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Try out PMC Labs and tell us what you think. Learn More. Gay and bisexual men might face unique, status-based competitive pressures given that their social and sexual relationships often occur with other men, who are known to compete for social and sexual gain.

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In a multistage study, we tested intra-minority gay community stress theory — that status-focused elements of the gay community challenge the mental health of gay and bisexual men. To examine the impact of individual differences in status concerns i.

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Sexual orientation disparities in mental health represent one of the most consistent findings in psychiatric epidemiology. Gay and bisexual men, in particular, are at increased risk of major depressive disorder, generalized anxiety disorder, and panic disorder as compared to heterosexual men e.

Numerous studies using diverse methodologies support the association between exposure to these minority stressors and adverse mental health outcomes among gay and bisexual men e.

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This theory draws on the tenets of three others to suggest that gay and bisexual men in particular face a unique confluence of stressors apart from heterosexist stigma and distinct from those facing women and heterosexual men. Intrasex competition theory, an evolutionary theory of mate selection, suggests that because sexual benefits accrue to high-status men, competition among men is common and low-status men are at particular risk of stress, exclusion, and associated mental health symptoms.

Substantial empirical evidence supports these tenets as applied to heterosexuals e.

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Sexual field theory Green, complements intrasex competition theory to suggest one way in which gay and bisexual men might be particularly stressed by these competitive, status-focused hierarchies. Namely, by virtue of sharing the same gender as their desired partners, gay and bisexual men can size themselves up using the same standards of social and sexual capital that they use to size up their potential partners.

The theory of precarious manhood Vandello et al. Qualitative research finds that gay and bisexual men who are masculine, attractive, and wealthy possess the most sexual and social capital and therefore the most protection from status-based stress Green, Finally, sexual, and maybe social, capital is distributed unequally in the gay community.

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We also examine differences in intra-minority gay community stress by race and ethnicity, sexual orientation identity, HIV status, socioeconomic status, relationship status, urbanicity of current residence, and age Study 1. To experimentally test our theory, we further hypothesize that gay and bisexual men who possess lower social and sexual status, measured in terms of attractiveness, masculinity, and wealth, will experience more social stress upon being experimentally rejected by other gay men, but not when being rejected by heterosexual men Study 2.

We expect that the stressful effects of intra-minority rejection will be particularly strong when this rejection comes from higher-status gay men Study 3.

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We also expect that gay and bisexual men of relatively lower perceived status will suffer the most stress and felt exclusion when rejected by other gay and bisexual men based on that status Study 4. Overall, this set of studies investigates the phenomenon of intra-minority gay community stress and its source in status-based rejection concerns.

We first used multiple methods and multiple samples to develop a measure of intra-minority stress as perceived by a diverse group of gay and bisexual men. We then administered this scale to a large and geographically diverse sample of gay and bisexual men to assess relationships between intra-minority stress and mental health and the role of intra-minority stress in mediating the association between individual differences in gay community status and mental health.


We delineated the properties of intraminority gay community stress from in-depth qualitative interviews with 49 gay and bisexual men. Twenty of these men were recruited and interviewed in New York City in ; 29 were recruited and interviewed in New Haven and Hartford, Connecticut in Participants were recruited through advertisements posted to social and sexual networking websites and mobile applications e.

The focus of the first set of interviews was on perceived associations among stress, health, and coping thus these interviewees were also selected for reporting ificant symptoms of depression or anxiety and being behaviorally at risk of HIV infection Pachankis, The focus of the second set of interviews was broadly on stress, health, and perceptions of community in New Haven and Hartford without the specific health-related inclusion criteria.

Notably, the a priori purpose of these interviews was not to gather experiences of intra-minority stress. In fact, the idea for present study emerged from the repeated and unprompted mention of gay community stress across both samples of interviewees. The concept of intra-minority gay community stress was further developed through iterative and inductive coding.

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First, four trained research assistants independently reviewed transcripts and coded the data for indications of gay community stress, defined as experiencing stress or related emotions e. In order to identify the various properties of this broad concept, two trained research assistants then independently coded the resulting text for specific themes that described specific gay community stressors. The resulting comprehensive list of themes i.

These themes were then translated into 27 scale items by a team of seven graduate students, postdoctoral fellows, and psychologists. To ensure adequate representation of gay and bisexual men across geographic locales, we recruited men in three waves.

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We first recruited men from the four largest U. We then recruited men from 20 randomly selected small urban areas, defined as the cities with a population of more thanexcluding the ten most populous cities in the U. S US Census, Finally, we recruited men from 20 randomly selected rural counties, defined as U.

