Social Identities, Non-Affirming Cultural Environments, and Mental Health Among Sexual Minority Adolescents

Background and Purpose: Sexual minority adolescents consistently report greater mental health inequities compared to their heterosexual peers. One of the driving explanations for these inequities is the presence of homophobic and heterosexist social environments. Literature suggests within-group heterogeneity in health equities and experiences based on membership to other minoritized social identities and experiences. For example, non-affirming cultural environments (religious, racial/ethnic) may exacerbate stressors and contribute to negative mental health outcomes. Despite this knowledge interplay of multiple social identities, current literature is limited in understanding on the relationship between racial/ethnic identification, non-affirming cultural environments, and mental health outcomes among sexual minority adolescents.

Methods: This study has utilized a large national dataset of sexual minority adolescents aged 14–17 years (N = 2588). We ask the following research questions: (1) what are the predictors of experiencing minority stress from non-affirming cultural environments (religious, and racial/ethnic)? and (2) what is the association between non-affirming cultural environments, and mental health (depression and anxiety) among sexual minority adolescents? We conducted a series of multivariate linear regression models. All models controlled for age, sex assigned at birth, sexual orientation, and race/ethnicity.

Results: In our sample, the mean values for stressors associated with non-affirming religious environment is 22.1 (range 0-100) and for non-affirming racial/ethnic environment is 25.5 (range 0-100). First, we examined the relationship between racial identification and experiencing stressors associated with non-affirming cultural environments. Identifying with any non-White racial group compared to White was significantly associated with reporting higher scores on stress associated with non-affirming racial/ethnic environments, while, identifying as Black or African American, and Latino/Hispanic compared to White was associated with higher scores on stress from non-affirming religious environment. In the next models, non-affirming religious and racial/ethnic environments were positively associated with both, reporting higher depressive and anxiety symptoms among participants.

Conclusion and Implication: Findings challenge the homogenous treatment and operationalization of minority stressors and furthers our understanding of intersectional experiences often rooted in multiple minority identities that may contribute to mental health inequities. The results indicate that adolescents from racial/ethnic minorities may experience heightened negative mental health associated with conflicting values and norms associated with different social memberships. Practice and intervention with adolescents on building positive sexual identities and addressing mental health concerns must be responsive to the interplay between multiple intersecting social identities and environments. Further research is needed to examine the role of multiple minority identities and non-affirming cultural environments on mental health among sexual minority adolescents, and how these may change over time.