Development and Initial Validation of the Lesbian, Gay, Bisexual Multidimensional Stigma Inventory

Background and Purpose: Disparate rates of mental illness, suicidality, and substance use among lesbian, gay, bisexual, and queer (LGB+) individuals are linked to experiences of minority stress. Minority stress may result from sexual identity stigmatization present in a heterosexist society. Instruments that assess minority stress often do not account for the complexity of these constructs, contributing to a measurement gap. This study examined the development of the Lesbian, Gay, Bisexual Multidimensional Stigma Inventory (LGBMSI)—a comprehensive, rigorous, and pragmatic measure of stigma experiences for LGB+ adults—and evaluated its initial validity and reliability.

Methods: LGBMSI development consisted of: initial item pool creation, expert review of the initial item pool, and pilot testing the instrument. The initial item pool consisted of 75 items—48 items were based on existing empirical research and a prior qualitative study of LGB+ adults and their experiences with sexual identity stigma; 27 additional items were adapted from existing minority stress instruments. Three scholars (with expertise in sexual identity stigma, instrument development, and survey administration) independently reviewed the initial item pool to strengthen instrument content validity and assess its construction. LGBMSI refinements were made based upon a review of experts’ written feedback, resulting in an item pool of 74 items. The LGBMSI pilot test utilized cross-sectional data collected from an online sample of 422 LGB+ adults in the United States. Exploratory factor analysis (EFA) was used to assess the LGBMSI item pool for factor structure and to examine item performance.

The EFA used the principal axis factoring extraction method to accommodate non-normal data distributions. Promax, an oblique rotation technique, was applied to improve factor structure interpretability and allow for correlated factors. The number of factors extracted was based on conceptual and statistical information, including the theoretical/empirical foundation of the LGBMSI, examination of a scree plot, and review of the reproduced residual matrix in each factor analysis. To support identification of the most appropriate factor solution, pattern matrix factor loadings ≥.4 on a single factor were retained; items not meeting this threshold or with factor loadings ≥.4 for two or more factors were eliminated; and, items with communalities <.4 were also eliminated. To optimize instrument length, retained items were reviewed for conceptual overlap.

Results: EFA and reduction of conceptually redundant items resulted in a 35-item LGBMSI with seven factors: (a) structural stigma, (b) intra-community stigma, (c) enacted stigma, (d) rejection/harassment, (e) perceived stigma, (f) identity concealment, and (g) internalized stigma. Content validity of the LGBMSI is supported by the instrument development process. LGBMSI internal consistency reliability is excellent (α=.92) and subscale reliability is very good (α=.80–.89).

Conclusions and Implications: Findings suggest that the LGBMSI holds promise as a multidimensional, pragmatic sexual identity stigma instrument for use with LGB+ adults. The LGBMSI addresses a range of sexual identity stigma and minority stress constructs, including stigma types not found in most multidimensional measures of minority stress (i.e., structural stigma, intra-community stigma). Continued evaluation of the LGBMSI will further assess its psychometric properties.