Abstract
Some past work indicates that sexual minorities may experience impairments in social health, or the perceived and actual availability and quality of one’s social relationships, relative to heterosexuals; however, research has been limited in many ways. Furthermore, it is important to investigate etiological factors that may be associated with these disparities, such as self-reported discrimination. The current work tested whether sexual minority adults in the United States reported less positive social health (i.e., loneliness, friendship strain, familial strain, and social capital) relative to heterosexuals and whether self-reported discrimination accounted for these disparities. Participants for the current study (N = 579) were recruited via Amazon’s Mechanical Turk, including 365 self-identified heterosexuals (105 women) and 214 sexual minorities (103 women). Consistent with hypotheses, sexual minorities reported impaired social health relative to heterosexuals, with divergent patterns emerging by sexual orientation subgroup (which were generally consistent across sexes). Additionally, self-reported discrimination accounted for disparities across three of four indicators of social health. These findings suggest that sexual minorities may face obstacles related to prejudice and discrimination that impair the functioning of their relationships and overall social health. Moreover, because social health is closely related to psychological and physical health, remediating disparities in social relationships may be necessary to address other health disparities based upon sexual orientation. Expanding upon these results, implications for efforts to build resilience among sexual minorities are discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Adler, N. E., & Rehkopf, D. H. (2008). US disparities in health: Descriptions, causes, and mechanisms. Annual Review of Public Health, 29, 235–252. doi:10.1146/annurev.publhealth.29.020907.090852.
Andersson, G., Noack, T., Seierstad, A., & Weedon-Fekjær, H. (2006). The demographics of same-sex marriages in Norway and Sweden. Demography, 43, 79–98. doi:10.1353/dem.2006.0001.
Baumeister, R. F., & Leary, M. R. (1995). The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin, 117, 497–529. doi:10.1037/0033-2909.117.3.497.
Berkman, L. F. (1995). The role of social relations in health promotion. Psychosomatic Medicine, 57, 245–254.
Berkman, L. F., Glass, T., Brissette, I., & Seeman, T. E. (2000). From social integration to health: Durkheim in the new millennium. Social Science and Medicine, 51, 843–857. doi:10.1016/S0277-9536(00)00065-4.
Berkman, L. F., & Syme, S. L. (1979). Social networks, host resistance, and mortality: A nine-year follow-up study of Alameda County residents. American Journal of Epidemiology, 109, 186–204.
Berscheid, E. (1999). The greening of relationship science. American Psychologist, 54, 260–266. doi:10.1037/0003-066X.54.4.260.
Bos, H. M., Sandfort, T. G., de Bruyn, E. H., & Hakvoort, E. M. (2008). Same-sex attraction, social relationships, psychosocial functioning, and school performance in early adolescence. Developmental Psychology, 44, 59–68. doi:10.1037/0012-1649.44.1.59.
Bourdieu, P. (1986). The forms of capital. In J. Richardson (Ed.), Handbook of theory and research for the sociology of education (pp. 241–258). New York: Greenwood Press.
Bowlby, J. (1969). Attachment and loss. New York: Basic Books.
Brewer, M. B., & Caporael, L. R. (1990). Selfish genes versus selfish people: Sociobiology as origin myth. Motivation and Emotion, 14, 237–243. doi:10.1007/BF00996182.
Brooks, K. P., & Dunkel Schetter, C. (2011). Social negativity and health: Conceptual and measurement issues. Social and Personality Psychology Compass, 5, 904–918. doi:10.1111/j.1751-9004.2011.00395.x.
Buhrmester, M., Kwang, T., & Gosling, S. D. (2011). Amazon’s Mechanical Turk: A new source of inexpensive, yet high-quality, data? Perspectives on Psychological Science, 6, 3–5. doi:10.1177/1745691610393980.
Buss, D. M., & Kenrick, D. T. (1998). Evolutionary social psychology. In D. T. Gilbert, S. T. Fiske, & G. Lindzey (Eds.), The handbook of social psychology (pp. 982–1026). New York: McGraw-Hill.
Cacioppo, J. T., Hawkley, L. C., & Thisted, R. A. (2010). Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychology and Aging, 25, 453–463. doi:10.1037/a0017216
Clark, R., Anderson, N. B., Clark, V. R., & Williams, D. R. (1999). Racism as a stressor for African Americans: A biopsychosocial model. American Psychologist, 54, 805–816. doi:10.1037/0003-066X.54.10.805.
