Context matters: Minority stress and mental health experiences of diverse LGBTQ people

This chapter reviews research documenting mental health disparities between LGBTQ populations and their heterosexual and/or cisgender peers. Specifically, LGBTQ people are at greater risk of developing mood, anxiety, and substance use disorders and suicidality. Such disparities are interpreted from the perspectives of minority stress theory, syndemics theory, and intersectionality. Minority stress theory posits that societal heterosexism and cissexism produce social stress that precipitates mental health concerns among LGBTQ people. Syndemics theory holds that multiple, co-occurring conditions (e.g., trauma, substance use, depression, HIV) health conditions synergistically enhance risk and worsen functioning among LGBTQ populations. Intersectionality as an analytic perspective emphasizes that other systems of oppression-such as racism, classism, or sexism-co-occur with heterosexism and cissexism and work in tandem with them to shape the experiences and functioning of diverse LGBTQ people. This chapter also briefly describes interventions designed to improve the mental health of LGBTQ people, as well as the strengths and protective factors among LGBTQ populations. The chapter closes with a clinical case vignette that illustrates the themes of the chapter, as well as a brief discussion that explicitly identifies how those themes operate in the vignette.