Stigma and Discrimination

Homophobia, stigma, and discrimination persist in the United States and negatively affect the health and well-being of gay, bisexual, other men who have sex with men (MSM), and other members of the LGBT community. Homophobia, stigma, and discrimination are social determinants of health that can affect physical and mental health, whether MSM seek and are able to obtain health services, and the quality of the services they receive. Such barriers to health need to be addressed at different  levels of society, such as health care settings, work places, and schools in order to increase opportunities for improving the health of MSM.

Homophobia and stigma persist in the United States even though acceptance of same-sex relationships has been steadily increasing. For example, a Gallup poll conducted in May 2010 found that more than half (52%) of Americans believed that gay and lesbian relationships were acceptable. Forty-three percent of Americans believed that gay and lesbian relationships are not morally acceptable.

The Effects of Negative Attitudes About Homosexuality

Negative attitudes about homosexuality can lead to rejection by friends and family, discriminatory acts and violence that harm specific individuals, and laws and policies that adversely affect the lives of many people; this can have damaging effects on the health of MSM and other sexual minorities. Homophobia, stigma and discrimination can:

• Limit MSM's ability to access high quality health care that is responsive to health issues of MSM
• Affect income, employment status, and the ability to get and keep health insurance
• Contribute to poor mental health and unhealthy behaviors, such as substance abuse, risky sexual behaviors, and suicide attempts
• Affect MSM's ability to establish and maintain long-term same-sex relationships that reduce HIV & STD risk
• Make it difficult for some MSM to be open about same-sex behaviors with others, which can increase stress, limit social support, and negatively affect health

The effects of homophobia, stigma and discrimination can be especially hard on adolescents and young adults. Young MSM and other sexual minorities are at increased risk of being bullied in school. They are also at risk of being rejected by their families and, as a result, are at increased risk of homelessness. A study published in 2009 compared gay, lesbian, and bisexual young adults who experienced strong rejection from their families with their peers who had more supportive families. The researchers found that those who experienced stronger rejection were:

• 8.4 times more likely to have tried to commit suicide
• 5.9 times more likely to report high levels of depression
• 3.4 times more likely to use illegal drugs
• 3.4 times more likely to have risky sex

Reducing the Effects of Stigma and Discrimination

MSM and their family and friends can take steps to reduce the effects of homophobia, stigma and discrimination and protect their physical and mental health. One way to cope with the stress from stigma and discrimination is social support. Some studies show that gay men who have good social support—from family, friends, and the wider gay community—have:

• higher self-esteem,
• a more positive group identity, and
• more positive mental health.

Whether you are gay or straight, you can help reduce homophobia, stigma and discrimination in your community and decrease the negative health effects. Even small things can make a difference, such as supporting a family member, friend, co-worker.