Structural Stigma Domains & Mental Health in U.S. Sexual & Gender Minorities: A Dominance Analysis
A Van der Star, AC Deckert, AG Brooks, AB Randall, DA Colburn, VL Banyard, KJ MitchellAbstract
Background
Structural stigma factors (e.g., laws/policies, population attitudes, and public safety markers) have been associated with sexual and gender minority (SGM) mental health, but findings have been mixed. It remains unknown what indicators of structural stigma are most salient, and if SGM subgroup heterogeneity can explain inconsistent results. This study aimed to examine what structural SGM stigma indicator across legal, attitudinal, or public safety domains is most strongly related to anxious and depressive symptoms, using dominance analysis stratified by gender identity, age group, and urbanicity.
Methods
Cross-sectional data from Project Lift Up, collected among U.S. youth and young adults (n = 4,981) in 2022 and 2023, with self-report measures on symptomatology and other demographics, were merged with six state-level structural stigma indicators (i.e., two indicators for each domain), derived from the Movement Advancement Project, American Values Atlas, and U.S. Department of Justice.
Results
Compared with legal structural stigma (sexual orientation or gender identity-based), population attitudes towards same-sex marriage, and hate crime rates (sexual orientation or gender identity-based), negative population attitudes towards non-discrimination laws showed the strongest general, conditional, and over most indicators, complete predictive dominance for anxious and depressive symptoms (.078 ≤ r ≤ .096, ps < .05), across pooled and stratified models.
Conclusions
While negative population attitudes towards non-discrimination laws were the most salient predictor of SGM symptomatology, all indicators were highly correlated. These findings suggest that structural SGM stigma operates as an interconnected, multidimensional construct. Although modest, effect sizes for structural stigma-associated symptomatology may still translate to a sizable total burden in mental ill-health among SGM and beyond.