Initial Development and Validation of the Brief Internalized Heterosexist Racism Scale for Gay and Bisexual Black Men: A Measure of Internalized Heterosexist Racism

We introduce internalized heterosexist racism (IHR), or the internalization of damaging stereotypes, harmful beliefs, and negative attitudes about being a sexual minority person of color. We also present the initial development and validation of the Brief Internalized Heterosexist Racism Scale for gay and bisexual Black men (IHR-GBBM), a unidimensional, 10-item measure of IHR. Exploratory factor analyses on an internet-obtained sample of gay and bisexual Black men (N = 312; Mean age = 30.36 years) show that the IHR-GBBM had evidence of good internal consistency, and good convergent, discriminant, concurrent, and incremental validity. The IHR-GBBM was positively correlated with internalized racism, internalized heterosexism, and discrimination (racist, heterosexist). IHR was also negatively correlated with race stigma consciousness, weakly positively correlated with sexual identity stigma consciousness, but not correlated with either race identity, sexual identity, or social desirability. Hierarchical regressions showed that the IHR-GBBM explained an additional variance of 2.8% and 3.1% in anxiety symptoms and substance use coping, respectively, after accounting for (1) sociodemographics, (2) internalized racism and internalized heterosexism, and (3) an interaction of internalized racism and internalized heterosexism. Older participants and those who were "out" about their sexual identity reported lower IHR. Those who did not know/want to report their HIV status reported greater IHR. Results revealed no sexual identity, sexual position, relationship status, income, education, or employment status differences in IHR. We hope the development of the IHR-GBBM spurs future research on predictors and consequences of IHR. We discuss limitations and implications for the future study of internalized heterosexist racism.

Use of the Heterosexist Harassment, Rejection, and Discrimination Scale With Different Sexual Orientation, Gender, and Racial/Ethnic Groups: An Examination of Measurement Invariance

The Heterosexist Harassment, Rejection, and Discrimination Scale (HHRDS) is one of the most commonly used measures of sexual orientation-related discrimination, but little is known about its psychometric properties across different sexual orientations, gender, and racial/ethnic groups. A three-factor model was initially obtained, but most studies treat the HHRDS unidimensionally. Therefore, we tested whether the HHRDS exhibited measurement invariance across sexual orientation, gender, and racial/ethnic groups among 792 sexual minority young adults (aged 18-29) who participated in an online study. Across models, the three-factor solution fit better than the one-factor solution. All models achieved configural invariance and most achieved metric invariance; none of the considered models achieved scalar invariance (1-3 items were not equivalent across groups, depending on the comparison). Findings suggest that the HHRDS generally functions equivalently across sexual orientation, gender, and racial/ethnic groups, but some caution in interpreting scores is warranted.

It's Complicated: Minority Stress, Social Support, In-Group Social Contact, and Sexual Minority Older Adults' Well-Being

BACKGROUND AND OBJECTIVES

We applied the Minority Stress Model to sexual minority older adults to examine how distal minority stressors of ageism and heterosexism related to psychological well-being (life satisfaction, quality of life, psychological distress, and loneliness). We investigated social support and in-group social contact as stress-ameliorating factors and tested for a potential intersection of stress due to minority identities.

RESEARCH DESIGN AND METHODS

A sample of 189 sexual minority older adults (50-86 years; M = 60.41) completed survey measures online. Hierarchical regression analyses with interaction terms were utilized to test study hypotheses.

RESULTS

Findings offered partial support for the Minority Stress Model. Large effect sizes were obtained, explaining 32%-56% of the variance in psychological well-being with models including ageism, heterosexism, stress-ameliorating factors, and demographics. Ageism and heterosexism related to greater psychological distress; however, heterosexism became nonsignificant after controlling for stress-ameliorating factors. Ageism and heterosexism's relations to loneliness and quality of life followed similar patterns. Social support was a strong predictor of better psychological well-being for all measures. In-group social contact buffered against distress resulting from ageism, but heightened distress resulting from heterosexism. The interaction of ageism and heterosexism was not significant.

