Multiple minorities as multiply marginalized: Applying the minority stress theory to LGBTQ people of color

The evidence is now overwhelming that discrimination negatively impacts both the physical and mental health of minority groups. Members of multiple-minority groups, such as lesbian, gay, bisexual, transgender, queer people of color (LGBTQ-POC), are more likely to be exposed to experiences of stigmatization, discrimination, and fear of rejection. However, whether the stress of having these unfavorable experiences translates into increased risk for negative health outcomes is unanswered by the literature. Research to date attempts to address the relationship of stress as a minority and health outcomes through examining the role of microaggressions, exploring the concepts of risk and resilience, and most notably the creation of the minority stress model. The model analyzes the complex relationship between external (discrimination/prejudice) and internal (self-doubt/rumination) stressors that shape the experience of multiple-minority groups, which helps us understand the lived experiences of LGBTQ-POC. LGBTQ-POC are adversely affected by cumulative discrimination and social exclusion, including racism from the LGBTQ community, and homophobia and heterosexism within their racial/ethnic community. In this way, they are a multiply marginalized group, which has implications not only for their risk of mental illness, but also for their access to mental health care, and the quality of care they receive. Using the minority stress model as a frame of reference, we will discuss current approaches to capturing the toll that stress as an LGBTQ-POC has on mental health consequences.