Relationship Between Discrimination and Mental Health Among Sexual Minority Individuals: The Roles of Loneliness, Social Support, and Weight Discrimination

Abstract

Sexual minority adults experience elevated rates of depression and anxiety, in part due to exposure to minority stressors such as discrimination. Loneliness may be one mechanism through which discrimination contributes to poor mental health, while perceived social support may buffer these associations. In addition, weight discrimination may represent an important but understudied form of stigma that can compound the psychological burden of perceived discrimination. Guided by Minority Stress Theory, this thesis examined whether loneliness mediated the associations between perceived discrimination and depressive and anxiety symptoms, and whether perceived social support and weight discrimination moderated these relationships. Data were drawn from 8,493 sexual minority adults in the National Institutes of Health’s All of Us Research Program. Structural equation modeling was used to test separate moderated mediation models for depressive symptoms and anxiety symptoms. Greater perceived discrimination was associated with greater loneliness, which in turn was associated with higher depressive and anxiety symptoms. Perceived social support buffered both the association between loneliness and mental health symptoms and the direct association between perceived discrimination and mental health symptoms. Weight discrimination strengthened the direct association between perceived discrimination and both depressive and anxiety symptoms. These findings support loneliness as an important pathway linking perceived discrimination to mental health among sexual minority adults. Results also suggest that social support may reduce, while weight discrimination may intensify, the mental health impact of discrimination. This thesis contributes to the minority stress literature by highlighting the importance of loneliness, social support, and intersecting forms of stigma in understanding depression and anxiety among sexual minority adults.