Starks Tyrel J, Hillesheim Joseph, Stephenson Rob, Robles Gabriel
Department of Psychology, Hunter College of the City University of New York, New York, NY, USA.
Doctoral Program in Health Psychology and Clinical Science, Graduate Center of the City University of New York, New York, NY, USA.
Psychol Sex Orientat Gend Divers. 2025 Mar;12(1):72-85. doi: 10.1037/sgd0000648. Epub 2023 May 29.
Mental health disparities are well documented among sexual minority men (SMM) and generally attributed to sexuality-based minority stress. Separate research has established that being in a main or primary partner relationship - particularly one of high quality - is associated with better mental health. The current study tested an integrated model predicting mental health from relationship status and quality, and evaluated the potential for these to indirectly link state-level policy with mental health. Adult cisgender SMM (=7705) completed an online survey, which included the Patient Health Questionnaire-4 and subscales of the Perceived Relationships Quality Components questionnaire. State-level policy was evaluated using State Equality Index (SEI) ratings from the Human Rights Campaign. The likelihood of being in a relationship was significantly greater for participants living in states with policies supportive of LGBTQ+ people. Partnered men with average levels of relationship quality or better reported significantly better mental health compared to single men. Single SMM did not differ significantly from partnered SMM with relationship quality one standard deviation below the mean and their mental health was significantly better than partnered men whose relationship functioning was two standard deviations below the mean. State-level policy was significantly associated with mental health through an indirect pathway involving relationship status. Results highlight the relevance of both relationship status and functioning to mental health among SMM. They also point to the need for ongoing advocacy to address structural inequality and to develop interventions that address the impact of stigma on close personal relationships in this population.
性少数男性（SMM）中的心理健康差异已有充分记录，一般归因于基于性取向的少数群体压力。另外的研究表明，处于主要伴侣关系中——尤其是高质量的伴侣关系——与更好的心理健康相关。当前的研究测试了一个从关系状态和质量预测心理健康的综合模型，并评估了这些因素间接将州级政策与心理健康联系起来的可能性。成年顺性别SMM（=7705）完成了一项在线调查，其中包括患者健康问卷-4和感知关系质量成分问卷的子量表。使用人权运动组织的州平等指数（SEI）评级来评估州级政策。生活在支持LGBTQ+人群政策的州的参与者处于恋爱关系中的可能性显著更高。与单身男性相比，关系质量处于平均水平或更好的有伴侣男性报告的心理健康状况明显更好。单身SMM与关系质量低于平均水平一个标准差的有伴侣SMM没有显著差异，且他们的心理健康状况明显优于关系功能低于平均水平两个标准差的有伴侣男性。州级政策通过涉及关系状态的间接途径与心理健康显著相关。结果突出了关系状态和功能对SMM心理健康的相关性。它们还指出需要持续进行宣传，以解决结构性不平等问题，并制定干预措施，以应对污名化对该人群亲密个人关系的影响。
