(PS9-75) Unpacking Mental Health Stigmas at the Intersection of Sex and Sexual Orientation

Stigma, or negative social attitudes, toward people with mental illness is pervasive and serves as a barrier to seeking and utilizing treatment. Recent studies have begun to examine the stigma experienced by different groups, such as sexual minorities (SM), as well as the impact of stigma on mental health outcomes (e.g., susceptibility to social anxiety among SM; Pachankis et al., 2023). However, there remains a gap in our understanding of whether stigma towards people with mental illness is more pronounced in certain demographic groups. For example, preliminary data find that stigma toward mental illness is more prevalent in males than females (McKenzie et al., 2022). Moreover, while there is substantial research on stigma towards mental illness generally, less is known about disorder-specific stigmas (e.g., stigma toward people with generalized and social anxiety disorders) and how these stigmas differ by group (e.g., sex, sexual orientation). Given that stigma can exacerbate and maintain anxiety symptoms (Ahad et al. 2023), it is important to delineate demographic differences in stigma. The present study thus examines differences in general mental illness stigma, generalized anxiety stigma, and social anxiety stigma by sex, sexual orientation, and their intersection. 

Data were drawn from three studies (Ns = 221, 382, 939). Undergraduates (Study 1) and community adults (Studies 2 & 3) completed self-report measures of mental illness stigma, generalized anxiety stigma, and social anxiety stigma. In Study 1, stigma varied by sex and sexual orientation with males reporting significantly higher mental health stigmas (i.e., mental illness stigma, generalized anxiety stigma, and social anxiety stigma) than females, and SM reporting higher mental health stigmas than heterosexual participants. In Studies 2 and 3, stigma did not vary by sexual orientation; however, stigma did vary by sex with males reporting higher mental health stigmas than females. In Studies 1 and 2, we also observed that sexual minority males reported higher generalized anxiety stigma and social anxiety stigma than heterosexual males (ps < 0.01). 

Considering how SM, males, and SM males endorsed relatively higher stigmas, our results suggest that sex and sexual orientation may uniquely contribute to stigmatized beliefs. In general, people may be more or less susceptible to elevated mental health stigmas depending on the demographic groups they belong to and how those groups are socialized to mental health. We suspect that emotional expression norms (e.g., masculine norms of emotional stoicism) in tandem with experiences of sexual identity-related discrimination (e.g., social rejection; Ahad et al. 2023), contribute to higher mental health stigmas among SM males. For one, after experiencing discrimination, stoicism norms may reinforce stigma by preventing SM males from challenging, or seeking support for, their avoidant or anxious thoughts. To clarify the mechanisms underlying sex- and sexuality-based disparities in stigma, future research can evaluate sex/gender norms and sexual identity processes alongside mental health stigmas, including how stigmas are challenged or reinforced among different groups.