Mental Health Correlates of Sexual Orientation Microaggressions Among LGBQ College Students: Self-Esteem As A Protective Factor

Background: Although contemporary heterosexism is manifested through violence, it is commonly expressed in subtle, often unintentional ways, such as everyday microaggressions (Nadal et al., 2010). Minority stress theory posits that sexual minorities are at increased risk for psychological distress due to stigma and discrimination (Meyer, 2003). Little is known about the correlates of sexual orientation microaggressions. Further, the role of protective factors has received minimal attention.

Purpose: We examine the role of campus-based sexual orientation microaggressions, specifically microinvalidations, microinsults, and environmental microaggressions, and sexual orientation hostility on lesbian, gay, bisexual, and queer (LGBQ) college students’ risk for perceived stress, anxiety, and depression. We also ask, does self-esteem moderate any of these relationships?

Methods: Data were taken from an anonymous online survey conducted with a convenience sample of LGBQ college students and recent graduates in the United States and Canada (n=338; M=24 years; 22% people of Color; 57% female). Participants were recruited through LGBQ listserves and networks; the opportunity to win gift cards was offered as an incentive. 

Participants were asked about their experiences with various types of discrimination on campus (past year; 0=never; 5=very frequently). Scales were created to measure microinvalidations (10 items; α=.87), microinsults (16 items; α=.89), environmental microaggressions (6 items; α=.73), and sexual orientation hostility (13 items; α = .93).

Outcome measures included Perceived Stress Scale (α=.89; Cohen et al., 1983), Generalized Anxiety Disorder Scale (α=.90; Spitzer et al., 2006), and an adapted version of PHQ-9 (α=.88; Kroenke & Spitzer, 2002). Rosenberg’s (1979) scale assessed self-esteem (α=.91).

Linear regression models were conducted to examine the effects of each form of discrimination on the outcomes and interactions (discrimination X self-esteem) tested potential moderating effects. Controls included demographics and internalized stigma.

Results: In initial models, each form of discrimination was significantly and positively associated with each outcome (range β .13 - .26). Microinvalidations had the largest effect size for perceived stress (β=.21, p<.001) and anxiety (β=.21, p<.001), and microinsults for depression (β=.26, p<.001).

Self-esteem moderated the relationship between perceived stress and microinvalidations (β=-.09, p<.05) and hostility (β=-.22, p<.001),. It also moderated the relationship between depression and environmental microaggressions (β=-.12, p<.01), microinsults (β=-.08, p<.05), and hostility (β=-.17, p<.001). Moderating effects were not found for anxiety, but trended toward significance with hostility (β=-.13, p=.051).

Discussion: The results underscore the importance of prevention and intervention programs addressing subtle and overt forms of discrimination targeting LGBQ college students. The results suggest that subtle forms of discrimination can impact LGBQ students’ psychological health. Alongside hostility, mental health interventions need to consider various microaggressions. Interventions fostering students’ self-esteem can help protect against the negative consequences of discrimination, especially hostility.

The results have important implications for research on sexual minorities as well as for practitioners, particularly in using measures of subtle discrimination in mental health screenings. The study also has implications for campus climate initiatives and curriculum in mental health and related courses. Future research needs to investigate other potential protective factors, including interpersonal and organizational factors.