Sexual stigma as a psychosocial mediator between racialized status and mental health in sexual minority men.

PURPOSE: Sexual stigma remains a critical public health concern for gay, bisexual, and other sexual minority men (GBSMM), yet its role in shaping mental health disparities across racialized groups is not well understood. This study examined whether internalized, enacted, and perceived sexual stigmas mediate the relationship between racialized status and mental health outcomes.

METHODS

Data were drawn from the Generations study, a nationally representative longitudinal study of sexual minorities in the United States. The analytic sample included GBSMM assessed across three waves. Participants were categorized by racialized status as White, Black, Hispanic/Latino, or Multiracial. Longitudinal structural equation modeling tested direct and indirect effects of racialized status on psychological distress and loneliness through sexual stigma experiences.

RESULTS

At baseline, Black GBSMM reported significantly higher levels of internalized and enacted stigma than White GBSMM. Sexual stigma significantly mediated the relationship between racialized status and mental health outcomes over time. Among Black GBSMM, total indirect effects on psychological distress were β = 0.165 at Wave 2 and β = 0.114 at Wave 3, with enacted stigma as the strongest pathway (β = 0.111 and β = 0.075, respectively). Similar patterns were found for loneliness (β = 0.136 at Wave 2; β = 0.126 at Wave 3). Hispanic/Latino and Multiracial GBSMM also showed significant indirect effects, primarily through enacted stigma, with some variation by wave.

CONCLUSION

Sexual stigma is a critical mechanism linking racialized status to mental health in GBSMM. Interventions should target both exposure to stigma and internalization to reduce inequities.