Adam W. Fingerhut

Identity, minority stress and psychological well-being among gay men and lesbians

Exposure to gay-related discrimination, perceived stigma or other stressors is associated with poorer mental health for gay and lesbian individuals. Yet not all gay men and lesbians experience the same levels or types of stressors, nor do they react the same in response to stress exposure. Using a sample of self-identified gay and lesbian individuals who completed an online survey, this research examined whether social identity, specifically a sense of belonging to the lesbian, gay and bisexual (LGB) community, predicted both exposure and reactivity to gay-related stress. Results showed that those who were higher in gay identity reported significantly more discrimination but significantly less perceived stigma than those who were lower in gay identity. Although gay identity was not associated with reactivity to discrimination, it was associated with reactivity to perceived stigma. Those who were lower in gay identity reported significantly more depressive symptoms when they experienced high levels of perceived stigma than when they experienced low levels of perceived stigma. In contrast, those who were higher in gay identity were buffered against the negative consequences of perceived stigma; there were no differences in reported depression based on the experiences of perceived stigma. The theoretical and practical implications of these data are discussed.

Testing a Model of Minority Identity Achievement, Identity Affirmation, and Psychological Well-Being Among Ethnic Minority and Sexual Minority Individuals

How is social identity related to psychological well-being among minority individuals? Drawing on developmental models of identity formation (e.g., Erikson, 1968) and on Social Identity Theory (Tajfel & Turner, 1979), we tested a conceptual model examining links between two key aspects of social identity and psychological well-being. We proposed that the association between identity achievement (exploring and understanding the meaning of ones identity) and psychological well-being is mediated by identity affirmation (developing positive feelings and a sense of belonging to ones social group). Across three studies, including ethnic minority high school students (Study 1), ethnic minority college students (Study 2) and lesbian and gay male adults (Study 3), we found strong support for the model. Results suggest that the process of exploring and understanding ones minority identity can serve as an important basis for developing positive feelings toward and an enhanced sense of attachment to the group, which can in turn confer psychological benefits for minority individuals. Implications and directions for future research are discussed.

Relationship formalization and individual and relationship well-being among same-sex couples:

Although legal recognition of same-sex relationships has received considerable attention in recent years, we know little about the effects of legal recognition (e.g., domestic partnership) and social recognition (e.g., a public ceremony) on same-sex couples. We conducted an Internet survey of 239 Californians in same-sex relationships, including a randomly selected subsample of individuals from the California Domestic Partnership Registry. Social recognition was associated with life satisfaction and relationship satisfaction, but was unrelated to relationship investments. Legal recognition was associated with investments, but was unrelated to life and relationship satisfaction. In addition, we found some support for the hypothesis that relationship formalization moderates links between gay-related stress (e.g., internalized homophobia) and individual and relationship outcomes.

Stereotype threat among black and white women in health care settings.

The first of its kind, the present experiment applied stereotype threat-the threat of being judged by or confirming negative group-based stereotypes-to the health sciences. Black and White women (N = 162) engaged in a virtual health care situation. In the experimental condition, ones ethnic identity and negative stereotypes of Black women specifically were made salient. As predicted, Black women in the stereotype threat condition who were strongly identified as Black (in terms of having explored what their ethnic identity means to them and the role it plays in their lives) reported significantly greater anxiety while waiting to see the doctor in the virtual health care setting than all other women. It is hypothesized that stereotype threat experienced in health care settings is one overlooked social barrier contributing to disparities in health care utilization and broader health disparities among Black women.

Daily exposure to negative campaign messages decreases same-sex couples’ psychological and relational well-being

Throughout history, the rights of stigmatized minority group members have been subject to popular debate and voter referenda. The impact of the resulting devaluing social discourse on the well-being of minority group members remains unknown. For example, exposure to the discourse leading up to decisions on same-sex marriage may have negative consequences for sexual minority individuals and same-sex couples. We examined the impact of exposure to same-sex marriage campaign messages (e.g., commercials, billboards, yard signs) on the psychological and relational well-being of couples living in the four states that had same-sex marriage voter initiatives in the 2012 general election. Sixty-two same-sex couples (N = 124) completed a baseline survey and 10 daily diary reports during the month before the election. Daily exposure to negative campaign messages was associated with increased negative affect and decreased positive affect and relationship satisfaction. These associations persisted controlling for baseline levels of depression and daily fluctuations in general stress among both members of the couple. Exposure to a devaluing social discourse regarding the rights of same-sex couples represents a unique form of social stress resulting in negative consequences for the psychological and relational well-being of same-sex couples. Thus, the health of same-sex couples may be of particular concern in contexts where marriage policy decisions are pending and the subject of popular debate.

