Differential Effects of Perceived Discrimination and Affirmation in LGBQ People: Heterosexism During Childhood and Interoceptive Awareness as Individual Contexts

This study examined how two person-level contextual factors, heterosexism during childhood and interoceptive awareness, shape LGBQ individuals’ psychophysiological responses to perceived everyday discrimination and affirmation. Situated within minority stress and social safeness perspectives, and guided by an idionomic approach to within-person heterogeneity, we investigated both the prospective associations of these factors with health indicators and their moderating roles in momentary responses. A sample of 141 LGBQ adults in Hong Kong completed baseline measures of early exposure to heterosexism and interoceptive awareness before participating in a recall-based, repeated-measures lab task involving discrimination, affirmation, and neutral writing conditions. Outcomes included LGBQ collective self-esteem, rumination, affect, somatic distress, and heart rate variability (HRV). Both early heterosexism and interoceptive awareness prospectively predicted nearly all self-reported outcomes in expected directions. Moderation analyses showed that, among individuals with greater early heterosexism, the beneficial effects of perceived affirmation on LGBQ collective self-esteem, rumination, and negative affect were smaller whereas the adversarial effects of perceived discrimination on somatic distress and a frequency-domain HRV indicator were larger. In contrast, the moderating role of interoceptive awareness was limited to positive affect with unexpected simple effects. Effects on HRV indicators were inconclusive. Findings highlight the importance of trauma-informed and body-oriented approaches in clinical and community services for LGBQ people. These results also underscore the value of assessing contextual antecedents for advancing LGBQ health research and intervention. • Early heterosexism exposure showed adversarial associations with health indicators. • Early heterosexism weakened benefits of recalled LGBQ-affirming moments. • Interoceptive awareness showed beneficial associations with health indicators. • Interoceptive awareness helped access positive emotions from ambiguous stimuli.