“I Don’t Feel Like the Odd One”: Utilizing Content Analysis to Compare the Effects of Social Media Use on Well-Being Among Sexual Minority and Nonminority US Young Adults

Abstract

Purpose:

Although there is evidence of associations between social media (SM) use and mental well-being among the general population, these associations among lesbian, gay, and bisexual (LGB) persons are poorly understood. This study compared the influence of SM experiences on mental well-being between LGB and non-LGB persons.

Design and Setting:

Online cross-sectional survey.

Participants:

National sample of 2408 US adults aged 18 to 30 years.

Method:

We asked participants to provide examples of when SM affected their well-being separately in good and bad ways. We coded, summed, and used rate ratios (RRs) to compare responses of LGB and non-LGB individuals. Thematically similar codes were described and grouped into categories.

Results:

Most responses described positive SM effects. However, of 6 codes that were significantly more frequent among LGB respondents, only social capital (RR = 1.58, 95% confidence interval [CI], 1.17-2.12) described a positive effect. Five codes described negative effects of SM for LGB users: negative emotional contagion (RR = 1.28, 95% CI, 1.04-1.58), comparison with others (RR = 1.28, 95% CI, 1.01-1.62), real-life repercussions (RR = 1.86, 95% CI, 1.18-2.94), envy (RR = 2.49, 95% CI, 1.48-4.19), and need for profile management (RR = 2.32, 95% CI, 1.07-5.03).

Conclusion:

These findings suggest that, for LGB persons, gaining social capital from SM is valuable for establishing and maintaining connections. Increased negative SM experiences may pose a risk for the mental well-being of LGB individuals.

Keywords

LGBT young adults social media content analysis mental health

Purpose

Social media (SM) comprises a diverse set of online platforms for virtual communication. Social media use is ubiquitous; about 90% of US persons aged 18 to 29 years have at least 1 account.¹ Social media has changed the nature of social relationships among youth, leading researchers to investigate the mental health impacts of SM on young adults.

For lesbian, gay, and bisexual (LGB) persons, SM is now a primary mode of socializing,^2
-4 perhaps to compensate for perceived limited availability of off-line connections, social capital, resources, and support.⁵ This is especially true for LGB young adults who live in geographically isolated areas or have unsupportive families or environments.^6,7

Although the volume of SM use (ie, total time of usage and frequency of checks) does not seem to vary significantly between LGB and non-LGB youth,^4,6 previous quantitative research suggests that motivation, characteristics, quality, stressors, and outcomes associated with SM use may differ across groups of young SM users. For example, gay, bisexual, and other men who have sex with men report using SM to make new friends, reconnect with friends, and connect with the gay community.⁸ Compared with non-LGB peers, LGB college students use SM for social communication, identity exploration, identity expression, and finding romantic partners. Perceived social support on SM was associated with a decrease in loneliness among LGB youth.⁹ However, LGB individuals are more likely to report being victimized and cyberbullied on SM than their non-LGB peers.¹⁰

Previous qualitative studies have explored the nature and quality of SM experience for LGB individuals. For example, SM may provide lesbian mothers and young men who have sex with men a space to disclose experiences, build a supportive community, and combat isolation, as well as afford a sense of anonymity, removing some of the dangers of stigma and rejection.^11,12 Moreover, for young gay and bisexual men in small cities, SM provides a venue to connect with others, a way to feel “like they belong.”¹³

On the other hand, previous research has pointed out the potential role of SM as an amplifier of inequalities for sharing and understanding public health information.¹⁴ Specifically, LGB youth have expressed the need to balance the positive and negative aspects of SM use. For example, some LGB youth have conveyed concerns about the uncertainty and lack of accountability of SM-only connections.^5,12 Also, although some LGB youth living in large urban areas identify affirming responses from SM contacts, negative experiences like homophobic/transphobic comments seem to be pervasive.¹⁵ However, none of these studies compared the SM experience of LGB youth with that of their heterosexual counterparts. In order to understand potential risk and protective factors for the mental health of young LGB individuals, it is important to compare the quality of SM experiences between LGB and non-LGB youth.

