@phdthesis{discovery10149741,
            note = {Copyright {\copyright} The Author 2022. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author's request.},
            year = {2022},
           month = {June},
          school = {UCL (University College London)},
           title = {Sexual orientation minority status, psychological distress, and the effect of minority stress in Taiwan},
          author = {Cheng, Kai-Yuan},
             url = {https://discovery.ucl.ac.uk/id/eprint/10149741/},
        abstract = {Background: Studies have found that sexual orientation minority (SOM) status (for example,
gay, lesbian, and bisexuality) is associated with a higher risk of psychological distress,
depression, anxiety, and other mental health problems, and that exposure to minority stressors
increases the risk of psychological distress in this population. Previous studies have, however,
commonly suffered from inadequate definitions of SOM status, small sample sizes, or high
selection bias. Little evidence exists on the minority stress theory in the Taiwanese SOM
population.
Aim: This study aims to investigate (1) whether SOM status is associated with higher levels
of psychological distress, (2) the mediating effect of minority stress on this association, and 3)
potential mediators of the association between minority stress and psychological distress.
Methods: A systematic review was performed to accumulate evidence from China, Hong
Kong, Macao, Taiwan, and Singapore. Quantitative data analysis was performed using a
population-based survey of 3,118 young adults and a hospital-based purposive sample of 120
SOM individuals. Furthermore, 323 SOM Taiwanese adults were recruited using web-based
respondent-driven sampling (webRDS) to complete a survey on minority stress and mental
health.
Results: SOM status has been consistently associated with higher level of psychological
distress in Chinese cultural settings. The population-based survey in 2011 found that 9\% of
Taiwanese young adults have SOM identities and that SOM identity is associated with more
psychological distress. However, the application of different dimensions of sexual orientation
led to differing results. Modelling using the hospital-based and the webRDS samples
suggested that exposures to minority stressors including discrimination, internalised
heterosexism, concealment motivation, and acceptance concerns are associated with more psychological distress. Loneliness and self-esteem were both found to mediate the effect of
minority stress on psychological distress. Finally, social support from family members and
peers were shown to alleviate the negative impact of minority stress on mental health.}
}