How Discrimination and Stress Impact the Mental Health of Young Sexual Minority Men

A Rutgers Health analysis of participants over three years finds discrimination, stigma and chronic stress contribute to anxiety, depression, PTSD and substance use disparities

Young sexual minority men face higher rates of anxiety, depression, post-traumatic stress disorder (PTSD) and substance use compared with their heterosexual peers, according to Rutgers Health researchers.

In their study, published in the journal Youth, the researchers found discrimination, internalized homophobia and perceived stress are significantly associated with poorer mental health outcomes and increased substance use.

“Discrimination had the largest impact on the severity of all mental health outcomes,” said Perry N. Halkitis, dean of the Rutgers School of Public Health and senior author of the study. “This may be because of the external nature of discrimination, which is less controllable by the individual compared to the other, more internal-facing stressors.”

These findings reinforce the public health implications that discrimination and stress have on driving substance use and mental health disparities among vulnerable populations.

Perry N. Halkitis

Dean, Rutgers School of Public Health

Drawing on data collected over 36 months from 528 young sexual minority men ages 22 to 23 in New York City, researchers found perceived stress consistently increased the frequency of alcohol intoxication, club drug use and poly club drug use—defined as the concurrent use of two or more psychoactive substances. Additionally, they found that depression and PTSD severity are strong predictors of more frequent club and poly club drug use.

In contrast, experiences of discrimination and internalized homophobia were associated with fewer days of club and poly club drug use, possibly indicating social withdrawal from nightlife settings where such substances are commonly used.

“These findings reinforce the public health implications that discrimination and stress have on driving substance use and mental health disparities among vulnerable populations,” Halkitis said.

Researchers found that experiences of minority stress and discrimination can lead some sexual minority men to develop unhealthy ways of coping. They noted that efforts to reduce stigma and promote acceptance, while helping individuals build resilience and support networks, could improve overall health and well-being, such as access to community support groups and LGBTQ affirming mental health care.

“This is true not only for LGBTQ populations but also for any marginalized group in society,” the researchers added.

They recommend that future studies should explore additional stressors, such as socioeconomic status and parental education factors, as well as measures of resilience and support systems, the researchers said. Expanding this research beyond New York City also could help assess how dynamics between this population, stress, discrimination and health vary across geographic settings, the researchers said.

Explore more of the ways Rutgers research is shaping the future.