Minority stress theory posits that sexual minority individuals are exposed to unique stressors, including discrimination and social rejection. This exposure may be associated with internalized homonegativity and identity concealment, but social support from within LGB communities can help buffer the impact of these factors on mental health outcomes.¹⁶ These stressors may explain some disparities in depression and other negative mental health outcomes among LGB individuals.^17
-19 However, there is a paucity of evidence on how group-specific risk and protective factors behave on SM, how they interact with each other, and the resulting effects on mental health. To investigate these potential effects of SM on mental health, first we sought to answer how SM experience differs between LGB and non-LGB youth. To do this, we used qualitative data from a national sample of US young adults to compare self-reported positive and negative SM experiences between LGB and non-LGB participants.

Design, Setting, and Participants

This content analysis was part of an online national study that used quantitative and qualitative data to examine how SM use impacts health outcomes among young adults. In 2018, we commissioned Qualtrics Sampling Services to recruit an online sample of 2408 US adults aged 18 to 30 years, reflective of the 2010 US Census in terms of key sociodemographic factors. For recruitment, a combination of demographic screening questions and recruitment quotas that best reflect the population makeup of the United States was used (eg, age, race, ethnicity). Participants received financial incentives, depending on the agreement between each participant and Qualtrics.

Method

Data Collection

We used Qualtrics software²⁰ to create an online survey compatible with smartphones, laptops, and desktop computers. The survey was available for 30 days and it contained questions related to demographics, SM usage, contextual variables, and mental health. Surveys contained an open-ended question that asked, “In 4 or 5 sentences, please tell us your stories about the ways in which SM has had a (1) positive and (2) negative effect on your life.” This question was presented near the end of the survey, and respondents were able to freely type responses. Responses provided the qualitative data for this analysis. Recruitment and survey procedures were approved by the [redacted] institutional review board.

We assessed sexual orientation with the question ”Do you consider yourself to be” and 6 options: (1) exclusively heterosexual or straight, (2) mostly heterosexual or straight, (3) bisexual, (4) mostly gay or lesbian, (5) exclusively gay or lesbian, or (6) queer. We considered “mostly heterosexual” as a separate sexual orientation category from heterosexual because previous research showed this group to be at risk for mental health concerns.^21

-24 Therefore, for analysis purposes, participants who identified as “exclusively heterosexual or straight” were categorized as “non-LGB” and the other 5 categories were combined into the “LGB” group. Given that the larger study was focused in recruiting a sample that would resemble the US population as closely as possible, the mostly gay or lesbian, exclusively gay or lesbian, and queer categories were too small (n = 38, n = 89, and n = 15, respectively) to analyze separately.

Analysis Strategies

A rigorous hybrid approach to code development may start with an initial set of codes based on previously existing knowledge about the phenomena and then seek feedback from the data to supplement with newly developed codes that are related to the experience under study (ie, directed content analysis approach).²⁵ For this study, the central unit of analysis was the survey participant. Because each respondent was able to provide only 1 response (regardless of whether the response covered only positive SM experiences or only negative or both), the number of participants and responses are the same.

Our codebook development used a hybrid approach of inductive and deductive coding to provide meaning to concepts not yet clearly articulated in existing theoretical frameworks.²⁶ First, 3 noncoding authors developed a tentative list of codes based on previous qualitative research on positive and negative SM experiences and our own research questions. Two coders independently coded a 20-response subsample, followed by discussions between noncoding authors and each coder to condense similar codes. To increase the credibility of our process, we integrated feedback from 2 qualitative research experts. We completed our codebook with 23 unique codes: 13 derived using a deductive approach from our previous work and hypotheses, 10 derived based on the data used for this analysis.

Next, we conducted 2 rounds of coding tests. For each iteration, coders independently coded 20 response subsamples. After each iteration, we assessed inter-rater reliability, which was excellent (κ = .90).²⁷ Subsequently, coders coded the remaining 2348 responses, selecting multiple codes if a response met the criteria for more than 1 code. After each iteration, conflicts and discrepancies were resolved one on one with the first author and each coder.

