Structural stigma and everyday adversity among sexual and gender minority adolescents in Europe
R Bränström, BD Smart, JE PachankisAbstract
Background
Sexual and gender minority (SGM) adolescents experience elevated mental health risks, partly due to stigma-related stressors operating at structural, interpersonal, and individual levels. While structural stigma has been linked to poorer mental health, less is known about how unfavorable national contexts shape everyday stigma exposure among SGM youth. This study examines whether structural stigma increases adolescents’ exposure to interpersonal stressors across 30 European countries.
Methods
We analyzed data from 18,681 SGM adolescents aged 15–17 years from the 2019 EU-LGBTI Survey. Country-level structural stigma was coded using national legislation on partnership recognition and anti-discrimination protections. Individual-level measures included victimization, school bullying, harassment, identity concealment to avoid adversity, mental health indicators, and sociodemographics. Multilevel generalized mixed-effects models tested associations between structural stigma and interpersonal stressors. A MAIHDA framework assessed how structural and interpersonal factors jointly contributed to mental health outcomes.
Results
Higher structural stigma was associated with greater exposure to interpersonal stigma among several SGM subgroups. Gay and bisexual boys in higher-stigma countries had higher odds of victimization (aOR = 1.60, 95% CI 1.13–2.27) and identity concealment to avoid adversity (aOR = 1.85, 95% CI 1.31–2.61). Lesbian and bisexual girls also showed higher odds of identity concealment (aOR = 1.47, 95% CI 1.07–2.03). Interpersonal adverse events were strongly associated with poorer mental health and explained substantial variance in depressive symptoms, alongside identity concealment and structural stigma.
Conclusions
Structural stigma increases SGM adolescents’ exposure to interpersonal adversity and identity concealment, both of which contribute to poorer mental health. Protective policies may therefore reduce stigma-related harm across Europe.