Sexual orientation, social support, and mental health resilience in a US national sample of adults

Sexual minority mental health disparities can be attributed, in large part, to chronic exposure to stress. There is growing interest in understanding the factors associated with psychological resilience, or the ability to positively cope with life's stressors. Using nationally representative data (2012-2013; N = 14,470), this study compared differences in resilience status (operationalized empirically using SF-12 mental health score among respondents reporting 2+ past-year stressful life events; respondents were categorized as "flourishing," "average," or "languishing") by sexual orientation and assessed whether social support mediated sexual minority disparities in resilience. Comparisons were made across four sexual orientation groups: heterosexuals and three sexual minority subgroups (lesbians/gay men, bisexual, heterosexual-identified sexual minorities [HSM]). Generally, heterosexual respondents were more likely to be flourishing, less likely to be languishing, and reported more social support, compared to sexual minority respondents. In multivariable analysis, bisexual women, HSM women, and gay men had lower odds of resilience than heterosexual women and men, respectively. In mediation models, lower social support was associated with reduced resilience for all sexual minority subgroups except lesbian/gay women. This study demonstrated that sexual orientation is an important determinant of resilience, and further, that social support contributes to sexual minority peoples' abilities to flourish when faced with stress.