Aklan State University

School of Arts and Sciences

Bachelor of Science in Nursing
Banga, Aklan

In Partial Fulfillment of the

Requirements for the Subject
Nursing Research 1
Research Title Topic: The Psychological Effect of LGBT Discrimination

Submitted by:
Bontia, Lourenz S.
BSN III

Submitted to:
Mrs. Carol Joy Palma-Remaneses, RN, MHSS

November 22, 2016

1. Oppression and Discrimination among Lesbian, Gay, Bisexual, and Transgendered People
and Communities: A Challenge for Community Psychology1

ABSTRACT
Lesbian, gay, bisexual, and transgendered (LGBT) people continue to experience various
forms of oppression and discrimination in North America and throughout the world, despite the
social, legal, and political advances that have been launched in an attempt to grant LGBT people
basic human rights. Even though LGBT people and communities have been actively engaged in
community organizing and social action efforts since the early twentieth century, research on LGBT
issues has been, for the most part, conspicuously absent within the very field of psychology that is
explicitly focused on community research and actionCommunity Psychology. The psychological and
social impact of oppression, rejection, discrimination, harassment, and violence on LGBT people is
reviewed, and recent advances in the areas of LGBT health, public policy, and research are detailed.
Recent advances within the field of Community Psychology with regard to LGBT research and action
are highlighted, and a call to action is offered to integrate the knowledge and skills within LGBT
communities with Community Psychology's models of intervention, prevention, and social change in
order to build better theory and intervention for LGBT people and communities.

2. Effects of Perceived Discrimination on Mental Health and Mental Health Services Utilization
Among Gay, Lesbian, Bisexual and Transgender Persons2

ABSTRACT

Objectives. Previous research has found that lesbian, gay, bisexual and transgender (LGBT)
individuals are at risk for a variety of mental health disorders. We examined the extent to which a
recent experience of a major discriminatory event may contribute to poor mental health among
LGBT persons.

Methods. Data were derived from a cross-sectional strata-cluster survey of adults in Hennepin
County, Minnesota, who identified as LGBT (n = 472) or heterosexual (n = 7,412).

Results. Compared to heterosexuals, LGBT individuals had poorer mental health (higher levels of
psychological distress, greater likelihood of having a diagnosis of depression or anxiety, greater
perceived mental health needs, and greater use of mental health services), more substance use
(higher levels of binge drinking, greater likelihood of being a smoker and greater number of
cigarettes smoked per day), and were more likely to report unmet mental healthcare needs. LGBT
individuals were also more likely to report having experienced a major incident of discrimination over
the past year than heterosexual individuals. Although perceived discrimination was associated with
almost all of the indicators of mental health and utilization of mental health care that we examined,
adjusting for discrimination did not significantly reduce mental health disparities between
heterosexual and LGBT persons.

Conclusion. LGBT individuals experienced more major discrimination and reported worse mental
health than heterosexuals, but discrimination did not account for this disparity. Future research
should explore additional forms of discrimination and additional stressors associated with minority
sexual orientation that may account for these disparities.

1 Harper, G. W., & Schneider, M. (2003). Oppression and Discrimination among Lesbian, Gay, Bisexual, and Transgendered People and
Communities: A Challenge for Community Psychology. Retrieved November 20, 2016, from SpringerLink:
http://link.springer.com/article/10.1023/A:1023906620085

2 Burgess, D., Lee, R., Tran, A., & Ryn, M. (2008, October 11). Effects of Perceived Discrimination on Mental Health and Mental Health Services
Utilization Among Gay, Lesbian, Bisexual and Transgender Persons. Retrieved November 20, 2016, from Taylor & Francis Online:
http://www.tandfonline.com/doi/abs/10.1080/15574090802226626
3. Experiences of Harassment, Discrimination, and Physical Violence Among Young Gay and
Bisexual Men3

ABSTRACT

Objectives. We examined the 6-month cumulative incidence of anti-gay harassment, discrimination,

and violence among young gay/bisexual men and documented their associations with mental health.

Methods. Gay/bisexual men from 3 cities in the southwestern United States completed self-
administered questionnaires.

Results. Thirty-seven percent of men reported experiencing anti-gay verbal harassment in the
previous 6 months; 11.2% reported discrimination, and 4.8% reported physical violence. Men were
more likely to report these experiences if they were younger, were more open in disclosing their
sexual orientation to others, and were HIV positive. Reports of mistreatment were associated with
lower self-esteem and increased suicidal ideation.

Conclusions. Absent policies preventing anti-gay mistreatment, empowerment and community-

building programs are needed for young gay/bisexual men to both create safe social settings and
help them cope with the psychological effects of these events.