DISCUSSION AND IMPLICATIONS

Ageism was a distinct source of distress for sexual minority older adults. Although social support emerged as crucial to well-being, the mixed findings related to in-group contact as a stress-ameliorating factor may indicate a need for tailored social engagement to optimize community connection as protective for sexual minority older adults.

A conditional embrace-Swedish LGBTQ+ spaces through the eyes of ethnic minority non-heterosexual individuals

Introduction

In research on sexuality, marginalized sub-groups within sexual minorities have often been overlooked. From the vantage point of Sweden, internationally ranked as an exemplary progressive nation in equality issues and LGBTQ+ rights, and with an increasingly diversified population, the lived experiences of ethnic minority non-heterosexual people are still very much lacking in voice and visibility. The present study aimed to examine experiences within Swedish non-heterosexual spaces, held by ethnic minority non-heterosexual individuals.

Method

A thematic analysis of in-depth interviews with 22 Swedish non-heterosexual individuals, 13 cis-men and nine cis-women, with diverse first- and second-generation immigration backgrounds, was conducted.

Results

Two main themes were identified. The first theme, "Constantly contested identities," is composed of the sub-themes "Ingrained, intersecting ideals" and "Prejudiced spaces," and the second theme, "Effects and counteractions," of the sub-themes "Never fully human" and "Representation and separatism." The results, presented starting from a more theoretical level, moving to situated knowledge, and finally to psychological and practical implications, demonstrate that ethnic minority non-heterosexual people experience problematic and intersecting ideals, with related discrimination, in various Swedish non-heterosexual settings. Experiences of alienation, exotification, and tokenism were common among the participants and had negative psychological effects, including multiple-minority stress and a constant outsider feeling. Representation and participation in separatist forums were utilized as primary strategies to counteract the negative effects.

Discussion

The findings shed light on previously under-researched ideals and actions within Swedish LGBTQ+ spaces, and raises questions about how positive belonging can be achieved for multiple-minorities. Further research and continued critical discussions about ethnic minority non-heterosexual people's plight within non-heterosexual settings in Sweden, and beyond, is advocated.

A Test of Objectification Theory with Sexual Minority Women

With this study, we aimed to advance objectification theory research with sexual minority women by examining the understudied roles of appearance anxiety and interoceptive awareness concomitantly with other key variables, including sexual objectification experiences, internalization of cultural appearance standards, body surveillance, and body shame. We also examined depressive symptoms as a criterion variable in addition to eating disorder symptoms. Survey data from 201 sexual minority women were analyzed. Manifest variable path analysis of the hypothesized model explained 35% and 27% of the variance in eating disorder and depressive symptoms, respectively. Results revealed a distinct pattern of cross-sectional direct and indirect relations for eating disorder and depressive symptoms. Specifically, body shame was a key unique correlate of eating disorder symptoms and linked internalization of cultural appearance standards and body surveillance with eating disorder symptoms. Appearance anxiety was a key unique correlate of depressive symptoms and linked internalization of cultural appearance standards and body surveillance with depressive symptoms. Sexual objectification experiences and interoceptive awareness generally did not yield significant unique direct or indirect relations in the model. These findings suggest distinct and complementary points of intervention to mitigate eating disorder and depressive symptoms for sexual minority women.

