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MST by Ayesha & Mudassar Final.pptx

  1. MINORITY STRESS THEORY (MST) Presented By Ayesha Azam Mudassar Hussain
  2. Not my fault I was born gay 19 year old boy commits suicide Due to Homophobic Bullying * Avinshu, known as Avi by his friends, uploaded the post on July 2, around 10 pm and switched his phone off. Next day, his body was found on the beach near his resident by the locals. *
  3. Not my fault I was born gay 19 year old boy commits suicide Due to Homophobic Bullying * Avinshu, known as Avi by his friends, uploaded the post on July 2, around 10 pm and switched his phone off. Next day, his body was found on the beach near his resident by the locals. * “Everyone knows I am a boy. But the way I walk, think and talk is like a girl. People in India do not like that. Please do not blame my family. Help them. We are poor. I love my mom, dad and sister. I thank them for supporting me. It is not my fault that I was born gay.”
  4. Aim To give the class an idea and understanding about the Sexual Minority Stress Theory of LGBTQ+
  5. Seq LGBTQ Terms Historical Background Theoretical Background Minority Stress MST Assumptions MST Process MST Limitation Alternative Model Critical Analysis Criticism Applications MST in Pakistan Scale on MST Researches Conclusion
  6. What Does LGBTQ Mean? • LGBTQ is an acronym for lesbian, gay, bisexual, transgender and queer or questioning. These terms are used to describe a person’s sexual orientation or gender identity. “Queer Community” or “Rainbow Community” also used to describe LGBTQ people. • Lesbian, A lesbian is a female homosexual: a female who experiences romantic love or sexual attraction to other females. • Gay, Gay is a term that primarily refers to a homosexual person or the trait of being homosexual. Gay is often used to describe homosexual males, but lesbians may also be referred to as gay. • Bisexual, Bisexuality is romantic attraction, sexual attraction or sexual behavior toward both males and females, or romantic or sexual attraction to people of any sex or gender identity; this latter aspect is sometimes termed pansexuality.
  7. Conti…. • Transgender, Transgender is an umbrella term for people whose gender identity differs from what is typically associated with the sex they were assigned at birth. It is sometimes abbreviated to trans. • Queer, Queer is an umbrella term for sexual and gender minorities that are not heterosexual or cisgender. Queer was originally used pejoratively against those with same-sex desires but, beginning in the late-1980s, queer scholars and activists began to reclaim the word. • Gender Non-Conforming, refers to people who do not follow other people’s ideas or stereotypes about how they should look, or act based on the female or male sex they were assigned at birth.
  8. Historical Background • In early 1960s and 1970s, the social movement arises regarding the mental health of LGB related to the classification of homosexuality as a mental disorder in DSM. The result of this gay affirmative perspective, in 1973, in the second addition of DSM homosexuality was removed. “Is homosexuality a mental disorder?” has been operationalized as “do homosexuals have higher prevalence of mental disorder?” than heterosexual population. • Later, if LGB people are at relatively higher risk of mental health issues then it is needed to find out the factors that led them towards these issues as well as factors that may play part in reducing those issues. • To address the stress of minority individuals based on the assumptions of social constructive approach of disorders, Minority Stress Theory (MST) was proposed by Meyer in 2003.
  9. What is Minority Stress? • Minority stress refers to a conceptual model that defines stressors fixed in the social position of sexual minority individuals as causes of health related circumstances, such as mental disorder, psychological distress, physical disorders, health behaviors (e.g., smoking Drug abusing), and more generally a sense of wellbeing (Mayer, 2003). • The minority stress theory suggests that because of stigma, prejudice and discrimination lesbian, gay, bisexual, and transgender people experience more stress than do heterosexual and that this stress can lead to mental and physical disorders. • MST stated that “sexual minorities face unique and hostile stressors (e.g., homophobic victimization) related to their sexual minority identity; consequently, these stressors have negative effects on their health” (Meyer, 2003).