4. Nursing's Silence on Lesbian, Gay, Bisexual, and Transgender Issues: The Need for
Emancipatory Efforts4

ABSTRACT

The purpose of this study was to selectively review the nursing literature for publications related to
lesbian, gay, bisexual, and transgender health, using (1) a key word search of CINAHL, the
database of nursing and allied health publications; (2) from the top-10 nursing journals by 5-year
impact factor from 2005 to 2009, counting articles about lesbian, gay, bisexual, and transgender
issues; and (3) content analysis of the articles found in those journals. Only 0.16% of articles
focused on lesbian, gay, bisexual, and transgender health (8 of nearly 5000 articles) and were
biased toward authors outside of the United States. We discuss the impact of this silence.

5. Discrimination and mental health among lesbian, gay, and bisexual adults in the United
States.5

ABSTRACT

Health disparities among sexual minority groups, particularly mental health disparities, are well-
documented. Numerous studies have demonstrated heightened prevalence of depressive and
anxiety disorders among lesbian, gay, and bisexual groups as compared with heterosexuals. Some
authors posit that these disparities are the result of the stress that prejudice and perceived
discrimination can cause. The current study extends previous research by examining the
associations between multiple types of discrimination, based on race or ethnicity, gender, and sexual
orientation, and past-year mental health disorders in a national sample of self-identified lesbian, gay,
and bisexual women and men (n = 577). Findings suggest that different types of discrimination may

3 Huebner, D., Rebchook, G., & Kegeles, S. (2003). Experiences of Harassment, Discrimination, and Physical Violence Among Young Gay and
Bisexual Men. Retrieved November 20, 2016, from AJPH: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.94.7.1200

4 Eliason, M. J., Dibble, S. D., & DeJoseph, J. P. (2010, September). Nursing's Silence on Lesbian, Gay, Bisexual, and Transgender Issues: The
Need for Emancipatory Efforts. Retrieved November 20, 2016, from Advances in Nursing Science:
http://journals.lww.com/advancesinnursingscience/Abstract/2010/07000/Nursing_s_Silence_on_Lesbian,_Gay,_Bisexual,_and.4.aspx

5 Bostwick, W. B., Boyd, C. J., Hughes, T. L., West, B. T., & McCabe, S. E. (2016). Discrimination and mental health among lesbian, gay, and
bisexual adults in the United States. Retrieved November 20, 2016, from APA: http://psycnet.apa.org/journals/ort/84/1/35/
be differentially associated with past-year mental health disorders. Notably, sexual orientation
discrimination was associated with higher odds of a past-year disorder only in combination with other
types of discrimination. These findings point to the complexity of the relationship between
discrimination experiences and mental health, and suggest that further work is needed to better
explicate the interplay among multiple marginalized identities, discrimination, and mental health.

6. The Potential Impact of Discrimination Fears of Older Gays, Lesbians, Bisexuals and
Transgender Individuals Living in Small- to Moderate-Sized Cities on Long-Term Health Care 6

ABSTRACT

As an exploration of the potential impact of fears of discrimination against GLBTs in long-

term health care settings, this study compared perceptions of GLBT persons and heterosexuals. A
total of 132 GLBT persons and 187 heterosexuals living in Eastern Washington completed a survey
that contained demographic questions and perceptions of discrimination in long-term care settings.
Most respondents suspected that staff and residents of care facilities discriminate against GLBTs.
GLBT respondents who believed that residents of care facilities are victims of discrimination were
more likely to believe that they would have to hide their sexual orientation if admitted to a care
facility. GLBT respondents were more likely than heterosexual respondents to believe that GLBTs do
not have equal access to health care and social services, that GLBTs residents of care facilities are
victims of discrimination, that GLBT sensitivity training programs would benefit staff and residents of
care facilities, and that GLBT retirement facilities would be a positive development for older GLBTs.
This study is offered as a preliminary investigation of concerns about GLBT discrimination in health
care settings, how concerns are expressed, and the implications of those concerns for health care
needs.

7. Association Between Socioeconomic Position Discrimination and Psychological Distress:

Findings From a Community-Based Sample of Gay and Bisexual Men in New York City7

ABSTRACT

Objectives. We examined the association between discrimination and mental health distress,
focusing specifically on the relative importance of discrimination because of particular demographic
domains (i.e., race/ethnicity, socioeconomic position [SEP]).

Methods. The research team surveyed a sample of gay and bisexual men (n = 294) at a community
event in New York City. Participants completed a survey on demographics, discrimination
experiences in the past 12 months, attributed domains of discrimination, and mental health distress.