Psychosis in transgender and gender non-conforming individuals: A review of the literature and a call for more research

Epidemiological studies have described higher rates of psychotic disorder diagnoses in transgender, as compared to cisgender, individuals. With the exception of this work and a small number of published case studies, however, there has been little consideration of gender diversity in psychosis research or clinical care. In this paper, we will review and critically evaluate the limited literature on gender diversity and clinical psychosis and articulate the critical need for more work in this field, more specifically on the following areas and how they bear on clinical care: 1) diagnostic biases; 2) how chronic non-affirmation and bias, gender dysphoria, and other gender minority stressors may operate as trauma and can contribute to clinically significant psychotic symptoms; 3) the potential impact of gender-affirming care, such as hormone therapies, on mental health and barriers for receiving such care in transgender and nonbinary individuals; and 4) culturally-sensitive and gender-affirming approaches for addressing psychosis. Finally, we consider ways in which researchers may engage in ethical, gender-affirming, and accurate approaches to better address gender identity in psychosis research. We hope that such research will aid in the creation of clinical guidelines for understanding, diagnosing, and treating psychosis in gender diverse individuals.

Internalised stigma as durable social determinant of HIV care for transnational patients of Puerto Rican ancestry

Intersectional stigmas have been contributing barriers to linkage and retention in HIV care for Latinx communities. Our analysis examines whether reductions in HIV-related and other stigmas were associated (or not) with progression on the HIV continuum of care for Puerto Ricans living with HIV, patients of the U.S. Special Projects of National Significance (SPNS) initiative: 'Culturally Appropriate Interventions of Outreach, Access and Retention among Latinx Populations from 2013 to 2018.' We conducted multivariate regression modelling to test our primary hypotheses. Internalised (HIV and racial/ethnic) stigma scores and age at baseline were predictors of ART adherence at six months assessment. Internalised stigma (HIV and racial/ethnic), depression, and resiliency scores were predictors of the likelihood of detectable HIV viral load at six months assessment. Our study confirms the importance of understanding internalised stigma on its own terms, as a durable construct that has implications for HIV treatment disparities for Puerto Ricans living with HIV.

Ethnic/racial and gender differences in body image disorders among a diverse sample of sexual minority U.S. adults

This study assessed the occurrence of probable eating disorders (EDs), ED symptoms, probable body dysmorphic disorder (BDD), BDD symptoms, drive for muscularity, and appearance and performance enhancement drug (APED) misuse, in an ethnically/racially diverse sample of 962 cisgender sexual minority (SM) individuals in the United States, aged 18-30 years old. The overall occurrence of probable ED, probable BDD, and APED misuse in the current sample was 32.7 %, 50.9 %, and 30.6 %, respectively. With respect to ethnicity/race, Hispanic SMs reported the highest rates of EDs, BDD, APED misuse, and drive for muscularity, and may therefore be particularly at risk for developing body image disorders (BIDs). With respect to gender, SM men reported significantly greater drive for muscularity and APED misuse compared to SM women, while SM women reported significantly higher occurrence of probable ED and ED symptoms. The occurrence of EDs, BDD, and APED misuse were higher among SMs in this sample compared to previous rates found among heterosexual samples, suggesting that SMs, regardless of gender and ethnicity/race, are vulnerable to experiencing BIDs and APED misuse. Future research is needed to identify the mechanisms that place SMs at (increased) risk for BIDs, which will aid prevention/intervention development.

A Meta-Analysis of the Relationship Between Internalized Racial Oppression and Health-Related Outcomes

Internalized racism represents a critical component of the system of racial oppression wherein People of Color adopt the negative beliefs about their race held by members of the White majority group. In this meta-analysis, the authors reviewed 29 studies (32 effect sizes) on the relationships between internalized racism and negative physical and mental health outcomes published between 1999 and 2015 and tested for literature-driven moderator effects using subgroup analyses. Results suggested that the direct overall relation between internalized racism and health was strongest for negative mental health outcomes ( r = .26), followed by negative physical health outcomes ( r = .11). Significant moderator effects were found for scale of measurement, country of sample (United States vs. international), and sampling method. Moderator effects of gender, publication type, year, and sample setting were not statistically significant. These findings are discussed and their implications for practice, advocacy, education/training, and research are described.

