Glick Jennifer L, Nguyen Megan G, Huang Aimee K, Alexander Kamila A, German Danielle
Community Health Science & Policy (CHSP), School of Public Health, Louisiana State University Health Sciences Center (LSUHSC), New Orleans, Louisiana, United States of America.
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
PLoS One. 2025 May 22;20(5):e0323869. doi: 10.1371/journal.pone.0323869. eCollection 2025.
Sexual minority women (SMW; women who self-identify as lesbian, queer, etc., as well as heterosexually-identified women who experience attraction to romantic or sexual partnerships with women) and vulnerabilized women (those marginalized due to structural forces such as housing insecurity, violence, sex exchange, drug use, or HIV positive status) experience a range of mental health challenges compared to their heterosexual and general population counterparts. General populations studies show a positive relationship between social support and mental health; less is known about SMW experiencing intersecting multi-layered vulnerabilities. This study characterizes mental health stressors, identifies social support sources and forms, and explores the relationship between social support and mental health among vulnerabilized SMW in Baltimore, MD.
We conducted virtual, in-depth semi-structured interviews with vulnerabilized cisgender SMW (n = 25) between June and October 2021. We utilized an inductive analytical approach to identify central themes and develop a categorization structure. Results are presented using narrative synthesis and illustrative quotes. To understand different forms of mental health-related social support provided across sources, data was sorted into a matrix and analyzed.
Vulnerabilized SMW commonly self-reported depression and anxiety. Participants identified three primary mental health stressors: 1) managing identity-related stigma; 2) relationships, loss, and isolation; and 3) financial struggles. The most important type of social support for mental health was non-judgement related to sexual orientation and/or mental health struggles. Family, friends, and partners were providing similar amounts of support, primarily emotional support.
Vulnerabilized SMW have unique mental health and social support-related experiences and needs, potentially attributed to experiences with multiple marginalization, compounded by struggles with intersecting structural vulnerabilities. More research is warranted to explore different sources and forms of social support as predictors of mental health. Findings indicate need for public health interventions that address sexual orientation and mental health stigma.
性少数群体女性（SMW；自我认同为女同性恋、酷儿等的女性，以及对与女性建立浪漫或性伴侣关系有吸引力的异性恋认同女性）和弱势女性（因住房不安全、暴力、性交易、吸毒或艾滋病毒阳性等结构性力量而被边缘化的女性）与她们的异性恋和普通人群相比，面临一系列心理健康挑战。普通人群研究表明社会支持与心理健康之间存在积极关系；对于经历多重交叉脆弱性的性少数群体女性了解较少。本研究描述了心理健康压力源，确定了社会支持来源和形式，并探讨了马里兰州巴尔的摩市弱势性少数群体女性中社会支持与心理健康之间的关系。
2021年6月至10月期间，我们对弱势顺性别性少数群体女性（n = 25）进行了虚拟的、深入的半结构化访谈。我们采用归纳分析方法来确定核心主题并建立分类结构。结果通过叙述性综合和说明性引语呈现。为了了解不同来源提供的与心理健康相关的社会支持的不同形式，数据被整理成一个矩阵并进行分析。
弱势性少数群体女性普遍自我报告有抑郁和焦虑。参与者确定了三个主要的心理健康压力源：1）应对与身份相关的耻辱感；2）人际关系、失去和孤独；3）经济困难。对心理健康最重要的社会支持类型是与性取向和/或心理健康困难相关的无评判态度。家人、朋友和伴侣提供的支持量相似，主要是情感支持。
弱势性少数群体女性有独特的心理健康和与社会支持相关的经历及需求，这可能归因于多重边缘化的经历，并因与交叉结构性脆弱性的斗争而加剧。有必要进行更多研究，以探索作为心理健康预测因素的不同社会支持来源和形式。研究结果表明需要开展解决性取向和心理健康耻辱感问题的公共卫生干预措施。
