ArticlePsychology and psychotherapy2026
Longitudinal associations between internalized homophobia trajectories and psychological distress among sexual minority adults: A growth mixture model.
Article in Psychology and psychotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionInternalized homophobia (IH) is a key minority stressor that contributes to poor mental health among sexual minority people. Yet little is known about how IH changes over time or how changes in IH influence later psychological distress. This study explored distinct longitudinal trajectories of IH and their links with psychological distress among sexual minority adults.
methodsData came from three waves of the United States Generations Study conducted between 2016 and 2019 (N = 616). IH was assessed using the 5-item Internalized Homophobia Scale and psychological distress using the 6-item Kessler scale. Growth mixture modelling identified patterns of IH change, and multivariate regression models examined associations between trajectory classes and later psychological distress, adjusting for age, race, education and employment. Analyses were also stratified by sexual minority subgroup.
resultsFour IH trajectories were identified: low-decreasing (66%), moderate-increasing (18%), high-decreasing (5%) and high-increasing (11%). Participants in the high-increasing group reported the highest psychological distress, whereas those whose IH declined from high levels at baseline reported the lowest distress. Bisexual participants showed particularly high psychological distress and appeared to benefit most from reductions in IH.
conclusionIH changes meaningfully over time and carries important implications for mental health. Increases in IH predict higher psychological distress, while decreases are protective. These findings highlight the need for interventions and social policies that reduce stigma and support resilience among diverse sexual minority populations.
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