Minority Stress 101: How Chronic Stigma Affects LGBTQ+ Bodies and Minds

Minority stress theory is a concept that has emerged in recent years and gained a great deal of popularity and support among mental and psychological health experts.

There’s a growing understanding of how being a minority can be a cause of undue stress, even in societies where minorities experience general acceptance.

In this post, we’ll take a much closer look at what minority stress is and what causes it. We’ll look at stigma, prejudice, and discrimination and how they create stress, what the psychological impact of minority stress is, and what long-term consequences minority stress can have.

But we’ll also explore how to reduce and cope with the chronic stress of being a minority, as well as what sort of therapies can be helpful in addressing it, all with the goal of helping you protect your mental and emotional health.

What Is Minority Stress and Where Does the Concept Come From

The term “minority stress” emerged in response to higher rates of health problems among minorities.

According to this theory, data shows that  “health disparities are produced by excess exposure to social stress faced by sexual minority populations due to their stigmatized social status (relative to heterosexual populations).”[1]

For example, Black Americans have noticeably higher rates of high blood pressure and hypertension (a sign of chronic stress) compared to White Americans. Among the LGBTQ+ community, rates of substance abuse are also higher compared to heterosexuals and non-queer people, as are instances of suicide and cancer.

Social scientists have developed an interest in exploring the stress and potentially linking it to disparities in lifestyle, treatment, pressure, stigma, prejudice, and discrimination. Studies have begun to provide concrete evidence to back up the minority stress theory.

For example, one 2021 paper [3] found that people of multiple marginalized groups—for example, LGBT and people of color—tend to have significantly higher stress levels than those of a single marginalized identity. Socioeconomic status also appears to play a significant role in minority stress.

How Stigma, Prejudice, and Discrimination Create Chronic Stress

Prejudice is a preconceived negative attitude or belief people have toward an individual or a group.

Discrimination is any action or behavior that results from prejudice. Typically, it involves some form of unfair treatment.

Stigma is an umbrella term that encompasses both prejudice and discrimination. It may be due to race (racial ethnic stigma), gender identity (transgender or genderqueer stigma), or sexual orientation (LGBTQ+ stigma).

According to the American Psychological Association [4], “Stigma and discrimination can contribute to worsening symptoms and reduced likelihood of getting treatment.” 

Effects of stigma can include, but are not limited to:

• Reduced self-esteem;
• Lower hopefulness and positivity;
• Increased risk of psychiatric symptoms;
• Greater social relationship difficulties;
• Social isolation;
• More difficulties in the workplace.

All of these things can be stressors, which, if not coped with in a healthy manner, can lead to higher rates of stress.

One important thing to keep in mind is that on top of minority-specific stressors, minorities still have to deal with general life stressors. These include stresses of a family life or losing one’s job. For minorities, these general stressors exist in tandem with workplace prejudice, bullying, and/or harassment.

One study quantified other stressors minorities face [5]:

• “Distal stressors include stressors that originate from people or institutions that impact the LGBTQ+ person. These include discriminatory policies and laws, acute major life events (e.g., losing a job, being victimized by violence), chronic stressors (e.g., living in poverty), more minor, “everyday” experiences of discrimination or microaggressions (e.g., being treated unfairly or with disrespect), or even non-events—expected positive experiences or events that were thwarted due to stigma and prejudice.
• Proximal stressors arise from a socialization process in which sexual and gender minority people learn to reject themselves for being LGBTQ+ (internalized stigma), develop expectations to be stigmatized due to awareness of prevailing social stigma (expectations of rejection), and/or hide their LGBTQ+ identity as a way to protect themselves against distal minority stressors (identity concealment). Concealment may be protective in some environments, but it can also limit access to social support and affirmation, complicating its role in minority stress theory.”

All of the many, many stressors minorities have to deal with can compound and create a great deal more chronic stress than people not in a minority group ever have to cope with.

These compounded experiences reflect a framework known as “intersectionality.” Intersectionality explains how multiple marginalized identities interact to compound stress,and overall increase health disparities between majority and minority individuals.

The Psychological Impact of Minority Stress on LGBTQ+ Individuals

There is very clear evidence to prove that minority stress can have serious psychological impact on LGBTQ+ individuals:

• Higher rates of depression;
• Higher rates of anxiety;
• Higher rates of psychological distress;
• Fear of rejection;
• Feelings of isolation and loneliness, which can compound depression or cause people to withdraw from social connections;
• Suicidal thoughts and ideation.

