Exploring Discrimination and Mental Health Disparities Faced By Black Sexual Minority Women Using a Minority Stress Framework

Abstract

Black sexual minority women are triply marginalized due to their race, gender, and sexual orientation. We compared three dimensions of discrimination-frequency (regularity of occurrences), scope (number of types of discriminatory acts experienced), and number of bases (number of social statuses to which discrimination was attributed)-and self-reported mental health (depressive symptoms, psychological well-being, and social well-being) between 64 Black sexual minority women and each of two groups sharing two of three marginalized statuses: (a) 67 White sexual minority women and (b) 67 Black sexual minority men. Black sexual minority women reported greater discrimination frequency, scope, and number of bases and poorer psychological and social well-being than White sexual minority women and more discrimination bases, a higher level of depressive symptoms, and poorer social well-being than Black sexual minority men. We then tested and contrasted dimensions of discrimination as mediators between social status (race or gender) and mental health outcomes. Discrimination frequency and scope mediated the association between race and mental health, with a stronger effect via frequency among sexual minority women. Number of discrimination bases mediated the association between gender and mental health among Black sexual minorities. Future research and clinical practice would benefit from considering Black sexual minority women's mental health in a multidimensional minority stress context.

Keywords: human sex differences; intersectionality; mental health; minority stress; racial and ethnic differences; racial and ethnic discrimination; sex discrimination; sexual orientation.

Figure 1

Single-mediator models of the indirect effects of race on mental health via discrimination. Sociodemographic characteristics (i.e., age, sexual orientation, education, unemployment, and net financial worth) were statistically adjusted for in all analyses. For each model, the unstandardized coefficients and standard errors, b(standard error), of all paths and bias-corrected and accelerated confidence interval of the indirect effect are included. Only models with a significant indirect effect (i.e., confidence interval that does not straddle zero) are shown. *p < .05. **p < .01. ***p < .001.

Figure 2

Single-mediator models of the indirect effects of gender on mental health via discrimination. Sociodemographic characteristics (i.e., age, sexual orientation, education, unemployment, and net financial worth) were statistically adjusted for in all analyses. For both models, the unstandardized coefficients and standard errors, b(standard error), of all paths and bias-corrected and accelerated confidence interval of the indirect effect are included. Only models with a significant indirect effect (i.e., confidence interval that does not straddle zero) are shown. *p < .05. **p < .01. ***p < .001.