Table 1 indicates the distribution of participants by population density. Overall, 1, individuals completed an eligibility screen. Of these, 1, met the eligibility criteria including: being over age 18, currently living in the U. Our final analytic sample consisted of respondents.

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As indicated in Table 1we recruited a relatively diverse sample. The mean age was approximately One-quarter of the sample identified as Hispanic and about one-quarter identified as bisexual. Retained participants were more likely to be younger, Hispanic, have a college education, identify as gay, and be single.

In the second column, please indicate how stressed you feel by that potential aspect of the mainstream gay community.

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We understand that the gay community can mean different things to different people. Please answer the following questions in regard to your perception of the mainstream gay community.

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To further confirm our qualitative findings and for descriptive purposes, participants indicated the extent to which they believed that the item was true i. For all primary analyses, participants also indicated the extent to which they perceived the item to be stressful i.

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Of these participants, 26 After confirming the normal distribution of each perceived stress item, we performed a principal components extraction on the 29 items to estimate the factorability of the matrix of GCSS items and of factors. The Kaiser-Meyer-Olkin index of. We then performed a factor analysis using maximum likelihood estimation and oblique rotation on the 29 items.

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Again, we identified four factors with eigenvalues greater than 1. These four factors ed for We removed nine items that were weakly correlated with any given factor i.

No remaining items loaded onto more than one factor i. The perceived community competitiveness factor consisted of items describing fighting, gossip, materialism, and judgment within the gay community.

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The perceived community exclusion factor included items describing racism, sexual racism, and exclusion of HIV-positive gay and bisexual men. Factor loadings of the resulting 20 items are shown in Table 2.

To confirm the structural stability of this four-factor structure, we then performed two confirmatory factor analyses CFAusing maximum likelihood estimation, on the resulting 20 items using AMOS 23 Arbuckle, In order to conduct these CFAs, we administered the scale to two samples.

Sweden contains among the highest gender and income equality in the world United Nations Development Programme, and very few structural forms of disadvantage for sexual minorities International Lesbian, Gay, Bisexual, Trans and Intersex Association - European Region, The four factors were allowed to correlate given evidence for ificant associations among the subscales in the EFA. The two CFAs confirmed the structural stability of the scale in these new samples.

In order to confirm the temporal stability of our scale, we re-contacted participants from the primary study one year after their initial participation to complete the gay community stress measure again. We asked participants to indicate the state, city, and ZIP code of their current residence, which we then linked to Census estimates of the population size of these locales. We administered measures of the stress constructs delineated in minority stress theory, including both distal, societally based stressors i.

research finds that this scale predicts mental health symptoms among sexual minorities e.

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research demonstrates associations between this scale and depression, anxiety, and relationship problems e. research demonstrates associations between this scale and mental health outcomes across diverse samples of gay and bisexual men e. Research among diverse gay and bisexual male populations demonstrates consistent associations between this scale and several measures of minority stress and wellbeing among gay and bisexual men e.

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Participants responded to three items capturing individual differences in social and sexual status, selected based upon their prominence during our qualitative interviews and other qualitative studies of gay community interactions Green, The measure consisted of an item assessing masculinity i. Because these items loaded onto a single factor loadings ranged.

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No participants in the final analytic sample were missing demographic or mental health outcome data. Missing values for the minority stress predictors ranged from 3. Similarly, although no participants were missing values on the original 27 items of the Gay Community Stress Scale, we imputed values for the two items not completed by the first participants from the other 27 items and demographic measures using PROC MI.

All measures were normally distributed.

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After establishing internal reliability, scale structure, and factor stability as described above, we tested our first hypothesis that intra-minority stress, now operationalized in terms of the scales four factors i. We used linear regression to examine the association between the GCSS and mental health symptoms, controlling for demographic covariates, all distal and proximal minority stress measures, and general life stress.

We then examined our second hypothesis, that intra-minority stress, operationalized as the four factors of the GCSS, would mediate the association between individual differences in status and mental health.

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To do so, we first used linear regression to estimate the association between status and GCSS and then GCSS and mental health symptoms after controlling for demographic covariates associated with mental health symptoms. We first examined the overall endorsement of the 20 scale items in our sample.

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Using the agreement stem, participants indicated a relatively high degree of agreement with each of the items, with the mean agreement across items being 3. Using the stress stem, participants indicated experiencing a relatively moderate degree of stress from the gay community. ZIP: 48509 48529 48519

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