Young sexual minority men experience a number of health disparities, including higher incidence of substance misuse, in part due to heteronormative systems of oppression, such as discrimination and stigma. In particular, prior research has documented that higher levels of minority stress such as heterosexist discrimination have been linked to higher rates of hazardous alcohol use. The current cross-sectional study tested two concurrent mechanisms—internalized heterosexism and rejection sensitivity—linking heterosexist discrimination and hazardous alcohol use, through a structural equation model. The sample consisted of predominately White (60%), young (Mage = 26.8; SD = 3.91), and sexual minority cisgender men (n = 325). The model yielded an excellent fit to the data (CFI = 0.99; RMSEA = 0.06; SRMR = 0.02). We found that more frequent heterosexist discrimination was associated with higher levels of hazardous alcohol use via higher levels of internalized heterosexism. Rejection sensitivity did not emerge as a significant indirect effect. Our findings highlight the complexity of minority stress mechanisms such as the important role of internalized heterosexism and need for further research regarding the role of rejection sensitivity. Clinically, our findings have implications for future behavioral health interventions that may help ameliorate the alcohol use-related health disparities affecting sexual minority individuals by targeting minority stress mechanisms.
Heterosexist discrimination and hazardous alcohol use among young sexual minority men: Examining the roles of internalized heterosexism and rejection sensitivity
Stigma and Health [Epub 2026 Mar 16]. doi: 10.1037/sah0000684.