As outlined in this chapter, sexual minority individuals continue to experience prejudice and discrimination as a result of the social stigma that most societies place on sexual behavior and sexual identities outside of heteronormative ideals. This stigma persists across many domains of life, including education and the workplace, but is arguably most pronounced in the domain of intimacy and romantic relationships. In this chapter, I provide an overview of several studies my colleagues and I have conducted aimed at understanding how sexual minority individuals and members of same-sex relationships experience stigma in the context of their intimate relationships. I will demonstrate how experiences of stigma can lead to negative outcomes for members of same-sex relationships in terms of their mental health as well as the quality of their relationships. In doing so, this research illustrates how theories of minority stress can be used to understand the ways in which social stigma can be detrimental to the health and relationships of sexual minority individuals and same-sex couples.

The Minority Stress Model

The minority stress model, as proposed by Ilan Meyer (2003), attempts to explain why sexual minority individuals, on average, experience higher rates of mental health problems relative to their straight peers. Noting that these inequalities in mental health are not likely to be caused by sexual orientation itself, the minority stress model contends that the reason for poorer mental health outcomes among sexual minority populations lies in the fact that sexual minority individuals have a disadvantaged status in society, relative to their straight peers. This disadvantaged social status is created by the stigma that societies place on same-sex sexual behavior and sexual minority identities, which does not apply to straights given the privileging of straightity as normative.

As a result of this disadvantaged social status, sexual minority individuals are exposed to a variety of social stressors that straight individuals are not (Meyer, Schwartz, & Frost, 2008). Being fired from your job because you are lesbian (i.e., prejudice events), being called names because you are bisexual (i.e., harassment), being socially avoided because you are gay (i.e., everyday discrimination), having to worry about when it is safe to disclose or “come out” about your sexual orientation (i.e., stigma concealment), and thinking you are not as valued as a person because of your sexual orientation (i.e., internalized stigma) are all examples of social stress that sexual minorities experience that their straight peers do not. As a result of “excess exposure” to these and other forms of minority stress, sexual minorities are more likely to experience mental health problems like elevated rates of depression, anxiety, substance use, and suicidal ideation. Thus, the minority stress model contends that sexual minority individuals experience higher rates of mental health problems than their straight peers due to excess exposure to social stress stemming from their stigmatized and disadvantaged social status (Meyer, 2003).

Stigma and Minority Stress in Same-Sex Relationships

At the time of this writing, same-sex marriage was either performed or recognized in 32 countries throughout the world, and attitudes toward homosexuality and same-sex marriage are drastically improved according to opinion polls in most western countries (Ayoub & Garretson, 2017; Fetner, 2016). However, it is important to recognize that the vast majority of countries across the globe do not legally recognize same-sex couples, and in some countries same-sex sexual behavior continues to be criminalized. Even in countries with equal marriage laws, many same-sex couples experience stigma and discrimination from co-workers, peers and family. Thus, the domain of intimacy and romantic relationships remains a significant part of sexual minority individuals’ lives in which they continue to experience social stigma.

Minority Stress as Barriers to Achieving Relationship Goals

In order to understand how experiences of minority stress in the relational domain might explain inequalities in mental health between sexual minority individuals and straights, my colleagues and I (Frost & LeBlanc, 2014) conducted a survey of a purposive sample of 431 lesbian, gay, and bisexual (55%) individuals and straight identified (45%) individuals living in the United States and Canada. We specifically wanted to examine the extent to which participants experienced stress related to experiencing barriers to achieving their goals in the domain of romantic relationships (e.g., getting married, buying a house, planning to have children, moving in together), relative to other domains such as the workplace and education. Participants were asked to complete the “Personal Project Inventory” which provided data on the goals they were pursuing across these life domains, as well as the intensity of perceived barriers to the achievement of these goals, which served as our measure of stress (i.e., barriers to goal pursuit). We also asked participants to complete previously validated measures of depression and psychological well-being. We found that sexual minority individuals reported significantly more depressive symptoms and lower levels of psychological well-being than straights. Sexual minorities also reported more barriers to goal pursuit than straight participants. People who reported more stress in the form of frustrated goal pursuit scored significantly poorer on mental health and well-being outcomes and their inclusion in models attenuated sexual orientation differences in mental health. Importantly, when we held constant differences in the stress related to frustrated goal pursuit, the differences between sexual minorities and straights in mental health and well-being were much less pronounced. The critical factor explaining sexual minority differences in mental health and well-being was barriers to relationship projects from interpersonal sources, like family, friends, and neighbors.

As support for the minority stress model, these findings suggest that stigma in the domain of intimacy and relationships may prevent sexual minorities from achieving their goals for intimacy and relationships, and in doing so contribute to mental health inequalities observed between sexual minority and straight individuals. These findings should be taken into consideration as the changing social context regarding marriage equality and interpersonal attitudes may impact the everyday relationship activities of sexual minority individuals in ways that are detrimental to their health and well-being.

