Double binds: an autoethnographic study of gay minority stress

In contemporary and mainstream therapeutic discourse, the concept of ‘minority stress’ remains largely absent. Yet, minority stress offers a crucial psychosocial perspective on the mental health of marginalised groups – one that extends beyond narrowly focused, sometimes overly pathologizing, psychological theories.

In this autoethnographic study I explore my personal experiences of minority stress from the perspective of a gay man, analysing its impacts on my mental and physical health. Employing a unique approach akin to ‘auto-archaeology’ (Fox, 2010), I draw from a range of personal ‘artifacts’ including lyrics, songs, dreams, diary entries, photos, and personal communications to illuminate this journey.

Minority stress encompasses both distal and proximal stressors, reflecting the additional, unique and enduring challenges faced by individuals outside majority society (Hendricks & Testa, 2012; Meyer, 1993; 1995; 2003). Distal stressors are a psychosocial stress linked to discrimination and prejudice that create a ‘hostile and stressful social environment’ (Meyer, 2003, p.1). Proximal stressors are coping mechanisms employed by minority individuals to navigate discrimination, often adding to their stress burden. These layers overlap and are interdependent (Meyer, 2003; Pearlin, 1999), creating a cyclical pattern of prejudice, expectations of rejection, hiding, concealing, internalized stigma and negative coping processes (Meyer, 2003) that can be deleterious, resulting in poorer mental and physical health outcomes (Hatzenbuehler et al, 2008; Williams et al, 2008) compared with those in dominant groups.

Carolyn Ellis et al. (2010) define autoethnography as ‘an approach to research and writing that seeks to describe and systematically analyse (graphy) personal experience (auto) in order to understand cultural experience (ethno). [Autoethnographers] use personal experience to illustrate facets of cultural experience, and, in so doing, make characteristics of a culture familiar for insiders and outsiders’ (p. 276). I offer my experiences as data that is vital and valid, the inherent subjectivity being the power of the research that might be otherwise less profound, or inaccessible via other research methods. Autoethnography allows me to get inside existing research, in this case the seemingly abstract and theoretical idea of minority stress.

This exploration not only highlights the challenges of minority stress but also underscores its positive dimensions, such as resilience and the importance of community support as buffers against its impacts. It also introduces the idea of creativity as an additional protective factor.

Many LGBTQ+ clients are dissatisfied with therapy encounters (Bieschke et al., 2007; Hunt, 2014; Kort, 2018), failing to get the support they need and further adding to shame. This study asserts that understanding the theory of minority stress can bridge gaps in understanding and communication between therapists and clients. It urges non-minority therapists to recognize the often-overlooked clinical implications of minority stress and suggests the potential for a group therapy model.

Additionally, this study serves as a model for mid-career therapists to engage in reflexive exploration of the cultures in which they work, a personal development that might enrich and revitalise their professional practice. Finally, this narrative account extends an invitation to individuals from minority groups to share their stories, fostering a collective dialogue much needed in today’s fractured world.