Addressing Minority Stress and Mental Health among Men Who Have Sex with Men (MSM) in China

Sun, Shufang; Pachankis, John E.; Li, Xiaoming; Operario, Don

doi:10.1007/s11904-019-00479-w

Cited by 169LGBTQ Health, Identity, and PolicyHIV/AIDS Research and InterventionsHIV, Drug Use, Sexual Risk

Addressing Minority Stress and Mental Health among Men Who Have Sex with Men (MSM) in China

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Sun, Shufang, Pachankis, John E., Li, Xiaoming, Operario, Don·2020·Current HIV/AIDS Reports

DOI 10.1007/s11904-019-00479-wPMC PMC7050812

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Abstract

Purpose of review Men who have sex with men (MSM) in China experience elevated risks of mental health issues in comparison to the general population in China, which contribute to vulnerability to HIV/STI risks and can comprise the effectiveness of HIV prevention efforts. A conceptual framework for understanding this mental health disparity is minority stress theory, which posits that experiences of external prejudice events (i.e., distal stressors) and internal stress processes such as internalized homophobia and concealment (i.e., proximal stressors) contribute to sexual minorities' elevated risk of psychological distress. To deepen the understanding of mental health among Chinese MSM and explore the potential utility of minority stress theory in this population, this paper synthesizes research evidence regarding prevalent mental health issues as well as how minority stress may be linked to psychological health in Chinese MSM. Recent findings Results indicate that Chinese MSM experience a high prevalence of several mental health issues including depression, anxiety, suicidal behaviors, and alcohol dependence. This review further reveals minority stress to be an important determinant of psychological distress among Chinese MSM, though evidence is mixed regarding the relationship between proximal minority stress and psychological health. Nonetheless, there is a lack of mental health services and interventions focusing on MSM in China. Culturally relevant, competent, and LGBT-affirmative mental health interventions are needed for Chinese MSM. To guide future intervention research, we provide considerations for reducing minority stress and promoting psychological health among Chinese MSM.

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Interpersonal minority stress reactions, especially concerns about social acceptance, are most strongly related to minority stress exposures and poor mental health among Chinese sexual minority individuals, more so than identity concealment.
“For this reason, interpersonal minority stress reactions, most notably concerns about social acceptance, appear to be the most strongly related to both minority stress exposures (e.g., lack of family support) and poor mental health among Chinese sexual minority individuals (Sun, Budge, et al., 2020; Sun, Pachankis, et al., 2020), even more so than identity concealment.”
From Guided internet-based LGBTQ-affirmative cognitive-behavioral therapy: A randomized controlled trial among sexual minority men in China (2024) · cites this paper as Sun, Pachankis, et al., 2020
The ‘Anticipated Stigma and Internalized Stigma and Mental Health’ section reports that acceptance concerns and interpersonal victimization were associated with distress in Chinese MSM, while identity concealment was not associated with distress in the cited national survey. The ‘Minority Stress for MSM in a Chinese Context’ section also links low family support to psychological distress, but does not establish that acceptance concerns are more strongly related to minority-stress exposures than concealment is. The paper’s evidence primarily concerns Chinese MSM, rather than all Chinese sexual minority individuals; page numbers were not available in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Chinese sexual minority men are at high risk of mental and behavioral health challenges.
“Increasing evidence suggests that Chinese sexual minority men are at high risk of mental and behavioral health challenges (Sun, Pachankis, et al., 2020)”
From Guided internet-based LGBTQ-affirmative cognitive-behavioral therapy: A randomized controlled trial among sexual minority men in China (2024) · cites this paper as Sun, Pachankis, et al., 2020

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Authors: Sun, S., Pachankis, J. E., Li, X., & Operario, D.
Affiliations: Brown University (US)
Yale University (US)
University of South Carolina (US)
Corresponding author: Sun, Shufang
ORCID: Sun, Shufang
Pachankis, John E.
Li, Xiaoming
Operario, Don
Venue: Current HIV/AIDS Reports
Publisher: Springer Science and Business Media LLC
Published: 2020-01-16
Volume: 17
Issue: 1
Pages: 35-62
ISSN: 1548-3568 (ISSN-L)
1548-3576
DOI: 10.1007/s11904-019-00479-w
PMC: PMC7050812
OpenAlex: W3000347242
Cited by: 169
References: 165
Citations by year: 2026: 28 · 2025: 33 · 2024: 28 · 2023: 31 · 2022: 22 · 2021: 17 · 2020: 10
FWCI: 3.23
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Current HIV/AIDS Reports (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Center for AIDS Research, University of Washington (P30AI042853, T32MH078788)
National Institute of Mental Health (R25MH067127, T32MH078788)
National Institute of Allergy and Infectious Diseases (P30AI042853)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R25HD045810)
Topics: Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords: men who have sex with men, minority stress, mental health, internalized homophobia, concealment, psychological distress, depression, anxiety, suicidal behavior, alcoholism, HIV prevention, culturally sensitive interventions, China
MeSH terms: Sexual and Gender Minorities, Psychological Distress, Adult, China, Depression, Humans, Male, Mental Health, HIV Infections, Prevalence, Homosexuality, Male, Homophobia

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Addressing Minority Stress and Mental Health among Men Who Have Sex with Men (MSM) in China

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