4.3 Article

Minority Stress, Structural Stigma, and Physical Health Among Sexual and Gender Minority Individuals: Examining the Relative Strength of the Relationships

Journal

ANNALS OF BEHAVIORAL MEDICINE
Volume 56, Issue 6, Pages 573-591

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/abm/kaab051

Keywords

Sexual and gender minority; Transgender; Minority stress; Structural stigma; Community safety; Physical health

Funding

  1. National Institute on Drug Abuse [K23DA039800]
  2. National Institute of Nursing Research [T32NR016920, F31NR019000]
  3. Robert Wood Johnson Foundation Future of Nursing Scholars Program
  4. Tourette Association of American
  5. American Academy of Neurology
  6. Tourette Association of America
  7. National Institute of Mental Health [K01MH113475, P30 MH062246]
  8. Patient-Centered Outcomes Research Institute (PCORI) Award [PPRN-1501-26848]
  9. National Institute of Diabetes, Digestive, and Kidney Disorders [K12DK111028]

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The study examined the components of minority stress and structural stigma that have the strongest relationships with physical health among SGM people. The results showed that safe community environments had the strongest relationships with physical health among most groups of SGM people, highlighting the importance of increasing safety and buffering the effects of unsafe communities for SGM health.
Background Sexual and gender minority (SGM; i.e., non-heterosexual and transgender or gender-expansive, respectively) people experience physical health disparities attributed to greater exposure to minority stress (experiences of discrimination or victimization, anticipation of discrimination or victimization, concealment of SGM status, and internalization of stigma) and structural stigma. Purpose To examine which components of minority stress and structural stigma have the strongest relationships with physical health among SGM people. Methods Participants (5,299 SGM people, 1,902 gender minority individuals) were from The Population Research in Identity and Disparities for Equality (PRIDE) Study. Dominance analyses estimated effect sizes showing how important each component of minority stress and structural stigma was to physical health outcomes. Results Among cisgender sexual minority women, transmasculine individuals, American Indian or Alaskan Native SGM individuals, Asian SGM individuals, and White SGM individuals a safe current environment for SGM people had the strongest relationship with physical health. For gender-expansive individuals and Black, African American, or African SGM individuals, the safety of the environment for SGM people in which they were raised had the strongest relationship with physical health. Among transfeminine individuals, victimization experiences had the strongest relationship with physical health. Among Hispanic, Latino, or Spanish individuals, accepting current environments had the strongest relationship with physical health. Among cisgender sexual minority men prejudice/discrimination experiences had the strongest relationship with physical health. Conclusion Safe community environments had the strongest relationships with physical health among most groups of SGM people. Increasing safety and buffering the effects of unsafe communities are important for SGM health.

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