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The relationship between minority stress and biological outcomes: A systematic review.

Authors
  • Flentje, Annesa1, 2
  • Heck, Nicholas C3
  • Brennan, James Michael4
  • Meyer, Ilan H5
  • 1 Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, CA, USA. [email protected]
  • 2 Alliance Health Project, Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, USA. [email protected]
  • 3 Putnam County Hospital, Greencastle, IN, USA.
  • 4 Department of Psychology, The University of Montana, Missoula, MT, USA.
  • 5 The Williams Institute, School of Law, University of California, Los Angeles, Los Angeles, CA, USA.
Type
Published Article
Journal
Journal of behavioral medicine
Publication Date
Oct 01, 2020
Volume
43
Issue
5
Pages
673–694
Identifiers
DOI: 10.1007/s10865-019-00120-6
PMID: 31863268
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Sexual minority (non-heterosexual) individuals experience higher rates of physical health problems. Minority stress has been the primary explanatory model to account for this disparity. The purpose of this study was to identify in published research empirically established relationships between minority stress processes and biological outcomes and identify avenues for future research. The PubMed database was queried with search terms relevant to minority stress and a comprehensive list of physical and biological outcomes. To be included in the analysis, studies had to examine the relationship between minority stress and a biological outcome among sexual minority individuals. Those meeting inclusion criteria were coded for key variables including methodology used, positive and null results, participant characteristics, and specific minority stress processes and biological outcomes considered. In total, 26 studies met inclusion criteria. Studies tested relationships between specific minority stress processes including prejudice, expectations of prejudice, concealment of sexual orientation, and internalized stigma and multiple biological outcomes, such as overall physical health, immune response, HIV specific outcomes, cardiovascular outcomes, metabolic outcomes, cancer related outcomes, and hormonal outcomes. Studies included both analyses that detected this relationship (42% of analyses) and analyses that did not detect this relationship (58%). There is substantial evidence to support the relationship between minority stress and biological outcomes, yet additional research is needed to identify the measurements and outcomes that have the most rigorous and replicable results.

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