needs when it comes to prevention and intervention. Results also highlight the need for a greater understanding of sexual orientation measurement methodology. / Dissertation/Thesis / Doctoral Dissertation Psychology 2018

Sexual minorities consistently report more alcohol use than heterosexual individuals, and sexual minority women tend to report more alcohol use than sexual minority men (Amadio, 2006; Kerr et al., 2015; Rosario et al., 2014). Some evidence suggests that this disparity in comparison to heterosexuals may be problematic drinking, such as binge drinking and alcohol dependence, rather than just higher consumption of alcohol. Thus, it is important to examine which variables are related to problematic drinking among sexual minority women. One factor that may explain problematic drinking for sexual minority women is proximal minority stress, such as anticipated stigma (expectations of unfair treatment) and internalized stigma (negative attitudes toward the self about one’s sexual orientation) (Meyer, 2003). Previous research has found that internalized stigma predicts more problematic drinking (Feinstein & Newcomb, 2016; Lea et al., 2014). Additionally, proximal minority stress may be indirectly related to problematic drinking through variables like depression, social support, and drinking motives (Lehavot & Simoni, 2011; Lewis et al., 2016). However, findings on anticipated stigma have inconsistently shown a relationship with problematic drinking (Hatzenbuehler et al., 2008; Reisner et al., 2015). The current study tested a path analysis model examining how proximal minority stress may be related to problematic drinking among sexual minority women. Participants included 101 women who identified as lesbian, bisexual, and other non-heterosexual orientations. Participants were mainly white, and came from all regions of the United States (Northeast, South, Midwest, West). They completed the following measures: the Internalized Stigma Subscale of the Perceived Stigma Scale (Mickelson, 2001), the Discrimination Scale (adapted from Williams, 1997), the Multidimensional Scale of Perceived Social Support (Zimet et al., 1988), the Center for Epidemiological Studies Depression Scale (Radloff, 1977), the Drinking Motives Questionnaire (Cooper, 1994), and the AUDIT (Saunders et al., 1993). The final model tested anticipated stigma and internalized stigma as predictors of social support and depression; depression significantly predicted coping and enhancement motives, which in turn predicted problematic drinking. Age, living in the Northeast, and being a racial/ethnic minority were covariates of depression, internalized stigma and social support respectively. A path analysis conducted via EQS determined that the model had good fit (Chi-square/df = 1.10, p = 0.32, CFI = .988, SRMR = 0.082, RMSEA = .032 (90% CI [0.001, 0.082]). These results support the hypotheses that minority stress is related to more problematic drinking through depression and substance use motives. Findings could suggest that future research and interventions should examine the replacement of negative coping mechanisms, like drinking, with more positive coping mechanisms among sexual minority women.

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Lesbian, gay, and bisexual (LGB) individuals, also known as sexual minorities, endure unique and excess stressors due to their stigmatized sexual minority identity. Commonly referred to as minority stress, these stressors may potentially lead to poorer mental health outcomes among sexual minority individuals as compared to their heterosexual counterparts. The manifestation and extent of these stressors depend on the complex relationships between one’s simultaneous intersecting identities (e.g., race, gender, and sexual orientation) and macro-level inequality reinforcement (e.g., structural barriers, societal representation, politics). Inequality at the macro-level creates power and oppression on a larger scale by emphasizing dominant societal norms and belief systems, which, in turn, could have consequences on interpersonal and individual levels. Previous minority stress literature neglects macro-level impact and tends to view sexual minorities as a homogenous group. In an effort to highlight within-group variability of minority stressors and their impact on sexual minorities at the intersection of race and gender, an intersectional lens was applied to assess existing minority stress literature that corresponded with three types of intersectionality (i.e., structural intersectionality, representational intersectionality, political intersectionality). Sexual minority stress research, with emphasis on external stressors aligning with macro-level forces, was selected for review. After organizing the literature by race, gender, and specific sexual minority identity, an intersectional lens was applied to explain the variation of experience based on converging identity intersections of sexual minority individuals. The variation of mental health outcomes was also identified. Findings revealed that literature primarily lined-up with structural intersectionality, followed by representational intersectionality, and, finally, political intersectionality. Ideally, this review would have equally distributed information on all within-group identity combinations, but this review further highlights group underrepresentation in the literature. Consistencies emerged for bisexuals and sexual minorities of color (SMOC) across the structural, representational, and political intersectionality categorizations. Overall, bisexuals and SMOC appear to be at a more significant macro-level disadvantage than gay or lesbian individuals and White sexual minorities. A recognizable pattern occurred based on gender across race/ethnicity in relation to structural and representational intersectionality. The stressors for women and gender minorities occurred in the context of societal power, assumed heterosexuality, and healthcare. By contrast, stressors for men concerned geographic location, employment, workplace, and appearance. While very little minority stress literature corresponded with political intersectionality, this review highlighted a large gap in previous research and what to explore in the future. The findings highlight the similarities and differences encountered by sexual minorities related to experiences, stress, and mental health regarding macro-level impacts. Additionally, gaps in the minority stress literature were also revealed, such as underrepresented identities and political influence. In the future, incorporation of intersectionality that should be applied prior to conducting minority stress research for a more comprehensive understanding.

Gender minorities and sexual minorities have been historically under researched in the field of psychology. This becomes more so the case when looking at the intersections of those who identify as both gender and sexual minorities. Prior research has indicated that minority stress models have been shown to be linked to disparities in mental health between sexual minorities and non-sexual minorities. This has also been shown to be true between gender minorities and cis gender individuals. Little research has ever been done to establish this model on those who fall within both minority groups and how these models may differ. The present study attempts to look at this intersection by comparing a mental health and minority stress model – comprised of anticipated discrimination, social support, and depression – for those identifying as a gender and sexual minority to those who identify as purely sexual minorities. In order to do this, participants (N = 315) were recruited from social media and were given a series of surveys. All participants identified as sexual minorities and 53% (n = 167) identified as Transgender or Gender Non-Conforming (TGNC). The cross-sectional, online quantitative study featured a battery of surveys that measured anticipated discrimination in both major and every day events, LGBT community connectedness, depression, and anxiety. A mediated moderated model and a series of t tests were performed to analyze the differences between sexual and gender minorities versus sexual minorities only. Results indicated that TGNC individuals had significantly higher levels of anticipated discrimination (M = 3.56, SD = .86 compared to M = 3.30, SD = .92), lower levels of social support (M = 4.66, SD = 1.26 compared to M = 5.20, SD = 1.24), and higher levels of depression (M = 31.81, SD = 12.97 compared to M = 25.32, SD = 12.80). Further, anticipated discrimination and fewer support resources explain the increase in depression for TGNC individuals (bootstrapped indirect effects = -.4111 SE = .1720 95%CI = -.8675, -.1634). Overall TGNC individuals showed to have worse experiences and outcomes than their gender conforming, cisgender peers. These results may suggest that future counselling methods for TGNC individuals could benefit by focusing on fostering social support through methods such as interpersonal psychotherapy.