The cumulative effects of stigma-related stress: Chronic stigma-related stress exposure exacerbates daily associations between enacted stigma and anxious/depressed affect

Sexual and gender minority individuals are at elevated risk for mood and anxiety disorders compared to heterosexual and cisgender individuals. Ecological momentary assessments studies have implicated experiences of enacted stigma (i.e., biased treatment) by linking these experiences with elevations in anxious and depressed affect. The current study utilizes a theory from the broader stress and affect literature to determine whether chronic enacted stigma exposure amplifies individuals’ negative affective reactions to experiences of enacted stigma at the daily level. We used data from a 30-day ecological momentary assessment study with 429 sexual minority women and gender diverse sexual minorities assigned female at birth (SMWGD) living in the US in 2020–21 to determine whether concurrent and prospective event-level associations between enacted stigma, anxious/depressed affect, and perceived coping efficacy were moderated by chronic enacted stigma exposure. Results demonstrate that individuals with moderate to high chronic stigma exposure experience larger increases in anxious/depressed affect and larger decreases in perceived coping efficacy following daily experiences of enacted stigma. Further, these effects of daily stigma on anxious/depressed affect persist for longer among individuals with high chronic stigma exposure. Interestingly, chronic stigma exposure did not moderate associations between daily general stressors (i.e., those unrelated to identity) and affect or perceived coping efficacy, suggesting that these effects are specific to stigma-related stressors. These results help to advance our understanding of both long-term and daily effects of exposure to enacted stigma, highlighting the potentially profound cumulative effects of stigma exposure and the need to intervene in this cycle. •Individuals with chronic stigma exposure experienced higher negative affect on days when they had daily stigma experiences.•These individuals continued to experience increases in negative affect later in the day following stigma experiences.•Individuals with chronic stigma exposure experienced lower coping efficacy on days when they had daily stigma experiences.•The daily effects of stigma on negative affect persisted for longer among individuals with chronic stigma exposure.•Chronic stigma exposure did not moderate daily effects of general stressors.