Therapy and Parental Acceptance for LGBTQ+ Latinx and Black Youth: A Moderated Mediation Analysis of Internalized Stigma, School Bullying, and Psychological Distress

Research on bullying and LGBTQ+ Black and Latinx youth is limited, yet findings suggest experiencing bullying is associated with high levels of psychological distress, which can be internalized. Similarly, research on aspects such as parental acceptance and informed therapy suggest these can operate as protective factors when experiencing oppression. Yet, these relations are often tested individually. Thus, using an intersectional approach, we explore the cumulative effect of these variables using a sample of LGBTQ+ Black and Latinx youth to highlight specific mental health disparities among these groups. Using a national online cross-sectional survey with LGBTQ+ Black and Latinx youth (N = 2414), we assessed the relation between school bullying (predictor), internalized LGBTQ+ stigma (mediator), and psychological distress (outcome) and tested the influence of access to therapy (moderator 1) and parental acceptance (moderator 2) in a moderated mediation analysis. Additionally, a second moderated mediation analysis tested among participants who have access to therapy if LGBTQ+ informed therapy (moderator 1) and parental acceptance (moderator 2) influenced the relation between our main variables. Using a moderated mediation analysis PROCESS Model 11 for two models, results suggested in model 1 that internalized stigma mediated the relation between school bullying and psychological distress. Furthermore, both parental acceptance and access to therapy moderated the association between school bullying and internalized LGBTQ+ stigma. The second model found that for those with access to therapy, receiving LGBTQ+ -informed therapy and high parental acceptance disrupted the relationship between school bullying and internalized LGBTQ+ stigma. Our findings suggested that LGBTQ+ Black and Latinx youth receiving LGBTQ+ informed therapy reported less internalized LGBTQ+ stigma, particularly when parental acceptance is high. Implications and limitations are discussed.