The Integrated Attachment and Sexual Minority Stress Model: Understanding the Role of Adult Attachment in the Health and Well-Being of Sexual Minority Men

BACKGROUND: The health and well-being of those sexual-minority men who are often behaviourally defined as men who have sex with men (MSM) is affected by a system of interlinked factors that interact on the structural, interpersonal, and individual levels. Recently, two of the most common MSM health issues have been (a) the risks of acquiring sexually transmitted infections (STIs), mostly HIV, and (b) the sexualized use of addictive substances, known as chemsex. AIMS: On the basis of the first comprehensive Czech dataset to integrate several mutually interlinked factors on the behavioural, as well as the psychological and structural domains, we attempt to shed light on the barriers to HIV testing and adherence to safer sex practices, including the most thorough description of the chemsex phenomenon that is available. We aim to go beyond the behavioural perspective and draw links to the well-being and satisfaction of this sexual minority and their sex lives. METHODS: A series of descriptive statistical analyses was conducted on a sample of 547 respondents obtained within a self-administered online survey. RESULTS: More than half of our respondents (55%) and three-quarters (72%) of the men younger than 25 years have never been tested for HIV. One-third of the respondents considered testing services to be insufficiently friendly to gay, bisexual, or other men, and they also reported stigmatization and discrimination by healthcare workers as a problem that exists. 84% of the MSM have experience with anal sex; 43% of them always use condoms. Of all the respondents, nearly 6% have had at least one chemsex experience during their life. Only 46% of the MSM reported being satisfied with their sex lives; 52% of those who were dissatisfied attributed this to “not having a steady partner” and 49% to “not having any sex”. CONCLUSION: The sexual behaviour of MSM and their experience with HIV testing, chemsex, perceived stigma, and satisfaction with their sex lives are among the phenomena that deserve to be more regularly covered by relevant epidemiological examinations. Although our current analysis was more exploratory than in-depth, it may contribute to a better understanding of the syndemic and multifactorial conditions that influence the sexual behaviour of MSM, including the minority stress that may be rooted in deficiencies in our understanding of these populations.

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Socioeconomic Status and Psychosocial Resources Mediate Racial/Ethnic Differences in Psychological Health Among Gay and Bisexual Men: A Longitudinal Analysis Using Structural Equation Modeling

American Journal of Men s Health ◽

10.1177/15579883211001197 ◽

2021 ◽

Vol 15 (2) ◽

pp. 155798832110011

Author(s):

Rainier Masa ◽

Sylvia Shangani ◽

Don Operario

Keyword(s):

Sexual Minority ◽

Psychological Health ◽

Well Being ◽

Sexual Minority Men ◽

Collective Self ◽

Race Ethnicity ◽

Minority Men ◽

Racial Ethnic ◽

Everyday Discrimination

A large body of research demonstrates disparities in psychological health attributed to sexual minority identity, racial/ethnic minority identity, and socioeconomic status (SES). Fewer studies have explicated the role of these multiple attributes on psychological health and explored the role of SES and psychosocial resources in determining outcomes. We analyzed data from Project STRIDE, a longitudinal survey involving a diverse sample of gay and bisexual adult men ( n = 198). Using structural equation modeling, we tested hypothesized direct and indirect effects of race/ethnicity, SES, and three psychosocial mediational variables (collective self-efficacy, everyday discrimination, internalized homophobia) on two outcome variables—psychological and social well-being—assessed at 1-year follow-up. Our model indicated that: (1) race/ethnicity and SES were significantly associated with each other and with each psychosocial mediator; (2) higher SES was directly and indirectly associated with both measures of well-being; and (3) collective self-esteem and everyday discrimination mediated the association between SES and both measures of well-being. The model also indicated that racial/ethnic associations with psychological mediators and outcomes are evident in the context of SES, but these effects might be suppressed when the model does not consider SES. Findings highlight the critical role of SES and race/ethnicity in determining the psychological and social well-being of sexual minority men. Specification of mediating variables—collective self-efficacy, everyday discrimination, internalized homophobia—indicates potential intervention targets to improve psychological and social health in sexual minority men. Associations between race/ethnicity and SES support the need for intersectional frameworks in addressing the health of sexual minority men.

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GayandLesbian Experiences of Discrimination, Health, and Well‐Being Surrounding the Presidential Election

10.31219/osf.io/dwscm ◽

2017 ◽

Author(s):

S. Mason Garrison ◽

Michael J. Doane ◽

Marta Elliott

Keyword(s):

Gay Men ◽

Minority Stress ◽

Sexual Minorities ◽

Well Being ◽

Stress Model ◽

Daily Diary Study ◽

Minority Stress Model ◽

Mental And Physical Health ◽

Fast Acting ◽

Health And Well Being

Sexual minorities have poorer mental and physical health than heterosexuals; these health disparities are consistently attributed to discrimination. However, the mechanisms linking discrimination with health outcomes remain unclear. This exploratory study examines whether fast-acting mechanisms, like “stressful social environment[s]” contribute to these disparities (minority stress model; Meyer, 2003) by exploiting the unanticipated election of Donald Trump on November 8th, 2016. Gay men and lesbians participated in a ten-day longitudinal daily-diary study, beginning the day before the election (November 7th–16th, 2016).On the day after the election, participants reported immediate changes in health (e.g., depression, Cohen’s d=1.33; illness, 0.44), well-being (e.g., happiness, -0.91), and discrimination (0.45). The immediacy and magnitude of participants’ responses are consistent with the minority stress model. This study provides a window into the experiences of gay men and lesbians, and illustrates how minority stresses, such as political uncertainty and discrimination, may impact vulnerable sexual minorities.