Cochran, S. D., & Mays, V. M. (2009). Burden of psychiatric morbidity among lesbian, gay, and bisexual individuals in the California Quality of Life Survey. Journal of Abnormal Psychology, 118, 647–658. doi:10.1037/a0016501.
Dar-Nimrod, I., & Heine, S. J. (2011). Genetic essentialism: On the deceptive determinism of DNA. Psychological Bulletin, 137, 800–818. doi:10.1037/a0021860.
Diamond, L., & Lucas, S. (2004). Sexual-minority and heterosexual youths’ peer relationships: Experiences, expectations, and implications for well-being. Journal of Research on Adolescence, 14, 313–340. doi:10.1111/j.1532-7795.2004.00077.x.
Dibble, S. L., Roberts, S. A., & Nussey, B. (2004). Comparing breast cancer risk between lesbians and their heterosexual sisters. Women’s Health Issues, 14, 60–68. doi:10.1016/j.whi.2004.03.004.
Dodge, B., & Sandfort, T. G. (2007). A review of mental health research on bisexual individuals when compared to homosexual and heterosexual individuals. In B. Firestein (Ed.), Becoming visible: Counseling bisexuals across the lifespan (pp. 28–51). New York: Columbia University Press.
Donald, C. A., Ware, J. E., Brook, R. H., & Davies-Avery, A. (1978). Conceptualization and measurement of health for adults in the health insurance study: Vol. IV, Social health. Santa Monica, CA: Rand Corporation.
Doyle, D. M., & Molix, L. (2014a). How does stigma spoil relationships? Evidence that perceived discrimination harms romantic relationship quality through impaired self-image. Journal of Applied Social Psychology, 44, 600–610. doi:10.1111/jasp.12252.
Doyle, D. M., & Molix, L. (2014b). Love on the margins: The effects of social stigma and relationship length on romantic relationship quality. Social Psychological and Personality Science, 5, 102–110. doi:10.1177/1948550613486677.
Doyle, D. M., & Molix, L. (2014c). Perceived discrimination as a stressor for close relationships: Identifying psychological and physiological pathways. Journal of Behavioral Medicine, 37, 1134–1144. doi:10.1007/s10865-014-9563-8.
Doyle, D. M., & Molix, L. (2015). Social stigma and sexual minorities’ romantic relationship functioning: A meta-analytic review. Personality and Social Psychology Bulletin, 41, 1363–1381. doi:10.1177/0146167215594592.
Durkheim, E. (1951). Suicide: A study in sociology. Glencoe, IL: Free Press.
Dush, C. M. K., & Amato, P. R. (2005). Consequences of relationship status and quality for subjective well-being. Journal of Social and Personal Relationships, 22, 607–627. doi:10.1177/0265407505056438.
Fokkema, T., & Kuyper, L. (2009). The relation between social embeddedness and loneliness among older lesbian, gay, and bisexual adults in the Netherlands. Archives of Sexual Behavior, 38, 264–275. doi:10.1007/s10508-007-9252-6.
Fujiwara, T., & Kawachi, I. (2008). A prospective study of individual-level social capital and major depression in the United States. Journal of Epidemiology and Community Health, 62, 627–633. doi:10.1136/jech.2007.064261.
Fujiwara, T., Kubzansky, L. D., Matsumoto, K., & Kawachi, I. (2012). The association between oxytocin and social capital. PLoS ONE, 7, e52018. doi:10.1371/journal.pone.0052018.
Goodman, J. K., Cryder, C. E., & Cheema, A. (2013). Data collection in a flat world: The strengths and weaknesses of Mechanical Turk samples. Journal of Behavioral Decision Making, 26, 213–224. doi:10.1002/bdm.1753
Grootaert, C., & van Bastelaer, T. (2002). Understanding and measuring social capital: A multidisciplinary tool for practitioners. Washington, DC: World Bank Publications.
Hatzenbuehler, M. L., Phelan, J. C., & Link, B. G. (2013). Stigma as a fundamental cause of population health inequalities. American Journal of Public Health, 103, 813–821. doi:10.2105/AJPH.2012.301069.
Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine, 40, 218–227. doi:10.1007/s12160-010-9210-8.
Holt-Lunstad, J., Birmingham, W., & Jones, B. Q. (2008). Is there something unique about marriage? The relative impact of marital status, relationship quality, and network social support on ambulatory blood pressure and mental health. Annals of Behavioral Medicine, 35, 239–244. doi:10.1007/s12160-008-9018-y.
Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7, 1–20. doi:10.1371/journal.pmed.1000316.
Hong, J. S., Espelage, D. L., & Kral, M. J. (2011). Understanding suicide among sexual minority youth in America: An ecological systems analysis. Journal of Adolescence, 34, 885–894. doi:10.1016/j.adolescence.2011.01.002.
House, J. S., Landis, K. R., & Umberson, D. (1988). Social relationships and health. Science, 241, 540–545. doi:10.1126/science.3399889.
Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004). A short scale for measuring loneliness in large surveys: Results from two population-based studies. Research on Aging, 26, 655–672. doi:10.1177/0164027504268574.
Hurtado, D., Kawachi, I., & Sudarsky, J. (2011). Social capital and self-rated health in Colombia: The good, the bad and the ugly. Social Science and Medicine, 72, 584–590. doi:10.1016/j.socscimed.2010.11.023.
Hyyppä, M. T., Mäki, J., Impivaara, O., & Aromaa, A. (2007). Individual-level measures of social capital as predictors of all-cause and cardiovascular mortality: A population-based prospective study of men and women in Finland. European Journal of Epidemiology, 22, 589–597. doi:10.1007/s10654-007-9153-y.
Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Washington, DC: The National Academies Press.
Kamen, C., Burns, M., & Beach, S. R. H. (2011). Minority stress in same-sex male relationships: When does it impact relationship satisfaction? Journal of Homosexuality, 58, 1372–1390. doi:10.1080/00918369.2011.614904.
Kawachi, I., & Berkman, L. F. (2001). Social ties and mental health. Journal of Urban Health, 78, 458–467. doi:10.1093/jurban/78.3.458.
Kiecolt-Glaser, J. K., Fisher, L. D., Ogrocki, P., Stout, J. C., Speicher, C. E., & Glaser, R. (1987). Marital quality, marital disruption, and immune function. Psychosomatic Medicine, 49, 13–34.
Kiecolt-Glaser, J. K., & Newton, T. L. (2001). Marriage and health: His and hers. Psychological Bulletin, 127, 472–503. doi:10.1037/0033-2909.127.4.472.
King, M., Semlyen, J., Tai, S. S., Killaspy, H., Osborn, D., Popelyuk, D., & Nazareth, I. (2008). A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry, 8, 70. doi:10.1186/1471-244X-8-70.
Klonoff, E. A., Landrine, H., & Campbell, R. (2000). Sexist discrimination may account for well-known gender differences in psychiatric symptoms. Psychology of Women Quarterly, 24, 93–99. doi:10.1111/j.1471-6402.2000.tb01025.x.
Krieger, N. (1999). Embodying inequality: A review of concepts, measures, and methods for studying health consequences of discrimination. International Journal of Health Services, 29, 295–352. doi:10.2190/M11W-VWXE-KQM9-G97Q.
Krieger, N. (2005). Stormy weather: Race, gene expression, and the science of health disparities. American Journal of Public Health, 95, 2155–2160. doi:10.2105/AJPH.2005.067108.
Kuyper, L., & Fokkema, T. (2010). Loneliness among older lesbian, gay, and bisexual adults: The role of minority stress. Archives of Sexual Behavior, 39, 1171–1180. doi:10.1007/s10508-009-9513-7.
Kwon, P. (2013). Resilience in lesbian, gay, and bisexual individuals. Personality and Social Psychology Review, 17, 371–383. doi:10.1177/1088868313490248.
Lick, D. J., Durso, L. E., & Johnson, K. L. (2013). Minority stress and physical health among sexual minorities. Perspectives on Psychological Science, 8, 521–548. doi:10.1177/1745691613497965.
Lin, N., Ye, X., & Ensel, W. M. (1999). Social support and depressed mood: A structural analysis. Journal of Health and Social Behavior, 40, 344–359. doi:10.2307/2676330.
