Annals of Behavioral Medicine

, Volume 47, Issue 1, pp 39–47 | Cite as

Structural Stigma and Hypothalamic–Pituitary–Adrenocortical Axis Reactivity in Lesbian, Gay, and Bisexual Young Adults

Original Article



Youth exposed to extreme adverse life conditions have blunted cortisol responses to stress.


This study aims to examine whether growing up in highly stigmatizing environments similarly shapes stigmatized individuals’ physiological responses to identity-related stress.


We recruited 74 lesbian, gay, and bisexual young adults (mean age = 23.68) from 24 states with varying levels of structural stigma surrounding homosexuality. State-level structural stigma was coded based on several dimensions, including policies that exclude sexual minorities from social institutions (e.g., same-sex marriage). Participants were exposed to a laboratory stressor, the Trier Social Stress Test (TSST), and neuroendocrine measures were collected.


Lesbian, gay, and bisexual young adults who were raised in highly stigmatizing environments as adolescents evidenced a blunted cortisol response following the TSST compared to those from low-stigma environments.


The stress of growing up in environments that target gays and lesbians for social exclusion may exert biological effects that are similar to traumatic life experiences.


Stigma HPA axis reactivity Sexual orientation 


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Copyright information

© The Society of Behavioral Medicine 2013

Authors and Affiliations

  1. 1.Department of Sociomedical Sciences, Mailman School of Public HealthColumbia UniversityNew YorkUSA
  2. 2.Boston Children’s HospitalHarvard Medical SchoolBostonUSA

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