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The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding
Stigma, Discrimination, and Victimization
Lesbians, gay men, and bisexual people are often the targets of stigma and discrimination because of their sexual orientation. In a 2005 national survey with a probability sample of self-identified lesbian, gay, and bisexual adults (n = 662), approximately 16 percent of lesbians and 18 percent of gay men reported they had experienced discrimination in employment or housing because of their sexual orientation (Herek, 2009a). Other studies with nonprobability samples also have shown that lesbian, gay, and bisexual adults are at risk for victimization because of their sexual orientation (Herek et al., 1999; Huebner et al., 2004; Otis and Skinner, 1996). Some evidence suggests that lesbians, gay men, and bisexual people have both lifetime and day-to-day experiences with bias and discrimination more frequently than heterosexual people. An analysis of data from the MIDUS survey, mentioned earlier in the chapter, found that self-identified homosexual and bisexual adults reported both lifetime and day-to-day experiences with discrimination more frequently than heterosexuals, and 42 percent attributed the discrimination partially or entirely to their sexual orientation (Mays and Cochran, 2001).
Not surprisingly, experiences with discrimination and victimization have negative effects on psychological well-being. In the MIDUS study, perceived discrimination was positively associated with indicators of psychiatric morbidity as well as harmful effects on quality of life (Mays and Cochran, 2001). Swim and colleagues (2009) found that everyday experiences with relatively minor incidents of prejudice based on sexual orientation were associated with elevations in negative mood (Swim et al., 2009). Szymanski (2005) examined the effects of external and internalized heterosexism and sexism on mental health in a study of 143 women who self-identified as lesbian (92 percent), bisexual (6 percent), and unsure (2 percent) and found that all three variables were related to psychological distress in the lesbians. Similarly, based on an Internet survey (n = 210), gay and bisexual men’s experiences of sexual stigma—including harassment, rejection, and discrimination—appear to be associated with psychological distress (Szymanski, 2009).
While little research has examined the additive effects of various forms of social discrimination—including antigay violence, discrimination, and harassment—one study found higher levels of psychological distress in gay and bisexual Latino men. Such experiences were also associated with social isolation and low self-esteem (Diaz et al., 2001).
Because of the unique discrimination faced by bisexual men and women from both heterosexual and homosexual people, some studies using small samples have examined bisexual people’s perception of their own identity. Results of a study comparing bisexual and lesbian/gay adults (n = 613)