Journal of Youth and Adolescence

, Volume 42, Issue 3, pp 394–402 | Cite as

Sexual Minority-Related Victimization as a Mediator of Mental Health Disparities in Sexual Minority Youth: A Longitudinal Analysis

  • Chad M. Burton
  • Michael P. Marshal
  • Deena J. Chisolm
  • Gina S. Sucato
  • Mark S. Friedman
Empirical Research

Abstract

Sexual minority youth (youth who are attracted to the same sex or endorse a gay/lesbian/bisexual identity) report significantly higher rates of depression and suicidality than heterosexual youth. The minority stress hypothesis contends that the stigma and discrimination experienced by sexual minority youth create a hostile social environment that can lead to chronic stress and mental health problems. The present study used longitudinal mediation models to directly test sexual minority-specific victimization as a potential explanatory mechanism of the mental health disparities of sexual minority youth. One hundred ninety-seven adolescents (14–19 years old; 70 % female; 29 % sexual minority) completed measures of sexual minority-specific victimization, depressive symptoms, and suicidality at two time points 6 months apart. Compared to heterosexual youth, sexual minority youth reported higher levels of sexual minority-specific victimization, depressive symptoms, and suicidality. Sexual minority-specific victimization significantly mediated the effect of sexual minority status on depressive symptoms and suicidality. The results support the minority stress hypothesis that targeted harassment and victimization are partly responsible for the higher levels of depressive symptoms and suicidality found in sexual minority youth. This research lends support to public policy initiatives that reduce bullying and hate crimes because reducing victimization can have a significant impact on the health and well-being of sexual minority youth.

