Resilience in Lesbian,Gay,and Bisexual Individuals

Abstract

To promote psychological health among lesbian, gay, and bisexual (LGB) individuals, more comprehensive research on resilience factors in LGB individuals is needed. This article presents a theoretical framework based on the existing literature, with an eye toward guiding future research in this area. Social support clearly serves as a resilience factor for LGB individuals, in part through its ability to lower reactivity to prejudice. Social support is particularly effective when it specifically supports people’s sexual orientation and is congruent with individuals’ developmental needs. The ability to accept emotions and to process them in an insightful manner also buffers the negative impact of prejudice. In addition, hope and optimism allow LGB individuals to maintain psychological health when faced with prejudice.

Keywords

sexual orientation resilience social support emotional openness hope optimism lesbian gay bisexual outness

As the research literature on lesbian, gay, and bisexual (LGB) individuals has developed over recent years, much attention has been appropriately placed on the stigma-related prejudice and discrimination experienced by sexual minority individuals (Kelleher, 2009; Meyer, 2003). Hatzenbuehler (2009) posited that when sexual minority individuals experience exposure to stress as a result of stigma, they are at greater risk for difficulties with emotional regulation, interpersonal relationships, and negative cognitions. These difficulties, in turn, are proposed to lead to a greater risk for psychopathology. In fact, a meta-analysis by Meyer (2003) found that gay men and lesbians were roughly twice as likely as heterosexual individuals to experience mental health disorders.

Further efforts to understand these difficulties among the LGB population are clearly warranted. In addition, continued efforts need to be made to reduce anti-LGB attitudes in the general population to lessen stigma-related stress. However, it is striking that there has not been a more comprehensive attempt to examine functioning among LGB individuals from a positive psychology perspective (Seligman & Csikszentmihalyi, 2000). Positive psychology research on the general population has led to a greater understanding of positive personal traits that allow people to remain resilient during stressful situations (Hart & Sasso, 2011). Given the impact of minority stress on LGB individuals (Meyer, 2003), one might expect an abundance of such research on LGB individuals. Unfortunately, this has not been the case. A number of scholars have lamented the relative paucity of studies taking a positive psychology approach to LGB individuals (e.g., Riggle, Whitman, Olson, Rostosky, & Strong, 2008; Savin-Williams, 2008). In discussing the developmental literature on LGB individuals, Savin-Williams noted the tendency of this research to be problem-focused and noted out of apparent exasperation: “I am hard pressed to identify any data-based positive attribute that characterizes the lives of same-sex oriented preadults relative to heterosexuals. Can this possibly be true?” (Savin-Williams, 2008, p. 137).

Ongoing efforts to understanding resilience in LGB individuals would benefit from a theoretical framework that relates to the larger body of research on resilience in the general population. The goal of the present article is to (a) propose a model of resilience in LGB individuals, (b) summarize the existing literature on resilience factors among LGB individuals using this framework, and (c) outline future directions for this area of research.

An Overview of the Model

The framework presented in this article is depicted in Figure 1. Numerous research studies have demonstrated that social support is clearly associated with better psychological and physical health in the general population (see review by Cohen, 2004). In a theoretical review, Cohen (2004) argued that social relationships promote health and well-being through two distinct mechanisms: the promotion of social connectedness and stress buffering. The model presented in Figure 1 proposes that these two mechanisms are especially important for LGB individuals. Social support can lead to a sense of connection with the LGB community, contributing to psychological health. In addition, the stress buffering mechanism of social support lowers reactivity to prejudice.

Figure 1.

Theoretical framework of resilience in lesbian, gay, and bisexual individuals.

Research suggests that the ability to accept and process emotions during stress is associated with psychological health. People instructed to suppress their emotions in response to emotion-provoking stimuli experience greater distress and physiological arousal compared with those instructed to accept their emotions (Campbell-Sills, Barlow, Brown, & Hofmann, 2006; Gross & Levenson, 1997). This increased physiological arousal can intensify efforts to further suppress emotions, leading to further strain and increased risk for psychological disorders (Barlow, Allen, & Choate, 2004). However, the experience of emotion in itself is not always adaptive. Emotional acceptance, to be regulated and beneficial, needs to occur in conjunction with an appraisal of one’s emotions (Salovey & Mayer, 1990). A large number of studies have shown that such emotional processing of traumatic events is beneficial in the general population (see review by Pennebaker, 1997). Given these findings, I propose that the ability to accept and process emotions protects LGB individuals from the negative effects of traumatic experiences with prejudice. For brevity, I will refer to this attribute as emotional openness throughout this article.

Another source of resilience lies in the ability to tolerate stress by focusing on the future, envisioning a better life and actively pursuing goals with determination. Characteristics such as hope and optimism have been demonstrated to be associated with resilience in the general population (Carver, Scheier, & Segerstrom, 2010; Peterson & Seligman, 2004; Scheier & Carver, 1992; Seligman & Csikszentmihalyi, 2000; Snyder, Rand, & Sigmon, 2005). Hopeful individuals are able to continue their pursuit of goals when faced with environmental obstacles (Snyder et al., 1991). Hope and optimism may allow LGB individuals to persevere despite encountering minority stress. Therefore, I propose that hope and optimism provide resilience in LGB individuals.

Social Support

Associations With Psychological Health

Social support appears to promote resilience among sexual minority individuals. A recent Internet-based survey of 1,381 LGB individuals revealed that higher perceived social support was associated with lower depression and anxiety (Lehavot & Simoni, 2011). Perceived social support was found to correlate moderately to highly with greater life satisfaction, less depression, and less loneliness in samples of lesbian individuals from both university and community samples (Keleher, Wei, & Liao, 2010). In addition, a 2-week daily diary study of lesbian and gay adults found that perceived social support significantly predicted self-esteem and satisfaction with life (Beals, Peplau, & Gable, 2009).

Social support is also associated with relationship satisfaction in lesbian and gay couples (Jordan & Deluty, 2000; Smith & Brown, 1997). Among lesbian and gay adoptive parents, social support is associated with less parenting stress and fewer depressive and anxiety symptoms (Goldberg & Smith, 2011; Tornello, Farr, & Patterson, 2011).

Clearly, social support enhances psychological and interpersonal functioning in LGB individuals. Research on the general population has identified a number of mechanisms responsible for these benefits, including greater self-worth, security, meaning, and the emulation of positive role models (see Cohen, 2004). Research has shown that these mechanisms are particularly important for LGB individuals. A connection with the greater LGB community contributes to psychological health through greater self-worth and a sense of belonging (Nesmith, Burton, & Cosgrove, 1999; Riggle et al., 2008).

Lower Reactivity to Prejudice

In addition to a direct relationship between social support and psychological well-being, social support also contributes to psychological health through stress buffering (Cohen, 2004). In a correlational study of young LGB adults, sexuality-related support attenuated the relation between sexuality-related stress and emotional distress (Doty, Willoughby, Lindahl, & Malik, 2010). This finding is consistent with the notion that social support is especially important for people with invisible stigmas, who are at greater risk for feeling invisible or alienated (e.g., Deaux & Ethier, 1998; Major, 2006).

Research also suggests that social support is especially beneficial when it affirms people’s sexual orientation. For instance, social support that was provided for LGB-specific issues was associated with lower depressive symptoms in one study of 820 LGB participants (Berghe, Dewaele, Cox, & Vincke, 2010). In a study of LGB adults age 60 and over, participants reported that they were more satisfied with social support that came from people who knew their sexual orientation (Grossman, D’Augelli, & Hershberger, 2000). Presumably, only these particular people in their social network would be in a position to buffer the effects of LGB-related stress. In addition, a 2-week daily diary study found that lesbian individuals who perceived greater support for their sexual orientation reported greater well-being during the course of the study and at a 2-month follow-up (Beals & Peplau, 2005).