Navigating double marginalisation: migrant Chinese sexual and gender minority young people's views on mental health challenges and supports

Sexual and/or gender minority young people who are also members of an ethnic minority can experience unique challenges. Limited research draws directly on the mental health experiences of these 'double minority' youth. This study focused on Chinese sexual/gender minority youth in New Zealand. It sought to explore features they found challenging for, or supportive of, their mental health and wellbeing. Semi-structured interviews were conducted with 11 Chinese sexual/gender minority participants aged between 19 and 29 years old and residing in Auckland, New Zealand. An inductive approach to qualitative data analysis was used. Two major domains of findings emerged. Firstly, participants described mental health challenges linked to racism, sexism, cis-heteronormativity and challenges in relation to intersecting identities. Secondly, Chinese culture and community connections, family and peer support and role models seemed to facilitate resiliency. However, the fear of 'losing face', unwillingness to disclose distress when unwell and mental health service providers' lack of cultural and linguistic competency were described as barriers to effective mental health support. In conclusion, Chinese and sexual/gender minority identities were integral parts of participants' sense of self, and this was associated with their mental health and wellbeing. Further research is required to explore ways to reduce barriers and promote resiliency.

Heterosexism, Racism, and the Mental Health of Sexual Minority People of Color

In the present study, we examined the additive and multiplicative associations of heterosexist discrimination, racist discrimination, internalized heterosexism, and internalized racism with psychological distress and well-being in 318 sexual minority People of Color. We tested multiplicative associations via two sets of interactions: cross-oppression (Heterosexist Discrimination × Internalized Racism, Racist Discrimination × Internalized Heterosexism) and same-oppression (Heterosexist Discrimination × Internalized Heterosexism, Racist Discrimination × Internalized Racism). Consistent with the additive perspective, heterosexist discrimination and internalized racism were uniquely positively associated with distress, whereas internalized heterosexism and internalized racism were uniquely negatively associated with well-being. The Heterosexist Discrimination × Internalized Racism and Racist Discrimination × Internalized Racism interactions were significant in relation to both distress and well-being. Internalized racism was associated with significantly poorer mental health until heterosexist and racist discrimination reached high levels. We discuss the implications of our findings for research and practice with sexual minority People of Color.

Gendered Racial Microaggressions and Traumatic Stress Symptoms Among Black Women

We investigated the relations between gendered racial microaggressions (i.e., subtle gendered racism), gendered racial socialization, and traumatic stress symptoms among Black women. We hypothesized that gendered racial microaggressions would be significantly associated with traumatic stress symptoms and that gendered racial socialization would moderate the relations between gendered racial microaggressions and traumatic stress symptoms. Participants were 226 Black women from across the United States who completed an online survey. Results from a hierarchical multiple regression analysis indicated that a greater frequency of gendered racial microaggressions was significantly associated with greater traumatic stress symptoms; internalized gendered racial oppression moderated the relations between gendered racial microaggressions and traumatic stress symptoms. The results of this study can inform future research on Black women’s experiences of gendered racism and the role of gendered racial socialization in their lives. Online slides for instructors who want to use this article for teaching are available on PWQ’s website at http://journals.sagepub.com/page/pwq/suppl/index

Integrating the Neurobiology of Minority Stress with an Intersectionality Framework for LGBTQ-Latinx Populations

The comprehensive lived experiences of lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals of color remain invisible in neurobiological studies of LGBTQ populations. Models of minority stress posit that LGBTQ and Latinx individuals experience and internalize sexual, ethnic, racial, and gender discrimination, which may adversely impact mental and physical health. However, the current minority stress models predominantly focus on single categorical social identities and do not account for interlocking systems and processes of oppression based on features of sexuality, race, ethnicity, sex, and gender, as explained by an intersectionality framework in feminist theory. Thus, it remains unclear how LGBTQ people of color internalize and navigate multiple cultural, institutional, and societal stressors, and, furthermore, how these sources of stress may affect health and well-being. A potential mechanism for this adverse internalization process is through the effects of stress on neurobiological regulation. This review will apply an intersectionality framework to the examination of how heterosexism, racism, and cissexism, as systems of oppression, create LGBTQ and Latinx lived experiences, and the differential impacts of these inequalities on neurobiological stress regulation. The overarching goal of this manuscript is to advocate for the application of intersectionality theory to advance the ecological validity of biopsychosocial models of multiple-minority stress.

