Young Black and Latino Sexual Minority Men’s Responses to the Minority Stress Model in the Context of LGBTQ-Affirmative CBT

Abstract

In the United States, young Black and Latino sexual minority men (YBLSMM) face mental health challenges resulting from minority stress. LGBTQ-affirmative cognitive-behavioral therapy (CBT) is an evidence-based treatment that has been shown to improve mental health among several LGBTQ+ populations, including YBLSMM in particular. One component of this treatment involves a discussion of the sexual minority stress model, providing insight into how YBLSMM experience sexual minority stress as part of their other intersectional identity-based stressors. This information is important to guide case conceptualization with diverse LGBTQ populations that face minority stress both due to their sexual identities and their racial or ethnic identities and therefore facilitate effective treatment outcomes and the development and improvement of existing interventions. Participants included 20 YBLSMM from a trial of LGBTQ-affirmative CBT. We transcribed sessions in which therapists and clients discussed the minority stress model underlying the treatment. Qualitative analysis suggested the following themes related to YBLSMM minority stress: (1) experiences of racism, racial/ethnic minority stress, or cultural stereotypes; (2) pressures to be masculine arising both from within and outside the SMM community; (3) conflict between religious upbringing and LGBTQ+ identity; (4) fears and anxieties related to aging within the LGBTQ community; (5) financial and socioeconomic stressors; and (6) stressors exclusive to sexual orientation. Findings revealed that YBLSMM often drew upon aspects of their identities, other than or in conjunction with their sexual minority identity, in terms of how the minority stress model applies to their lives. Findings suggest that LGBTQ-affirmative CBT may be beneficial to YBLSMM not just through addressing sexual minority stress but also through addressing stress linked to other aspects of YBLSMM’s identities, emphasizing the importance of practitioners comprehensively addressing these multifaceted stressors and incorporating them into case conceptualization when providing cognitive and behavioral therapy.