Major, B., & Sawyer, P. J. (2009). Attributions to discrimination: Antecedents and consequences. In T. D. Nelson (Ed.), Handbook of prejudice, stereotyping, and discrimination (pp. 89–110). New York: Taylor & Francis Group.
Masi, C. M., Chen, H. Y., Hawkley, L. C., & Cacioppo, J. T. (2011). A meta-analysis of interventions to reduce loneliness. Personality and Social Psychology Review, 15, 219–266. doi:10.1177/1088868310377394.
Mason, W., & Suri, S. (2012). Conducting behavioral research on Amazon’s Mechanical Turk. Behavior Research Methods, 44, 1–23. doi:10.3758/s13428-011-0124-6.
Matthews, C. R., & Adams, E. M. (2009). Using a social justice approach to prevent the mental health consequences of heterosexism. Journal of Primary Prevention, 30, 11–26. doi:10.1007/s10935-008-0166-4.
McCubbin, H. I., & Patterson, J. M. (1983). A family stress process: The double ABCX model of adjustment and adaptation. Marriage & Family Review, 6, 7–37. doi:10.1300/J002v06n01_02.
McGuire, T. G., & Miranda, J. (2008). New evidence regarding racial and ethnic disparities in mental health: Policy implications. Health Affairs, 27, 393–403. doi:10.1377/hlthaff.27.2.393.
Merin, Y. (2010). Equality for same-sex couples: The legal recognition of gay partnerships in Europe and the United States. Chicago: University of Chicago Press.
Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697. doi:10.1037/0033-2909.129.5.674.
Meyer, I. H., & Wilson, P. A. (2009). Sampling lesbian, gay, and bisexual populations. Journal of Counseling Psychology, 56, 23–31. doi:10.1037/a0014587.
Mustanski, B., Newcomb, M. E., & Garofalo, R. (2011). Mental health of lesbian, gay, and bisexual youths: A developmental resiliency perspective. Journal of Gay & Lesbian Social Services, 23, 204–225. doi:10.1080/10538720.2011.561474.
Otis, M. D., Rostosky, S. S., Riggle, E. D. B., & Hamrin, R. (2006). Stress and relationship quality in same-sex couples. Journal of Social and Personal Relationships, 23, 81–99. doi:10.1177/0265407506060179.
Paolacci, G., & Chandler, J. (2014). Inside the Turk: Understanding Mechanical Turk as a participant pool. Current Directions in Psychological Science, 23, 184–188. doi:10.1177/0963721414531598.
Paradies, Y. (2006). A systematic review of empirical research on self-reported racism and health. International Journal of Epidemiology, 35, 888–901. doi:10.1093/ije/dyl056.
Pascoe, E. A., & Richman, L. S. (2009). Perceived discrimination and health: A meta-analytic review. Psychological Bulletin, 135, 531–554. doi:10.1037/a0016059.
Pearson, J., & Wilkinson, L. (2013). Family relationships and adolescent well-being: Are families equally protective for same-sex attracted youth? Journal of Youth and Adolescence, 42, 376–393. doi:10.1007/s10964-012-9865-5.
Radkowsky, M., & Siegel, L. J. (1997). The gay adolescent: Stressors, adaptations, and psychosocial interventions. Clinical Psychology Review, 17, 191–216. doi:10.1016/S0272-7358(97)00007-X.
Randall, A. K., & Bodenmann, G. (2009). The role of stress on close relationships and marital satisfaction. Clinical Psychology Review, 29, 105–115. doi:10.1016/j.cpr.2008.10.004.
Reis, H. T., Collins, W. A., & Berscheid, E. (2000). The relationship context of human behavior and development. Psychological Bulletin, 126, 844–872. doi:10.1037/0033-2909.126.6.844.
Robles, T. F., Slatcher, R. B., Trombello, J. M., & McGinn, M. M. (2014). Marital quality and health: A meta-analytic review. Psychological Bulletin, 140, 140–187. doi:10.1037/a0031859.
Rothblum, E. (2007). From science fiction to computer-generated technology: Sampling lesbian, gay, and bisexual individuals. In I. H. Meyer & M. E. Northridge (Eds.), The health of sexual minorities: Public health perspectives on lesbian, gay, bisexual and transgender populations (pp. 441–454). New York: Springer.
