A Model of Intersectional Stress and Trauma in Asian American Sexual and Gender Minorities

Objective: Intersecting minority identities may confer unique risks for stress and trauma. In this article, we reviewed extant research on the processes and outcomes of racial and sexual/gender identity-related (i.e., "intersectional") stress and trauma among the understudied population of lesbian, gay, bisexual, transgender, and queer (LGBTQ) Asian Americans. Specifically, we proposed a model of intersectional stress and trauma in LGBTQ Asian Americans that builds upon elements of minority stress theory for sexual minorities. Method: We used PsycINFO and other online databases and search engines to search for information in developing and describing our model. We included 84 peer-reviewed empirical, qualitative, and review/theoretical articles, as well as books, book chapters, unpublished data, and organization reports from 1970 to 2016. Results: In the model, we detail how structural oppression, cultural norms and stigma, interpersonal discrimination, internalized minority stress cognitions, and maladaptive coping and poor social support interact in contributing to negative mental and sexual health outcomes in LGBTQ Asian Americans, as a function of their intersecting racial and sexual/gender identities. Conclusions: LGBTQ Asian Americans face unique stressors that can lead to traumatization. Future research should empirically validate our model of intersectional stress and trauma, increase scientific representation of all LGBTQ Asian American subgroups, and emphasize the LGBTQ Asian American identity as multifaceted and intersectional. Finally, components of our model appear to be promising areas for intervention. However, we urge clinicians to consider the utility of treatments from the perspective of indigenous practices and healing, compared with adaptation from Western, heteronormative treatment approaches.