Prevalence of Obesity, Prediabetes, and Diabetes in Sexual Minority Women of Diverse Races/Ethnicities: Findings From the 2014-2015 BRFSS Surveys

Purpose

The purpose of this study is to assess the weighted prevalence and odds ratios of obesity, prediabetes, and diabetes by (1) female sexual orientation (lesbian, bisexual, and straight) with racial/ethnic (Hispanic, non-Hispanic black, and non-Hispanic white) groups combined and (2) across and within racial/ethnic groups by sexual orientation.

Methods

A secondary analysis of pooled 2014-2015 Behavioral Risk Factor Surveillance System data from 28 states (N = 136 878) was conducted. Rao-Scott chi-square test statistics were computed and logistic regression models were developed to assess weighted prevalence and odds ratios of obesity, prediabetes, and diabetes with adjustments for demographics (age, income, and education), depression, and health care access factors.

Results

With racial/ethnic groups combined, lesbian and bisexual women, relative to straight women, had a significantly increased likelihood for obesity when controlling for demographics. Bisexual women were found to have significantly reduced odds for diabetes, compared with straight women, with adjustments for demographics, depression, and health care access factors. Compared with their non-Hispanic white counterparts, Hispanic lesbian women had significantly increased odds for obesity and diabetes, while non-Hispanic black bisexual women had a significantly greater likelihood for obesity, holding demographics, depression, and health care access factors constant. Non-Hispanic white lesbian women had an increased likelihood for obesity relative to their straight, ethnic/racial counterparts. Prediabetes subsample analysis revealed the prevalence was low across all female sexual orientation groups.

Conclusion

Sexual minority women, particularly those of color, may be at increased risk for obesity and diabetes. Research is needed to confirm the findings.

Relationship Characteristics and Dyadic Approaches to HIV Health-Enhancing Behaviours Among a Sample of Same-Sex Male Couples From Three U.S. Cities

Recent modelling estimates up to two-thirds of new HIV infections among men who have sex with men occur within partnerships, indicating the importance of dyadic HIV prevention efforts. Although new interventions are available to promote dyadic health-enhancing behaviours, minimal research has examined what factors influence partners’ mutual engagement in these behaviours, a critical component of intervention success. Actor-partner interdependence modelling was used to examine associations between relationship characteristics and several dyadic outcomes theorised as antecedents to health-enhancing behaviours: planning and decision making, communication, and joint effort. Among 270 male-male partnerships, relationship satisfaction was significantly associated with all three outcomes for actors (p = .02, .02, .06 respectively). Latino men reported poorer planning and decision making (actor p = .032) and communication (partner p = .044). Alcohol use was significantly and negatively associated with all outcomes except actors’ planning and decision making (actors: p = .11, .038, .004 respectively; partners: p = .03, .056, .02 respectively). Having a sexual agreement was significantly associated with actors’ planning and decision making (p = .007) and communication (p = .008). Focusing on interactions between partners produces a more comprehensive understanding of male couples’ ability to engage in health-enhancing behaviours. This knowledge further identifies new and important foci for the tailoring of dyadic HIV prevention and care interventions.

Multiple forms of discrimination and relationships with health and wellbeing: findings from national cross-sectional surveys in Aotearoa/New Zealand

BACKGROUND

The complex ways in which experiences of discrimination are patterned in society, including the exposure of communities to multiple overlapping forms of discrimination within social systems of oppression, is increasingly recognised in the health sciences. However, research examining the impacts on health and contribution to racial/ethnic health inequities remains limited. This study aims to contribute to the field by exploring the prevalence and patterning of experience of multiple forms of discrimination in Aotearoa/New Zealand, and associations with health and wellbeing.

