Due to society’s anti-homosexual attitudes, heterosexual and LGBQ-identifying individuals internalize negative messages about their sexual orientation long before they become aware of their own sexuality. This can result in negative self-labels of oneself and one’s sexuality. Furthermore, this self-labeling immediately appoints negative attitudes and characterizations to the individual, resulting in psychologically adverse consequences (Meyer, 1995).
Internalized heterosexism can be defined as the negative social attitudes and assumptions toward non-heterosexual individuals, which are internalized by lesbian, gay, and bisexual individuals. For example, one study found that the majority of lesbian and gay-identifying participants reported experiences of internalized heterosexism to varying extents (Szymanski et al., 2008; Shidlo, 1994).
Due to challenging societal notions in disclosure of one’s sexuality, IH is presumably at its peak during one’s process of “coming out”. Furthermore, this is unlikely to go away even after an individual discloses their sexuality to others. Moreover, the burden of IH on LGB individuals can differ from mild (with a proclivity for self-doubt) to severe (through self-destructive behaviors, unconcealed self-hatred) (Szymanski et al., 2008; Meyer, 1995).
This paper will explore the limitations of terms used for internalized heterosexism. This will include primary psychological theories that are applied when examining IH, as well as highlight the relationship research between psychological distress and IH.
Limitations of Internalized Homophobia
Within psychological literature, internalized heterosexism is also known as internalized homophobia or internalized homonegativity. The terms internalized homophobia and homophobia, however, have been critiqued as insufficient to describe the repressive experiences of LGB individuals.
George Weinberg introduced the term homophobia in 1972 to put a name to the hostility homosexuals faced. As a heterosexual psychologist, Weinberg was trained to consider homosexuality as a pathology. However, he believed this incorrect and coined the term to distinguish phobia about homosexuals (Weinberg, 1972; Herek, 2004).
While Weinberg’s theory was an essential contribution to changing how sexual orientation was viewed within US society, Herek (2004) regards Weinberg with high esteem and his role in modifying thoughts of sexual orientation in American society. They argue that his definition of homophobia accentuates individual fear rather than focusing on the oppressive systems contributing to homophobia (Herek, 2004).
When using the term internalized homophobia, many researchers advise against conceptualizing it as something internal to the individual and use it as a relation in which prevalent heterosexism is applied to the self. Despite these understandings, pursuits of alternative terminology have yet to be recognized in many formalities (Frost & Meyer, 2009).
Homophobia, however, is not actually a phobia at all. Instead, it is a term rooted in bias and hostility. The term also assumes that homophobia resides in the individual rather than a heterosexist society that rejects those who are not heterosexual. Though this subject is mainly known as “internalized homophobia,” it is essential to recognize this distinction. For this paper, the term IH will reflect this topic.
Psychological Framework: Minority Stress Theory
Internalized heterosexism has been investigated from numerous psychological frameworks, such as the development perspective and minority stress theory. Most research has recognized sexual minority health differences through this framework. The minority stress framework states that SM individuals endure constant, added stressors due to identity stigmatization, leading to adverse health outcomes (Meyer, 2003). This framework illustrates two types of stressors: distal and proximal stressors. Stressors external to the individual, such as experiences of discrimination, are distal minority stressors. In contrast, proximal stressors include internal stigma processes, such as identity concealment and internalized heterosexism (Salim et al., 2020).
Evidence for this minority stress theory for internalizing mental health problems was shown through Meyer’s 1995 study of gay men in New York City. The testing of minority stress processes showed that internalized homophobia, acts of discrimination and cruelty (prejudice), as well as expectations of exclusion and bigotry (stigma), predict psychological distress in gay men. Therefore, the minority stress hypothesis was supported because stressors have meaningful and disparate associations including various mental health measures (Meyer, 1995; Newcomb & Mustanski, 2010).
Hatzenbuehler (2009) proposed an extension of minority stress theory to understand the relationship between distal minority stressors and mental health outcomes. This integrative model examined general psychological processes (e.g., rumination) and group-specific processes (e.g., IH) and found that negative health outcomes are a result of an increase in proximal stressors, which are related to distal stressors (Hatzenbuehler, 2009).
His integrative meditation model proposed that the stigma-induced stress that sexual minorities face increases the risk of dysregulation of general psychological processes (social/interpersonal, coping, and cognitive processes). Furthermore, these psychological processes interact with proximal stressors, which intensify and are intensified by group-specific processes. Therefore, the interaction of psychological and group-specific processes is a mediator between distal minority stress and mental health outcomes (Hatzenbuehler, 2009; Micheals et al., 2019).
Impacts of Internalized Heterosexism
Robust research literature has demonstrated that internalized heterosexism, or the internalization of the societal devaluation of LGB identity, is associated with adverse health outcomes. Additionally, IH is a critical cause of psychological distress in sexual minority individuals, often with pathogenic impacts on psychological functioning. (Shidlo, 1994; Ummak et al., 2021).
In 1984, Alan Malyon hypothesized that the harmful effects of internalized homophobia occur due to disruptions of identity formation and the repression of homosexual feelings. He believed that internalized homophobia could lead to depression, low self-esteem, patterns of cognition, as well as a disruption in identity formation, psychological integrity, superego functioning, and object relations (Maylon, 1982).