The Persistence of Minority Stress in a “Post Marriage Equality” Context

In order to examine the degree to which minority stress continues to impact the mental health of same-sex couples in the US after access to equal marriage was available, my colleagues and I (LeBlanc, Frost, & Bowen, 2018) examined the degree to which the perception of unequal recognition — as a minority stressor – explained variation in mental health above and beyond legal relationship recognition. We predicted that members of same-sex couples with legal marital status would report more positive mental health outcomes compared to members of same-sex couples who were not legally married. We also predicted that perceiving the social climate as not affording equal recognition to same-sex couples would be related to worse mental health for members of same-sex couples, regardless of legal marital status. Dyadic data from both members of 106 same-sex couples – diverse in terms of couple gender, time known, region of the U.S. and race/ethnicity – were collected and analyzed. The survey contained measures of legal marital status, perceived unequal social recognition and mental health outcomes (i.e., depressive symptoms, non-specific psychological distress and problematic drinking behavior).

The results demonstrated that perceived unequal relationship recognition was predictive of poorer mental health, above and beyond whether or not members of same-sex couples were in a legally recognized relationship. Focusing on potential differences in mental health by levels of legal relationship recognition, the study found that members of same-sex couples recognized as registered domestic partners or civil unions (RDP/CUs), but not as legal marriages, demonstrated significantly lower levels of mental health compared to those with legal marriages and those with no legal relationship status. Those who were legally married reported the most positive mental health outcomes but were not statistically distinguishable from those with no legal recognition for their relationship.

These findings illustrated a consistent and robust pattern of associations with multiple indicators of mental health, suggesting that the degree to which members of same-sex couples perceive their relationship to have unequal recognition is a meaningful factor underlying mental health outcomes. In other words, although institutionalized forms of discrimination, such as unequal access to legal marriage, have documented associations with mental health in sexual minority populations, the lived experience of perceived inequality likely represents a more proximal form of minority stress (Meyer 2003); one that potentially exists as shared lived experience at the couple-level “and may even persist in contexts where structural stigma has been reduced or eliminated” (LeBlanc et al., 2018, p. 405). These findings also importantly highlight how equal access to legal marriage is an important social change but is not sufficient to eliminate longstanding social stigma as a risk for mental health problems faced by sexual minority individuals and members of same-sex couples. The constantly shifting social and policy climate facing sexual minorities and same-sex couples continues to warrant attention from social scientists, public health scholars and policymakers in light of its potential impact on mental health.

Resilience and Resistance to Minority Stress in Same-Sex Relationships

It is important to qualify that the research findings I have discussed up to this point pertain to groups of sexual minority individuals and same-sex couples and reflect the average experience. Not all sexual minority individuals and members of same-sex couples experience minority stress and not all who do are impacted by it in the same way. In fact, many sexual minority individuals and members of same-sex couples live healthy lives in rewarding relationships. Recognizing this important variability in individual experience highlights how sexual minority individuals and members of same-sex relationships are resilient in the face of minority stress. An example of this resilience can be seen in a study of the meaning making processes that same-sex couples employ in negotiating minority stress within the context of their relationships (Frost, 2011). In order to explore how members of same-sex couples potentially exercise resilience in the face of minority stress, I conducted a study asking 99 individuals in same-sex relationships to write about their relational high points, low points, decisions, and goals, as well as their experiences of stigma directly related to their relationships. Narrative analysis of these stories revealed that participants utilized several psychological strategies for making meaning of their experiences of stigma within the context of their relationships. Some strategies emphasized a negative, delimiting, and contaminating effect of stigma on their relationships, as is commonly found in existing research. However, other strategies emphasized how stigma can be made sense of in ways that allow individuals to overcome its negative effects. For example, some same-sex couples who participated in this research constructed meanings of stigma-related stressors as challenges that reaffirmed their commitment to and bond with their partners. Others saw stigma as providing an opportunity to (re)define notions of commitment and relational legitimacy. These narrative strategies for making meaning of stigma-related stressors represent more than simply coping with minority stress. They represent attempts to reclaim experiences of being stigmatized in ways that allow individuals to resist and even thrive in the face of social stigma. Thus, through individual and group-level meaning (re)making processes of minority stressors, social stigma can, indirectly, result in positive outcomes for sexual minorities well-being and same-sex relationships.

Summary and Conclusions

In this chapter, I have reviewed several studies that my colleagues and I have conducted that have collectively attempted to demonstrate the ways in which social stigma can impact the health and relationships of sexual minority individuals and same-sex couples. These are by no means the only studies on this topic (see Rostosky & Riggle, 2017b for a review, and Doyle and Molix, 2015 for a meta-analysis). However, it is my hope that the details of these studies illustrate the potential utility of minority stress theory to highlight the ways in which the continued stigmatization of same-sex couples across the globe, even in areas that have progressive laws and policies, continues to put sexual minority individuals and same-sex couples at risk for negative health and relationship outcomes. This research has been useful for efforts to change laws and policies to be more inclusive of same-sex couples rights and eliminate discrimination against same-sex couples. However, while these efforts are by no means complete and will continue for years to come, research on minority stress can also be useful in informing the work of community health workers, counselors, and clinicians working with sexual minority communities to help them cope with, overcome, and resist the potential negative impact of social stigma (Meyer & Frost, 2013).