Multilevel Stigma and Depression Among a National Sample of Black and Latinx LGBTQ+ Adolescents in the United States

• Published in: Journal of psychopathology and clinical science 2023-07, Vol.132 (5), p.577-589
• Main Authors: Jackson, Skyler D., Harvey, Tyler D., Watson, Ryan J., Pereira, Kobe, Clark, Kirsty A.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Psychopathology; Adolescents; Bisexuality; Black or African American - psychology; Black or African American - statistics & numerical data; Black People; Bullying; Bullying - psychology; Bullying - statistics & numerical data; Conversion therapy; Depression - epidemiology; Depression - ethnology; Depression - etiology; Depression - psychology; Female; Heterosexism; Hispanic or Latino - psychology; Hispanic or Latino - statistics & numerical data; Human; Humans; Internalization; Intersectionality; Latinos/Latinas; Lesbianism; LGBTQ; LGBTQ people; Major Depression; Male; Mental depression; Mental health; Oppression; Psychopathology; Racism; Resilience; Sexual and Gender Minorities - psychology; Sexual and Gender Minorities - statistics & numerical data; Sexual Behavior - ethnology; Sexual Behavior - psychology; Sexual Behavior - statistics & numerical data; Sexual Orientation; Social Stigma; Stigma; Symptoms; Teenagers; Transgender persons; United States - epidemiology
• ISSN: 2769-7541; 2769-755X
• DOI: 10.1037/abn0000841

Limited research has examined how multiple forms of oppression (e.g., racism, heterosexism, transphobia)-manifesting across multiple levels (e.g., interpersonal, structural)-can place Black and Latinx lesbian, gay, bisexual, transgender, queer, and other sexual/gender minority (LGBTQ+) adolescents at increased risk for internalizing psychopathology, including depression. Utilizing a national sample of 2,561 Black and Latinx LGBTQ+ adolescents (aged 13-17), we examined associations among depressive symptoms and several adolescent-focused manifestations of stigma, including: (a) interpersonal racial/ethnic bullying, (b) interpersonal sexual orientation bullying, (c) nine state-level forms of structural stigma or protection for LGBTQ+ adolescents, and (d) a new adolescent-focused composite index of state-level anti-LGBTQ+ structural stigma. Racial/ethnic bullying and sexual orientation bullying were found to be prevalent among the sample and were associated-both independently and jointly-with increased depressive symptoms. One harmful state-level anti-LGBTQ+ structural stigma indicator (i.e., anti-LGBTQ+ community attitudes) and seven protective state-level anti-LGBTQ+ structural stigma indicators (e.g., conversion therapy bans) were associated with odds of depressive symptoms, in the expected directions. Black and Latinx LGBTQ+ adolescents residing in states with greater overall anti-LGBTQ+ structural stigma reported increased depressive symptoms, even when adjusting for racial/ethnic and sexual orientation bullying. Additionally, Black and Latinx LGBTQ+ adolescents living in the most stigmatizing states demonstrated 32% increased odds of depressive symptoms, as compared to those living in the most LGBTQ+ affirming states. Multilevel, intersectional interventions could have optimal effects on the mental health and resilience of Black and Latinx LGBTQ+ adolescents. General Scientific SummaryThe mental health problems of U.S. Black and Latinx lesbian, gay, bisexual, transgender, queer, and other sexual/gender minority (LGBTQ+) adolescents may be driven, in part, due to their exposure to multiple, interlocking forms of oppression (e.g., racism, heterosexism, transphobia) manifesting at multiple levels (e.g., interpersonal, structural). This study finds that depressive symptoms among Black and Latinx LGBTQ+ adolescents (aged 13-17) are predicted by (a) their exposure to racial/ethnic and sexual orientation bullying and (b) the level of anti-LGBTQ+ structural sti