How much is sexual minority stress confounded with familial causes? A systematic multilevel meta-analysis

https://xcancel.com/profjmb/status/2087173795031245302

Non-heterosexuals tend to have worse mental health compared to heterosexuals. Is this due to minority stress–stigma and discrimination? In a new study, we should that the answer is “mostly not.” Link to the article in the next post, followed by an explanatory thread. (1/n)

https://www.cambridge.org/core/journals/psychological-medicine/article/how-much-is-sexual-minority-stress-confounded-with-familial-causes-a-systematic-multilevel-metaanalysis/A681A8ACF60DAEC2CFE9F652184F4CF4 (2/n)

The idea that non-heterosexual people have increased depression, anxiety, and suicidality because of mistreatment is plausible, and the theory–Sexual Minority Stress Theory (SMST)–has been the dominant explanation for 30 years. (3/n)

For example, a 2003 study by Meyer, the foremost SMST proponent, has been cited 20,000 times! NIH has funded SMST research, which has used it to explain even worse mental health among transgender youth. (4/n)

Virtually all empirical studies on SMST have been correlational. This is understandable, since one cannot do an RCT, and causally informative studies are difficult to conceive. (5/n)

Two facts raise concerns against SMST. First, despite the fact that Western tolerance of sexual minorities has grown considerably, mental health disparities remain as large as ever. (6/n)

Second, there are potential confounds that need to be excluded. From childhood, gay men are more neurotic, which can explain some of the disparity. There is a genetic correlation between non-heterosexual orientation and depression/anxiety in both males and females. (7/n)

In our new study, we use simple and compelling logic to estimate the degree to which minority stress accounts for the mental health disparities. The answer, again, is “not much.” The study is causally informative, providing “strong inference.” (8/n)

Here’s the logic: By SMST, non-heterosexuals should have worse mental health compared with their heterosexual family members, even MZ (identical) twins. Those heterosexual family members have not experienced any sexual minority stress. (9/n)

In fact, the discrepancy between non heterosexuals and their heterosexual family members should be as large as between the former and non relatives. (9.5/n)

This figure clearly shows the results. The bar for “Population” shows the effect size difference between non-heterosexuals and heterosexual non-relatives. The other two bars show the difference for family members. See how they rapidly drop off. (10/n)

(10/n)

This means that most of the mental health disparity between non-heterosexuals and heterosexuals is due to aspects shared in the same family. Probably especially genes. (11/n)

What are the implications of our study? First, researchers should stop conducting studies of minority stress that do not consider competing hypotheses. NIH should stop funding such studies. (12/n)

Second, this isn’t about blaming anyone, nor about encouraging bad behavior towards non-heterosexuals. We need to look elsewhere, other than minority stress, if we want to improve their mental health. (13/n)

We hope our method will be applied to study gender dysphoria and transgender. There are databases that have the requisite information. Chances are, they are highly restricted for political reasons. Lift these restrictions! (14/n)

Here are links to two articles I wrote on this topic:

rdcu.be/fzgcn

rdcu.be/fzgem (n/n)