Discrimination Predicts Depression Among Black Sexual Minority Women Who Survived Physical and Sexual Violence

Background/Purpose: Experiencing non-violent discrimination related to one’s minority status(es) (e.g., gender, race, class, sexual minority identity) has been linked to adverse mental health outcomes, such as depression. Similarly, sexual assault has been linked to depression. Little research has explored the combined effect of non-violent discrimination and sexual assault on mental health outcomes. The present study evaluates to what extent non-violent discrimination (racial, gender, sexual minority status) and exposure to sexual assaultpredicts depression among Black women living in Baltimore City, Maryland.

Methods: Data come from the ESSENCE Project, a retrospective cohort study examining built and social environmental correlates of sexual assault and HIV risk among Black women (N=226; 94 exposed to violence, 132 unexposed) recruited from low-income health clinics in Baltimore. We analyzed cross-sectional survey data including demographic information, exposure to sexual violence, depression (via the Center for Epidemiological Studies Depression Scale), and discrimination (via the Everyday Discrimination Scale). Analyses included descriptive statistics, t-tests to estimate prevalence of discrimination by violence exposure, and a multiple linear regression to assess the effect of discrimination, violence exposure, and sexual minority status (lesbian, bisexual) on depression.

Results: Nearly 45% (n=94) of participants were exposed to sexual violence, with 82% (n=77) of that group also reporting physical violence from an intimate partner; 15% of participants self-identified as a sexual minority (21.3% exposed, 10.6% unexposed); and 87% (n=198) of participantsreporting at least one experience of discrimination in their lifetime (93.6% exposed, 83.3% unexposed). Women exposed to violence and sexual minority women faced higher discrimination than their counterparts (mean difference of 6.27 and 5.05, respectively). The model regressing sexual minority status, sexual violence, and discrimination frequency on depression was significant, F_{(3, 222)}=323.286, p<.01; sexual violence (b=3.77, SE=0.78, p=.01) and discrimination (b=.17, SE=0.034, p=.01) were significant predictors while sexual minority status was not (b=.2.20, SE=1.173, p=.062), though this could be due to having too few sexual minority women.

Conclusions and Implications: We found support that non-violent discrimination, sexual violence, and sexual minority status have an influence on depression both separately and combined. These findings support the theory of intersectionality, which posits that identities are co-occurring; thus, holding multiple minority identities (i.e., Black, sexual minority women) can magnify experiences of discrimination and sexual violence, which can affect negative mental health outcomes, such as depression. Researchers examining sexual violence should include forms of non-violent, identity-based discrimination such as race, gender, and sexual minority status, to better understand the true effect of these complex social problems on sexual assault and mental health outcomes.