Specifically, LGBQ individuals encounter higher rates of mood and anxiety disorders, suicide attempts, and substance use disorders due to sexual orientation-based stressors, sexual orientation-based victimization, perceived stigma due to sexual orientation, and internalized homophobia experienced by LGB individuals (Newcomb & Mustanski, 2010). Below are studies analyzing the relationship between IH and psychological stress. These factors mediate the relationship between the two, as well as other interpersonal and intrapersonal areas that are impacted by internalized heterosexism.
IH and Psychological Distress: Mediating Roles of Self-Criticism and Community Connectedness
Puckett’s (2015) investigation revealed some of the psychological and social processes of negative mental health outcomes. This study expanded on the mechanisms explaining the relationship between IH and the mental health of sexual minorities. Additionally, the study examined the role of self-criticism and community connectedness (or lack thereof) as mediators of IH and psychological distress.
The findings suggested that this relationship accounted for less community connectedness with other LGB individuals and higher self-criticism. Although self-criticism has not been adequately examined in the literature, this study found that self-criticism is a mediator between IH and psychological distress.
The impact of social support has been established as a buffer against the adverse outcomes of heterosexism, and IH was shown to be affiliated with reduced social support (Szymanski et al., 2008). In Puckett’s study, LGB community connection appeared as another approach in which IH affects mental health. The greater IH of an individual, the less they were involved with other sexual minorities. For these individuals, the lack of affirmatory and supportive connections contributed to and maintenance their negative self-image; a result of living in a heteronormative society, the embodiment of a negative self-image can be maintained through lack of supporting and affirmatory connections (Puckett et al., 2015).
IH and Mental Health: Effect of Religious Affiliation
Considering that homosexuality is not approved of in most religious communities in the United States, Barnes and Meyer (2012) sought to understand the relationship between IH, mental health, and exposure to these non-affirming religious environments. Using a minority stress model framework, the study examined the relationship between these non-affirming religious environments and internalized homophobia, a stress process expressed in minority stress theory, and mental health consequences in LGB individuals.
The results showed that the LGB participants were religious to a lesser degree than the overall population in the United States. However, Black and Latinx LGBs documented greater levels of religiosity than did White participants. Additionally, Latinx LGBs were detected to have higher levels of IH than White LGBs.
Secondly, the study found that those involved in non-affirming religious spaces had significantly higher levels of IH and that Latinx participants had higher levels of IH compared to White participants. In the complete sample and Latinos compared with Whites. Additionally, the researchers stated that their findings on the distinction between Latinos and Blacks are too provisional for interpretation. IH was also a predictor of psychological well-being and depressive symptoms. However, involvement in a non-affirming religion was not correlated with adverse mental health (Barnes & Meyer, 2012). This study emphasizes remembering IH as not a trait of an individual but the impression of the interaction between the environment and the individual.
Relationship Between IH & Life Satisfaction
Researchers have also explored the relationship between internalized heterosexism and protective resiliency factors, such as life satisfaction, and internalized heterosexism has been considered empirically by various researchers. Michaels (2019) examined the pathways between heterosexist discrimination, internalized heterosexism, meaning in life, stress-related growth, and life satisfaction among SM individuals. This work supports Hatzenbuehler’s Integrative Mediation model, which shows how as IH increases, heterosexist discrimination increases along with it, and therefore, life satisfaction was also found to decrease. Internalized heterosexism was also connected to reduced levels of life satisfaction and stress-related growth. Indirectly, the positive relationship between minority stress and stress-related growth was also affected. This study elucidated the negative associations between internalized heterosexism and life satisfaction (Micheals et al., 2019).
Most research on LGB health has been primarily conducted in Westernized countries. Ummak and others (2021) explored how life satisfaction and internalized homonegativity vary regarding social contexts defined by nationality and sexual orientation. Due to internalized heterosexism’s actualization through heteronormative cultural attitudes, the researchers hypothesized that women from more individualistic countries would experience more internalized heterosexism (Ummak et al., 2021).
The participants were either from Turkey or Belgium, which comprise distinct social contexts. Turkish culture is stated to have more collectivist tendencies, promoting communal obligation and duty toward one’s community and society. In contrast, Belgium emphasizes individual autonomy and personal rights through its individualist culture.
The results found that LB women from Turkey faced a more internalized heterosexism than those from Belgium. Considering the findings that LB women in Belgium reported lower internalized heterosexism, this aligns with previous research and the hypothesis stated by the researchers; LGB individuals undergo less internalized heterosexism when living where there are more policies and practices opposed to discrimination (Ummak et al., 2021).
Relationship Between IH & Relationship Quality
Using the minority stress model as a theoretical reference, Frost & Meyer (2009) examined the association between internalized homophobia and relationship quality among gay men, lesbians, and bisexuals.
Previous psychological examinations have shown that outness, community connectedness, and depressive symptoms overlapped with IH. Therefore, in this study, IH was conceptualized as a distinct minority stressor, and the previously stated concepts and their associations were analyzed.
When accounting for the mediating role of depression, the effects of IH were attenuated. This finding implies that increased depressive symptoms cause relationship problems due to IH. As for outness and IH, a strong negative relationship was found. However, there was no association with relationship quality present regarding outness. Therefore, although there is a relationship between IH and outness, they are not synonymous, supporting previous research that indicated IH’s negative relation to relationship quality, but not outness.
Community connectedness was significantly correlated with internalized homophobia and was associated with relationship quality. Among coupled participants, greater connectedness related to an amplified relationship strain. Overall, the results unveiled that outness, community connectedness, and depressive symptoms are interconnected but distinct constructs, each distinctive role in LGB experiences (Frost & Meyer, 2009).
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