Research on the general population has demonstrated an important mechanism through which social support buffers the negative impact of stressful events. Specifically, studies have shown that people may rely on their social network to formulate more positive appraisals of stressful events (see review by Cohen, 2004). Evidence exists that this mechanism is important for LGB individuals in lowering reactivity to prejudice. A correlational study of 307 gay men found that greater social support was related to more positive attributions and less self-blame for discriminatory events (Burns, Kamen, Lehman, & Beach, 2012), which is associated with lower reactivity.

In summary, the vast literature on social support in the general population is generalizable to LGB individuals with some modifications. The literature suggests that social support for stigma-related stressors is particularly important for LGB individuals. LGB individuals also thrive when their social network is affirming of their sexual orientation.

Developmental Issues for LGB Youths

The literature suggests that LGB youths have particular developmental needs regarding social support. For LGB youths and young adults, social support from family and friends that affirms their sexual orientation is particularly important. Such support is associated with less depression and suicide risk in LGB young adults (Ryan, Huebner, Diaz, & Sanchez, 2009) and less internalized homophobia in bisexual young adult college students (Sheets & Mohr, 2009). Notably, internalized homophobia is an important indicator of an LGB person’s reactivity to prejudice.

Social support from family members in particular is associated with self-acceptance among LGB adolescents and young adults (Shilo & Savaya, 2011). Affirmation from family is associated with higher self-esteem, better health, less substance abuse, and fewer psychological difficulties among LGB adolescents (Ryan, Russell, Huebner, Diaz, & Sanchez, 2010). A 12-month prospective study found that greater social support from the family at Time 1 predicted more positive attitudes regarding sexual identity in LGB youths and young adults at Time 2 (Rosario, Schrimshaw, & Hunter, 2008).

Given the importance of family support, LGB youths who are ostracized by their families after coming out are extremely vulnerable. Family rejection can lead to homelessness, substance abuse, suicidality, and other severe problems among LGB youths (D’Augelli, Hershberger, & Pilkington, 2001; Savin-Williams, 1994). In the event of family rejection, alternate sources of support from adults become critically important. A qualitative study of LGB adolescents and young adults recruited for a drop-in center for sexual minority adolescents and young adults found that support from a parental figure was important for a majority of participants, particularly if their relationships with their parents were problematic (Nesmith et al., 1999). The study also found that a majority of participants benefited from meeting a key individual who catalyzed a connection with the greater LGB community. Such connections allow LGB youths to identify positive role models and mentors, a critical aspect of the type of social support that they need at an early age. A sense of community also leads to empowerment (Riggle et al., 2008), which lowers reactivity to prejudice.

A major issue faced by many LGB youths is bullying and a lack of safety in school. This type of discrimination is particularly insidious, leading to greater school avoidance, academic difficulties, dropout, physical injuries resulting from assault, substance abuse, and psychological difficulties (see reviews by Darwich, Hymel, & Waterhouse, 2012; Murdock & Bolch, 2005). For LGB youths, social support from adults who can serve a protective function is particularly critical. A large survey of over 19,000 lesbian and gay high school students found that greater support from adults within their school was related to less school avoidance, less substance use, and less victimization (Darwich et al., 2012). Another study of high school youth found that greater support from teachers was associated with a greater sense of school belonging; support from family and friends, however, was not associated with school belonging (Murdock & Bolch, 2005). This finding makes sense in light of the model: Teachers, not family members or friends, have the greatest influence in reducing bullying.

Finally, it appears important for schools to foster an overall climate of safety for LGB students. Schools that have a Gay–Straight Alliance (GSA), a student organization for sexual minority students and their allies that is designed to reduce prejudice, have lower rates of victimization (Goodenow, Szalacha, & Westheimer, 2006) and higher grades (Walls, Kane, & Wisneski, 2010) among their LGB students.

In summary, consistent with the theoretical model, the literature suggests that contextual and developmental issues are important in providing resilience to LGB youths. Given their greater reliance on parental figures for a sense of well-being compared with older adults, LGB youths greatly benefit from support from parents or other adults who can play a parental role. In buffering the effects of bullying, the support of school authorities, teachers, and peers represents a more proximal protective factor compared with general social support. Such persons are in a position to affect the school environment in a manner that protects LGB students from stigma-related prejudice.

Developmental Issues for LGB Adults

Older LGB adults are likely to have different developmental needs compared with their younger counterparts. Indeed, the relationship between support from family and psychological health becomes attenuated as adults get older (Mustanski, Newcomb, & Garofalo, 2011). A study of LGB adults age 50 and over found that social support from friends, but not from family, was associated with higher quality of life, lower depressive and anxiety symptoms, and less internalized homophobia (Masini & Barrett, 2007). Another study of lesbian individuals similarly found that social support from friends, but not from family, was associated with fewer depressive symptoms when both forms of social support were entered together in a regression analysis (Oetjen & Rothblum, 2000). Finally, LGB adults benefit from workplaces that provide social support that affirms their sexual orientation (Huffman, Watrous-Rodriguez, & King, 2008).

Is Outness Beneficial?

Although terms such as “being out” and “being closeted” imply two dichotomous categories, there are varying degrees of outness. For instance, an LGB person may be out with friends and certain family members, but closeted with coworkers and other family members. In building social networks and soliciting social support, LGB individuals continually make difficult decisions regarding whether to disclose or conceal their sexual orientation from different people, which is a chronic source of stress. Although some may surmise that the ability to conceal a stigmatized identity might provide some relief, attempts to conceal one’s sexual orientation can be distressing due to the constant threat of discovery (Pachankis, 2007). Social support is particularly beneficial in mitigating the stress of disclosing one’s sexual orientation. Beals et al. (2009) found that perceived social support was particularly important on days in which respondents disclosed their sexual orientation to someone new. Higher social support on these days predicted greater well-being at a 2-month follow-up, after controlling for baseline levels of well-being.

Disclosing one’s sexual orientation has many potential benefits, such as a greater sense of authenticity (see review by Vaughan & Waehler, 2010). In addition, greater disclosure can also lead to higher social support. In samples of lesbian individuals, outness is positively correlated with perceived social support (Jordan & Deluty, 1998; Lehavot & Simoni, 2011). Shilo and Savaya (2011) also found a positive relation between outness and social support from friends in a sample of LGB adolescents and young adults. Given that these studies were correlational, the causal direction is not clear, but this relationship is probably bidirectional. Sharing such an important aspect of one’s identity is likely to promote closer relationships, and one is more likely to disclose when one already has a supportive social network in place.

A number of studies have examined the question of whether outness is associated with mental health. Outness correlates with higher self-esteem (Halpin & Allen, 2004; Jordan & Deluty, 1998), lower anxiety (Jordan & Deluty, 1998; Lehavot & Simoni, 2011), fewer depressive symptoms (Ayala & Coleman, 2000; Lehavot & Simoni, 2011; Lewis, Derlega, Berndt, Morris, & Rose, 2001), less overall psychological distress (Morris, Waldo, & Rothblum, 2001), greater positive affect (Halpin & Allen, 2004; Jordan & Deluty, 1998), greater well-being (Halpin & Allen, 2004), and less parenting stress (Tornello et al., 2011). A daily diary study found lesbian and gay participants reported greater positive affect, self-esteem, and life satisfaction on days during which they disclosed their sexual orientation, compared with days during which they deliberately concealed their sexual orientation (Beals et al., 2009). In addition, a study of bisexual men in New York City found that concealment of sexual orientation was correlated with poorer mental health (Schrimshaw, Siegel, Downing, & Parsons, 2013).

