Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario, M5S 1V4, Canada; Women's College Research Institute, Women's College Hospital, 76 Grenville Street, 6th Floor, Toronto, Ontario, M5G 1N8, Canada.
School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI, 48109, United States.
Soc Sci Med. 2020 Jan;245:112663. doi: 10.1016/j.socscimed.2019.112663. Epub 2019 Nov 5.
Sexual minorities' mental health disparities are produced in larger contexts of sexual stigma. There is limited understanding of pathways between sexual stigma dimensions (e.g., enacted, perceived, internalized), psychological processes, and depression.
We aimed to test the psychological mediation framework among transgender and cisgender sexual minorities in Kingston, Montego Bay, and Ocho Rios, Jamaica.
We conducted structural equation modeling using maximum likelihood estimation to examine direct and indirect pathways from sexual stigma to recent (past 2-week) depressive symptoms via mediators of resilient coping, social support quantity, and empowerment, and the moderation effect of social support quality.
Model 1 used a latent sexual stigma construct (indicators: enacted, perceived, and internalized stigma dimensions). Model 2 examined sexual stigma dimensions (enacted, perceived, internalized) as observed variables. Among participants (n=871; mean age: 25.5, SD: 5.4), 90.82% reported recent depressive symptoms. Both models fit the data well. In Model 1, the sexual stigma latent construct had a significant direct effect on depressive symptoms; social support quantity and resilient coping were partial mediators. In Model 2, enacted sexual stigma had a significant direct effect on depressive symptoms. Internalized sexual stigma had a significant indirect effect via social support quantity, resilient coping, and empowerment. Perceived sexual stigma had an indirect effect on depressive symptoms via empowerment. Social support quality moderated the relationship between: internalized stigma and empowerment, empowerment and resilient coping, social support quantity and resilient coping, and resilient coping and depressive symptoms.
Findings suggest the importance of considering the synergistic effect of multiple sexual stigma dimensions on depression; exploring different sexual stigma dimensions to inform tailored stigma reduction and stigma coping interventions; andaddressing coping (e.g., resilience), social isolation (e.g., social support quantity/quality), and cognitive (e.g., empowerment) factors to mitigate the impacts of sexual stigma on depression among sexual minorities.
性少数群体的心理健康差异是在更大的性污名化背景下产生的。对于性污名维度（如实施、感知、内化）、心理过程和抑郁之间的关系途径，人们的理解有限。
我们旨在测试牙买加金斯敦、蒙特哥贝和奥乔里奥斯的跨性别和顺性别性少数群体中的心理中介框架。
我们使用最大似然估计进行结构方程建模，以检验性污名与最近（过去 2 周）抑郁症状之间的直接和间接途径，通过弹性应对、社会支持数量和赋权的中介，以及社会支持质量的调节作用。
模型 1 使用潜在的性污名构建（指标：实施、感知和内化污名维度）。模型 2 将性污名维度（实施、感知、内化）作为观察变量进行检验。在参与者（n=871；平均年龄：25.5，SD：5.4）中，90.82%报告了最近的抑郁症状。两个模型都很好地拟合了数据。在模型 1 中，性污名潜在结构对抑郁症状有显著的直接影响；社会支持数量和弹性应对是部分中介。在模型 2 中，实施性污名对抑郁症状有显著的直接影响。内化性污名通过社会支持数量、弹性应对和赋权对抑郁症状有显著的间接影响。感知性污名通过赋权对抑郁症状有间接影响。社会支持质量调节了内化污名与赋权、赋权与弹性应对、社会支持数量与弹性应对以及弹性应对与抑郁症状之间的关系。
研究结果表明，考虑多种性污名维度对抑郁的协同影响、探索不同的性污名维度以提供针对性的污名减少和污名应对干预以及解决应对（如弹性）、社会隔离（如社会支持数量/质量）和认知（如赋权）因素的重要性，以减轻性少数群体中性污名对抑郁的影响。
