(PS9-30) Self-Hate Mediates the Relationship Between Enacted Stigma and Suicidality in Sexual Minorities

Background: Sexual minorities are at a significantly higher risk of suicide than their heterosexual counterparts (Gómez-Chica et al., 2024). Minority stress theory posits that experiences of enacted stigma, including discrimination and verbal and physical aggression contribute to the heightened risk of suicide among sexual minorities (Green et al., 2022; Hoy-Ellis, 2021). However, not all individuals who experience enacted stigma develop suicidal thoughts or behaviors, suggesting that additional mechanisms may be involved. One potential mechanism is self-hate, which refers to a deep-seated negative self-evaluation characterized by strong feelings of worthlessness and viewing oneself as having undesirable qualities (Turnell et al., 2019). Self-hate can develop when individuals repeatedly experience discrimination and stigma, leading sexual minorities to internalize negative societal messages about themselves and their identity (Nguyen et al., 2024). We hypothesized that self-hate serves as a mechanism linking enacted stigma to suicidality in sexual minorities and that greater experiences of enacted stigma predict higher self-hate, which increases suicidality.

Methods: Participants from Amazon Mechanical Turk (n = 376; M_age = 35.20, 52.8% cisgender women, 70.9% white, 48.6% bisexual) completed the Minority Stress Scale, Self-Hate Scale, and the Suicide Behavior Questionnaire. We tested our hypothesis using a mediation model. 

Results: Our mediation model was supported and explained 13.5% of the variance in suicidality (R² = .135, F (1, 374) = 6.908, p < .01). Enacted stigma significantly predicted self-hate (path a; b = .1343, p < .01) and self-hate predicted suicidality (path b; b = .463, p < .001). Enacted stigma significantly predicted suicidality in the model (path c’; b = .116, p < .05). The percentile bootstrap confidence interval examining the indirect effect of enacted stigma on suicidality through self-hate did not contain zero (ab = 0.062, 95% CI [0.012– 0.114]), suggesting a partial mediating effect of enacted stigma on suicidality through self-hate.

Conclusions: Our findings are in line with minority stress theory, supporting the notion that enacted stigma contributes to suicidality among sexual minority individuals, highlighting the detrimental effects of discrimination and prejudice on mental health. LGB Affirmative Cognitive Behavior Therapy (Pachankis et al., 2015) would be useful in learning strategies for reducing self-hate. Providing support that helps individuals process stigma-related distress while fostering hope, resilience, and effective coping strategies, is essential for reducing suicide risk in this community.