Greater outness among gay and lesbian couples is also associated with higher relationship satisfaction (Caron & Ulin, 1997; Clausell & Roisman, 2009; Jordan & Deluty, 2000). Clausell and Roisman’s (2009) study is particularly noteworthy for its use of observer ratings of couple interactions. Gay and lesbian couples were videotaped in a 10-minute interaction in which they attempted to resolve the issue that they most often fought about. Research assistants coded the emotional tone of this interaction. Greater outness reported by an individual was correlated with a more positive tone in the individual and the partner. In addition, an individual’s outness was associated with greater self-reported relationship quality for the individual and the partner. This latter finding remained significant after controlling for Big Five personality variables (McCrae & Costa, 1997). In addition, relationship satisfaction in same-sex couples is associated not only with individual levels of disclosure but also with the similarity in levels of disclosure between the two partners. In a path analysis of outness and relationship satisfaction in lesbian couples, Jordan and Deluty (2000) found that discrepancies in partners’ level of disclosure were directly related to lower relationship satisfaction.

Outness is also related to physical health due to a pragmatic issue: Outness to physicians can lead to better medical care. Disclosure to a physician generates better rapport and also leads to more relevant medical care, for example, in treating a gynecological issue that requires the concurrent treatment of the partner (Bjorkman & Malterud, 2007). A study of 489 lesbian individuals found that outness to their physician was a strong predictor of more regular healthcare use (Steele, Tinmouth, & Lu, 2006; see also Bergeron & Senn, 2003). Nearly a quarter of the sample reported that their physicians inquired about their sexual orientation; of these women, everyone disclosed. Other measures of perceived LGB-positive attitudes of the physician were also highly related to disclosure.

Despite evidence that outness is related to better psychological functioning and well-being, outness should not be considered a universal resilience factor. In many of the studies that demonstrated relations among outness and positive outcomes, the effect sizes of the relations were often modest. In addition, some studies failed to find a correlation between outness and psychological distress (Frost & Meyer, 2009; Lewis, Derlega, Griffin, & Krowinski, 2003; Oetjen & Rothblum, 2000) or relationship satisfaction (Frost & Meyer, 2009). In fact, not all studies support a positive correlation between outness and psychological health (Huebner & Davis, 2005).

The model presented in this article helps to reconcile these discrepant findings. To the extent that LGB individuals can disclose their sexual orientation to supportive others, outness is beneficial. In other words, the key resilience variable is social support, not outness. Reactions to disclosure are obviously not universally positive, making disclosure a risky proposition in some situations. Lewis et al. (2001) found that outness is associated with more family stress and greater concerns about other people misunderstanding one’s sexual orientation. Given that outness can have negative consequences, a major consideration is whether disclosure to a particular person will result in greater or lesser social support.

Consistent with this framework, significant evidence shows that contextual variables moderate the relationship between outness and well-being. Legate, Ryan, and Weinstein (2012) found that the relation between outness and psychological health was moderated by the degree to which one’s social network supported one’s autonomy. Among people with a support network that supported their individual choices and actions, outness was associated with less anger, less depression, and higher self-esteem. These relations were not found among people with a support network that attempted to control their actions. This study lends further support to the conclusion that social support is an important aspect of resilience, whereas outness is more distally related to resilience.

Outness among LGB youths in school

As noted earlier, LGB youths often endure chronic stigma-related stress at school. Consequently, they are at greater risk for using alcohol, tobacco, and illicit substances compared with heterosexual youths (see meta-analysis by Marshal et al., 2008). Research on the relation between outness and substance use has revealed mixed findings (see the review by Rosario, Schrimshaw, & Hunter, 2009), likely another indication that the research question “is outness beneficial?” is overly broad. In a study of LGB college students, Rosario et al. (2009) found that the relation between outness and substance abuse was entirely dependent on the reactions to disclosure. In particular, the number of rejecting reactions to disclosure was associated with alcohol, tobacco, and marijuana use. In addition, affirming reactions to disclosure attenuated the relation between rejecting reactions and level of alcohol use. Consistent with the theoretical model in Figure 1, the impact of disclosure on social support is the key variable. In addition, a study of LGB adolescents and young adults found that a history of losing friends as a result of disclosure was associated with past suicide attempts (Hershberger, Pilkington, & D’Augelli, 1997). In contrast, Wright and Perry (2006) found that greater outness among LGB adolescents and young adults to people in their support network was associated with lower sexual identity-related distress. Again, no consistent relationship exists between outness and well-being in youths. The critical factor in the relation between outness and well-being appears to be whether others’ reactions to disclosure are supportive or rejecting in nature, which directly affects perceived social support.

Outness in the workplace

For adults, workplace settings vary widely in responses to sexual orientation disclosure. Despite a recent trend in American society toward greater acceptance of LGB individuals (Berkley & Watt, 2006), abuse and discrimination remain present in the workplace (Willis, 2011). Even with greater legal protections against sexual orientation discrimination, anti-LGB attacks continue. Just as overt racism can be replaced by modern racism (McConahay, 1983) as racial minorities gain greater legal protections, LGB individuals may find themselves to be the target of more covert forms of discrimination (Colgan, Creegan, McKearney, & Wright, 2007; Ozturk, 2011). Even organizations that label themselves as LGB-friendly are not free of prejudice or differential treatment based on a bias of heteronormativity (Colgan, Creegan, McKearney, & Wright, 2008; Rumens & Kerfoot, 2009). Individuals who reported that their workplace was “gay-friendly” in one study nevertheless reported that they still experienced discrimination, including sexual harassment and intrusive questions regarding their personal lives (Giuffre, Dellinger, & Williams, 2008). In addition, LGB-affirmative policies in the workplace can lead to “blowback,” a backlash based on a misperception by coworkers that LGB workers receive preferential treatment (Hill, 2009).

Given these hazards, the decision whether to be out with coworkers is a difficult career decision for LGB individuals (Button, 2001, 2004; Chrobot-Mason, Button, & DiClementi, 2001; Griffith & Hebl, 2002; Ragins, 2004; Ragins, Singh, & Cornwell, 2007). For LGB individuals, disclosure may lead to stigma-related prejudice and discrimination, leading to psychological distress and other problems. Huebner and Davis (2005) found that gay and bisexual men who were out at the workplace had higher levels of salivary cortisol, indicative of greater stress, and reported greater negative affect compared with gay and bisexual men who concealed their sexual orientation. Furthermore, outness increases the risk for verbal and physical assault, fewer promotion opportunities, and termination at work (D’Augelli & Grossman, 2001; Hill, 2009). However, consistent with other research demonstrating the costs of concealment, LGB workers who conceal their sexual orientation have less commitment to their employing organization, greater conflict between their home life and work life, lower productivity, and lower job satisfaction (Day & Schoenrade, 1997; Griffith & Hebl, 2002; Hill, 2009). Given the risks associated with both disclosure and concealment of sexual orientation, it is not surprising that in a national sample of over 500 LGB employees, no relation was found between outness and psychological distress or work outcomes (Ragins et al., 2007).

A critical factor for LGB individuals considering disclosure in the workplace is social support. Support from supervisors is associated with higher job satisfaction among LGB employees (Huffman et al., 2008). Other adults in the workplace also play an important role in promoting the well-being of LGB employees: Support from coworkers is related to greater overall life satisfaction (Huffman et al., 2008). In addition, coworker support, support from supervisors, and organizational support, such as nondiscrimination policies and LGB-affirmative activities, are all correlated with greater outness among LGB employees (Huffman et al., 2008; Woods, 1994).

In summary, research suggests that outness at work is not directly related to psychological health. Whether outness contributes to psychological health appears to depend on its impact on social support, which depends on the degree to which the workplace is affirming of its LGB employees.

