The Mental Health of Multiethnic Sexual Minority Girls: The Role of Risks, Stress and Self-Efficacy
Multiethnic sexual minority girls (MSMG) are vulnerable to health and mental health risks, such as depression, suicide, self-harm, and stress resulting from a “triple jeopardy” of (1) sexual, (2) racial and (3) gender marginalization, yet remain virtually unstudied. Such populations are considered to experience a unique form of minority stress wherein exposure to stigma-related stressors may negatively impact emotional coping processes and exacerbate risks – thereby further increasing disparities in mental health outcomes. Numerous stressors compounded by elevated risk behaviors and low levels of self-efficacy may significantly contribute to increased levels of psychological distress among MSMG. The purpose of this study was to create a health profile of MSMG and identify contributors to their mental health.
Methods:
Data was part of a larger mixed-methods project undertaken in the south-eastern United States from 2011-2012. Participants (n=116) were MSMG recruited through a community organization delivering services to sexual minority youth in an urban environment. Participants, ages 13-21 (x=16.8) were predominantly Hispanic (61%) and Black non-Hispanic (34%) and identified primarily as lesbian (47%) and bisexual (32%). MSMG completed structured, comprehensive psychosocial assessments developed in cooperation with the community organization, which included questions about a wide variety of risk factors. In addition, self-efficacy was measured using The General Self-Efficacy Scale (Schwarzer & Jerusalem, 1995). Three phases of analysis were conducted using SPSS (V. 22): (1) a health profile categorized into six distinct domains, (2) biserial correlations, and (3) logistic regression.
Results:
A mental health profile of participants was created which identified a wide range and high prevalence of risks, including those related to: (1) physical health, (2) behavioural health, (3) abuse and victimization, (4) sexual health, and (5) school. Biserial correlations revealed interesting demographic differences. For example, being Hispanic was positively correlated with a lack of family acceptance (.202) and substance abuse (.298), while being African-American was negatively correlated with substance abuse (-.398), all at (p<.01). The logistic regression model examining factors contributing to self-reported poor mental health among MSMG was statistically significant (χ2= 50.167/ 7, p<.001), reflecting a fairly strong relationship (Nagelkerke’s R2=.503). Based on minority stress theory, this clinical study found that the odds of self-reported poor mental health were 5 times higher for each unit increase in stress, (OR=5.5; 95% CI=1.6, 18.9), almost 7 times higher for sexual abuse (OR=6.7; 95% CI=1.9, 23.3), 3 times higher for substance abuse (OR=3.1; CI= 1.0, 9.1); and 4 times higher for academic problems (OR=4.3; CI=1.3, 13.7). Younger age (OR=.639; CI=.438, .931) was also associated with increased reports of mental health problems, while higher rates of self-efficacy (OR=.906; CI=.821, .998) significantly decreased the likelihood of poor mental health.
Conclusions and Implications:
MSMG experience distinct health and social risk factors that may negatively impact their mental health. Policy-makers and practitioners should strive to reduce the disparities MSMG experience through the provision of evidence-informed strengths-based approaches that address risks associated with intersecting minority identities and enhance self-efficacy. Recommendations for research with vulnerable population will be offered.