Minority Stress and Wellbeing
A handout explaining the minority stress model: how stigma, discrimination, expectation of rejection and concealment add up to extra stress for people in marginalised groups, and what helps protect wellbeing.
About this resource
Ilan Meyer's minority stress model proposes that people who belong to stigmatised groups experience chronic stress over and above the ordinary stresses of life. The model describes distal stressors, which are external events such as discrimination, harassment and exclusion, and proximal stressors, which are internal processes such as expecting rejection, hiding one's identity, and absorbing negative attitudes about one's group. The model was developed in research with lesbian, gay and bisexual people and has since been applied to other minority groups.
Mark Hatzenbuehler extended the model by describing the psychological pathways through which minority stress affects mental health: increased rumination, emotion regulation difficulties, social isolation and negative beliefs about the self. These are the same processes that CBT and ACT target, which is why standard skills are useful here, alongside connection with others who share the person's experience.
This handout explains the model in plain language, normalises the client's experience, and outlines protective factors. It is written for adults and adolescents and does not assume which minority group the reader belongs to. The professional version adds notes on affirming practice and on avoiding the error of locating the problem inside the client.
How to use it
- Offer the handout when a client has described stress connected to their identity, or when assessment suggests that stigma or concealment is contributing to their difficulties. Let the client define their own identity and experience.
- Read the model together and ask the client to identify which stressors are most present for them. Be clear that the stress originates in the environment, not in the person.
- Use the protective factors section to identify existing supports and gaps. Community connection is one of the strongest protective factors and is worth exploring concretely.
- Link to standard skills where the pathways are active: thought records for internalised negative beliefs, worry or rumination work, and values-based action for reconnecting with life.
- Assess safety. Where the client is experiencing ongoing harassment or violence, safety and practical support come before psychological work.
References
- Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674-697.
- Hatzenbuehler, M. L. (2009). How does sexual minority stigma "get under the skin"? A psychological mediation framework. Psychological Bulletin, 135(5), 707-730.
- Pachankis, J. E. (2007). The psychological implications of concealing a stigma: A cognitive-affective-behavioral model. Psychological Bulletin, 133(2), 328-345.