For this content analysis, we focused on quantitative descriptions of the data and qualitative examples that represent these codes. We summed the counts for each code from the responses of both non-LGB and LGB participants. Then, we computed rate ratios (RRs) and 95% confidence intervals (CIs) to determine whether there were significance differences in the occurrence of each code between LGB and non-LGB respondents. Using RR accounted for the difference in number of individuals in the LGB and non-LGB groups (n = 417 and n = 1598, respectively). Statistical significance was set at P < .05. These analyses were conducted using Stata 15.²⁸ Finally, we grouped codes into larger code categories for interpretation. Coding and qualitative analyses were conducted using Nvivo 12.²⁹

Results

Sample

After removing nonrespondents from the qualitative item, our final sample comments on either or both the positives and negatives of SM consisted of 2015 responses, 20.7% from LGB participants. This is similar to rates found in previous research in which the “mostly heterosexual” category was grouped with other LGB minorities.^21,24 Table 1 describes respondents’ demographic characteristics; there were group differences in terms of sex, education, employment, income, and relationship status.

Table 1.

Participant Characteristics and Bivariate Associations With Sexual Orientation (N = 2015)^a.

Sociodemographic Characteristic	Whole Sample	Sexual Orientation		P Value^b
Sociodemographic Characteristic	Whole Sample	Non-LGB (79.3%)	LGB (20.7%)	P Value^b
Age group				.99
18-24	18.5	79.3	20.6
25-30	81.5	79.3	20.7
Sex				<.001
Male	52.7	49.8	37.9
Female	47.3	50.2	62.1
Race				.11
White, non-Hispanic	68.5	68.8	67.6
Black, non-Hispanic	7.5	7.7	6.9
Hispanic	14.2	13.2	17.8
Asian	8.6	9.1	6.7
Other^d	1.2	1.2	1.2
Education				.01
High school or less	13.3	12.5	16.5
Some college or technical school	30.8	30.1	33.4
College graduate	33.9	34.3	32.5
Graduate school	21.9	23.1	17.6
Employment status				.004
Employed	75.6	76.7	71.9
Homemaker	6.1	5.6	7.7
Student	12.4	12.6	11.3
Unemployed	5.9	5.1	9.1
Annual household income				<.001
<$25 000	15.5	14.6	19.0
$25 000-<$50 000	27.3	25.9	33.0
$50 000-<$75 000	23.0	23.1	22.7
$75 000 or above	34.2	36.4	25.3
Relationship status				<.001
Single	42.1	41.8	43.2
Member of unmarried couple	26.4	24.6	33.1
Married	31.5	33.6	23.7
Living situation				.21
By myself	17.6	17.8	17.0
Parent or guardian	20.4	19.5	24.0
Significant other	46.7	47.5	43.7
Other^e	15.3	15.2	15.3

^a Includes individuals who responded to open-ended questions.

^b P value derived from χ² tests for categorical variables.

^c Column and row totals may not equal 100 due to rounding.

^d Includes individuals who self-identified as American Indian/Native Alaskan, Native Hawaiian/Pacific Islander, or Other, non-Hispanic.

^e Included friends and acquaintances.

Code Frequencies and RRs

Table 2 displays code definitions, frequencies, and RR. Of 23 final codes, we categorized 10 as positive effects of SM: social connectedness, long-distance connections, positive emotional contagion, social capital, positive personal interactions, informational support, SM emotional support, membership, identity formation, and positive body image. Conversely, 11 codes were considered negative: negative emotional contagion, negative personal interactions, comparison with others, bullying, negative body image, unmet expectations, real-life repercussions, jealousy/envy, fear of missing out, social isolation, and profile management. Two codes—no negative characteristics and no positive characteristics—described neither positive nor negative attributes; thus, we categorized them as “informational purpose” codes.

Table 2.

Code Counts and Rate Ratios Comparing the Responses of Non-LGB and LGB Participants’ Responses to Open-Ended Question About Social Media Experiences (N = 2015).