  10. Minority Stress Theory • MST stated that minority status of an individual regarding his sexual orientation, ethnicity and gender is considered as one of the circumstances in the environment that expose him/her to the stressors that ultimately lead him towards mental health problems. • But the identification of oneself with his own minority group also provides an individual the opportunity of social support and affiliation that may reduce the level of stress (Meyer, 2003). • Minority stress theory proposes that sexual minority health disparities can be explained in large part by stressors induced by a hostile, homophobic culture, which often results in a lifetime of harassment, maltreatment, discrimination and victimization. • The model was originally conceptualized for sexual minorities. • Minority stressor including experiences of prejudice, homophobia , sexual stigma expectations of rejection, hiding, concealing, internalized homophobia and coping processes (Meyer, 2003)
  11. Theoretical Background • MST follow the Stress model of Dohrenwend (2000) to explain the processes involved in minority stress. • Explained stress in the context of strengths and vulnerabilities existing in the environment as well as in an individual. • Elaboration of Social stress theory that explains that people with minority status are more exposed to environmental stimuli and vulnerable to stress as they have lower coping strategies that lead to the mental health issues. • The basis of MST is not found in one theory rather a combination of various sociological and psychosocial theories. • Boswell suggests that societal mistreatment, violence, and discrimination causes stress, psychological difficulties, shame and guilt, self-destructive behaviors, mood disturbance, dissociative conditions, personality and behavior disorders were symptoms of the mental illness of transsexualism. (Boswell, 1991).
  12. Social Psychological Theories • Provide the basis for intergroup relationship and their impact on the health of minority groups. • Social identity and Self-categorization theories: provide the psychological grounds to understand intergroup relations and their impact on the self. • Social comparison theory: Interactions with others are crucial for the development of a sense of self and well-being. • Symbolic interaction theory and Social evaluation theory: Negative regard from others leads to negative self-regard. • Human beings learn about themselves by comparing themselves with others.
  13. Social Theories • Concerned with the isolation from societal structures, norms, values and institutions. • Durkheim theory of normlessness (1951): stated normlessness as a cause of distress. • Moss’s (1973): incongruent in information and minority’s person own experience in the society, lead negative impact on the health of that minority individual. • Pearlin (1982) emphasis of Merton’s theory of social stress, consider society as a stressor, minority person will be the victim of these conflicts because society provides structures to only majority groups
  14. Conti.. • Allport’s concept: • Prejudice as harmful for environment for the minority person leads to adverse effects. • these effects, which he called “traits due to victimizations,”. • Negative regard from others and harm to the minority person is self- evident. • Unifying concept of stress theory: • Lazarus and Folkman (1984): “mismatch” between the individual and his or her experience of society as the essence of all social stress. • Selye (1982): harmony with one’s environment as the basis of healthy living. • Allison (1998): if individual is a member of a stigmatized minority group, the disharmony between the individual and the dominant culture can resultant stress significant
  15. Amalgamation of Social and Social Psychological Theories Social Theories concerned with the isolation from societal structures, norms, values and institutions. • Durkheim theory of normlessness (1951) • Moss’s incongruent information (1973) • Pearlin’s emphasis of Merton’s theory of social stress, Society as a stressor (1982) Social Psychological Theories provide the basis for intergroup relationship and their impact on the health of minority groups. • Social identity and self- categorization • Social comparison theory • Symbolic interaction theory • Social evaluation theory
  16. Division 44 of American Psychological Association • The Society for the Psychological Study of Lesbian, Gay and Bisexual Issues was founded in 1985 as a Division of the American Psychological Association, to represent sexual orientation issues within and beyond the Association. • The official name as it stood in 2004 still does not include “Transgender,” suggesting DIV 44 is woefully behind the learning curve regarding the complex relationships involving aspects of gender variance and sexuality. • On November 20, 2017 APA Div. 44 again change its name from Society for the Psychological Study of Lesbian, Gay, Bisexual, and Transgender Issues to Society for the Psychology of Sexual Orientation and Gender Diversity (APA, 2017).
  17. Extension of MST from LGB to LGBT • Initially this theory was developed just for LGB community. • Testa, Habarth, Peta and Bockting (2015) planned the extension in MST in transgenders and gender nonconforming (TGNC) based on the assumptions and concepts of MST • Different studies were done to find the significant relationship of transgenders and TGNC with minority stress • Both LGB and TGNC individuals face same internalized homophobia, concealment, and expectation of rejections • In 2018 Meyer in a session acknowledged the mentioned extension of theory of MST. He emphasized the genuine addition of non-affirmation gender identity as distal stressor and considered it as an important component
  18. Extension of MST from LGBT to Other Minorites • Racism is a mental health hazard to all people of color in western nations. • MST, which was first described in relation to the LGBT community, explains that ethnic minorities also face three additional types of stress not experienced by the majority. • The first is the objective experience of racial abuse, secondly, “perceived stigma” or the expectation of discrimination which leaves them on edge, and finally the internalization of negative attitudes fostering a sense of inferiority within them. • These combine to form a toxic cocktail that chips away at a migrant’s psychological well- being.
