2. Minority stress: Causes, effects, and responses

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How minority stress affects people

Minority stress is the extra stress that people with minority identities experience because of stigma, discrimination, and social exclusion. This stress can affect mental and physical health.

There are three key ways minority stress affects people:

1. External stressors: These are stressful events like discrimination, violence, and exclusion.
2. Expecting stress: The fear of being mistreated, which can cause people to always be on guard.
3. Internalized stress: Taking in negative beliefs from society and applying them to oneself.

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Types of minority stress

Minority stress can happen in different ways, from outside experiences to inner struggles. These fall into two main types:

1. Distal stressors come from the outside world and include discrimination, violence, microaggressions, and exclusion. Think of distal stressors like scratches on the skin — they happen because of external forces.⁴
2. Proximal stressors are personal thoughts and feelings, like fear of rejection, hiding one’s identity, or believing negative stereotypes. Think of proximal stressors like a stomach ache — they come from within.^{5 6}

Both types of stress can build up over time, affecting mental and physical health.

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Internalized homo/bi/transphobia

Internalized homo/bi/transphobia happens when people absorb negative societal attitudes about LGBTQ+ identities and turn them inward. This can start before a person even fully understands their own sexual orientation or gender identity.

Once they begin to identify as LGBTQ+, they may apply these negative ideas to themselves, leading to:

• Low self-esteem: Feeling unworthy or ashamed of their identity.
• Inner conflict: Struggling to accept themselves due to negative messages from society.
• Mental health challenges: Higher levels of anxiety, depression, and distress.

Believing harmful stereotypes about one’s own community can increase stress and emotional suffering, reinforcing feelings of isolation and self-doubt.¹

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Expectations of rejection and discrimination

When people expect to be rejected or discriminated against because of their minority identity, they often become hypervigilant — always on guard, anticipating mistreatment.

At first, this may feel like a way to protect oneself from harm. However, over time, it can take a serious toll on mental and physical health.

The effects of long-term hypervigilance include:

• Increased stress and exhaustion: Constant alertness drains emotional and physical energy.
• Distrust in social situations: People may withdraw from interactions to avoid potential rejection.
• Feelings of isolation: The fear of mistreatment can lead to avoiding new relationships or opportunities.

Even when discrimination does not occur, just expecting it can cause distress. For LGBTQ+ individuals, this expectation may be reinforced by past experiences of rejection or negative social messages about their identity.⁷

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Prejudiced events: discrimination and violence

Rejection, discrimination, and violence are some of the most direct sources of minority stress. These happen when someone faces unfair treatment because of their minority identity.

Prejudiced events have a strong impact because they bring up deep feelings, like fear of being rejected or expecting violence, which can be even more upsetting than the event itself.

One of the most direct sources of minority stress is experiencing discrimination, rejection, or violence based on one’s identity.

These experiences can range from subtle (microaggressions, exclusion) to severe (harassment, hate crimes). In both cases, they can have lasting psychological effects, including:

• Heightened fear and anxiety: Worrying about future mistreatment.
• Harm to self-esteem: Internalizing negative messages from society.
• Barriers to opportunity: Discrimination can limit access to jobs, housing, and social acceptance.

Even a single instance of discrimination can have a deep impact. But when these experiences happen repeatedly, they build up over time, increasing stress and worsening mental health.⁸

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