Code	Definition	Non-LGB, n = 1598	LGB, n = 417	Rate Ratio (95% CI)^a
Positive social media effects
Social connectedness	Social media (SM) helps people to stay in touch and/or interact with loved ones and community.	597	153	0.98 (0.81-1.17)
Long-distance connections	SM helps to keep in touch with connections that otherwise would be lost.	336	98	1.10 (0.88-1.39)
Positive emotional contagion	SM content that negatively influences a user's emotional status.	345	74	0.80 (0.62-1.04)
Social capital	SM helped the participant to create new connections and meeting new people.	154	65	1.58 (1.17-2.12)^b
Informational support	Participant mentions SM as source of people or resources for obtaining useful information.	120	43	1.41 (0.99-2.01)
Positive personal interactions	SM exchanges that users find uplifting and stimulating.	106	26	0.95 (0.61-1.47)
Emotional support	Participant mentions SM as a source of people to talk to about one's problems and feel appreciated.	88	33	1.27 (0.83-1.93)
Membership	SM provides a way for individuals to join groups and feel like they belong.	56	18	1.18 (0.69-2.03)
Identity formation	SM allows users to explore their identity and other individual characteristics.	4	5	4.04 (0.98-16.65)
Positive body image	SM user's feelings of being satisfied with their body, weight, or appearance.	8	1	0.36 (0.04-3.05)
Negative social media effects
Negative emotional contagion	SM content that negatively influences a user's emotional status.	374	125	1.28 (1.04-1.58)^b
Negative personal interactions	SM exchanges that make people stressed, sad, depressed, upset, or angry.	310	81	1.01 (0.79-1.29)
Comparison with others	SM content (eg, accomplishments) causes one to compare one’s life or body to that of others.	276	98	1.28 (1.01-1.62)^b
Bullying	Situations or interactions in which participant was called out, harassed, or insulted on SM.	82	31	1.36 (0.89-2.09)
Negative body image	SM user's feelings of being dissatisfied with their body, weight, or appearance.	79	21	0.85 (0.52-1.38)
Social isolation	SM may make users feel like they have poor to no contact with society.	66	23	1.33 (0.82-2.16)
Real-life repercussions	For participants who felt SM usage is related to real-life adverse events in their lives.	58	29	1.86 (1.18-2.94)^b
Envy	SM may be a vehicle for jealousy or envy between couples and friends.	37	26	2.49 (1.48-4.19)^b
Unmet expectations	On SM, some persons may find unfulfilled their expectations of finding support, fun, friends, and so on.	26	11	1.45 (0.70-3.00)
Fear of missing out	On SM, users may experience a constant fear of missing out on the fun they could be having.	21	9	1.93 (0.87-4.32)
Profile management	SM allows people the ability to edit and manage how they present themselves.	17	11	2.32 (1.07-5.03)^b
Informational purpose codes
No negative characteristics	Any response expressing no negative SM experiences.	330	49	0.56 (0.41-0.76)^b
No positive characteristics	Any response expressing no positive SM experiences.	176	36	0.79 (0.55-1.49)

Abbreviations: CI, confidence interval; LGB, lesbian, gay, and bisexual.

^a Comparing nonheterosexual versus heterosexual participant.

^b P < .05.

Overall code count was 4732, of which 49.2% were related to positive SM effects, 38.3% to negative SM effects, and 12.5% to informational purpose. Most codes identified in responses described positive SM effects from both non-LGB and LGB participants (49.5% and 48.4%, respectively). However, a sizeable minority of codes described a negative SM effect among responses of both groups (non-LGB 36.7% and LGB 43.6%). Specifically, we identified 4 larger code categories that encompassed similar characteristics of the SM experience, detailed below. For conciseness, we provide quote examples only for codes for which frequency was significantly different between responses of LGB and non-LGB respondents. Examples for remaining codes are available upon request.

A place to form and maintain connection with others

Three codes about positive SM effects related to the ability of users to establish new connections (social capital) and maintain old ones, whether with people living physically close (social connectedness) or afar (long-distance connections). Within this category, only the code “social capital” was more frequent among LGB participants compared to non-LGB counterparts (n = 65, RR = 1.58, 95% CI, 1.17-2.12).

On the one hand, both LGB and non-LGB participants saw the value of SM in helping form new connections: “…I am also able to meet and communicate with people I would’ve never met without social media. Social media has changed my life. It has helped me in a lot of ways…” (male, LGB, 22). SM “helped me to connect with people around me that I otherwise wouldn’t have known” (female, non-LGB, 20).

On the other hand, LGB participants also highlighted the possibility of increasing their social capital as an intermediate step in building more meaningful relationships and increasing their sense of belonging in the LGB community:

SM allowed for me to have a supportive community when I needed it most. The people I know online, they have provided me with more support than my own family. The community I’ve found through social media serves as a welcome escape from my personal struggles in real life. (female, LGB, 23)

SM helped me meet new people. I’ve met people I’d never have known about before. I don’t feel like the odd one out when I talk about my strange interests. (male, LGB, 28).

