4. Minority stress: Framework and models

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Psychological mediation framework

This framework explains how stress from stigma can lead to mental health problems. It suggests that:

• People with minority identities experience higher levels of stress due to stigma and discrimination.
• This stress can cause problems with emotions, relationships, and thinking, increasing the risk of mental health challenges.
• These difficulties act as a bridge between stigma-related stress and mental health problems.¹⁸

A key part of this process is rumination — overthinking negative experiences — which can worsen the link between stress and mental health struggles.¹⁹

Stigma-related stressors are known to trigger:

• Overthinking (or rumination)
• Feeling socially isolated
• Negative self-beliefs

This model helps explain why stigma-related stress affects emotional regulation, relationships, and self-image, all of which are important for mental health.

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Rejection sensitivity model

A recent idea is the rejection sensitivity model, which helps explain how people react when they fear being rejected.

When someone expects rejection, they may:

• Feel anxious or angry.
• Change their behaviour to avoid situations where they might be excluded.

Studies show that rejection sensitivity is linked to:

• Depression
• Social anxiety
• Generalized anxiety disorder
• Posttraumatic stress disorder (PTSD)

This model helps connect discrimination and mental health struggles, showing how the fear of rejection can shape a person’s emotional well-being.^{3 20 21}

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Transdiagnostic minority stress model

The transdiagnostic minority stress model explains how minority stress can affect mental health in different ways, especially for sexual minorities. It suggests that stress impacts three main areas:²²

1. Negative experiences: Avoidance, anxiety, and feelings of loss.
2. Positive motivation: Challenges with finding rewards, forming habits, and/or staying motivated.
3. Social functioning: Difficulty with relationships, feeling disconnected, lacking self-confidence, or struggling to communicate.

By addressing these three areas, this model helps guide better mental health interventions for sexual and gender minorities (SGM).

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Interventions to reduce minority stress

To help people cope with minority stress, interventions can focus on:

Intervention	How it helps
Improving emotional awareness	Recognizing, managing, and accepting emotions.
Reducing avoidance behaviours	Encourages people to face challenges instead of avoiding them.
Building assertive communication skills	Supports expressing needs and setting boundaries.
Challenging negative thoughts	Helps reshape harmful beliefs linked to minority stress.
Recognizing personal strengths	Encourages resilience and self-worth.
Strengthening social support	Builds positive, affirming relationships.

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