Keywords

Sexual minority youth Victimization Depression Suicidality Minority stress 

References

  1. Almeida, J., Johnson, R. M., Corliss, H. L., Molnar, B. E., & Azrael, D. (2009). Emotional distress among LGBT youth: The influence of perceived discrimination based on sexual orientation. Journal of Youth and Adolescence, 38, 1001–1014.PubMedCrossRefGoogle Scholar
  2. Austin, S. B., Ziyadeh, N., Fisher, L. B., Kahn, J. A., Colditz, G. A., & Frazier, A. L. (2004). Sexual orientation and tobacco use in a cohort study of US adolescent girls and boys. Archives of Pediatrics and Adolescent Medicine, 158, 317–322.PubMedCrossRefGoogle Scholar
  3. Bollen, K. A., & Curran, P. J. (2006). Latent curve models: A structural equation perspective. Hoboken, NJ: John Wiley and Sons.Google Scholar
  4. Bontempo, D. E., & D’Augelli, A. R. (2002). Effects of at-school victimization and sexual orientation on lesbian, gay, or bisexual youths’ health risk behavior. Journal of Adolescent Health, 30, 364–374.PubMedCrossRefGoogle Scholar
  5. Bostwick, W. B., Boyd, C. J., Hughes, T. L., & McCabe, S. E. (2010). Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States. American Journal of Public Health, 100, 468–475.PubMedCrossRefGoogle Scholar
  6. CDC (Centers for Disease Control and Prevention). (2011). Morbidity and mortality weekly report: Sexual identity, sex of sexual contacts, and health-risk behaviors among students in grades 9–12: Youth risk behavior, surveillance, selected sites, United States, 2001–2009, Early release, Vol. 60.Google Scholar
  7. Feinstein, B. A., Goldfried, M. R., & Davila, J. (2012). The relationship between experiences of discrimination and mental health among lesbians and gay men: An examination of internalized homonegativity and rejection sensitivity as potential mechanisms. Journal of Consulting and Clinical Psychology, 80, 917–927.PubMedCrossRefGoogle Scholar
  8. Friedman, M. S., Marshal, M. P., Guadamuz, T. E., Wei, C., Wong, C. F., Saewyc, E. M., et al. (2011). A meta-analysis of disparities in childhood sexual abuse, parental physical abuse, and peer victimization among sexual minority and sexual nonminority individuals. American Journal of Public Health, 101, 1481–1494.PubMedCrossRefGoogle Scholar
  9. Garofalo, R., Wolf, C., Wissow, L. S., Woods, E. R., & Goodman, E. (1999). Sexual orientation and risk of suicide attempts among a representative sample of youth. Archives of Pediatrics and Adolescent Medicine, 153, 487–493.PubMedGoogle Scholar
  10. Haas, A., Eliason, M., Mays, V. M., Mathy, R. M., Cochran, S. D., D’Augelli, A. R., et al. (2011). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: Review and recommendations. Journal of Homosexuality, 58, 10–51.PubMedCrossRefGoogle Scholar
  11. Hatzenbuehler, M. L. (2011). The social environment and suicide attempts in lesbian, gay, and bisexual youth. Pediatrics, 127, 896–903.PubMedCrossRefGoogle Scholar
  12. Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling [White paper]. Retrieved from http://www.afhayes.com/public/process2012.pdf.
  13. Hershberger, S. L., & D’Augelli, A. R. (1995). The impact of victimization on the mental health and suicidality of lesbian, gay, and bisexual youths. Developmental Psychology, 31, 65–74.CrossRefGoogle Scholar
  14. Hughes, T., Szalacha, L. A., & McNair, R. (2010). Substance abuse and mental health disparities: Comparisons across sexual identity groups in a national sample of young Australian women. Social Science and Medicine, 71(4), 824–831.PubMedCrossRefGoogle Scholar
  15. IOM (Institute of Medicine). (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Washington, DC: The National Academies Press.Google Scholar
  16. MacKinnon, D. P. (2008). Introduction to statistical mediation analysis. New York: Erlbaum.Google Scholar
  17. MacKinnon, D. P., Warsi, G., & Dwyer, J. H. (1995). A simulation study of mediated effect measures. Multivariate Behavioral Research, 30, 42–62.CrossRefGoogle Scholar
  18. Marshal, M. P., Dietz, L. J., Friedman, M. S., Stall, R., Smith, H. A., McGinley, J., et al. (2011). Suicidality and depression disparities between sexual minority and heterosexual youth: A meta-analytic review. Journal of Adolescent Health, 49, 115–123.PubMedCrossRefGoogle Scholar
  19. Marshal, M. P., Friedman, M. S., Stall, R., King, K. M., Miles, J., Gold, M. A., et al. (2008). Sexual orientation and adolescent substance use: A meta-analysis and methodological review. Addiction, 103(4), 546–556.PubMedCrossRefGoogle Scholar
  20. McCormack, M. (2012). The declining significance of homophobia: How teenage boys are redefining masculinity and heterosexuality. Oxford: New York.CrossRefGoogle Scholar
  21. Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697.PubMedCrossRefGoogle Scholar
  22. Poteat, V. P., & Espelage, D. L. (2007). Predicting psychosocial consequences of homophobic victimization in middle school students. Journal of Early Adolescence, 27, 175–191.CrossRefGoogle Scholar
  23. Poteat, V. P., Mereish, E. H., DiGiovanni, C. D., & Koenig, B. W. (2011). The effects of general and homophobic victimization on adolescents’ psychosocial and educational concerns: The importance of intersecting identities and parent support. Journal of Counseling Psychology, 58, 597–609.PubMedCrossRefGoogle Scholar
  24. Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
  25. Remafedi, G., French, S., Story, M., Resnick, M. D., & Blum, R. (1998). The relationship between suicide risk and sexual orientation: Results of a population-based study. American Journal of Public Health, 88, 57–60.PubMedCrossRefGoogle Scholar
  26. Russell, S. T., & Joyner, K. (2001). Adolescent sexual orientation and suicide risk: Evidence from a national study. American Journal of Public Health, 91, 1276–1281.PubMedCrossRefGoogle Scholar
  27. Russell, S. T., Ryan, C., Toomey, R. B., Diaz, R. M., & Sanchez, J. (2011). Lesbian, gay, bisexual, and transgender adolescent school victimization: Implications for young adult health and adjustment. Journal of School Health, 81, 223–230.PubMedCrossRefGoogle Scholar
  28. Ryan, C., Russell, S. T., Huebner, D., Diaz, R., & Sanchez, J. (2010). Family acceptance in adolescence and the health of LGBT adults. Journal of Child and Adolescent Psychiatric Nursing, 23, 205–213.PubMedCrossRefGoogle Scholar
  29. Savin-Williams, R. C. (2005). The new gay teenagei. Cambridge, MA: Harvard University Press.Google Scholar
  30. Shields, J. P., Whitaker, K., Glassman, J., Franks, H. M., & Howard, K. (2012). Impact of victimization on risk of suicide among lesbian, gay, and bisexual high school students in San Francisco. Journal of Adolescent Health, 50, 418–420.PubMedCrossRefGoogle Scholar
  31. Shrout, P. E., & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7, 422–445.PubMedCrossRefGoogle Scholar
  32. Swearer, S. M., Turner, R. K., Givens, J. E., & Pollack, W. S. (2008). “You’re so gay!”: Do different forms of bullying matter for adolescent males? School Psychology Review, 37, 160–173.Google Scholar
  33. U.S. Department of Health and Human Services. (2012). Healthy People 2020. Retrieved June 01, 2012 from http://www.hhs.gov/ash/oah/resources-and-publications/healthy-people-2020.html.
  34. Williams, T., Connolly, J., Pepler, D., & Craig, W. (2005). Peer victimization, social support, and psychosocial adjustment of sexual minority adolescents. Journal of Youth and Adolescence, 34, 471–482.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Chad M. Burton
    • 1
    • 5
  • Michael P. Marshal
    • 1
  • Deena J. Chisolm
    • 2
  • Gina S. Sucato
    • 3
  • Mark S. Friedman
    • 4
  1. 1.Department of PsychiatryUniversity of PittsburghPittsburghUSA
  2. 2.Department of PediatricsThe Ohio State UniversityColumbusUSA
  3. 3.Department of PediatricsUniversity of PittsburghPittsburghUSA
  4. 4.Graduate School of Public HealthUniversity of PittsburghPittsburghUSA
  5. 5.Western Psychiatric Institute and ClinicPittsburghUSA

Personalised recommendations