Nursing College, Guangxi Medical University, Nanning, Guangxi, China.
Nanning Municipal Center for Disease Prevention and Control, Nanning, Guangxi, China.
BMC Public Health. 2022 Apr 21;22(1):797. doi: 10.1186/s12889-022-13231-8.
This study aimed to investigate sexual orientation disclosure and mental health among young men who have sex with men (YMSMs). To this end, we constructed a chained multimediator model of sexual minority stigma, sexual minority identity, social support, and resilience, with the moderator of sexual orientation disclosure.
We conducted a cross-sectional survey of 345 YMSMs in Nanning, China. Bivariate analysis was used to evaluate factors associated with sexual orientation disclosure. Sexual minority stigma was used to predict identity, with social support as the step 1 mediator and resilience as the step 2 mediator. Sexual minority identity was analyzed using a chained moderated mediation model; sexual orientation disclosure was included as a moderator in all models to control its confounding effect.
The average age of YMSMs was 20.0 ± 1.3 years. Bivariate analysis indicated that YMSMs who disclosed sexual orientation may have experienced less stigma (15.49 ± 3.02 vs 16.21 ± 2.74), obtained more social support (65.98 ± 11.18 vs 63.19 ± 11.13), had strong psychological resilience (37.40 ± 8.57 vs 35.39 ± 7.73), and had a more positive self-identity (104.12 ± 21.10 vs 95.35 ± 16.67); differences between subgroups were statistically significant (p < 0.05). Sexual minority stigma, perceived stigma, and enacted stigma were significantly associated with social support and resilience. The association between sexual minority stigma and sexual minority identity was significantly mediated by social support (indirect effect [95% CI] = - 3.307 [- 4.782, - 1.907]). Resilience significantly mediated the same association for identity (- 2.544 [- 4.052, - 1.114]). The chained relationship from sexual minority stigma to social support, resilience, and identity was also significant, with an indirect effect of - 0.404 [- 0.621, - 0.249].
Among YMSMs in China, sexual minority stigma affects sexual minority identity through social support and resilience. Given the psychological effects of stigma, social support and resilience must be considered to better promote positive self-identity and mental health among YMSMs.
本研究旨在探讨男男性行为者（MSM）的性取向披露和心理健康。为此，我们构建了一个包含性少数群体污名、性少数群体认同、社会支持和韧性的链式中介模型，并以性取向披露为调节变量。
我们对中国南宁的 345 名 MSM 进行了横断面调查。使用单变量分析评估与性取向披露相关的因素。性少数群体污名用于预测认同，社会支持为第一步中介，韧性为第二步中介。使用链式中介调节模型分析性少数群体认同；在所有模型中都包含性取向披露作为调节变量，以控制其混杂效应。
MSM 的平均年龄为 20.0±1.3 岁。单变量分析表明，披露性取向的 MSM 可能经历的污名较少（15.49±3.02 与 16.21±2.74），获得的社会支持更多（65.98±11.18 与 63.19±11.13），心理韧性更强（37.40±8.57 与 35.39±7.73），自我认同更积极（104.12±21.10 与 95.35±16.67）；亚组之间的差异具有统计学意义（p<0.05）。性少数群体污名、感知污名和实施污名与社会支持和韧性显著相关。性少数群体污名与性少数群体认同的关系通过社会支持显著中介（间接效应[95%CI]=-3.307[-4.782,-1.907]）。韧性也显著中介了认同的相同关联（-2.544[-4.052,-1.114]）。性少数群体污名到社会支持、韧性和认同的链式关系也具有统计学意义，间接效应为-0.404[-0.621,-0.249]。
在中国的 MSM 中，性少数群体污名通过社会支持和韧性影响性少数群体认同。鉴于污名的心理影响，必须考虑社会支持和韧性，以更好地促进 MSM 的积极自我认同和心理健康。
