John Pachankis, PhD

Associate Professor of Epidemiology (Chronic Diseases)

Research Interests

Anxiety; Behavioral Sciences; Depression; HIV; Mental Health; Social Behavior; Social Change; Social Conditions; Social Sciences; Behavioral Research; Social Stigma

Research Organizations

School of Public Health: Chronic Disease Epidemiology: Social & Behavioral Sciences

Research Summary

John Pachankis is an Associate Professor in the Social and Behavioral Sciences division of the Yale School of Public Health, where he studies the health of lesbian, gay, bisexual, and transgender (LGBT) individuals. He specifically seeks to identify the psychological processes and social contextual factors explaining LGBT individuals’ disproportionate experiences with various adverse mental and physical health outcomes. To accomplish these aims, he combines social psychological methods with life course developmental models of stigma, health, and mental health. For example, one line of his research examines the psychosocial consequences of concealing one’s sexual orientation in various contexts and across formative years of development. Another seeks to examine the longitudinal effects of migrating to urban areas on young gay and bisexual men’s health. He draws upon his training as a clinical psychologist to translate the results of these studies into psychosocial interventions to improve the health of the LGBT community. One of these intervention projects, for example, seeks to promote resilient coping among young gay and bisexual men to counter the negative mental health effects of stigma.

Extensive Research Description

I study the mental health of lesbian, gay, bisexual, and transgender (LGBT) individuals. I am specifically interested in two questions: (1) Why do LGBT people consistently face poorer mental health than the general population? and (2) What structural and individual-level interventions might reduce this disparity? In answering this first question, my research suggests that LGBT people’s exposure to stigma-related stress might explain their poorer mental health. For example, across several studies, I have examined the strategies that some gay and bisexual men use to cope with the stress of concealing their sexual orientation across early development with complex mental health implications. I am also interested in the distinct aspects of sexual minority individuals’ lives compared to heterosexual people’s lives that might further explain sexual orientation disparities in mental health. For example, I have studied the stress and opportunities afforded by young gay and bisexual men’s migration to large cities. I also study sources of stress that seemingly emerge from within the mainstream gay community, but that might ultimately derive from wider homophobia. In this way, I am interested in the particularly hidden and subtle mechanisms through which stigma operates to compromise the health and wellbeing of sexual and gender minority populations. I use social epidemiological, psychological, and mixed methods approaches to conduct this research.

As for the second question: Drawing on my background as a clinical psychologist, one of my primary goals is to translate the results of these formative studies into psychosocial interventions to improve the health of the LGBT community. One of these interventions has shown preliminary evidence for helping young gay and bisexual men cope with early and ongoing stress to reduce their depression, anxiety, substance use, condomless sex, and sexual compulsivity. Its efficacy was established in the first randomized controlled trial of an LGB-affirmative mental health treatment. My collaborative research examines the efficacy of similar LGB-affirmative interventions delivered via novel technologies (e.g., smartphones), in diverse settings (e.g., Eastern Europe), and with diverse segments of the LGBT community (e.g., rural youth). I have a longstanding interest in psychotherapy process research, including determining what psychological interventions work for whom and the reasons explaining why psychological interventions work in the first place.

My research has been featured in national and international media outlets, such as the New York Times and Time. This work has also been cited in several amici curiae briefs in cases related to LGBT stigma and discrimination before state and federal courts, including the U.S. Supreme Court. I teach an interdisciplinary class called Stigma and Health at the Yale School of Public Health that examines stigma across multiple levels (e.g., societal, psychological) and across numerous stigmatizing conditions and identities to understand stigma’s full impact on population health. Students have taken this course to understand the impact of stigma on the health of many dozens of stigmatized populations. By the end of the course, I think that students fully understand that stigma is a major determinant of population health, while also possessing some optimism about a better way forward through changing social structures and individual behavior in a theoretically and empirically informed way.

The National Institute of Mental Health, the National Institute on Drug Abuse, and the Fogarty International Center of NIH provide funding for my research.

Selected Publications

  • Pachankis, J. E., Cochran, S. D., & Mays, V. M. (2015). The mental health of sexual minority adults in and out of the closet: A population-based study. Journal of Consulting and Clinical Psychology, 83, 890-901.
  • Pachankis, J. E., Hatzenbuehler, M. L., Rendina, H. J., Safren, S. A., & Parsons, J. T. (2015). LGB-affirmative cognitive behavioral therapy for young adult gay and bisexual men: A randomized controlled trial of a transdiagnostic minority stress approach. Journal of Consulting and Clinical Psychology, 83, 875-889.
  • Pachankis, J. E. (2015). A transdiagnostic minority stress pathways approach for treating psychosocial syndemic conditions among gay and bisexual men. Archives of Sexual Behavior, 44, 1843-1860.
  • Pachankis, J. E., Rendina, H. J., Restar, A., Ventuneac, A., & Parsons, J. T. (2015). A minority stress—emotion regulation model of sexual compulsivity among highly sexually active gay and bisexual men. Health Psychology, 34, 829–840.
  • Pachankis, J. E., Hatzenbuehler, M. L., Hickson, F., Weatherburn, P., Berg, R., Marcus, U., & Schmidt, A. J. (2015). Hidden from health: Structural stigma, sexual orientation concealment, and HIV across 38 countries in the European MSM Internet Survey. AIDS, 29, 1239-1246.
  • Pachankis, J. E. (2014). Uncovering clinical principles and techniques to address minority stress, mental health, and related health risks among gay and bisexual men. Clinical Psychology: Science and Practice, 21, 313-330.
  • Pachankis, J. E., Hatzenbuehler, M. L., & Starks, T. J. (2014). The influence of structural stigma and rejection sensitivity on young sexual minority men's daily tobacco and alcohol use. Social Science & Medicine, 103, 67-75.
  • Pachankis, J.E., Rendina, H. J., Ventuneac, A., Grov, C., & Parsons, J. (2014). The role of maladaptive cognitions in hypersexuality among gay and bisexual men. Archives of Sexual Behavior. 43, 669-683.
  • Pachankis, J.E., Lelutiu-Weinberger, C, Golub, S. A., & Parsons, J.T. (2013). The development of an online risk-reduction intervention for young gay and bisexual men using social networking technology. AIDS and Behavior, 17, 2986-2998.
  • Pachankis, J. E., Buttenwieser, I. G., Bernstein, L. B., & Bayles, D. O. (2013). A longitudinal, mixed methods study of sexual position identity, behavior, and fantasies among young sexual minority men. Archives of Sexual Behavior, 42, 1242-1253.
  • Pachankis, J. E., & Hatzenbuehler, M. L. (2013). The social development of contingent self-worth among sexual minority young men: An empirical test of the "Best Little Boy in the World" hypothesis. Basic and Applied Social Psychology, 35, 176-190.

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