Factors Associated with Discrimination-Related Distress Among Sexual and Gender Minority Individuals: A Predictive Analysis

Sexual and gender minority (SGM) individuals face disparate rates of mental health outcomes, such as psychological distress, which contributes to suicidality. This may be attributable to minority stress, which posits that health inequities impacting this community are driven by increased exposure to stigma- and discrimination-related stressors. The negative physical and psychological health impacts of psychological distress and discrimination are well-documented in the literature. Structural stigma – in the form of harmful anti-LGBTQIA+ laws and policies – is associated with increased suicidality. However, little is known about factors associated with perceived discrimination occurrences and discrimination-related distress. First, a systematic review was conducted to understand the usage of the Daily Heterosexist Experiences Questionnaire as a dependent variable given its usage in our study to measure the outcomes of perceived discrimination occurrences and discrimination-related distress. This yielded a final sample size of ten eligible articles included for data extraction and quality assessment. This review informed the present study, which was a cross-sectional, web-based survey of 1,033 SGM participants in the United States. Using the DHEQ to measure perceived discrimination occurrences and related distress, this study was grounded within the social-ecological model, which considers the multifaceted interactions between individual, relationship, community, and societal factors on health outcomes. This study evaluated various psychosocial variables as potential predictors of, and protectors against, experiencing perceived discrimination occurrences and related distress. A multiple hierarchical regression analysis identified models that explained approximately 22.30% and 82.90% of the variance in experiencing perceived discrimination occurrences (Adjusted R² = .223, F(25, 671) = 7.694, p < .001) and discrimination-related distress (Adjusted R² = .829, F(26, 670) = 130.987, p < .001), respectively. Additionally, this study applied an intersectional analysis to examine factors associated with experiencing perceived discrimination occurrences and discrimination-related distress at the intersections of SGM identity, being an individual from a racial or ethnic minority background, and having a diagnosed disability. A multiple hierarchical regression analysis identified models that explained approximately 14.30% and 14.60% of the variance in experiencing perceived discrimination occurrences (Adjusted R² = .143, F(15, 691) = 8.829, p < .001) and discrimination-related distress (Adjusted R² = .146, F(15, 691) = 7.873, p < .001), respectively. Significant factors associated with experiencing discrimination occurrences and discrimination-related distress emerged, with trends observed across each of the four models. Impacts of harmful rhetoric, the role of laws and policies, and areas for intervention are critical points of focus to reduce discrimination and related distress within the SGM community.