Emotional Openness

As noted in the overview of the model, emotional openness is an important resilience factor in the general population. People who are able to accept their emotions regarding stressful events and process their emotions in an insightful manner have better physical and mental health compared with people who suppress their emotions (see review by Pennebaker, 1997). For instance, Pennebaker (1993) found that participants who processed traumatic events using more negative emotion words, with greater insight, and with more causal connections had improved physical health and reduced autonomic nervous system activity.

These findings in the general population are especially relevant for LGB individuals, given their heightened exposure to stressful events. As noted earlier, stigma-related stress is particularly salient when LGB individuals disclose their sexual orientation to others. Beals et al.’s (2009) daily diary study revealed that the relation between outness and satisfaction with life is mediated by emotional processing. The emotional processing measure used in their study included items such as acknowledging and exploring one’s feelings regarding one’s sexual orientation. This finding further explains the distal relation between outness and psychological health. Consistent with the theoretical model of the present article, outness affects psychological health through the key mechanisms of social support and emotional openness.

A number of studies on the general population have established that increasing emotional openness through expressive writing is beneficial (see review by Frattaroli, 2006). People instructed to explore in writing their “very deepest emotions and thoughts” regarding “an extremely emotional issue” (Pennebaker, 1997, p. 162) were found to subsequently have fewer physician visits, healthier physiological markers, better academic performance, better job performance, fewer physical symptoms, and fewer psychological symptoms.

Utilizing Pennebaker and Beall’s (1986) expressive writing paradigm, Pachankis and Goldfried (2010) examined whether expressive writing buffers the impact of stigma-related stress among gay men. In a 3-day study of gay male undergraduate students, participants were randomly assigned to one of three groups: (a) an expressive writing condition for the most stressful gay-related event of the day, (b) the same expressive writing condition with an additional component of reviewing the previous day’s writing, and (c) a control condition involving writing about a neutral topic. No significant differences were found between the two expressive writing groups. Both expressive writing groups reported significantly higher positive affect on the day after writing compared with the control group, controlling for pretest levels of positive affect. At the 3-month follow-up, both expressive writing groups reported greater outness compared with the control group, controlling for pretest levels of outness.

The expressive writing intervention utilized by Pachankis and Goldfried (2010) buffered the impact of stigma-related stress on study participants. This finding is consistent with the present theoretical model, in which emotional openness affects psychological health by lowering reactivity to prejudice. Pachankis and Goldfried also found that the benefits of expressive writing were evident only in participants who entered the study with low social support. Participants who entered the study with high social support did not benefit from the expressive writing intervention. These findings make sense in light of the model. People who lack social support have a greater need for finding an avenue for lowering reactivity to prejudice. In contrast, individuals who already have an established method of lowering reactivity to prejudice, namely, seeking the support of others, may not need an alternate source. In fact, working on emotional openness as a solitary activity may not fit their particular coping style or personality (e.g., extraversion).

In another examination of expressive writing, Lewis et al. (2005) conducted a longitudinal study in which lesbian participants in an experimental condition were instructed to write for a 2-week period regarding their most stressful experiences related to their sexual orientation. Control group participants were instructed to write in a neutral and objective manner regarding their daily activities. At the 2-month follow-up, experimental participants who were out to fewer people reported less distress compared with baseline levels. In contrast, experimental participants who were out to more people reported more distress compared with baseline levels. These findings mirror Pachankis and Goldfried’s (2010) results and are consistent with the present model. Participants who are out to fewer people are likely to lack the type of social support that reduces reactivity to prejudice. Consequently, they benefit more from an intervention that operates through an alternate mechanism for resilience, namely, emotional openness.

Hope and Optimism

As noted, hope and optimism provide resilience in the general population. These characteristics allow people to confront and overcome obstacles and challenges in a constructive manner. People with high hope pursue goals with willpower and determination, successfully plan ways of achieving goals, and overcome goal-related obstacles (Snyder et al., 1991). Hope is also associated with effective coping mechanisms and positive thinking during times of stress (Irving, Snyder, & Crowson, 1998; Snyder & McCullough, 2000). Thus, high-hope individuals are likely to experience a stressful event as a challenge that motivates them toward their goals, rather than as a threat (Roesch, Duangado, Vaughn, Aldridge, & Villodas, 2010). Consequently, high-hope individuals sustain their effort in pursuing goals in the face of obstacles, pursue a greater number of goals, and pursue more difficult goals (Snyder et al., 1991).

Relatedly, people with high dispositional optimism have generalized beliefs that they will encounter more positive outcomes than negative outcomes (Scheier & Carver, 1985). A number of longitudinal studies have demonstrated that dispositional optimism leads to better physical and psychological health (see reviews by Carver et al., 2010; Scheier & Carver, 1992). Similar to hope, optimism is also correlated with more adaptive coping mechanisms under stress (Carver et al., 2010; Scheier & Carver, 1992).

Theoretically, one would expect hope and optimism to play an important role in the psychological health of LGB individuals, given the stigma-related stress they encounter. Experiences of prejudice and discrimination are likely to raise questions regarding the future. LGB youths who are shunned by family or bullied by peers are likely to have questions about their ability to withstand this experience and to have a positive future. LGB employees who encounter prejudice in the workplace may question their ability to succeed in their careers. The ability to generate positive expectations regarding the future despite current obstacles is likely to be an important resilience factor. Therefore, in the framework presented in this article, hope/optimism is proposed as a third mechanism that lowers reactivity to prejudice, which contributes to psychological health.

In support of this conceptualization, a qualitative study found that Latino/Latina gay and lesbian youths were able to thrive in their career development despite experiences with prejudice and discrimination by maintaining a sense of independence and having a determination to overcome their occupational obstacles (Adams, Cahill, & Ackerlind, 2005). Hope and persistence were clearly evident in one participant in the study (Adams et al., 2005) who noted, “People that put me down . . . it’s like they make me want my career more than ever because I see myself as being a bigger and better person when I’m done” (p. 210). Such hopeful thinking not only buffers the negative impact of prejudice and discrimination but also serves as a source of motivation in pursuing goals for the future.

To examine hope as a protective factor over time, Kwon and Hugelshofer (2010) conducted a 1-month prospective study of 65 LGB individuals in which baseline Hope Scale (Snyder et al., 1991) scores buffered the negative effects of negative workplace climate over the course of the study. Among individuals who experienced low workplace discrimination, hope did not predict changes in life satisfaction over the course of the study. However, among individuals who experienced high workplace discrimination, high-hope individuals reported substantially higher life satisfaction compared with low-hope individuals, after controlling for baseline levels of life satisfaction. In summary, hope and optimism have been clearly established as a resilience factor in the general population, and research on this issue suggests that they serve as resilience factors for LGB individuals.

Directions for Future Research

As evident in the present article, much of the research on resilience in LGB individuals has been conducted over the last two decades, with gaining momentum. Given the recency of this research, there is ample room for further tests of the validity of the model presented in this article. In addition, future research may uncover additional mechanisms not specified in the present model.

Potential Additional Mechanisms

LGB individuals report that altruism is a positive aspect of their sexual orientation (DiFulvio, 2011; Harper, Brodsky, & Bruce, 2012; Riggle et al., 2008). It is not clear from the research literature whether this phenomenon is fully captured by the present model. Serving as a positive role model for others and being involved in social justice and activism bolsters one’s connection with the LGB community, and therefore increases social support. It is also possible that involvement in social justice increases hope and optimism, given that social justice efforts aim to create a better future. However, it is also possible that altruism operates independently from social support and future orientation. Generosity and empathy may operate as additional mechanisms involved in resilience in LGB individuals, a possibility that merits further investigation.

