Intersectional discrimination, identity conflict, and posttraumatic stress symptoms among bisexual+ people of color

Abstract

Bisexual and other multigender-attracted (e.g., pansexual, queer) people (bi+) report disproportionately high posttraumatic stress symptoms (PTSS) linked to a high frequency of discrimination and general trauma exposure. Bi+ people of color (POC) may be particularly vulnerable to PTSS given exposure to intersectional discrimination (e.g., LGBTQ+ racism, racial/ethnic heterosexism). Identity conflict (i.e., perceived incongruence between one's sexual and racial/ethnic identities) may link intersectional discrimination to PTSS. Using cross-sectional survey data from 295 bi+ POC (M_age = 27.6 years), we estimated three structural equation models to test associations between intersectional discrimination and PTSS severity (Model 1), provisional posttraumatic stress disorder (PTSD) diagnosis (Model 2), and PTSD symptom domains (intrusions, avoidance, negative alterations in cognitions and mood [NACM], arousal/reactivity; Model 3). Each model adjusted for exposure to potentially traumatic events (PTEs) and estimated indirect effects via identity conflict. Accounting for PTEs, intersectional discrimination was associated with higher PTSS severity, β = .21, p = .003, and all PTSD symptom domains, βs = .15–.21, ps = .005–.025, but not provisional PTSD diagnosis, β = .15, p = .071. Discrimination direct effects were nonsignificant (accounting for identity conflict); however, indirect effects via identity conflict were significant for PTSS severity, β = .11, p < .013 (Model 1), and avoidance, β = .13, p = .007, and NACM symptoms, β = .12, p = .005 (Model 3). Other indirect effects were nonsignificant. Findings highlight intersectional minority stressors as risk factors for PTSS among bi+ POC, above and beyond trauma exposure, which may inform trauma-focused treatments.