Song Haoming
Department of Sociology, Case Western Reserve University, USA.
Soc Sci Med. 2025 May;373:117985. doi: 10.1016/j.socscimed.2025.117985. Epub 2025 Mar 19.
Emerging studies link the mental health of lesbian, gay, and bisexual (LGB) adults to structural stigma, focusing on state policies. Limited work considered cultural norms and the time changing nature of culture and policy. In this study, we draw from the structural stigma theory and hypothesize that both policy protection and cultural acceptance will independently promote LGB mental health and explore their interactive roles. Composing a novel state-year longitudinal dataset on policy and culture related to sexual minority people, we link it to a sample of cisgender LGB adults from the large-scale, representative Behavioral Risk Factor Surveillance System (2016-2023). Our multilevel regression models predicted depressive diagnosis and frequent mental distress from varied stigma measures, controlling for state-level and individual-level factors. The results revealed that LGB adults especially bisexual women faced elevated mental health challenges. Models generally showed structural stigma measures in the policy and culture domains were not independent, significant predictors of LGB mental health. Moreover, there was generally no significant and sizable interactions between policy and culture. One exception came from lesbian women, where policy protection was negatively associated with worse mental health, reducing frequent mental distress by around 6 percentage points across policy score ranges. We conclude by discussing the varied findings and encouraging future studies to incorporate the time-changing nature of policy and culture when linking structural stigma to LGB mental health.
新兴研究将女同性恋、男同性恋和双性恋（LGB）成年人的心理健康与结构性污名联系起来，重点关注国家政策。仅有有限的研究考虑了文化规范以及文化和政策随时间变化的性质。在本研究中，我们借鉴结构性污名理论，并假设政策保护和文化接纳都会独立促进LGB群体的心理健康，并探讨它们的交互作用。我们编制了一个关于性少数群体相关政策和文化的新颖的州年度纵向数据集，并将其与来自大规模、具有代表性的行为风险因素监测系统（2016 - 2023年）的顺性别LGB成年人样本相链接。我们的多层次回归模型从各种污名测量指标预测抑郁诊断和频繁的心理困扰，并控制州级和个体层面的因素。结果显示，LGB成年人，尤其是双性恋女性面临着更高的心理健康挑战。模型总体表明，政策和文化领域的结构性污名测量指标并非LGB群体心理健康的独立显著预测因素。此外，政策和文化之间通常没有显著且可观的交互作用。一个例外是女同性恋女性，政策保护与更差的心理健康呈负相关，在政策得分范围内，频繁的心理困扰减少了约6个百分点。我们通过讨论各种研究结果来得出结论，并鼓励未来的研究在将结构性污名与LGB群体心理健康联系起来时，纳入政策和文化随时间变化的性质。