Physical Health Consequences of Long-Term Minority Stress

The physical health consequences of long-term minority stressors are similar to the consequences of “ordinary” chronic stress:

• Increased inflammation;
• Reduced immunity;
• Higher blood pressure;
• Stress-eating and unhealthy coping mechanisms;
• Metabolic syndrome;
• Insulin resistance;
• Higher abdominal fat storage;
• Higher risk of asthma;
• Higher likelihood of cellular changes associated with increased cancer risk;
• Disruption of the hypothalamic-pituitary-adrenal (HPA) axis, your body’s “stress response system”;
• Higher cortisol levels;
• Reduced responsiveness of the body’s ability to control inflammation effectively;
• Increased physiological “load” on the body, leading to slower healing and recovery times.

The danger here is that minority stress can exist at the same time as chronic stress caused by work or home life challenges. This can lead to even greater adverse health outcomes and significantly higher risk of cardiovascular health problems, obesity, diabetes, cancer, and a host of other diseases and conditions.

How Internalized Stigma and Expectations of Rejection Affect Mental Health

Experts talk about two types of discrimination: experienced and anticipated. [6]

“Experienced discrimination is any experience of prejudice that LGBTQ+ people face due to their LGBTQ+ identities. It includes direct, “blatant” harassment or victimization (such as being physically assaulted because you are LGBTQ+), as well as “subtle” or vicarious stigma experiences (such as hearing homophobic jokes or reading news about yet another transgender person being harmed).”

“Anticipated discrimination is the belief that you personally (as an LGBTQ+ person) will experience prejudice. When you repeatedly experience or witness discrimination, it makes sense for you to start to expect it. Anticipated discrimination includes fear of prejudice and hypervigilance in situations where you may experience prejudice.”

When we talk about internalized stigma, what we’re really talking about is what happens when people begin to absorb and accept negative social beliefs about their identity, often influenced by past discrimination and the expectation it will happen again.

Think about it: maybe you’ve experienced some sort of prejudicial treatment or discrimination in the past, or you’ve seen others receiving such treatment. It’s only natural that you’d expect the same sort of rejection or unfair treatment.

As you internalize that expectation (for example, internalized homophobia or internalized transphobia), you begin to anticipate discrimination, fear it, and even look for it. This internalized fear, and constant expectation of discrimination, puts your nervous system always in a state of “high alert.” You become constantly watchful and ready for any mistreatment that may be coming your way.

This behavior can lead to higher rates of stress, greater anxiety, a dysregulated nervous system, and more likelihood of depression. The longer you live with this voice that tells you that you’re not only “not good enough”, but maybe even universally or generally disliked, rejected, or hated, the more vulnerable you become to experiencing thoughts of suicide and emotional dispair.

It’s for this reason that suicide rates are higher among minorities, along with depression, anxiety, and other poor mental health outcomes.

Protective Factors: What Helps Buffer Against Minority Stress

If you’re dealing with—or even just worried about—minority stress, don’t lose hope! There are things you can do to protect your mental health and safeguard your heart against the stress, pressure, and stigma that you may be either experiencing or anticipating (fearing).

Try:

• Practicing self-compassion. One meta-analysis [7] found that self-compassion—a combination of “self-kindness (the ability to treat oneself with kindness during moments of suffering or failure), common humanity (the understanding that one shares the experience of suffering with other humans), and mindfulness (in the context of self-compassion, the ability to attend to one’s feelings of suffering without being overwhelmed by them)”—led to drastically lower risk of stress-induced mental and physical health issues.
• Talking openly about your struggles. Seek counseling, talk to a therapist, or share your difficulties with safe family, friends, or with online communities. National Alliance on Mental Illness (NAMI) notes that some people also find value in posting on social media [8] as a useful coping mechanism though it is important to choose safe and affirming spaces.
• Being conscious of language. Remind people of how the words they use to speak to you have the power to harm or heal. But also be mindful of your own power and practice being self-aware regarding the language you use to refer to yourself, either aloud or in your own mind. Your own self-talk could be amplifying the internalized stigma and making the experience worse for you.
• Choosing empowerment over shame. Your life is your own, your story is your own, and you don’t have to let anyone make you feel ashamed of either. You control how you feel about yourself. Decide to feel empowered by your life and reject shame. It’s easier said than done—albeit, a daily battle and one that’s not lightly won—but that conscious choosing, is a powerful first step.