In addition, participants in a focus group of sexual minority adolescents and young adults noted that they gained a sense of strength and empowerment by resisting discrimination and fighting back when they were bullied (Scourfield, Roen, & McDermott, 2008). These responses are consistent with the character strengths of courage and bravery identified in the positive psychology literature (Peterson & Seligman, 2004). More research is needed to examine whether courage and bravery lead to better psychological health, and to examine potential moderators of this relationship.

Research Methodology

More longitudinal studies examining the mechanisms identified in this model, and potential alternate mechanisms, are warranted. Such studies are necessary to adequately understand the attributes that allow LGB individuals to be resilient under stress. Unfortunately, the vast majority of research studies on LGB individuals has utilized cross-sectional designs (Moradi, Mohr, Worthington, & Fassinger, 2009), limiting our current understanding of resilience among LGB individuals. Future longitudinal studies examining this article’s framework could investigate the roles of social support, emotional openness, and hope/optimism in lowering reactivity to prejudice. Indicators of lower reactivity to prejudice include lower internalized homophobia, more positive attributions regarding experiences of prejudice, and healthier emotional responses to prejudice (e.g., less shame). According to the framework, these indicators would subsequently predict psychological health. Finally, as discussed earlier, the framework would also hypothesize a main effect of social support on psychological health over time, independent of its interaction with stress. Additional mechanisms could also be investigated longitudinally for potential future inclusion in the model.

Ethnic Differences

LGB individuals from racial and ethnic minority groups, who face minority stress with respect to race or ethnicity as well as sexual orientation, represent an understudied population (Huang et al., 2010; Moradi, DeBlaere, & Huang, 2010). Meyer (2010) argued that LGB individuals of color may not only face a higher level of stress but may also be more resilient in handling the stress.

Few studies have examined ethnic differences in the relation between social support and well-being, which is surprising given that social support is likely to be affected by cultural variables. Wong and Tang (2003) found that Chinese gay men in Hong Kong experienced greater life satisfaction if they had greater social support from the gay community. This finding suggests some generalizability across ethnicity in the relation between social support and psychological health. However, these men were recruited from gay support groups and may not be representative of the LGB population in Hong Kong. Zea, Reisen, and Poppen (1999) found that perceived social support was associated with lower depressive symptoms and higher self-esteem among gay and lesbian Latino/Latina adults. More research is needed to examine the generalizability of social support as a resilience factor across ethnic groups.

Similarly, more research on outness in LGB ethnic minority individuals is needed. Morris et al. (2001) found ethnic group differences in the association between outness and lower psychological distress in lesbians and bisexual women. This association was significant among the European American, African American, and Native American subsamples, but not for the Latina, Jewish, or Asian American subsamples. Unfortunately, the Jewish and Asian American subsamples were smaller relative to the other groups, making these null findings equivocal. However, the weak association between outness and distress among Latina women suggests that outness may not be related to well-being for this group, a finding that merits replication. Given the present article’s model, research examining ethnic differences in the relation between outness and psychological health should probe for cultural differences in affirmation from others after sexual orientation disclosure. Finally, research on emotional openness and hope/optimism as resilience factors in LGB individuals also needs to consider potential ethnic group differences.

Bisexual Individuals

Bisexual individuals are especially vulnerable to stigma-related stress, given that they face stigma and biphobia from heterosexual individuals and lesbian/gay individuals (see review by American Psychological Association, 2012). Unfortunately, bisexual individuals comprise an understudied group relative to lesbian and gay individuals (Moradi et al., 2009). Bisexual participants, when included in research studies on LGB issues, are often combined with lesbian and gay participants in the data analyses. Moradi et al. (2009) noted that including their responses with those of lesbian and gay individuals may lead to misleading conclusions, given that bisexual individuals have different experiences than lesbian and gay individuals. For example, a large community survey of adults in Australia found that bisexual individuals reported greater anxiety, depression, and negative affect compared with lesbian, gay, or heterosexual individuals (Jorm, Korten, Rodgers, Jacomb, & Christensen, 2002). The same study also found that bisexual individuals reported less positive family support and greater negative support from friends in comparison with lesbian, gay, or heterosexual individuals. Bisexual individuals also report greater identity confusion, less outness, and less community support compared with lesbian or gay individuals (Balsam & Mohr, 2007). More research on resilience among bisexual individuals is warranted given the additional challenges that they often encounter.

Transgender Individuals

While writing the present article, I reviewed the literature on resilience in all sexual minority groups and intended to include research regarding transgender individuals. Unfortunately, there is a paucity of research on resilience in transgender individuals. Even among studies that included the “T” in the title or participant recruitment, the actual number of transgender individuals included in the study sample was often very low or zero.

Although some overlap exists between LGB and transgender individuals, particularly in their experience of stigma-related prejudice and discrimination, they differ in important ways (see Moradi et al., 2009). For instance, transgender individuals face decisions regarding gender transition and also face particular kinds of prejudice and discrimination that LGB individuals do not encounter. Moreover, gender identity is separate from sexual orientation, and many transgender individuals identify as heterosexual. Thus, generalizing research conducted on a primarily LGB population to the transgender population is problematic without specific research on transgender individuals.

The work of Singh and colleagues (Singh, Hays, & Watson, 2011; Singh & McKleroy, 2011) deserves to be highlighted as a potential starting point for further research that is specific to transgender individuals. They utilized a phenomenological interview format to uncover common themes of resilience. Consistent with the model in the present article, connection with a supportive community and hope emerged as common themes reported by participants. A majority of participants also identified social activism and serving as a role model as important sources of resilience. Further studies that link these constructs to psychological health are needed. With this evidence, we may be able to rebrand the theoretical model in the present article as a model of lesbian, gay, bisexual, and transgender resilience. Alternatively, such work may lead to the development of a different and more applicable model of resilience in transgender individuals.

Conclusion

For psychologists who engage in research or practice with the aim of improving the well-being of LGB individuals, it is not enough to understand the factors that lead to suffering in this population. It is also of paramount importance to understand the attributes that lead to flourishing and fulfillment in LGB individuals (see Seligman & Csikszentmihalyi, 2000). The model proposed in this article fits the research literature on resilience in LGB individuals conducted thus far. In addition, the model is grounded in the larger research literature examining resilience in the general population.

A greater understanding of resilience among LGB individuals would inform psychologists in developing effective interventions for LGB individuals, a critical need in our field (Cochran, 2001; Hatzenbuehler, 2009). This is especially important given that LGB individuals seek mental health services more often than heterosexual individuals (Cochran, Mays, & Sullivan, 2003). The present article’s framework has several potential implications in the development of empirically supported interventions for LGB individuals. Behavioral activation for depression, which reengages people in their lives and increases social activity, may be effective given the importance of social support as a resilience factor (Jacobson, Martell, & Dimidjian, 2001). In addition, emotion-focused and interpersonal cognitive approaches to therapy may be effective given the importance of emotional openness (Safran, Eubanks-Carter, & Muran, 2010). Finally, given the importance of hope and optimism, cognitive-behavioral therapy that increases positive appraisals regarding the future may be effective. In addition, primary prevention efforts geared toward increasing hope and optimism in LGB youths may be effective. Such prevention efforts have been found beneficial for other stigmatized groups, such as socioeconomically disadvantaged schoolchildren (Zhang, Jetten, Iyer, & Cui, 2012).

In critiquing the LGB research literature, Savin-Williams (2008) noted the “irresistible and overpowering attention to the problematic nature of same-sex oriented populations rather than a focus on their capacities to adjust, thrive, and lead exceptionally ordinary lives” (p. 137). Indeed, the psychological helping professions would benefit by being more captivated by the flourishing and strength evident in the LGB population. However, we cannot ignore the problems and challenges that LGB individuals face in society. In the present article, I propose that LGB individuals thrive when they have supportive social networks, accept their emotions and process them with insight, and view the future with hope and optimism. These resilience factors are powerful because they allow LGB individuals to thrive despite societal prejudice. The present article suggests a number of future lines of inquiry that will allow us to understand with greater specificity and sophistication the ways in which LGB individuals thrive.

