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Intracommunity intersectional discrimination and its impact on psychological distress and smoking behavior among sexual minority men from minority ethnic backgrounds

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  • Chan, Randolph C.H.
  • Lam, Marcus Shengkai
  • Mao, Limin
  • Prankumar, Sujith Kumar
  • Wong, Horas

Abstract

Despite growing awareness of the experiences of LGBTQ+ communities, there has been relatively little attention given to the issues of exclusion and marginalization that occur within these communities. This gap is particularly significant given the health disparities faced by LGBTQ+ individuals from minority ethnic backgrounds. To address this gap, this paper examines the experiences of intracommunity intersectional discrimination among sexual minority men from minority ethnic backgrounds. Additionally, it proposes an intracommunity stress-coping model that explains how individuals may turn to smoking as a coping mechanism to manage the psychological impact of discrimination within LGBTQ+ communities. This paper is based on data collected from a national behavioral surveillance study in Australia, which included 1056 cisgender sexual minority men of Asian backgrounds. A substantial proportion of participants reported experiencing discrimination based on body size (39.9%) or skin color (36.3%) within LGBTQ+ communities. While the severity of discrimination was found to be positively related to psychological distress, the analysis also revealed the cumulative effects of discrimination based on intersecting identities. Specifically, individuals who experienced discrimination across multiple intersecting identities reported higher rates of psychological distress and smoking behavior. The positive associations between intracommunity intersectional discrimination and smoking behavior were mediated by psychological distress. Given the detrimental impact of intracommunity intersectional discrimination, it is crucial to raise awareness about the stressors within LGBTQ+ communities. Practitioners in mental health services and smoking cessation programs should be equipped with the knowledge and skills to effectively address the intracommunity stress experienced by Asian sexual minority men with multiple marginalized identities.

Suggested Citation

  • Chan, Randolph C.H. & Lam, Marcus Shengkai & Mao, Limin & Prankumar, Sujith Kumar & Wong, Horas, 2025. "Intracommunity intersectional discrimination and its impact on psychological distress and smoking behavior among sexual minority men from minority ethnic backgrounds," Social Science & Medicine, Elsevier, vol. 370(C).
    • Handle: RePEc:eee:socmed:v:370:y:2025:i:c:s0277953625000528
    DOI: 10.1016/j.socscimed.2025.117723
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    References listed on IDEAS

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    1. Bauer, Greta R. & Scheim, Ayden I., 2019. "Methods for analytic intercategorical intersectionality in quantitative research: Discrimination as a mediator of health inequalities," Social Science & Medicine, Elsevier, vol. 226(C), pages 236-245.
    2. Bowleg, L., 2012. "The problem with the phrase women and minorities: Intersectionality-an important theoretical framework for public health," American Journal of Public Health, American Public Health Association, vol. 102(7), pages 1267-1273.
    3. Layland, Eric K. & Maggs, Jennifer L. & Kipke, Michele D. & Bray, Bethany C., 2022. "Intersecting racism and homonegativism among sexual minority men of color: Latent class analysis of multidimensional stigma with subgroup differences in health and sociostructural burdens," Social Science & Medicine, Elsevier, vol. 293(C).
    4. Harari, Lexi & Lee, Chioun, 2021. "Intersectionality in quantitative health disparities research: A systematic review of challenges and limitations in empirical studies," Social Science & Medicine, Elsevier, vol. 277(C).
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