Addressing Minority Stress and Mental Health among Men Who Have Sex with Men (MSM) in China

  • Shufang SunEmail author
  • John E. Pachankis
  • Xiaoming Li
  • Don Operario
The Global Epidemic (SH Vermund, Section Editor)
Part of the following topical collections:
  1. Topical Collection on The Global Epidemic
  2. Topical Collection on The Global Epidemic


Purpose of Review

Men who have sex with men (MSM) in China experience elevated risks of mental health issues in comparison to the general population in China, which contribute to vulnerability to HIV/STI risks and can comprise the effectiveness of HIV prevention efforts. A conceptual framework for understanding this mental health disparity is minority stress theory, which posits that experiences of external prejudice events (i.e., distal stressors) and internal stress processes such as internalized homophobia and concealment (i.e., proximal stressors) contribute to sexual minorities’ elevated risk of psychological distress. To deepen the understanding of mental health among Chinese MSM and explore the potential utility of minority stress theory in this population, this paper synthesizes research evidence regarding prevalent mental health issues as well as how minority stress may be linked to psychological health in Chinese MSM.

Recent Findings

Results indicate that Chinese MSM experience a high prevalence of several mental health issues including depression, anxiety, suicidal behaviors, and alcohol dependence.


This review further reveals minority stress to be an important determinant of psychological distress among Chinese MSM, though evidence is mixed regarding the relationship between proximal minority stress and psychological health. Nonetheless, there is a lack of mental health services and interventions focusing on MSM in China. Culturally relevant, competent, and LGBT-affirmative mental health interventions are needed for Chinese MSM. To guide future intervention research, we provide considerations for reducing minority stress and promoting psychological health among Chinese MSM.


China Men who have sex with men Minority stress Stigma Psychological health 



Effort by the first author was supported by the National Institute of Mental Health (T32MH078788) and the Providence/Boston Center for AIDS Research (P30AI042853).

Compliance with Ethical Standards

Conflict of Interest

None of the authors have any conflict of interest to declare.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  • Shufang Sun
    • 1
    Email author
  • John E. Pachankis
    • 2
  • Xiaoming Li
    • 3
  • Don Operario
    • 4
  1. 1.Department of Psychiatry and Human BehaviorBrown University Alpert Medical SchoolProvidenceUSA
  2. 2.Department of Social and Behavioral SciencesYale School of Public HealthNew HavenUSA
  3. 3.Department of Health Promotion, Education, and BehaviorUniversity of South Carolina Arnold School of Public HealthColumbiaUSA
  4. 4.Department of Behavioral and Social SciencesBrown School of Public HealthProvidenceUSA

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