Department of Psychology, San Diego State University, San Diego, CA, United States.
Soc Sci Med. 2024 Dec;363:117484. doi: 10.1016/j.socscimed.2024.117484. Epub 2024 Nov 8.
Research in public health and psychology has identified sexual minority stigma-related risk factors that contribute to sexual orientation-based health disparities across settings and societies worldwide. Existing scholarship, however, has predominantly focused on these factors as independent, stand-alone risk factors, neglecting their interconnected nature across different levels. This article theoretically explores how sexual minority stigma may function as a multilevel socioecological system, by building on prevailing theories and emphasizing the interplay between structural, interpersonal, and intrapersonal stigma-related factors. Drawing on the minority stress and socioecological theories, three central tenets are proposed, namely 1) chronosystem with immediate, accumulating, or lasting effects across spatiotemporal contexts, 2) nested multilevel system with cross-level effects, and 3) mechanistic pathways linking stigma exposure to health. By providing a nuanced and comprehensive understanding of how sexual minority stigma may operate as a multilevel socioecological system, this article reflects on the novel implications of this interpretation for future research and aims to guide future conceptualizations and studies, acknowledging the complexity of sexual minority stigma exposure across historical contexts, societies, and the individual life course in shaping physical and mental health of sexual minorities. Limitations of current research and recommendations for future research are being discussed.
公共卫生和心理学研究已经确定了与性少数群体耻辱感相关的风险因素，这些因素导致了全球不同环境和社会中的性取向健康差距。然而，现有学术研究主要侧重于这些因素作为独立的、孤立的风险因素，而忽略了它们在不同层次上的相互联系。本文通过借鉴现有理论并强调与性少数群体耻辱感相关的结构性、人际间和个体内因素之间的相互作用，从理论上探讨了性少数群体耻辱感如何作为一个多层次的社会生态系统发挥作用。基于少数群体应激和社会生态学理论，提出了三个核心原则，即 1）具有即时、累积或持久影响的时间系统，跨越时空背景；2）具有跨层次影响的嵌套多层次系统；3）将耻辱感暴露与健康联系起来的机制途径。通过提供对性少数群体耻辱感如何作为一个多层次社会生态系统运作的细致和全面的理解，本文反映了这种解释对未来研究的新意义，并旨在指导未来的概念化和研究，承认性少数群体耻辱感暴露在塑造性少数群体身心健康方面在历史背景、社会和个体生命历程中的复杂性。讨论了当前研究的局限性和对未来研究的建议。