  19. Basic Assumptions of Minority Stress Theory
  20. Minority Stress is Unique Minority Stress is unique, because it is not a stressor that is experienced by everyone. For example, starting a new job can be stressful for anyone but starting a new job and being afraid to mention your spouse for fear of being fired is a combined stressor that individuals in same-sex relationships experience.
  21. Minority Stress is Chronic Minority Stress is chronic, because it remains a relatively stable presence in someone’s life due to underlying social and cultural structures. A stressful day at work can be ended when you clock out. Sometimes the stress of work may follow some individuals home, but there is relief. However, for individuals living in a racist, sexist, heterosexist, or cissexist society, there is little room for escape from that situation.
  22. Minority Stress is Socially Based Minority Stress is socially based, in that it is about more than individuals. Rather, Minority Stress stems from social processes, institutions, and structures beyond the individual events or conditions that characterize general stressors. For example, a transgender woman might experience stress, as anyone experiences stress, when visiting the doctor. But that same transgender woman may have to deal with a medical record that does not recognize her affirmed gender identity and that could cause her to be continually misgendered during her doctor’s appointment – an added degree of stress caused by a medical institution that influences the behavior of medical professionals and staff.
  23. Four years before he killed himself, 16-year-old Bobby Griffith wrote in his diary: "I can't let anyone find out that I'm not straight. It would be so humiliating. My friends would hate me, I just know it. They might even want to beat me up. . . . I guess I'm no good to anyone . . . not even God. Life is so cruel, and unfair. Sometimes I feel like disappearing from the face of this earth In the predawn hours of August 27, 1983, two months after his twentieth birthday, Bobby Griffith killed himself (Meyer, 1995)
  24. Minority stress theory distinguishes between Distal and Proximal stress processes. Distal stress processes are external to the minority individual, including experiences with rejection, prejudice and discrimination. Proximal stress processes are internal include fear of rejection, previous experiences with prejudice, and disliked one's own minority group following a prejudice event.
  25. Minority Stress Process (Meyer, 2003)
  26. Three Primary principles Leading to chronically high levels of stress that cause poor health outcomes include: 1. Minority status leads to increased exposure to distal stressors. 2. Minority status leads to increased exposure to proximal stressors, due to distal stressors. 3. Minority individuals suffer adverse health outcomes, which are caused by exposure to proximal and distal stressors.
  27. Limitations Identified by Bailey (2019) According to Baily Minority Stress Model deserve Reconsideration , not rust extension. • It should predict the mental health risks in non-heterosexual individuals who grow up in intolerant or stigmatizing individual. MST don’t talk about it rather presenting the opposing evidence in this argument. • Netherlands, a highly tolerant culture, have higher emotional disorders in non- heterosexuals • MST reliance is on self-reported data to quantify stigmatization. The accuracy of this data may influence by individual temperament • Do non-heterosexuals who report more experiences of stigmatization tend to develop more neuroticism? Or do non-heterosexuals who experience more symptoms of neuroticism also tend to elicit more experience of stigmatization? • It seems predictable that psychiatric symptoms could make affected individuals more likely to experience of stigmatization.
  28. Alternative Model (Zuker, Lawrence & Kreukels, 2016) • An alternative model that recognizes temperament postulating a reversed direction of effect. They stated that person with mental illness experiences more stigmatization as they are inclined to believe that they do. • If he/she displays deviant or unusual behaviours it will generate stigmatization. Alternatively, he/she has more tendency to perceive neutral events as stigmatization • If Feinstein’s ideas of RS role in self-reported stigmatization lead to minority stress is correct, it gives the whole reconsideration of MST. RS is detectable early in development. In future, Lawrence suggested that the role of temperament will eventually be accepted globally by researchers. • Bailey proposed that although the minority stress has emerged from societal oppression. But it would be shameful for all non-heterosexual individuals, if the socio-political concerns prevented researchers from conscientious considerations of any reasonable hypotheses (Bailey, 2019).
