The Rejection Sensitivity Model as a Framework for Understanding Sexual Minority Mental Health

  • Brian A. FeinsteinEmail author
Target Article


Sexual minorities are disproportionately affected by mental health problems (e.g., depression, anxiety, substance use disorders, suicidality). Minority stress theory and the psychological mediation framework have become the predominant conceptual models used to explain these disparities, and they have led to substantial advances in research on stigma-related stress and mental health. However, the field’s reliance on these models has limited the extent to which other theories have been considered as potential frameworks for further advancing our understanding of sexual minority mental health. In this article, I discuss how the rejection sensitivity (RS) model can be used to complement and extend minority stress theory and the psychological mediation framework by: (1) emphasizing the role of perception in stigma-related experiences; (2) acknowledging the unique consequences of different anticipatory emotions; (3) describing additional mechanisms linking proximal minority stressors to mental health; and (4) further specifying the temporal order of these processes. I conclude by discussing the importance of attending to developmental processes in research on sexual orientation-related RS and describing important directions for future research.


Rejection sensitivity Minority stress Sexual minority Gay, lesbian, and bisexual Sexual orientation 



I would like to thank several people for providing comments on earlier drafts of this article, including Drs. Joanne Davila, Christina Dyar, Brian Mustanski, Michael Newcomb, and John Pachankis.


The author’s time was supported by a grant from the National Institute on Drug Abuse (K08DA045575). The content is solely the responsibility of the author and does not necessarily represent the official views of the funding agency.

Compliance with Ethical Standards

Conflict of interest

Brian A. Feinstein declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by the author.


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Authors and Affiliations

  1. 1.Institute for Sexual and Gender Minority Health and WellbeingNorthwestern UniversityChicagoUSA

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