Conductor of potential protective factors for mental health

Seven of the positive codes about SM (membership, emotional support, informational support, positive personal interactions, positive emotional contagion, identity formation, and positive body image) described experiences in which respondents perceived support, felt a sense of belonging to a community, or had pleasurable interactions over SM. The most frequently occurring code in this category was positive emotional contagion. We found no significant difference in code counts between responses of non-LGB and LGB participants.

On SM, several LGB identity-related stress processes may occur

Five codes described negative SM experiences that might be perceived by the individual as related to their sexual minority identity (eg, LGB). Of these, negative emotional contagion (n = 125, RR = 1.28, 95% CI, 1.04-1.58), real-life repercussions (n = 29, RR = 1.86, 95% CI, 1.18-2.94), and profile management (n = 11, RR = 2.32, 95% CI, 1.07-5.03) were significantly more frequent among LGB individuals. Two codes—bullying and negative personal interactions—were not significantly different between groups.

Negative Emotional Contagion

Both non-LGB and LGB respondents expressed their concerns about the pervasive and sometimes contagious negativity on SM. For example: “When I read things happening to children. Some sort of abuse. Also, shootings and killings. Makes me very sad” (female, non-LGB, 29). “There is just so much negativity going on all the time. A lot of it is important but horrible, but a lot of it is generally horrible. It’s a real drain” (female, LGB, 28).

However, LGB participants also mentioned the negativity of certain content affected them because it seemed to specifically target sexual minorities, generating or increasing negativity and anger:

Seeing some extreme views has made me less optimistic about the future. Hearing people say that I should be attacked, not have work, etc. has made me less likely to want to share my opinions. Social media’s polarizing influence has made me afraid to talk to friends about some things. (male, LGB, 26)

Reading people’s negative/hateful/ignorant/incorrect comments on social media really makes me angry/upset. I get really fired up and want to fight back with them (which in the past I have). (female, LGB, 24)

Real-Life Repercussions

While both non-LGB and LGB respondents described repercussions in everyday life from SM experiences, non-LGB participants described SM’s complication of romantic relationships and friendships: “It’s terrible. I am constantly checking in…I’ve found out a lot through social media from past guys I’ve dated and now I check constantly regarding current relationships and it ruins the relationship because of lack of trust […]” (female, non-LGB, 27).

Social media is addicting. I have friends that sit around during their free time and look at it nonstop. It has definitely affected my friendships in a negative way. My friends will often pay more attention to their phones than to me. (female, non-LGB, 24)

LGB participants described consequences related to being accidentally outed on SM and dealing with family rejection and/or workplace discrimination: “I became outed by changing my status on Myspace […]. It caused issues with my mother and sister […]. That caused me to delay actually coming out (in person) to my whole family until I was about 24” (male, LGB, 26). “Social media caused the majority of my family to go after me for my political views and homosexuality. […] I never post anything on my own because I’m afraid of people’s reactions” (female, LGB, 21).

I get judged for certain things I say and people can make rude nasty responses. I had to use a picture of my cat [for my profile picture] because a potential employer viewed my Facebook page and didn’t give me an interview based off my Facebook page. (female, LGB, 28)

Profile Management

Most of the profile management-coded responses commented on the pressure and negative effect of editing profile photos: “Too many people Photoshop their photos and pose to make themselves look more attractive. Those standards tend to have a negative effect on a lot of individuals” (female, non-LGB, 20).

However, for some LGB participants, this pressure was on the content, words, and ideas they share on SM, to the point of sometimes feeling socially isolated:

I would say before social media and having exposure to lots of followers for my costuming, I didn’t care that much about how I looked. But I have to be very attentive now about what I write that’s publicly visible, and what I have to filter for only friends/family, which makes me feel like a self-imposed isolation or silence about my views, in order not to stir the water with my followers/supporters/fans. (female, LGB, 29)

Worsening feelings of disconnect

The final category included 6 codes encompassing negative SM experiences that may generate or maintain a feeling of disconnect from others. Unlike the codes from the previous category, respondents did not report a perception of the experience being related to their sexual identity; whereas 4 of these codes (fear of missing out, negative body image, unmet expectations, and social isolation) showed no frequency difference between groups, “comparison with others” (n = 98, RR = 1.28, 95% CI, 1.01-1.62) and “envy” (n = 26, RR = 2.49, 95% CI, 1.48-4.19) were more frequent among LGB participants.