Rothman, K. J., Gallacher, J. E., & Hatch, E. E. (2013). Why representativeness should be avoided. International Journal of Epidemiology, 42, 1012–1014. doi:10.1093/ije/dys223.
Russell, D., Peplau, L. A., & Cutrona, C. E. (1980). The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence. Journal of Personality and Social Psychology, 39, 472–480. doi:10.1037/0022-3514.39.3.472.
Ryff, C. D., & Singer, B. (2000). Interpersonal flourishing: A positive health agenda for the new millennium. Personality and Social Psychology Review, 4, 30–44. doi:10.1207/S15327957PSPR0401_4.
Shapiro, D. N., Chandler, J., & Mueller, P. A. (2013). Using Mechanical Turk to study clinical populations. Clinical Psychological Science, 1, 213–220. doi:10.1177/2167702612469015.
Trail, T. E., Goff, P. A., Bradbury, T. N., & Karney, B. R. (2012). The costs of racism for marriage: How racial discrimination hurts, and ethnic identity protects, newlywed marriages among Latinos. Personality and Social Psychology Bulletin, 38, 454–465. doi:10.1177/0146167211429450.
Umberson, D., & Montez, J. K. (2010). Social relationships and health: A flashpoint for health policy. Journal of Health and Social Behavior, 51, S54–S66. doi:10.1177/0022146510383501.
United States Department of Health and Human Services, Healthy People 2020. (2014). Disparities. Retrieved February 1, 2014 from http://healthypeople.gov/2020/about/disparitiesAbout.aspx.
Valanis, B. G., Bowen, D. J., Bassford, T., Whitlock, E., Charney, P., & Carter, R. A. (2000). Sexual orientation and health: Comparisons in the Women’s Health Initiative sample. Archives of Family Medicine, 9, 843–853.
Vrangalova, Z., & Savin-Williams, R. C. (2012). Mostly heterosexual and mostly gay/lesbian: Evidence for new sexual orientation identities. Archives of Sexual Behavior, 41, 85–101. doi:10.1007/s10508-012-9921-y.
Walen, H. R., & Lachman, M. E. (2000). Social support and strain from partner, family, and friends: Costs and benefits for men and women in adulthood. Journal of Social and Personal Relationships, 17, 5–30. doi:10.1177/0265407500171001.
Wang, J., Häusermann, M., Vounatsou, P., Aggleton, P., & Weiss, M. G. (2007). Health status, behavior, and care utilization in the Geneva Gay Men’s Health Survey. Preventive Medicine, 44, 70–75. doi:10.1016/j.ypmed.2006.08.013.
Weiss, J. T. (2004). GL vs. BT: The archaeology of biphobia and transphobia within the US gay and lesbian community. Journal of Bisexuality, 3, 25–55. doi:10.1300/J159v03n03_02.
Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: Evidence and needed research. Journal of Behavioral Medicine, 32, 20–47. doi:10.1007/s10865-008-9185-0.
Williams, D. R., Yu, Y., Jackson, J. S., & Anderson, N. B. (1997). Racial differences in physical and mental health socio-economic status, stress and discrimination. Journal of Health Psychology, 2, 335–351. doi:10.1177/135910539700200305.
Williams, T., Connolly, J., Pepler, D., & Craig, W. (2005). Peer victimization, social support, and psychosocial adjustment of sexual minority adolescents. Journal of Youth and Adolescence, 34, 471–482. doi:10.1007/s10964-005-7264-x.
Zou, C., Andersen, J. P., & Blosnich, J. R. (2013). The association between bullying and physical health among gay, lesbian, and bisexual individuals. Journal of the American Psychiatric Nurses Association, 19, 356–365. doi:10.1177/1078390313510739.
Acknowledgments
David Matthew Doyle is now a post-doctoral fellow in the Department of Epidemiology, Columbia University, supported by training grant T32MH13043 from the National Institute of Mental Health. This research constituted a portion of David Matthew Doyle’s dissertation under the direction of Lisa Molix.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Doyle, D.M., Molix, L. Disparities in Social Health by Sexual Orientation and the Etiologic Role of Self-Reported Discrimination. Arch Sex Behav 45, 1317–1327 (2016). https://doi.org/10.1007/s10508-015-0639-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10508-015-0639-5