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"Multiple minority stress and LGBT community resilience among sexual minority men": Correction to McConnell et al. (2018).

Psychology of Sexual Orientation and Gender Diversity ◽

10.1037/sgd0000290 ◽

2018 ◽

Vol 5 (2) ◽

pp. 168-168 ◽

Cited By ~ 1

Keyword(s):

Sexual Minority ◽

Minority Stress ◽

Community Resilience ◽

Sexual Minority Men ◽

Lgbt Community ◽

Minority Men ◽

Multiple Minority

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Minority stress, intra-minority stress and social anxiety: Examining an extended psychological mediation framework among sexual minority men

European Journal of Public Health ◽

10.1093/eurpub/ckz185.140 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

C Mahon ◽

G Kiernan ◽

P Gallagher

Keyword(s):

Sexual Orientation ◽

Social Anxiety ◽

Sense Of Coherence ◽

Sexual Minority ◽

Minority Stress ◽

Rejection Sensitivity ◽

Sexual Minority Men ◽

Lgbt Community ◽

Minority Men ◽

Everyday Discrimination

Abstract Background Compared to their heterosexual counterparts, sexual minority men (SMM) are at an increased risk of social anxiety disorder. Distal (i.e., everyday discrimination) and proximal (i.e., internalised homophobia, rejection sensitivity, concealment of sexual orientation) minority stress processes are associated with heightened social anxiety for SMM. Stressors emerging from within the sexual minority male community, termed intra-minority stress, and psychological processes that may foster resilience (i.e., a sense of coherence, connectedness to the LGBT community) are less explored in this area. This study examined potential pathways between everyday discrimination, intra-minority stress, proximal minority stressors, resilience and social anxiety. Methods Self-identified SMM (N = 255) residing in the Republic of Ireland completed an online survey containing measures of minority stress, intra-minority stress, resilience and social anxiety. Structural equation modelling was used to examine the model. Results The model yielded a good fit to the data, X2(16) = 26.61, CFI = .99, TLI = .97, RMSEA = .05, and SRMR = .03. Rejection sensitivity and a sense of coherence had a significant indirect effect in the relationships between both exogenous variables (i.e., discrimination and intra-minority stress) and social anxiety. There were no significant pathways to social anxiety involving concealment of sexual orientation, internalised homophobia or LGBT community connectedness. Conclusions For SMM, minority stress processes and intra-minority stress are important determinants of social anxiety. Our findings demonstrate that proximal minority stressors may operate differently in a social anxiety context for SMM in western European countries. A sense of coherence was an integral factor in the model and demonstrated the strongest association with social anxiety.

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Exploring the role of LGBT-affirming churches in health promotion for Black sexual minority men

Culture Health & Sexuality ◽

10.1080/13691058.2019.1666429 ◽

2019 ◽

Vol 22 (10) ◽

pp. 1191-1206 ◽

Cited By ~ 1

Author(s):

Jordan J. White ◽

Derek T. Dangerfield ◽

Erin Donovan ◽

Derek Miller ◽

Suzanne M. Grieb

Keyword(s):

Health Promotion ◽

Sexual Minority ◽

Sexual Minority Men ◽

Minority Men

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Gay and Lesbian Experiences of Discrimination, Health, and Well-Being

Social Psychological and Personality Science ◽

10.1177/1948550617732391 ◽

2017 ◽

Vol 9 (2) ◽

pp. 131-142 ◽

Cited By ~ 10

Author(s):

S. Mason Garrison ◽

Michael J. Doane ◽

Marta Elliott

Keyword(s):

Gay Men ◽

Minority Stress ◽

Sexual Minorities ◽

Well Being ◽

Donald Trump ◽

Daily Diary Study ◽

Minority Stress Model ◽

Mental And Physical Health ◽

Fast Acting ◽

Health And Well Being

Sexual minorities have poorer mental and physical health than heterosexuals; these health disparities are consistently attributed to discrimination. However, the mechanisms linking discrimination with health outcomes remain unclear. This exploratory study examines whether fast-acting mechanisms, like the minority stress model's “stressful social environment[s],” contribute to these disparities by exploiting the unanticipated election of Donald Trump on November 8, 2016. Gay men and lesbians participated in a 10-day longitudinal daily-diary study, beginning the day before the election (November 7–16, 2016). On the day after the election, participants reported immediate changes in health (e.g., depression, Cohen’s d = 1.33; illness, 0.44), well-being (e.g., happiness, −0.91), and discrimination (0.45). The immediacy and magnitude of participants’ responses are consistent with the minority stress model. This study provides a window into the experiences of gay men and lesbians, and illustrates how minority stresses, such as political uncertainty and discrimination, may impact vulnerable sexual minorities.

Download Full-text