  29. Critical Evaluation • Parsimony • Theory is very parsimonious in the fact that the explanations of minority stress and its outcomes are easily understandable • Logical Consistency • The theory explains the associations of distil and proximal stressors with mental health outcomes. There is logical consistency in said associations. • Generalization/Scope • Initially made to address issues of the Lesbian, Gay, and Bisexual (LGB) population • Research is readily extending the application of theory onto various minorities including, Transgender and Gender Non-Conforming (Alessi, 2014) individuals, queer (Meyer, 2020) and autistic population • Empirical Evidence • Within group • Between group
  30. Criticism • Methodological Limitations • Correlational Studies • Lack of experimental and longitudinal studies • Lack of studies aiming for complete replication • Focus on Negative Experience • Lessor focus on positive factors present around minority populations • Different Outcomes for Different Minorities • Racial minorities • Biological Reasons for Stressors • Genetic predisposition to depression and anxiety
  32. Social Level • Court Room Briefs • Meyer was an expert witness in the Perry v. Schwarzenegger trial, testifying on the mental health impact on gay couples denied the right to marry. His testimony relied on empirical studies showing that gays and lesbians encounter a disproportionate level of stress and mental health difficulties because of discrimination, and that these stresses amplify the social stigma that makes them more susceptible to depression, suicide and substance abuse. • Policy Makers • Anti-harassment laws for LGBTQ • Gay Marriage legalization in various countries • Social Organizations • National level anti-prejudice programs • Work-Place • Providing a safe space while at work while minimizing distil stressors
  33. Individual Level • Based on how individual minorities react to distil stressors and what mental health outcomes are, clinician can sort out an intervention plan. HAVE YOU EVER WORKED WITH A CLIENT WHO IDENTIFIED AS TRANSGENDER?
  34. Multilevel Approach to Stigma (Cook, Purdie-Vaughns, Meyer, & Busch, 2014)
  35. Intrapersonal level Interventions Intrapersonal interventions target the way people think, feel, or behave. • Intrapersonal interventions targeting members of stigmatized groups • Education and counseling • Expressive-writing • Belonging • Value affirmation • Intrapersonal interventions targeting non-stigmatized groups • Education • Cognitive dissonance
  36. Interpersonal level Interventions • Interpersonal interventions targeting members of stigmatized groups • Information processing • Community and rehabilitation • Interpersonal interventions targeting non-stigmatized groups • Information processing • Intergroup contact
  37. Structural level Interventions • Structural interventions targeting members of stigmatized groups • Community diversity values • Legal/policy intervention • Structural interventions targeting members of non-stigmatized groups • Advertising • Mass media • Educational intervention
  38. LGB affirmative Treatment (Alessi, 2014) • First half • Examining four minority stress components • prejudice events stigma, internalized homophobia and sexual orientation concealment • Second half • Assessed for • interpersonal, social, coping, emotional regulation and cognitive processes. • Integrated approach to therapy including • CBT • Psychodynamic psychotherapy • LGB affirmative therapy
  39. Framework for Clinical Work with Transgender and Gender Nonconforming Clients. (Hendricks & Testa, 2012) • Based on the minority stress model they suggested clinicians to • Increase their understanding of gender non-normative paradigm • Better understand their clients. • Another factors that the authors pointed out is that the clinicians • Must understand the feelings of hurt that trans individuals have felt due to the gender identity disorder diagnosis that has been existing in DSM. • The authors suggested group level coping which is supported by the Meyer’s conceptualization that people when they identify with alike individuals, they cope better
  40. Minority Stress in Context to Pakistan • The minority communities have been in Pakistan amicably since independence and playing their active role in the development of society especially in education and health sectors. • Despite being living in encouraging environment as good and responsible citizens, the minority communities have been facing inequality, discrimination and victimization by both the state and society. These minorities have been marginalized in almost every part of life including employment, education, and top of all-the religious freedom. • The minorities, especially the Christians have some serious issues about their security and often mention that they have been targeted especially under Blasphemy Law in which they have been prosecuted in the name of religion. • Most of these blasphemy cases have been found out to be the result of personal enmity and religious vendettas (Khalid & Rashid, 2019).