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) received no financial support for the research, authorship, and/or publication of this article.

References

Adams

E. M.

Cahill

B. J.

Ackerlind

S. J.

(2005). A qualitative study of Latino lesbian and gay youths experiences with discrimination and the career development process. Journal of Vocational Behavior, 66, 199-218.

American Psychological Association. (2012). Guidelines for psychological practice with lesbian, gay, and bisexual clients. American Psychologist, 67, 10-42.

Ayala

Coleman

(2000). Predictors of depression among lesbian women. Journal of Lesbian Studies, 4(3), 71-86.

Balsam

K. F.

Mohr

J. J.

(2007). Adaptation to sexual orientation stigma: A comparison of bisexual and lesbian/gay adults. Journal of Counseling Psychology, 54, 306-319.

Barlow

D. H.

Allen

L. B.

Choate

M. L.

(2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205-230.

Beals

K. P.

Peplau

L. A.

(2005). Identity support, identity devaluation, and well-being among lesbians. Psychology of Women Quarterly, 29, 140-148.

Beals

K. P.

Peplau

L. A.

Gable

S. L.

(2009). Stigma management and well-being: The role of perceived social support, emotional processing, and suppression. Personality and Social Psychology Bulletin, 35, 867-879.

Bergeron

Senn

C. Y.

(2003). Health care utilization in a sample of Canadian lesbian women: Predictors of risk and resilience. Women & Health, 37(3), 19-35.

Berghe

W. V.

Dewaele

Cox

Vincke

(2010). Minority-specific determinants of mental well-being among lesbian, gay, and bisexual youth. Journal of Applied Social Psychology, 40, 153-166.

10.

Berkley

R. A.

Watt

A. H.

(2006). Impact of same-sex harassment and gender-role stereotypes on Title VII protection for gay, lesbian, and bisexual employees. Employee Responsibilities and Rights Journal, 18, 3-19.

11.

Bjorkman

Malterud

(2007). Being lesbian—Does the doctor need to know? A qualitative study about the significance of disclosure in general practice. Scandinavian Journal of Primary Health Care, 25, 58-62.

12.

Burns

M. N.

Kamen

Lehman

K. A.

Beach

S. R. H.

(2012). Attributions for discriminatory events and satisfaction with social support in gay men. Archives of Sexual Behavior, 41, 659-671.

13.

Button

(2001). Organizational efforts to affirm sexual diversity: A cross-level examination. Journal of Applied Psychology, 86, 17-28.

14.

Button

(2004). Identity management strategies used by gay and lesbian employees: A quantitative investigation. Group & Organization Management, 29, 470-494.

15.

Campbell-Sills

Barlow

D. H.

Brown

T. A.

Hofmann

S. G.

(2006). Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorders. Behaviour Research and Therapy, 44, 1251-1263.

16.

Caron

S. L.

Ulin

(1997). Closeting and the quality of lesbian relationships. Families in Society, 78, 413-419.

17.

Carver

C. S.

Scheier

M. F.

Segerstrom

S. C.

(2010). Optimism. Clinical Psychology Review, 30, 879-889.

18.

Chrobot-Mason

Button

S. B.

DiClementi

J. D.

(2001). Sexual identity management strategies: An exploration of antecedents and consequences. Sex Roles, 45, 321-336.

19.

Clausell

Roisman

G. I.

(2009). Outness, Big Five personality traits, and same-sex relationship quality. Journal of Social and Personal Relationships, 26, 211-226.

20.

Cochran

S. D.

(2001). Emerging issues in research on lesbians’ and gay men’s mental health: Does sexual orientation really matter? American Psychologist, 56, 931-947.

21.

Cochran

S. D.

Mays

V. M.

Sullivan

J. G.

(2003). Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States. Journal of Consulting and Clinical Psychology, 71, 53-61.

22.

Cohen

(2004). Social relationships and health. American Psychologist, 59, 676-684.

23.

Colgan

Creegan

McKearney

Wright

(2007). Equality and diversity practices at work: Lesbian, gay and bisexual workers. Equal Opportunities International, 26, 590-609.

24.

Colgan

Creegan

McKearney

Wright

(2008). Lesbian workers: Personal strategies amid changing organizational responses to sexual minorities in UK workplaces. Journal of Lesbian Studies, 12, 65-86.

25.

Darwich

Hymel

Waterhouse

(2012). School avoidance and substance use among lesbian, gay, bisexual, and questioning youths: The impact of peer victimization and adult support. Journal of Educational Psychology, 104, 381-392.

26.

D’Augelli

A. R.

Grossman

A. H.

(2001). Disclosure of sexual orientation, victimization, and mental health among lesbian, gay, and bisexual older adults. Journal of Interpersonal Violence, 16, 1008-1027.

27.

D’Augelli

A. R.

Hershberger

S. L.

Pilkington

N. M.

(2001). Suicidality patterns and sexual orientation-related factors among lesbian, gay, and bisexual youth. Suicide and Life-Threatening Behavior, 31, 250-265.

28.

Day

N. E.

Schoenrade

(1997). Staying in the closet versus coming out: Relationships between communication about sexual orientation and work attitudes. Personnel Psychology, 50, 147-163.

29.

Deaux

Ethier

K. A.

(1998). Negotiating social identity. In Swim

J. K.

Stangor

(Eds.), Prejudice: The target’s perspective (pp. 302-323). San Diego, CA: Academic Press.

30.

DiFulvio

G. T.

(2011). Sexual minority youth, social connection and resilience: From personal struggle to collective identity. Social Science & Medicine, 72, 1611-1617.

31.

Doty

N. D.

Willoughby

B. L. B.

Lindahl

K. M.

Malik

N. M.

(2010). Sexuality related social support among lesbian, gay, and bisexual youth. Journal of Youth and Adolescence, 39, 1134-1147.

32.

Frattaroli

(2006). Experimental disclosure and its moderators: A meta-analysis. Psychological Bulletin, 132, 823-865.

33.

Frost

D. M.

Meyer

I. H.

(2009). Internalized homophobia and relationship quality among lesbians, gay men, and bisexuals. Journal of Counseling Psychology, 56, 97-109.

34.

Giuffre

Dellinger

Williams

C. L.

(2008). “No retribution for being gay?” Inequality in gay-friendly workplaces. Sociological Spectrum, 28, 254-277.

35.

Goldberg

A. E.

Smith

J. Z.

(2011). Stigma, social context, and mental health: Lesbian and gay couples across the transition to adoptive parenthood. Journal of Counseling Psychology, 58, 139-150.

36.

Goodenow

Szalacha

Westheimer

(2006). School support groups, other school factors, and the safety of sexual minority adolescents. Psychology in the Schools, 43, 573-589.

37.

Griffith

K. H.

Hebl

M. R.

(2002). The disclosure dilemma for gay men and lesbians: “Coming out” at work. Journal of Applied Psychology, 87, 1191-1199.

38.

Gross

J. J.

Levenson

R. W.

(1997). Hiding feelings: The acute effects of inhibiting negative and positive emotion. Journal of Abnormal Psychology, 106, 95-103.

39.

Grossman

A. H.

D’Augelli

A. R.

Hershberger

S. L.

(2000). Social support networks of lesbian, gay, and bisexual adults 60 years of age and older. Journals of Gerontology: Psychological Sciences, 55B, P171-P179.

40.

Halpin

S. A.

Allen

M. W.

(2004). Changes in the psychosocial well-being during stages of gay identity development. Journal of Homosexuality, 47(2), 109-126.

41.

Harper

G. W.

Brodsky

Bruce

(2012). What’s good about being gay? Perspectives from youth. Journal of LGBT Youth, 9, 22-41.