Results. In adjusted models, discrimination was associated with higher depressive (B = 0.31; P < .01)
and anxious (B=0.29; P<.01) symptoms. A statistically significant quadratic term (discrimination-
squared; P<.01) fit both models, such that moderate levels of discrimination were most robustly
associated with poorer mental health. Discrimination because of SEP was associated with higher
discrimination scores and was predictive of higher depressive (B = 0.22; P < .01) and anxious (B =
0.50; P<.01) symptoms. No other statistically significant relationship was found between
discrimination domains and distress.

6 Jackson, N., Johnson, M., & Roberts, R. (2008). The Potential Impact of Discrimination Fears of Older Gays, Lesbians, Bisexuals and
Transgender Individuals Living in Small- to Moderate-Sized Cities on Long-Term Health Care. Retrieved November 20, 2016, from Taylor &
Francis Online: http://www.tandfonline.com/doi/abs/10.1080/00918360801982298

7 Kristi E. Gamarel, E. M. (2012). Association Between Socioeconomic Position Discrimination and Psychological Distress: Findings From a
Community-Based Sample of Gay and Bisexual Men in New York City. Retrieved November 20, 2016, from AJPH:
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.300668
Conclusions. In this sample, SEP emerged as the most important domain of discrimination in its
association with mental health distress. Future research should consider intersecting domains of
discrimination to better understand social disparities in mental health.

8. Disclosure, discrimination and desire: experiences of Black and South Asian gay men in
Britain8

ABSTRACT

Using findings from a qualitative investigation based on in-depth email interviews with 47
Black and South Asian gay men in Britain, this paper explores the cross-cutting identities and
discourses in relation to being both gay and from an ethnic minority background. Taking an
intersectional approach, detailed accounts of identity negotiation, cultural pressures, experiences of
discrimination and exclusion and the relationship between minority ethnic gay men and mainstream
White gay culture are presented and explored. The major findings common to both groups were:
cultural barriers limiting disclosure of sexuality to family and wider social networks; experiences of
discrimination by White gay men that included exclusion as well as objectification; a lack of positive
gay role models and imagery relating to men from minority ethnic backgrounds. Among South Asian
gay men, a major theme was regret at being unable to fulfil family expectations regarding marriage
and children, while among Black gay men, there was a strong belief that same-sex behaviour
subverted cultural notions related to how masculinity is configured. The paper concludes by
highlighting the importance of social location, particularly education and income, when examining the
intersection of ethnicity and sexuality in future research.

9. Perceived discrimination and well-being in gay men: the protective role of behavioural
identification9

ABSTRACT

Gay men regularly experience both individual and structural prejudice and discrimination,
which have been shown to negatively impact well-being. The current study examined the potentially
protective role of behavioural identification, a dimension of group identity, as a mediator of the
relationship between perceived discrimination and well-being among gay men. The results revealed
that behavioural identification mediated a positive indirect relationship between perceived
discrimination and self-esteem, suppressing the negative association between these two variables. A
similar pattern of results was obtained for positive affect. Implications of these results with regard to
public policies targeting gay men are addressed.

10. Transgender Women and the Sex Work Industry: Roots in Systemic, Institutional, and
Interpersonal Discrimination10

ABSTRACT

8 McKeown, E., Nelson, S., Anderson, J., Low, N., & Jonathan, E. (2010, June 07). Disclosure, discrimination and desire: experiences of Black
and South Asian gay men in Britain. Retrieved November 2010, 2016, from
http://www.tandfonline.com/doi/abs/10.1080/13691058.2010.499963

9 Doyle, D., & Molix, L. (2011). Perceived discrimination and well-being in gay men: the protective role of behavioural identification. Retrieved
November 20, 2016, from Taylor & Francis Online: http://www.tandfonline.com/doi/abs/10.1080/19419899.2011.653689

10 Nadal, K. (2013). Transgender Women and the Sex Work Industry: Roots in Systemic, Institutional, and Interpersonal Discrimination.
Retrieved November 20, 2016, from Taylor & Francis Online: http://www.tandfonline.com/doi/abs/10.1080/15299732.2014.867572
 Because transgender people face discrimination on systemic, institutional, and interpersonal
levels, the previous literature has supported that many transgender women view the sex work
industry as their only viable career option. The current article reviews the literature on discrimination
against transgender people, explores how discrimination influences their participation in sex work,
and discusses how institutional discrimination against transgender women manifests within the
criminal justice system. Furthermore, recommendations are provided for advocating for the rights of
transgender people while promoting healthy behaviors and higher quality of life. Throughout the
article, quotes from previous qualitative research are used to illustrate the experiences of
transgender women through their own voices and perspectives.