Depression, anxiety, and life satisfaction in gay and bisexual men in Lebanon: A cross-sectional correlational study

Minority stress theory postulates that exposure to distal and proximal stressors due to one’s sexual orientation can undermine mental health outcomes and identity process theory posits that mental health is undermined when these stressors result in identity threat (i.e., decreased levels of self-esteem, self-efficacy, continuity and positive distinctiveness). Drawing upon tenets of these theories, this study examines the unique contributions of intrapsychic and group-based factors to predicting depression, anxiety and life satisfaction in a sample of 241 gay and bisexual men in Lebanon. Cross-sectional correlational survey data were analyzed using hierarchical multiple regression. Life satisfaction was predicted by sexuality-related identity threat, sexuality deflection as a sexuality management strategy, and identity resilience. Depression was predicted by sexuality-related identity threat, homophobic school bullying, and identity resilience. Anxiety was predicted by sexuality-related identity threat, sexuality acceptance as a sexuality management strategy, and general outness. Consistent with minority stress theory and identity process theory, the results show the significance of identity threat in the onset of poor mental health and the general importance of intrapsychic factors, over and above group-based variables, as risk or protective factors for mental health in gay and bisexual men in Lebanon. Culturally tailored mental health promotion strategies should focus on reducing sexuality-related identity threat, addressing societal stigma, and fostering protective factors, such as identity resilience and family support.