Rejection Sensitivity and Minority Stress: A Challenge for Clinicians and Interventionists
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COMMENTARY
Rejection Sensitivity and Minority Stress: A Challenge for Clinicians and Interventionists Ilan H. Meyer1 Received: 28 October 2019 / Revised: 21 November 2019 / Accepted: 25 November 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Minority stress theory (MST) makes a simple argument: Stigma and prejudice that are directed at sexual and gender minorities (SGM) in our society bring about a variety of stressors (Hendricks & Testa, 2012; Meyer, 2003b; Testa, Habarth, Peta, Balsam, & Bockting, 2015). Stigma and prejudice, thus, are unique sources of stress that add to the stress that is ubiquitous in our society and to which everyone is exposed. Minority stress, like all stress theory, also recognizes the important roles of social support and coping in moderating the impact of stress. (More recently, the term resilience has been preferred, but it has a similar meaning in the stress process, see Meyer, 2015.) Because of the added exposure to stress, MST predicts that, all else being equal (e.g., at the same level of social class), SGM will experience more stress than heterosexual cisgender people. In turn, because of the role of stress in health, minority stress leads to adverse health outcomes among SGM and accounts for the resultant health disparities between SGM and their cisgender heterosexual counterparts. Although minority stress describes stress processes, including mediators and moderators, as they impact health outcomes, a broader perspective shows that the entire minority stress model is itself a mediator of the relationship of social status and health outcomes (Meyer, 2003b; Meyer, Schwartz, & Frost, 2008, see Fig. 1). The contribution of MST has been to explain how social structures characterized by homophobia and transphobia impact the health of SGM. I believe that the importance of minority stress has been in articulating a framework that identifies the cause of disease in anti-LGBT prejudice. This framework contrasts with the idea that pathology is inherent in sexual and gender minority identity, something opponents of LGBT rights have This commentary refers to the article available at https://doi. org/10.1007/s10508-019-1428-3. * Ilan H. Meyer [email protected] 1
The Williams Institute at UCLA School of Law, 1060 Veteran Avenue, Los Angeles, CA 90025, USA
been trying to convey, with echoes of this argument reverberating from the debates on the classification of homosexuality as a mental disorder (Bayer, 1981). In developing MST, I did not aspire to describe all of the many factors that can contribute to individual variation in health outcomes. Minority stress does not account for many causes of health disorders—it does not include familial dynamics, personality, genetics, neurological, and other factors, except if they are related to homophobia or transphobia. In his target article, Feinstein (2019) proposed to add a new element, rejection sensitivity, to the minority stress model. Rejection sensitivity has been identified as an important process to address
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