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Study questions ‘sexual minority stress theory’, claims LGBTQIA+ mental health issues stem from familial causes, not backlash

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Compared with heterosexual persons, non-heterosexual persons (including LGBTQIA+ people) have worse mental health. And among the explanations offered is the Sexual Minority Stress Theory (SMST), said to explain the disparity as resulting from stigma and discrimination. 

Now, researchers interrogated the empirical support for SMST. 

The study – “How much is sexual minority stress confounded with familial causes? A systematic multilevel meta-analysis” by Péter Przemyslaw Ujma, John D. Haltigan and J. Michael Bailey – was published in Psychological Medicine.

In this study, the researchers systematically identified 17 empirical studies in which twins or non-twin siblings reported on both their sexual orientation and their mental health. Subsequently, they conducted a multilevel meta-analysis, focusing on the degree to which any sexual orientation disparity in mental health diminished with genetic relatedness.

The researchers found that up to two-thirds of the correlation between non-heterosexual orientation and mental health disappears once family members discordant for sexual orientation but sharing familial causes (genes and shared environmental factors) are compared. 

“This reduction identifies a substantial portion of this disparity which cannot be attributed to sexual minority stress,” stressed the researchers, so that “in light of this result, we conclude that much of the mental health disparities between heterosexual and non-heterosexual persons have been incorrectly attributed to sexual minority stress. Rather, a large proportion of the disparities is attributable to factors shared by both non-heterosexual and heterosexual persons who are genetically related and reared together.”

For the researchers: “These factors cannot reflect sexual minority stress. Rather, they must reflect genetic or shared environmental factors present in the families of non-heterosexual persons and also affecting heterosexual members.”

The researchers forwarded two other “potential explanations” of their findings: Distinct Lifeways Theory, which emphasizes ways that the lives of non-heterosexual persons and heterosexual persons tend to differ; and Narrative Possibilities Theory, which highlights potential iatrogenic harm of overemphasizing or exaggerating adversity in non-heterosexual persons’ lives. 

“In contrast to SMST, the newer theories are consistent with otherwise anomalous empirical findings we have mentioned, including the lack of elevated rates of depression and anxiety in the US Black population and the failure to find diminished rates of these problems in more tolerant cultures or eras,” they stressed.

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