Healthcare Stereotype Threat in Older Adults in the Health and Retirement Study

INTRODUCTION Healthcare stereotype threat is the threat of being personally reduced to group stereotypes that commonly operate within the healthcare domain, including stereotypes regarding unhealthy lifestyles and inferior intelligence. The objective of this study was to assess the extent to which people fear being judged in healthcare contexts on several characteristics, including race/ethnicity and age, and to test predictions that experience of such threats would be connected with poorer health and negative perceptions of health care. METHODS Data were collected as part of the 2012 Health and Retirement Study (HRS). A module on healthcare stereotype threat, designed by the research team, was administered to a random subset (n=2,048 of the total 20,555) of HRS participants. The final sample for the present healthcare stereotype threat experiment consists of 1,479 individuals. Logistic regression was used to test whether healthcare stereotype threat was associated with self-rated health, reported hypertension, and depressive symptoms, as well as with healthcare-related outcomes, including physician distrust, dissatisfaction with health care, and preventative care use. RESULTS Seventeen percent of respondents reported healthcare stereotype threat with respect to one or more aspects of their identities. As predicted, healthcare stereotype threat was associated with higher physician distrust and dissatisfaction with health care, poorer mental and physical health (i.e., self-rated health, hypertension, and depressive symptoms), and lower odds of receiving the influenza vaccine. CONCLUSIONS The first of its kind, this study demonstrates that people can experience healthcare stereotype threat on the basis of various stigmatized aspects of social identity, and that these experiences can be linked with larger health and healthcare-related outcomes, thereby contributing to disparities among minority groups.

Essentialist beliefs and sexual prejudice against gay men: divergence at the levels of categories versus traits

The relationship between essentialist thinking (e.g., belief in genetic or biological determinism) and prejudice has been inconsistent, at times yielding conflicting results for different target groups. In this article, we test whether essentialist beliefs regarding sexual orientation are differentially associated with sexual prejudice against gay men depending on whether these beliefs are assessed at a category level (e.g., beliefs about the biological bases of the category of sexual orientation) or a trait level (e.g., beliefs about the biological bases of stereotypical traits associated with sexual orientation). It is hypothesised that when genetic beliefs regarding the category are assessed, these beliefs should be associated with lower sexual prejudice. Conversely, when essentialist beliefs are examined on a trait level, increases in homophobia are predicted. Survey data from a sample of heterosexuals confirmed the hypotheses. Potential mediators, including the role of controllability, and implications for reducing sexual prejudice are discussed.

The role of social support and gay identity in the stress processes of a sample of Caucasian gay men.

Though research has demonstrated that gay men suffer stress-related mental health disparities compared with heterosexuals, little is known about factors that protect gay individuals from poor mental health and that buffer them in the face of minority stress. Using a daily diary approach, the current study examined three factors that may protect individuals from poor mental health: social support from friends, social support from family, and gay identity. Caucasian gay men (N = 89) completed a study purported to examine the everyday life experiences of gay individuals. Participants completed baseline measures of social support from friends and family, gay identity (i.e., sense of belonging to the gay community), and depression. Participants then completed measures of minority stress and negative affect at the end of each day for 14 consecutive days. Though all three predictors were negatively related to depression at baseline, only friend support remained significant when all predictors were included simultaneously. For the daily data, hierarchical linear modeling was used to examine the moderating role that each of the predictors served in the daily minority stress-mental health link. Only friend support moderated the link. Those with more friend support experienced little change in negative affect from average to above-average minority stress days. However, those with less support experienced increases in negative affect from average to above-average minority stress days. The research highlights the importance of friend support for coping, while also suggesting that predictors of minority stress may differ when stress is assessed retrospectively versus daily.