Sexual Minority Stress, Intraminority Gay Community Stress, and Mental Health Problems Among Gay and Bisexual Men in Taiwan: A Mediation Analysis

This study investigates the mediating effect of intraminority gay community stress on the relationships between sexual minority stress and mental health problems—including loneliness, depression, anxiety, and suicidality—among gay and bisexual men (GBM) in Taiwan. A total of 736 GBM were recruited from August 2021 to May 2022. Intraminority gay community stress was assessed using the Traditional Chinese Version of the Gay Community Stress Scale. The Homosexuality-Related Stigma Scale measured perceived familial sexual stigma. The Measure of Internalized Sexual Stigma for Lesbians and Gay Men quantified internalized sexual stigma. Scores from the latter two scales were combined to form an overall sexual minority stress score. Intraminority gay community stress significantly mediated the effects of sexual minority stress on loneliness (regression coefficient = 0.34, 95% confidence interval [CI]: 0.21, 0.50), depression (regression coefficient = 1.43, 95% CI: 1.03, 1.93), anxiety (regression coefficient = 1.21, 95% CI: 0.85, 1.69), and suicidality (regression coefficient = 0.09, 95% CI: 0.05, 0.14). The findings confirm that intraminority gay community stress acts as a mediator between sexual minority stress and mental health outcomes in GBM. Addressing both forms of stress is crucial for improving mental health interventions targeted at this population.