As we come to understand depression in the transgender community more accurately, it’s become clear that the major cause is what’s referred to as “minority stress;” that is, “stressors induced by a hostile, homophobic culture, which often results in a lifetime of harassment, maltreatment, discrimination and victimization.”When Worlds Collide – Mental Illness Within the Trans Community – Lionheart
Why are there greater mental health stresses on autistic people from gender-minority groups? To quote from the research paper,
“The increased rates of mental health problems in these minority populations are often a consequence of the stigma and marginalisation attached to living outside mainstream sociocultural norms (Meyer 2003). This stigma can lead to what Meyer (2003) refers to as ‘minority stress’. This stress could come from external adverse events, which among other forms of victimization could include verbal abuse, acts of violence, sexual assault by a known or unknown person, reduced opportunities for employment and medical care, and harassment from persons in positions of authority (Sandfort et al. 2007).”Ann’s Autism Blog: Autism, Transgender and Avoiding Tragedy
As evidenced by the minority disability movement, autism is increasingly being considered part of the identities of autistic people. Autistic individuals thus constitute an identity-based minority and may be exposed to excess social stress as a result of disadvantaged and stigmatized social status. This study tests the utility of the minority stress model as an explanation for the experience of mental health problems within a sample of high-functioning autistic individuals (N=111). Minority stressors including everyday discrimination, internalised stigma, and concealment significantly predicted poorer mental health, despite controlling for general stress exposure. These results indicate the potential utility of minority stress in explaining increased mental health problems in autistic populations. Implications for research and clinical applications are discussed.(PDF) Extending the Minority Stress Model to Understand Mental Health Problems Experienced by the Autistic Population
The minority stress model posits that social disadvantage and marginalization results in an increased burden, which in turn can result in mental and physical health disparities (Meyer et al., 2002; Frost et al., 2015). Predominantly, it has been used to investigate the health disparities seen in the queer community. The focus in the minority stress model shifts away from there being something inherent about LGBTQ+ communities and focuses instead on the experiences that sexual and gender minorities have within society. It sounds cliché, but it was a light-bulb moment—it was a lens through which I could reflect on an entire lifetime of experiences and make them coherent for once. Yet, as an idea, minority stress ran counter to the literature which associated the traits of autism itself with suicidality (Mikami et al., 2009), centered suffering as inherent to autism (Baron-Cohen and Bolton, 1993), or focused on the specific thinking styles of autistic people as causative of poor mental health—as if autistic people exist in a societal blackhole, and would still suffer in the absence of our entire social structure.
It is not hard to see the potential utility for the minority stress model when you pause and take stock of how autistic people are treated in society. The minority stress model captures the some of the complexity of existing while autistic. Autistic people are stereotyped—and the vast majority of stereotypes are negative (Wood and Freeth, 2016). Autistic people face employment discrimination, higher unemployment, and underemployment, as well as experiencing bullying in the workplace (Shattuck et al., 2012; Baldwin et al., 2014). Autistic children are more likely to be excluded from schools (Timpson and Great Britain, 2019). In the United Kingdom (UK), one-third of autistic people have access to neither employment or welfare payments (Redman, 2009), while 12% of Welsh autistic adults report experiencing homelessness (Evans, 2011). Statistics show disproportionate use of force against autistic people and those with learning disability in the UK (Home Office, 2018), while a third to half of all incidents involving the use of excessive force by police involves a disabled person (Perry and Carter-Long, 2016)—experiences which will obviously be further compounded by institutional racism (Holroyd, 2015). Autistic individuals are more likely to experience (poly)victimization, including being four times more likely to experience physical and psychological abuse from adults as children, 27 times more likely to experience teasing, and seven times more likely to experience sexual victimization (Weiss and Fardella, 2018). At the extreme end of the victimization—autistic children are more likely to die to filicide (Lucardie, 2005). Autistic lives are marked by an often-astounding excess stress burden across the life span.
Considering the study by Hirvikoski et al. (2016), I chose to study mental health and minority stress because people like me were (and still are) dying to suicide in their droves. To be clear, wanting a better future for my community is a value, and my work embodied it from the very beginning. I was propelled by values. How can you belong to a community who is actively suffering, and not want to make it better anyway that you can?
I found that exposure to minority stress does predict significantly worse well-being and higher psychological distress in the autistic community (Botha and Frost, 2020), including exposure to victimization and discrimination, everyday discrimination, expectation of rejection, expectation of rejection, outness (disclosure), concealment (masking of autism), internalized stigma, and it explains a large and significant proportion of the variance—in lay-man’s terms—the constant marginalization of autistic people is contributing to high rates of poor mental health. Aside from this, I noticed that despite being normally distributed (and not containing outliers), the mean psychological distress score was above the cut-off for indicating severe psychological distress (Kessler et al., 2003). Between the sadness of these findings and being exposed to all of these disturbing accounts of autism I considered (albeit briefly), giving up on academia all together without pursuing my Ph.D.
In the end, my thesis (Botha, 2020) showed that autistic community connectedness buffered against some of the effects of minority stress and was related to better mental health over time. Yet, I worry constantly that by trying to measure a function of autistic community connectedness, that I objectified it, in a way not dissimilar to the way people objectify autistic people—especially if others come to conflate the function of autistic community connectedness with its value. I studied autistic community connectedness, because I was worried that to only study minority stress would be to see only the worst of what happened to autistic people, and not appreciate our lives as a whole—which are much bigger than our trauma. But, to me, the numbers only explain a mechanism—the real joy, the real value, and the beauty of the autistic community was captured in my very first study. Autistic people talked about the autistic community with such a warmth, brightness, and with hope. The vibrant stories of belongingness, friendships, and political strength tell you exactly what you need to know about the value of such a community. This is something, that its function cannot, and should not even tell you.Frontiers | Academic, Activist, or Advocate? Angry, Entangled, and Emerging: A Critical Reflection on Autism Knowledge Production
Minority stress is the relationship between minority and dominant values and resultant conflict with the social environment experienced by minority group members.
The concept of minority stress stems from several social and psychological theoretical orientations and can be described as a relationship between minority and dominant values and resultant conflict with the social environment experienced by minority group members (Meyer, 1995; Mirowsky & Ross, 1989; Pearlin, 1989). Minority stress theory proposes that sexual minority health disparities can be explained in large part by stressors induced by a hostile, homophobic culture, which often results in a lifetime of harassment, maltreatment, discrimination and victimization (Marshal et al., 2008; Meyer, 2003) and may ultimately impact access to care.
Underlying the concept of minority stress are assumptions that stressors are unique (not experienced by nonstigmatized populations), chronic (related to social and cultural structures) and socially based (social processes, institutions and structures) (Meyer, 2003). While this theory has been applied to other populations, including women, immigrants, the impoverished and racial/ethnic minorities, there is still much room for additional investigation among sexual minority populations, as they do not have as rich a history in sociological investigation (Meyer et al., 2008).
A strong correlation may be drawn between (a) minority stress theory, which underscores stress processes (experience of prejudice, expectations of rejection, internalized homophobia) and ameliorative coping processes (Meyer, 2003); and (b) a greater likelihood for psychological distress and physical health problems…The minority stress perspective
Prolonged Adaptation Stress Syndrome is what happens when someone pretends to be something they’re not on an everyday basis. It is exhausting and soul-eating. This greatly contributes to the high level of mental illness in the trans community or autistic burnout in the neurodiverse community.ysabetwordsmith | Poem: “Type Integrity”