Research Departments & Organizations
Please visit esteem.yale.edu to learn more about my research.
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.