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Direction <p>This study examined how multidimensional internalized homophobia (IH)—a key proximal stressor in Minority Stress Theory—relates to depression and anxiety among Chinese lesbian/gay and bisexual individuals. Although internalized stigma is a well-established risk factor for mental health problems, little is known about how culturally specific IH processes and symptom-level interactions differ across sexual orientation subgroups in non-Western contexts.</p> Method <p>Using cross-sectional data from 668 LGB participants in China, we assessed three culturally grounded IH dimensions (internalized heteronormativity, social-oriented internalization, and family-oriented internalization) and applied network analysis to compare symptom structures across groups.</p> Result <p>Lesbian/gay individuals showed higher IH levels, whereas bisexual individuals reported more severe depressive symptoms. Networks revealed shared core edges—especially between heterosexual preference and orientation-based distress, and between family shame and filial-piety conflict—reflecting culturally embedded stress mechanisms. Subgroup comparisons indicated stronger links between family-oriented internalization and emotional symptoms among lesbian/gay individuals, while identity-related distress, social-oriented pressure, and depressed mood were more central among bisexual individuals.</p> Conclusion <p>Overall, the findings demonstrate how family obligations, social conformity pressures, and culturally embedded expectations shape the way in which IH connects to depression and anxiety. These insights support the development of culturally sensitive school- and community- based mental health services that foster identity development and positive coping strategies among sexual minority populations in China.</p>

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Mental Health and Internalized Homophobia Among Lesbian/Gay and Bisexual Individuals in China: a Comparative Network Analysis

  • 期刊论文

  • 发表日期：

    2026年3月4日

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  • Zheng Zhang,
  • Yangxinyu Yan,
  • Yun Meng,
  • Chuantao Zhou,
  • Amanda Wilson,
  • Hui Xie,
  • Yuanyuan Wang

摘要

Direction

This study examined how multidimensional internalized homophobia (IH)—a key proximal stressor in Minority Stress Theory—relates to depression and anxiety among Chinese lesbian/gay and bisexual individuals. Although internalized stigma is a well-established risk factor for mental health problems, little is known about how culturally specific IH processes and symptom-level interactions differ across sexual orientation subgroups in non-Western contexts.

Method

Using cross-sectional data from 668 LGB participants in China, we assessed three culturally grounded IH dimensions (internalized heteronormativity, social-oriented internalization, and family-oriented internalization) and applied network analysis to compare symptom structures across groups.

Result

Lesbian/gay individuals showed higher IH levels, whereas bisexual individuals reported more severe depressive symptoms. Networks revealed shared core edges—especially between heterosexual preference and orientation-based distress, and between family shame and filial-piety conflict—reflecting culturally embedded stress mechanisms. Subgroup comparisons indicated stronger links between family-oriented internalization and emotional symptoms among lesbian/gay individuals, while identity-related distress, social-oriented pressure, and depressed mood were more central among bisexual individuals.

Conclusion

Overall, the findings demonstrate how family obligations, social conformity pressures, and culturally embedded expectations shape the way in which IH connects to depression and anxiety. These insights support the development of culturally sensitive school- and community- based mental health services that foster identity development and positive coping strategies among sexual minority populations in China.