The Roles of Identity Centrality and Affirmation in the Associations Between Discrimination and Mental Health Among Bi+ Adults

Abstract

Bi+ individuals are at increased risk for mood and anxiety disorders compared to heterosexual and lesbian/gay individuals in part due to unique experiences of discrimination. Minority stress theory posits that associations between discrimination and adverse mental health outcomes may be stronger for those with higher identity centrality and lower identity affirmation, but few studies have tested these hypotheses. Therefore, the current study examined whether identity centrality and affirmation moderated the associations between discrimination and depression and anxiety symptoms among 715 bi+ adults. In bivariate analyses, discrimination was positively associated with depression and anxiety symptoms, whereas identity centrality and affirmation were not significantly associated with either. However, in multivariate analyses, identity centrality and affirmation were negatively associated with depression and anxiety symptoms, respectively. Neither identity centrality nor affirmation moderated any associations. These findings raise the question whether identity characteristics moderate associations between discrimination and mental health, but replication is needed.

Keywords:

• Affirmation
• anxiety
• bisexual
• centrality
• depression
• discrimination
• identity

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Of the 23 participants who were excluded from the analytic sample because they did not endorse a bi+ identity, primary sexual identities included lesbian or gay (n = 11), asexual (n = 8), unsure/questioning (n = 3), and “different identity” (n = 1).

Additional information

Funding

This project was supported by grants from the American Psychological Foundation and the Sexualities Project at Northwestern University (PI: Feinstein). Christina Dyar’s time was supported by a grant from the National Institute on Drug Abuse (K01DA046716; PI: Dyar). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

Notes on contributors

Taylor Macaulay

Taylor Macaulay is a clinical psychology doctoral student at Rosalind Franklin University of Medicine and Science. They earned a master’s degree in general clinical psychology from Eastern Michigan University in 2019 and a master’s degree in clinical psychology from Rosalind Franklin University of Medicine and Science in 2023. Their research has focused largely on the intersection of mental health and health behaviors, with a particular interest in minority stressors among sexual and gender minorities.

Izhani Rosa

Izhani Rosa is a doctoral student in the Combined Counseling/School Psychology Program at Northern Arizona University. Prior to pursuing her PhD, she earned her master’s in clinical counseling from Rosalind Franklin University of Medicine and Science.

Christina Dyar

Dr. Christina Dyar is an assistant professor in the College of Nursing at Ohio State University. She received her PhD in social psychology from Stony Brook University in 2016. Her research focuses on groups of sexual and gender minority individuals that have been underrepresented in research, including bi+ individuals (i.e., those with attractions to more than one gender), sexual minority women, and nonbinary individuals (i.e., those who identify outside of the gender binary). She is particularly interested in understanding the mechanisms by which stigma-related stress (e.g., discrimination, microaggression) impacts mental health and substance use. The overarching goal of her research is to improve interventions aiming to reduce health disparities among LGBTQ+ populations.

Joanne Davila

Dr. Joanne Davila is a professor of psychology at Stony Brook University. She received her PhD in clinical psychology from UCLA in 1993. Dr. Davila’s expertise is in the area of romantic relationships, mental health, and well-being in adolescents and adults across the sexual and gender identity spectrum, and she has published widely in these areas.

Brian A. Feinstein

Dr. Brian Feinstein received his PhD in clinical psychology from Stony Brook University in 2015. He is currently an associate professor in the Department of Psychology at Rosalind Franklin University of Medicine and Science. His research focuses on understanding and reducing the health disparities affecting sexual and gender minority (SGM) populations, especially bisexual and other multigender-attracted individuals. He is interested in understanding how different types of stress (e.g., discrimination, internalized stigma, rejection sensitivity) influence mental health, substance use, sexual risk behavior, and relationship functioning among SGM individuals and couples, as well as developing and testing interventions to improve health and relationships in these populations.