Despite the difference in frequency, responses of both non-LGB and LGB participants were similar for both these codes. Regarding “comparison with others,” participants expressed how SM makes them feel like their lives are worse or less successful than others’: “I have high school friends that I am not friends with anymore. I compare myself to them. Like they have more friends than me or they are having a better time than I am” (female, non-LGB, 20). “Seeing others post about their family, friends, and success makes me feel inferior” (male, LGB, 26).

In terms of the “envy” code, participants also expressed how seeing other people’s lives portrayed on SM makes them feel jealous, sometimes generating negative feelings toward those people or themselves: “I tend to feel jealous of a lot of people I see on social media. It makes me dislike people” (male, LGB, 30). “I have always had trouble with the way I see myself weight-wise. When I go on social media and see pictures of girls who are skinnier and in better shape, it makes me jealous” (female, non-LGB, 19).

Finally, among the 2 informational codes, responses of LGB participants expressed the absence of negative SM experiences much less frequently than non-LGB respondents (n = 49, RR = 0.56, 95% CI, 0.41-0.76).

Conclusion

Content analysis of open-ended responses in a national online survey found that although the majority of codes from both non-LGB and LGB young adults were positive regarding the effect of SM on participants’ lives, a sizable minority highlighted negative effects. Six codes were significantly more frequent among LGB respondents: 1 reflected positive effects (social capital) and 5 described negative effects of SM (negative emotional contagion, comparison with others, real-life repercussions, envy, and need for profile management). One informational code was less frequent among LGB respondents (no negative characteristics).

Our work has identified areas that are important to study when trying to understand the impact of SM on the well-being of LGB persons. Future research could seek to expand minority stress theory with constructs that capture the SM experience of LGB individuals. Most codes were positive toward SM experience across both non-LGB and LGB participants. Both groups thought SM was good at helping them to feel appreciated, supported, and like they belong. Social media was also described as positive for individual identity development. These findings support and extend those of previous qualitative research regarding the positive impact of SM on the lives of LGB persons.^11
-13 Specific to our study, LGB participants highlighted using SM to increase their social capital, establish new connections, and develop these into significant friendships/romantic relationships. Although there is evidence to support the value of SM-gained social capital in improving psychological well-being,^30,31 studies of LGB youth are limited. It is possible that increasing one’s social capital may be harder in real life for LGB persons than for others, especially in conservative areas.⁷ Our qualitative findings partially support this argument: LGB respondents from our sample thought of increasing one’s social capital via SM as a way to develop fulfilling relationships. Future research should consider the effect of social capital on the well-being of LGB youth in a more nuanced way. For example, examining how familial networks and nonfamilial identity-based SM networks reinforce or buffer environmental stressors. Previous research suggested social capital derived on SM from intimate SM contacts might be responsible for this potential positive effect.³¹ Conversely, social capital derived on SM from acquaintances may be more like distant friends, but it might provide additional information on shared challenges, which may be enriching for young LGB individuals who are seeking reaffirming connections. These are questions to address with extensive qualitative studies with diverse LGB participants.

Nearly 40% of our code frequency count covered negative SM experiences. Importantly, in responses of LGB participants, our content analysis found 5 of these codes more frequently, including “negative emotional contagion.” Previous research found emotional contagion can occur on SM and that amount of positive SM posts seen might have a protective effect on mental health among the general population.³² Unfortunately, our findings suggest that LGB youth might see or interact with more negative SM content in the form of news, comments, and status updates that target sexual orientation. This could negatively affect LGB youths’ mood, well-being, and perception of the world. Our findings expand the literature about the potential negative aspects of SM among LGB individuals, adding everyday life consequences of SM interactions.¹⁵ Indeed, LGB participants reported more “real-life repercussions” from their engagement with SM, including conflicts with family, friends, and co-workers, after being accidentally outed on SM. Potentially related, the “profile management” code was also more frequent in responses of LGB participants. The LGB persons might feel compelled to exert tighter control of profile settings on their SM platforms, attempting to compartmentalize their contacts, and perhaps part of their lives, to avoid an information overspill that could lead to real-life consequences, such as the ones our participants reported. These findings complement and extend those of previous research conducted among lesbian and bisexual women.^11,33 Future research should look into negative emotional contagion spread through SM, real-life repercussions of SM interactions, and profile management on SM as potential sources of targeted stress for LGB youth.