Therapeutic Approaches for Addressing Minority Stress

A number of therapies can be highly effective for combating minority stress, and data [9] shows that they offer a great deal of promise.

These include, but aren’t limited to:

• Cognitive behavioral therapy (CBT), which helps you identify and challenge self-defeating inner talk or negative thoughts related to stress.
• Mindfulness-based stress reduction, which uses mindfulness and meditation to reduce reactivity and create a present-moment awareness to combat stress. This also helps reset the nervous system.
• Loving-kindness meditation, which increases self-awareness and self-compassion through addressing and processing internalized stigma and negative self-perceptions.
• Affirmative therapy, which provides validation for your experiences of stigma and encourages a positive sense of self, leading to greater resilience.

Practical Coping Strategies for LGBTQ+ People Facing Chronic Stress

The coping mechanisms you’ll develop for facing chronic stress caused by minority stressors will look a lot like the mechanisms that’ll get you through the other stressors of daily life.

They include:

• Daily exercise;
• Proper sleep;
• Sufficient relaxation time;
• Engaging in activities you enjoy;
• Engaging in safe, social interactions and building safe, strong relationships;
• Engaging in community activities.

However, you may also want to add in some activities specific to the minority stress you are dealing with.

For example:

• Connect with LGBTQ+ groups or communities. Attend events, join online communities, or find other people with marginalized identities to build a network with (both virtually and in person) to facilitate community-based resilience.
• Find allies in your workplace, home, and community you can lean on for support, or who can provide you with positive reinforcement when you’re struggling or feeling stressed.
• Engage in activities that you enjoy with safe people who actively support and accept you, be they family, friends, coworkers, or members of the LGBTQ+ community.
• Meditate and practice mindfulness to reduce anxiety, regulate the nervous system, and increase your feelings of wellbeing.
• Practice some sort of creative expression, be it dancing, art, writing, music, etc. It’ll give you safe space to process and release your emotions, and can give you a feeling of control.
• Set boundaries in your life. Don’t be afraid to remove yourself from toxic situations or disengage from individuals who increase your stress.
• Practice positive self-talk and challenge negative thoughts as they arise.
• As always, be choosy as to the people you surround yourself with and those you allow to influence you.

Minority stress can be a heavy burden to bear, but with the right coping mechanisms and therapeutic approaches, you can still live a healthy, happy life.

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Frequently Asked Questions

How does minority stress impact LGBTQ+ youth specifically?

LGBTQ+ youth typically experience minority stress due to stigma at home and school, as well as seeing the way the LGBTQ+ community at large is treated in society. This already vulnerable population becomes even more prone to mental health issues (anxiety, depression, eating disorders, suicidal thoughts, as well as physical symptoms such as fatigue, sleep disturbunces, panic attacks, high blood pressure, and more.

How do coping mechanisms differ among LGBTQ+ subgroups?

Different subgroups within the LGBTQ+ community cope with stress in different ways. For example, transgender individuals typically seek out gender-affirming treatments and therapies or engage in gender-affirming activities. Sexual minority women may employ strategies like “confronting discrimination, accessing support from the sexual minority community, or challenging one’s own internalized negative beliefs about sexual minorities” [10] while sexual minority men may turn their rumination (dwelling on negative thoughts) into reflection and meditation.

How does community support influence resilience in LGBTQ+ individuals?

Community support is absolutely essential for encouraging resiliency in anyone, especially those experiencing minority stress, including LGBTQ+ individuals. For some, that looks like building a strong connection to LGBT community members. This can reduce isolation, create a sense of belonging and acceptance, provide positive identity support, and gives access to both role models and minority-specific resources.

Resources

Multiple Minority Stress and LGBT Community Resilience among Sexual Minority Men

Minority stress theory: Application, critique, and continued relevance

Minority stress and psychological well-being in queer populations

Trauma, Minority Stress, and Disproportionate Health Burden Among LGBTQ+ People

Minority Stress and LGBTQ+ Patients’ Mental Health

Stigma, Prejudice and Discrimination Against People with Mental Illness