METHODS

The study's conceptual approach is informed by Kaupapa Māori theory, Ecosocial theory, Critical Race Theory and intersectionality. Data are from the 2008, 2010 and 2012 General Social Surveys (GSS), biennial nationally-representative surveys in Aotearoa/New Zealand. We examined patterning of forms of discrimination in the last 12 months and frequency of experiencing multiple forms of discrimination. We also looked at associations between experience of multiple discrimination and self-rated health, mental health (using SF12), and life satisfaction using logistic regression. We used random effects meta-analysis to produce pooled estimates drawing from all three survey instances.

RESULTS

Māori, and people from Pacific and Asian ethnic groups, reported much higher prevalence of racial discrimination, were more likely to have any experience of discrimination, and were also more likely to experience multiple forms of discrimination, in the last year relative to respondents in the European/Other category. Discrimination was associated with poorer self-rated health, poorer mental health, and greater life dissatisfaction in unadjusted and adjusted estimates. Negative health impacts increased as the number of forms of discrimination experienced increased.

CONCLUSIONS

Discrimination impacts negatively on the health of indigenous peoples and those from minoritised ethnic groups in Aotearoa/New Zealand through higher exposure to racial discrimination, other forms of discrimination, and a greater likelihood of experiencing multiple forms of discrimination. This supports the need for research and interventions that more fully account for the multiple and interlocking ways in which discrimination impacts on health in racialised social hierarchies to maintain systems of privilege and oppression.

The Effects of System Justifying Beliefs on Skin-Tone Surveillance, Skin-Color Dissatisfaction, and Skin-Bleaching Behavior

In two studies with women living in India (Study 1, n = 177) and African American women in the United States (Study 2, n = 120), we investigated whether skin-tone surveillance, which theoretically is a manifestation of self-objectification, predicted greater skin-color dissatisfaction and greater skin-bleaching behavior. Given the existence of colorism in Indian and American societies, we expected that ideologies that rationalize and perpetuate the status quo would moderate the proposed relations. Results were consistent with objectification theory and system justification theory. The positive relation between skin-tone surveillance and skin-color dissatisfaction was weaker among women of color who more strongly (vs. weakly) endorsed system justifying ideologies, and the positive relation between skin-tone surveillance and skin-bleaching behavior was stronger among women of color who more strongly (vs. weakly) endorsed system justifying ideologies. Our results suggest that self-objectification theorists and researchers should consider culturally specific manifestations of self-objectification as well as protective and legitimating effects of system justifying ideologies. We encourage clinicians and policy makers to use public campaigns and individual-level interventions to target the norms and motivations underlying skin-bleaching. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/page/pwq/suppl/index

Discrimination, Subjective Wellbeing, and the Role of Gender: A Mediation Model of LGB Minority Stress

The present study examined the link between discrimination and the three components of subjective wellbeing (positive and negative affect and life satisfaction) among a cisgender sample of lesbian, gay, and bisexual (LGB) adults. Specifically, we investigated internalized homonegativity and expectations of rejection as potential mediators of the links between discrimination and subjective wellbeing among a sample of 215 participants. Results from our structural equation model demonstrated a strong, positive direct link between discrimination and negative affect. Discrimination also had small, negative indirect effects on life satisfaction through our two mediators. Interestingly, neither discrimination nor our two mediators were related with positive affect, demonstrating the need for future research to uncover potential buffers of this link. Finally, our model evidenced configural, metric, and scalar invariance, suggesting that our model applies well for both women and men. Practical implications and future directions for research are discussed.