  41. Scales Based on Theory • The sexual minority stress scale (SMSS) developed by Iniewicz et al, (2017) • Internalized Homophobia (IH), Expectations of Rejection (ExR), Concealment (Clm), and Sexual Minority Negative Events (SMNE) • Couple-Level Minority Stress Scale (Delozier et al, 2020) • Extended to include couple specific dynamics including • (1) Couple-Level Stigma; • (2) Couple-Level Discrimination; • (3) Seeking Safety as a Couple; • (4) Perceived Unequal Relationship Recognition; • (5) Couple-Level Visibility; • (6) Managing Stereotypes about Same-Sex Couples; • (7) Lack of Integration with Families of Origin; • (8) Lack of Social Support for Couples.
  42. Researches
  43. Level of depression among adolescents of religious minorities and their dominant counterparts in Pakistan (Iqbal et al, 2012) • In this study researchers investigated the level of depression among religious minority adolescents (Christian and Hindu) in comparison with their major dominant community (Muslims) in Pakistan. • The results showed that religious minorities in Pakistan are inclined to have higher level of depression than their dominant counterparts (Muslims adolescents)
  44. Suicides Among Lesbian and Gay Male Individuals: Findings From the National Violent Death Reporting System (Lyons et al, 2019) • This study intend to describe the characteristics and precipitating circumstances of suicide among lesbian and gay male decedents when compared with non-lesbian and non-gay male decedents. • Findings highlighted differences in the characteristics of suicide among lesbian and gay male and non-lesbian and non-gay male decedents. • Suicidal rate were 10% higher in LGBT peoples than other communities. • The majority of lesbian, gay, bisexual, or transgender decedents were identified as gay male (53.9%), followed by lesbian (28.0%), transgender (10.4%), and bisexual (7.5%).
  45. Perceived Stress: A Comparative Study of Student Nurses from Mainstream And Minority Religious Group In Pakistan (Ahmed & Mushtaq, 2014) • The objective of the present study is to investigate the difference between the minority student nurses and their dominant counterparts in Karachi, Pakistan, in their scores of perceived stress. • Result indicates that there is a statistically significant mean difference in the scores of perceived stress between Christian and Muslim student nurses (t= -3.103, df= 554, plus than .002). Findings of this study identify that the level of perceived stress in nursing students who belong to minority groups significantly higher than their dominant counterparts.
  46. Effects of Minority Stress, Group-Level Coping, and Social Support on Mental Health of German Gay Men (Sattler et al, 2016) • In the current study, the minority stress theory was investigated in German gay men. • It was hypothesized that minority stressors would positively predict mental health problems and that group-level coping and social support variables would moderate these predictions negatively. • Results showed that Minority stressors positively predicted mental health problems. Group-level coping did not interact with minority stressors, with the exception of disclosure and homopositivity interacting marginally with some minority stressors. • Further, only two interactions were found for social support variables and minority stress, one of them marginal. Gay and non-gay social support inversely predicted mental health problems. In addition, disclosure and homopositivity marginally predicted mental health problems.
  47. Transgender minority stress and mental health outcomes among hijras in India (Parikh-Chopra, 2018). • This study assessed transgender minority stress, mental health outcomes, social support, and coping strategies among hijras in India. • The findings suggest that hijras experience minimal transgender minority stress that affects their mental health outcomes, indicating that they are a well-functioning group. • Prejudice and everyday discrimination were the two primary transgender minority stressors research participants reported. • Results of the qualitative portion suggest that the research participants have available support systems, such as their guru, hijra community, and NGOs, to help minimize the effects of transgender minority stress on mental health
  48. Conclusion
  49. Conclusion • The minority stress theory has been useful and productive theory to understand and address disparities in the health outcomes among Minorities. • The theory points to social stress process caused by prejudice and stigma, such as experience of victimization of different types, ranging from harassment to hate crimes, and internalization of negative attitude. • The theory also points to the importance of considering resiliency factors such as social support and coping resources-in considering causes of health outcome. Ultimately according to this theory health outcomes are determined by the balance of positive (coping and social support) and negative (Stressors) effects. • Future work must take this balance into account to better understand and improve the health and wellbeing to minorities and other like communities.