Examining the Social Supports in the Relationship between Internalized Homophobia and Depression Among Black Male Sexual Minorities: A Mediation Analysis

Background and Purpose:

Minority stress theory posits that psychosocial support moderates the relationship between minority-specific stressors, like internalized homophobia (IH) and mental health outcomes, such as depression in sexual minority populations. A primary limitation of minority stress theory is that the research to support it is based on predominantly White samples. Although social supports for black sexual minorities exist, the ways social supports have been examined do not adequately capture the nuances of their intersectional identities. Further, Black sexual minorities who experience IH access support systems differently than white sexual minority peers as a result of discrimination based on their racial identity. As such, social support as a moderator might not fully capture the relationship between IH and depressive symptoms among Black sexual minorities. Therefore, this study aims to examine the relationship between IH and depressive symptoms via multiple types of social support (e.g., Black community, family, friends, and the gay community) using a mediation model.

Methods: We analyzed data from the POWER (Promoting Our Worth Equity and Resilience) Study, which was a cross-sectional observational study that recruited Black gay, bisexual men, and other men who have sex with men (MSM) at Black Pride events across six cities in the United States from 2014 to 2017. The analytic sample (n = 4,430) consisted of Black MSM M = age 31 (SD = 10.07) Participants completed a self-report questionnaire which assessed a variety of domains related to health and life experiences including depressive symptoms (Center for Epidemiological Studies-Depression), internalized homophobia, and multiple types of social support (e.g., Black community, family, friends and the gay community). We used the PROCESS Macro for SAS to test four mediation pathways concurrently.

Results: A consistent with previous findings, the direct effect of internalized homophobia was positively associated with depressive symptomatology B = 1.33 (95% CI [ 1.2, 1.4]). Black community, family, and friend support (independent of each other) were inversely associated with depressive symptomatology (p < .05). The bootstrapped unstandardized indirect effect was for Black community support B = .07 (95% CL [.01, .13]), for family support B = .14 (95% CI [.08, .21]), and friend support B = .01 (95% CI [.01, .17]). These findings are consistent with our hypotheses that Black, family, and friend support partially mediates the relationship between internalized homophobia and depressive symptomology. However, we did not find evidence that gay community support is independently associated with depressive symptomatology or mediates the relationship between internalized homophobia and depressive symptomatology.

Conclusions and Implications:

Study results suggest for Black sexual minorities some types of social support may additionally be conceptualized as intervening variables between minority stress and mental health outcomes. Notably, Gay community support was the only type of social support that was not significant suggesting a need to examine characteristics of gay community support structures (e.g., racism) that may not be serving Black sexual minorities.