A Grounded Theory of Sexual Minority Women and Transgender Individuals' Social Justice Activism

Psychosocial benefits of activism include increased empowerment, social connectedness, and resilience. Yet sexual minority women (SMW) and transgender individuals with multiple oppressed statuses and identities are especially prone to oppression-based experiences, even within minority activist communities. This study sought to develop an empirical model to explain the diverse meanings of social justice activism situated in SMW and transgender individuals' social identities, values, and experiences of oppression and privilege. Using a grounded theory design, 20 SMW and transgender individuals participated in initial, follow-up, and feedback interviews. The most frequent demographic identities were queer or bisexual, White, middle-class women with advanced degrees. The results indicated that social justice activism was intensely relational, replete with multiple benefits, yet rife with experiences of oppression from within and outside of activist communities. The empirically derived model shows the complexity of SMW and transgender individuals' experiences, meanings, and benefits of social justice activism.

"Invisible During My Own Crisis": Responses of LGBT People of Color to the Orlando Shooting

On June 12, 2016, the Pulse nightclub in Orlando, Florida was the target of one of the country's deadliest mass shootings. Pulse, a gay nightclub, was hosting a Latin Pride Night the evening of the tragedy, which resulted in the death of 49 victims and 53 casualties, over 90% of whom were lesbian, gay, bisexual, and transgender (LGBT) Latinx people, specifically. The present research investigates the narrative responses from LGBT people of color (LGBT-POC) following the tragedy. Results included an analysis of 94 participant narrative responses. Results were collected online from a sample of LGBT-POC with varying sexual, gender, and racial identities. Thematic analysis revealed four major themes: (1) Violence is Not New for LGBT-POC; (2) Personal Identification with Victims; (3) Lack of Intersectionality in Others' Responses to Orlando; and (4) Acknowledgment of Intersectionality across LGBT-POC. Discussion focuses on describing the ways in which LGBT-POC responded to the shooting regarding their multiple minority identities. Implications of this research reinforce the need for continued intersectional research with LGBT-POC.

A Psychometric Review of Measures Assessing Discrimination Against Sexual Minorities

Discrimination against sexual minorities is widespread and has deleterious consequences on victims' psychological and physical wellbeing. However, a review of the psychometric properties of instruments measuring lesbian, gay, and bisexual (LGB) discrimination has not been conducted. The results of this review, which involved evaluating 162 articles, reveal that most have suboptimal psychometric properties. Specifically, myriad scales possess questionable content validity as (1) items are not created in collaboration with sexual minorities; (2) measures possess a small number of items and, thus, may not sufficiently represent the domain of interest; and (3) scales are "adapted" from measures designed to examine race- and gender-based discrimination. Additional limitations include (1) summed scores are computed, often in the absence of scale score reliability metrics; (2) summed scores operate from the questionable assumption that diverse forms of discrimination are necessarily interrelated; (3) the dimensionality of instruments presumed to consist of subscales is seldom tested; (4) tests of criterion-related validity are routinely omitted; and (5) formal tests of measures' construct validity are seldom provided, necessitating that one infer validity based on the results obtained. The absence of "gold standard" measures, the attendant difficulty in formulating a coherent picture of this body of research, and suggestions for psychometric improvements are noted.

Disparities in Mental Health Quality of Life Between Hispanic and Non-Hispanic White LGB Midlife and Older Adults and the Influence of Lifetime Discrimination, Social Connectedness, Socioeconomic Status, and Perceived Stress

We assessed factors contributing to ethnic and racial disparities in mental health quality of life (MHQOL) among lesbian, gay, and bisexual (LGB) midlife and older adults. We utilized cross-sectional survey data from a sample of non-Hispanic White and Hispanic LGB adults aged 50 and older. Structural equation modeling was used to test the indirect effect of ethnicity/race on MHQOL via explanatory factors including social connectedness, lifetime discrimination, socioeconomic status (SES), and perceived stress. Hispanics reported significantly lower levels of MHQOL, compared to non-Hispanic Whites. In the final model, the association between ethnicity/race and MHQOL was explained by higher levels of perceived stress related to lower SES, higher frequency of lifetime discrimination, and lack of social connectedness among Hispanic LGB adults. This study suggests that perceived stress related to social disadvantage and marginalization plays an important role in MHQOL disparities among Hispanic LGB midlife and older adults.