Predictors of Physical Health Indicators and Behaviors Among Young Sexual Minority Women: Minority Affirmative and Stress Perspectives

Abstract

Research on the physical health of sexual minority groups has lagged behind research on their psychological health, and research on the physical health of sexual minority women (SMW) is particularly sparse. The current study used a combined cross-sectional and daily diary design to test propositions about the health of SMW drawn from both sexual minority affirmative and minority stress perspectives. Specifically, four health-related variables—physical health-related quality of life, body mass index (BMI), diet quality, and participation in physical activity—were examined in relation to heterosexist discrimination, internalized stigma, depressive symptoms, appearance norm internalization, gender nonconformity, and interactions with sexual minority others. Additionally, the study examined how these variables differ between lesbian and bisexual women. Results provided mixed support for both the minority stress and minority affirmative approaches to health, with more extensive support found for the minority stress model. Discrimination, internalized stigma, depressive symptoms, and muscular ideal internalization emerged as the most robust predictors of health outcomes. As hypothesized, discrimination predicted poorer health-related quality of life and higher BMI at the between-person level. Surprisingly, discrimination also predicted higher levels of physical activity at the between-person level, suggesting that SMW may attempt to cope with discrimination through exercise. As expected, internalized stigma predicted poorer diet quality on the within- and between-person levels, and depressive symptoms predicted poorer diet quality on the within-person level and poorer health-related quality of life on the between- and within-person levels. Finally, muscular ideal internalization predicted better diet quality, more physical activity, and lower BMI on the between-person level. No differences were found between lesbian and bisexual women in terms of health outcomes. However, lesbian women reported higher levels of discrimination relative to bisexual women, which was associated with both negative (poorer health-related quality of life) and positive (increased participation in physical activity) health outcomes. These results highlight the value of research that examines identity-specific variables in relation to the physical health of sexual minority communities.