Discrimination, Internalized Homophobia, and Concealment in Sexual Minority Physical and Mental Health

• Published in: Psychology of sexual orientation and gender diversity 2016-03, Vol.3 (1), p.37-48
• Main Authors: Walch, Susan E., Ngamake, Sakkaphat T., Bovornusvakool, Witsinee, Walker, Steven V.
• Format: Article
• Language: English
• Subjects: Bisexuality; Female; Health; Homosexuality (Attitudes Toward); Human; Internalization; Lesbianism; Male; Male Homosexuality; Mental Health; Minority Groups; Sex Discrimination; Sexual Minority Groups; Sexual Orientation
• ISSN: 2329-0382; 2329-0390
• DOI: 10.1037/sgd0000146

Mental and physical health disparities have been noted for sexual minorities. Minority stress models posit that discrimination plays an important role in these disparities. Evidence supporting the role of proximal and distal minority stressors in LGB mental health has accumulated, but examinations of the role of minority stress processes in LGB physical health remains limited. The role of proximal minority stressors of internalized homophobia and concealment in the relationship between the distal minority stressor of lifetime experiences with discrimination and mental and physical health status was examined among a nonprobability sample of 474 LGB adults. Lifetime reports of perceived discrimination were positively associated with both mental and physical health status. Structural equation modeling revealed a direct path between discrimination and physical health but the relationship between discrimination and mental health was explained by an indirect path through internalized homophobia, suggesting that internalized homophobia may influence the impact of discrimination on mental but not physical health, at least for LGB participants who conceal their sexual orientation. Model comparisons supported the indirect path between discrimination and mental health among LGB participants who conceal their sexual orientation but indicated direct paths between discrimination and both mental and physical health for LGB participants who widely disclose their sexual orientation. Efforts to reduce discrimination may be beneficial for LGB mental and physical health. Special attention to internalized homophobia is warranted for efforts to improve LGB mental health among those who are not able to be fully open about their sexual orientation.