42.

Hart

K. E.

Sasso

(2011). Mapping the contours of contemporary positive psychology. Canadian Psychology, 52, 82-92.

43.

Hatzenbuehler

M. L.

(2009). How does sexual minority stigma “get under the skin?” A psychological mediation framework. Psychological Bulletin, 135, 707-730.

44.

Hershberger

S. L.

Pilkington

N. W.

D’Augelli

A. R.

(1997). Predictors of suicide attempts among gay, lesbian, and bisexual youth. Journal of Adolescent Research, 12, 477-497.

45.

Hill

R. J.

(2009). Incorporating queers: Blowback, backlash, and other forms of resistance to workplace diversity initiatives that support sexual minorities. Advances in Developing Human Resources, 11, 37-53.

46.

Huang

Y.-P.

Brewster

M. E.

Moradi

Goodman

M. B.

Wiseman

M. C.

Martin

(2010). Content analysis of literature about LGB people of color: 1998-2007. The Counseling Psychologist, 38, 363-396.

47.

Huebner

D. M.

Davis

M. C.

(2005). Gay and bisexual men who disclose their sexual orientations in the workplace have higher workday levels of salivary cortisol and negative affect. Annals of Behavioral Medicine, 30, 260-267.

48.

Huffman

A. H.

Watrous-Rodriguez

King

E. B.

(2008). Supporting a diverse workforce: What type of support is most meaningful for lesbian and gay employees? Human Resource Management, 47, 237-253.

49.

Irving

L. M.

Snyder

C. R.

Crowson

J. J.

Jr. (1998). Hope and coping with cancer by college women. Journal of Personality, 22, 195-214.

50.

Jacobson

N. S.

Martell

C. R.

Dimidjian

(2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science and Practice, 8, 255-270.

51.

Jordan

K. M.

Deluty

R. H.

(1998). Coming out for lesbian women: Its relation to anxiety, positive affectivity, self-esteem and social support. Journal of Homosexuality, 35(2), 41-63.

52.

Jordan

K. M.

Deluty

R. H.

(2000). Social support, coming out, and relationship satisfaction in lesbian couples. Journal of Lesbian Studies, 4(1), 145-164.

53.

Jorm

A. F.

Korten

A. E.

Rodgers

Jacomb

P. A.

Christensen

(2002). Sexual orientation and mental health: Results from a community survey of young and middle-aged adults. British Journal of Psychiatry, 180, 423-427.

54.

Keleher

Wei

Liao

K. Y.

(2010). Attachment, positive feelings about being a lesbian, perceived general support, and well-being. Journal of Social & Clinical Psychology, 29, 847-873.

55.

Kelleher

(2009). Minority stress and health: Implications for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) young people. Counselling Psychology Quarterly, 22, 373-379.

56.

Kwon

Hugelshofer

D. S.

(2010). The protective role of hope for lesbian, gay, and bisexual individuals facing a hostile workplace climate. Journal of Gay & Lesbian Mental Health, 14, 3-18.

57.

Legate

Ryan

R. M.

Weinstein

(2012). Is coming out always a “good thing?” Exploring the relations of autonomy support, outness, and wellness for lesbian, gay, and bisexual individuals. Social Psychological & Personality Science, 3, 145-152.

58.

Lehavot

Simoni

J. M.

(2011). The impact of minority stress on mental health and substance use among sexual minority women. Journal of Consulting and Clinical Psychology, 79, 159-170.

59.

Lewis

R. J.

Derlega

V. J.

Berndt

Morris

L. M.

Rose

(2001). An empirical analysis of stressors for gay men and lesbians. Journal of Homosexuality, 42, 63-88.

60.

Lewis

R. J.

Derlega

V. J.

Clarke

E. G.

Kuang

J. C.

Jacobs

A. M.

McElligott

M. D.

(2005). An expressive writing intervention to cope with lesbian-related stress: The moderating effects of openness about sexual orientation. Psychology of Women Quarterly, 29, 149-157.

61.

Lewis

R. J.

Derlega

V. J.

Griffin

J. L.

Krowinski

A. C.

(2003). Stressors for gay men and lesbians: Life stress, gay-related stress, stigma consciousness, and depressive symptoms. Journal of Social & Clinical Psychology, 22, 716-729.

62.

Major

(2006). New perspectives on stigma and psychological well-being. In Levin

van Laar

(Eds.), Stigma and group inequality: Social psychological perspectives (pp. 193-210). Mahwah, NJ: Lawrence Erlbaum.

63.

Marshal

M. P.

Friedman

M. S.

Stall

King

K. M.

Miles

Gold

M. A.

Morse

J. Q.

(2008). Sexual orientation and adolescent substance use: A meta-analysis and methodological review. Addiction, 103, 546-556.

64.

Masini

B. E.

Barrett

H. A.

(2007). Social support as a predictor of psychological and physical well-being and lifestyle in lesbian, gay, and bisexual adults aged 50 and over. Journal of Gay & Lesbian Social Services, 20, 91-110.

65.

McConahay

J. B.

(1983). Modern racism and modern discrimination: The effects of race, racial attitudes, and context on simulated hiring decisions. Personality and Social Psychology Bulletin, 9, 551-558.

66.

McCrae

R. R.

Costa

P. T.

(1997). Personality trait structure as a human universal. American Psychologist, 52, 509-516.

67.

Meyer

I. H.

(2003). Prejudice, social stress and mental health in lesbian, gay and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674-697.

68.

Meyer

I. H.

(2010). Identity, stress, and resilience in lesbians, gay men, and bisexuals of color. The Counseling Psychologist, 38, 442-454.

69.

Moradi

DeBlaere

Huang

Y.-P.

(2010). Centralizing the experiences of LGB people of color in counseling psychology. The Counseling Psychologist, 38, 322-330.

70.

Moradi

Mohr

J. J.

Worthington

R. L.

Fassinger

R. E.

(2009). Counseling psychology research on sexual (orientation) minority issues: Conceptual and methodological challenges and opportunities. Journal of Counseling Psychology, 56, 5-22.

71.

Morris

J. F.

Waldo

C. R.

Rothblum

E. D.

(2001). A model of predictors and outcomes of outness among lesbian and bisexual women. American Journal of Orthopsychiatry, 71, 61-71.

72.

Murdock

T. B.

Bolch

M. B.

(2005). Risk and protective factors for poor school adjustment in lesbian, gay, and bisexual (LGB) high school youth: Variable and person-centered analyses. Psychology in the Schools, 42, 159-172.

73.

Mustanski

Newcomb

M. E.

Garofalo

(2011). Mental health of lesbian, gay, and bisexual youths: A developmental resiliency perspective. Journal of Gay & Lesbian Social Services, 23, 204-225.

74.

Nesmith

A. A.

Burton

D. L.

Cosgrove

T. J.

(1999). Gay, lesbian, and bisexual youth and young adults: Social support in their own words. Journal of Homosexuality, 37(1), 95-108.

75.

Oetjen

Rothblum

E. D.

(2000). When lesbians aren’t gay: Factors affecting depression among lesbians. Journal of Homosexuality, 39(1), 49-73.

76.

Ozturk

M. B.

(2011). Sexual orientation discrimination: Exploring the experiences of lesbian, gay and bisexual employees in Turkey. Human Relations, 64, 1099-1118.

77.

Pachankis

J. E.

(2007). The psychological implications of concealing a stigma: A cognitive-affective-behavioral model. Psychological Bulletin, 133, 328-345.

78.

Pachankis

J. E.

Goldfried

M. R.

(2010). Expressive writing for gay-related stress: Psychosocial benefits and mechanisms underlying improvement. Journal of Consulting and Clinical Psychology, 78, 98-110.

