A Latent Profile Analysis of Multidimensional Sexual Stigma in LGB Adults: Subgroup Differences and Associations with Distress and Substance Use

Introduction: Stigma has long been cited as a risk factor for sexual minority health disparities and is inherently a multifaceted construct, encompassing a wide range of processes. As such, it must be modeled in a way that demonstrates its complexity. The present study uses a person-centered approach to model sexual stigma multidimensionally in order to identify subgroups of lesbian, gay, and bisexual (LGB) adults that may experience such stigma differently. Methods: Analyzing data from the Generations study (N = 1518), mixed-indicator latent profile analysis was used to identify profiles characterized by different patterns of sexual stigma (i.e., healthcare stereotype threat, felt stigma, internalized stigma, everyday discrimination, criminal victimization and harassment, and job discrimination). Results: Five latent profiles were identified: Minimal Stigma, Healthcare Stigma, Multilevel Stigma, Enacted Stigma, and Proximal Stigma. Importantly, structural covariates like neighborhood acceptance and health insurance were associated with profile membership, and the association between stigma and psychological distress was especially strong for Proximal and Multilevel stigma, although profiles were not associated with alcohol or drug misuse. Conclusions: Variability in stigma experiences exists even in populations often considered homogenous, and stigma can be exacerbated by structural factors in ways that may be associated with poorer health among stigmatized groups. Policy Implications: Policy interventions must not only target stigma at the interpersonal or individual level but focus on reducing the adverse consequences of structural factors that may influence individuals’ exposure to various stigmatizing experiences. Our findings thus suggest important contextual areas of intervention towards improved LGB well-being.