Our work also adds to the literature on the impact of SM on the well-being of LGB individuals. We found that LGB youth’s responses contained “comparison with others” and “envy” more frequently than non-LGB persons. Both constructs have been associated with negative mental health, either by generating or increasing an already existing feeling of disconnection with others. In our data, “comparison with others” invariably described the comparing of oneself with someone whom one thinks is better off (ie, upward comparison). This form of social comparison has been consistently described as a risk factor for negative mental health outcomes.^34

-37 In addition, “envy” was also coded more frequently in the responses of our LGB participants. Previous research found that jealousy and envy on SM may behave as potential mediators in the relationship between SM use and negative mental health outcomes.^38,39 Future quantitative research that looks at understanding SM use among LGB youth should consider these as potential factors that may influence mental health outcomes.

Interestingly, the “no negative characteristics” was the only code found significantly less frequently in the responses of LGB participants. Essentially, this means that compared to non-LGB respondents, LGB respondents expressed much less frequently that they did not have a negative SM experience. This is not surprising, given that several codes that describe a negative SM experience were more frequent in responses of LGB individuals. Previous research has reported no significant difference in amounts of SM use between non-LGB and LGB populations.^4,6 In light of our findings, future qualitative inquiry should explore the complexities of why the majority of LGB individuals, given the otherwise significant number of negative SM experiences in their lives, keep using SM as a medium to connect with others and seek support.

Limitations

Our work has some limitations. First, among demographic characteristics, ages 25 to 30 years were overrepresented. This is important because younger individuals are recognized as heavy SM consumers. Second, our data did not contain geographic location of respondents, which could have been potentially useful to understand some SM experiences in the context of more conservative versus more liberal environments. Future qualitative research should focus on a more diverse sample of sexual minority groups. Third, instead of suitable measures, such as Krippendorff α,⁴⁰ we chose Cohen κ for determining inter-rater reliability. We did this given κ common usage in the health research field and because the excellent agreement between our coders was well above any threshold for potential concern regarding reliability.⁴¹ Fourth, because of subsample sizes, we were limited in our ability to compare codes and RRs between the 3 main sexual minority groups. Fifth, because of the way we coded the “no negative characteristics” code, we were unable to determine whether participants were providing a thoughtful answer to the question. Finally, in this research, we used minority stress theory¹⁶ to contextualize our findings. At this time, we did not seek to, nor ask the appropriate questions that could inform further theory development. Nonetheless, our findings unveiled aspects of the SM experience that are potentially unique to LGB persons. In-depth qualitative inquiry will aid in understanding the meaning and effects of SM experiences on the well-being of this population.

So What?

Research conducted in the past 10 to 12 years suggests that social media (SM) may play a role in mental well-being, but group-specific factors have been understudied. For lesbian, gay, and bisexual (LGB) minorities, we know very little in terms of whether and how SM use is related to mental health outcomes. This is important, given well-known mental health disparities for this population. Although more study is needed, our finding suggests that, among LGB persons, SM experiences may have an effect on individuals’ well-being. Clinicians and mental health practitioners may want to consider incorporating conversations about behaviors and experiences on SM with their LGB patients. Topics such as whether they feel an impact of SM on their daily lives might provide valuable insight on their social behaviors and availability of resources and support.

Our findings show that, for LGB individuals, gaining social capital online has potential ramifications for their ability of establishing and maintaining meaningful connections. These findings call for further research on the value of social capital gained through online platforms for one’s mental well-being, especially among minority populations with less ability to make these gains in the off-line world.

However, for the negative SM experiences, LGB individuals describe more real-life repercussions and these repercussions seem to impact their family dynamics and/or relationships in the workplace. These experiences may pose a distinct risk for the mental health and well-being of minority individuals and require more research efforts to thoroughly characterize and subsequently measure them, accounting for the increasing diversity of the US population.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the National Institute of Health Disparities and Minority Health (K99-MD012813) and the Fine Foundation (Grant number 171R32SM-2018).

ORCID iD

César Escobar-Viera

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