79.

Pennebaker

J. W.

(1993). Putting stress into words: Health, linguistic, and therapeutic implications. Behaviour Research and Therapy, 31, 539-548.

80.

Pennebaker

J. W.

(1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8, 162-166.

81.

Pennebaker

J. W.

Beall

S. K.

(1986). Confronting a traumatic event: Toward an understanding of inhibition and disease. Journal of Abnormal Psychology, 95, 274-281.

82.

Peterson

Seligman

M. E. P.

(2004). Character strengths and virtues: A handbook and classification. Washington, DC: American Psychological Association.

83.

Ragins

B. R.

(2004). Sexual orientation in the workplace: The unique work and career experiences of gay, lesbian and bisexual workers. Research in Personnel and Human Resource Management, 23, 37-122.

84.

Ragins

B. R.

Singh

Cornwell

J. M.

(2007). Making the invisible visible: Fear and disclosure of sexual orientation at work. Journal of Applied Psychology, 92, 1103-1118.

85.

Riggle

E. D. B.

Whitman

J. S.

Olson

Rostosky

S. S.

Strong

(2008). The positive aspects of being a lesbian or gay man. Professional Psychology: Research and Practice, 39, 210-217.

86.

Roesch

S. C.

Duangado

K. M.

Vaughn

A. A.

Aldridge

A. A.

Villodas

(2010). Dispositional hope and the propensity to cope: A daily diary assessment of minority adolescents. Cultural Diversity & Ethnic Minority Psychology, 16, 191-198.

87.

Rosario

Schrimshaw

E. W.

Hunter

(2008). Predicting different patterns of sexual identity development over time among lesbian, gay, and bisexual youths: A cluster analytic approach. American Journal of Community Psychology, 42, 266-282.

88.

Rosario

Schrimshaw

E. W.

Hunter

(2009). Disclosure of sexual orientation and subsequent substance use and abuse among lesbian, gay, and bisexual youths: Critical role of disclosure reactions. Psychology of Addictive Behaviors, 23, 175-184.

89.

Rumens

Kerfoot

(2009). Gay men at work: (Re)constructing the self as professional. Human Relations, 62, 763-786.

90.

Ryan

Huebner

Diaz

Sanchez

(2009). Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics, 123, 346-352.

91.

Ryan

Russell

S. T.

Huebner

Diaz

Sanchez

(2010). Family acceptance in adolescence and the health of LGBT young adults. Journal of Child and Adolescent Psychiatric Nursing, 23, 205-213.

92.

Safran

J. D.

Eubanks-Carter

Muran

J. C.

(2010). Emotion-focused/interpersonal cognitive therapy. New York, NY: Guilford.

93.

Salovey

Mayer

J. D.

(1990). Emotional intelligence. Imagination, Cognition and Personality, 9, 185-211.

94.

Savin-Williams

(1994). Verbal and physical abuse as stressors in the lives of lesbian, gay male, and bisexual youths: Associations with school problems, running away, substance abuse, prostitution, and suicide. Journal of Consulting and Clinical Psychology, 62, 261-269.

95.

Savin-Williams

(2008). Then and now: Recruitment, definition, diversity, and positive attributes of same-sex populations. Developmental Psychology, 44, 135-138.

96.

Scheier

M. F.

Carver

C. S.

(1985). Optimism, coping, and health: Assessment and implications of generalized outcome expectancies. Health Psychology, 4, 219-247.

97.

Scheier

M. F.

Carver

C. S.

(1992). Effects of optimism on psychological and physical well-being: Theoretical overview and empirical update. Cognitive Therapy and Research, 16, 201-228.

98.

Schrimshaw

E. W.

Siegel

Downing

M. J.

Parsons

J. T.

(2013). Disclosure and concealment of sexual orientation and the mental health of non-gay-identified, behaviorally bisexual men. Journal of Consulting and Clinical Psychology, 81, 141-153.

99.

Scourfield

Roen

McDermott

(2008). Lesbian, gay, bisexual and transgender young people’s experiences of distress: Resilience, ambivalence and self-destructive behaviour. Health and Social Care in the Community, 16, 329-336.

100.

Seligman

M. E. P.

Csikszentmihalyi

(2000). Positive psychology: An introduction. American Psychologist, 55, 5-14.

101.

Sheets

Jr. Mohr

(2009). Perceived social support from friends and family and psychosocial functioning in bisexual young adult college students. Journal of Counseling Psychology, 56, 152-163.

102.

Shilo

Savaya

(2011). Effects of family and friend support on LGB youths mental health and sexual orientation milestones. Family Relations, 60, 318-330.

103.

Singh

A. A.

Hays

D. G.

Watson

L. S.

(2011). Strength in the face of adversity: Resilience strategies of transgender individuals. Journal of Counseling & Development, 89, 20-27.

104.

Singh

A. A.

McKleroy

V. S.

(2011). “Just getting out of bed is a revolutionary act”: The resilience of transgender people of color who have survived traumatic life events. Traumatology, 17, 34-44.

105.

Smith

R. B.

Brown

R. A.

(1997). The impact of social support on gay male couples. Journal of Homosexuality, 33(2), 39-61.

106.

Snyder

C. R.

Harris

Anderson

J. R.

Holleran

S. A.

Irving

L. M.

Sigmon

S. T.

Harney

(1991). The will and the ways: Development and validation of an individual-differences measure of hope. Journal of Personality and Social Psychology, 60, 570-585.

107.

Snyder

C. R.

McCullough

M. E.

(2000). A positive psychology field of dreams: “If you build it, they will come.” Journal of Social & Clinical Psychology, 19, 151-160.

108.

Snyder

C. R.

Rand

K. L.

Sigmon

D. R.

(2005). Hope theory: A member of the positive psychology family. In Snyder

C. R.

Lopez

S. J.

(Eds.), Handbook of positive psychology (pp. 257-276). New York, NY: Oxford University Press.

109.

Steele

L. S.

Tinmouth

J. M.

(2006). Regular health care use by lesbians: A path analysis of predictive factors. Family Practice, 23, 631-636.

110.

Tornello

S. L.

Farr

R. H.

Patterson

C. J.

(2011). Predictors of parenting stress among gay adoptive fathers in the United States. Journal of Family Psychology, 25, 591-600.

111.

Vaughan

M. D.

Waehler

C. A.

(2010). Coming out growth: Conceptualizing and measuring stress-related growth associated with coming out to others as a sexual minority. Journal of Adult Development, 17, 94-109.

112.

Walls

N. E.

Kane

S. B.

Wisneski

(2010). Gay–straight alliances and school experiences of sexual minority youth. Youth & Society, 41, 307-332.

113.

Willis

(2011). Laboring in silence: Young lesbian, gay, bisexual, and queer-identifying workers’ negotiations of the workplace closet in Australian organizations. Youth & Society, 43, 957-981.

114.

Wong

Tang

C. S.

(2003). Personality, psychosocial variables, and life satisfaction of Chinese gay men in Hong Kong. Journal of Happiness Studies, 4, 285-293.

115.

Woods

J. D.

(1994). The corporate closet: The professional lives of gay men in America. New York, NY: Free Press.

116.

Wright

E. R.

Perry

B. L.

(2006). Sexual identity distress, social support, and the health of gay, lesbian, and bisexual youth. Journal of Homosexuality, 51(1), 81-110.

117.

Zea

M. C.

Reisen

C. A.

Poppen

P. J.

(1999). Psychological well-being among Latino lesbians and gay men. Cultural Diversity & Ethnic Minority Psychology, 5, 371-379.

118.

Zhang

Jetten

Iyer

Cui

(2012). “It will not always be this way”: Cognitive alternatives improve self-esteem in contexts of segregation. Social Psychological & Personality Science, 4, 159-166.