Stress, Stigma, and Sexual Minority Status: The Intersectional Ecology Model of LGBTQ Health

Abstract

One of the four overarching goals of Healthy People 2020 is to achieve health equity, eliminate health disparities, and improve the health of all groups, including the health of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) populations. In 2011, the Institute of Medicine (IOM) released a report that drew attention to the unique health disparities experienced by sexual minorities and underscored the need for a comprehensive approach to sexual minority health research. This article proposes a new model of LGBTQ health to help measure, explore, explain, and predict the impact of sexual minority status on health outcomes. The Intersectional Ecology Model of LGBTQ Health (IEM) demonstrates how the relentless hypervigilance of LGBTQ individuals in a heteronormative society impacts health outcomes through the primary vehicles of stigma and chronic, elevated stress. The purpose of the IEM is to guide future research and enhance public health practice for LGBTQ populations.

KEYWORDS:

• LGBTQ health
• health ecology model
• social context
• sexual and gender minority health
• stigma
• stress cycle