Objective: Although structural stigma (i.e., discriminatory laws, policies, and community attitudes) toward sexual minorities predicts adverse health and wellbeing, this association has typically only been examined within a single country and potential mechanisms remain unknown. Consequently, we examined the association between structural stigma and sexual minorities' life satisfaction across 28 countries, identity concealment as a potential mechanism of this association, and, in high-stigma countries, the potential for concealment to protect sexual minorities from discrimination and victimization, and therefore even poorer life satisfaction than they would otherwise experience in those countries.
Method: Sexual minority adults (n = 85,582) from 28 European countries responded to questions regarding sexual minority stigma, identity concealment, and life satisfaction. Structural stigma was assessed as national laws, policies, and attitudes affecting sexual minorities in each country.
Results: Country-level structural stigma explained 60% of country-level variation in life satisfaction and more than 70% of country-level variation in sexual orientation concealment. Sexual orientation concealment mediated the association between structural stigma and life satisfaction. Especially in high-stigma countries, concealment also protected against even lower life satisfaction than would be experienced if a sexual minority individual did not conceal in those countries because it partially protected against discrimination and victimization.
Conclusions: Sexual minorities' life satisfaction varies greatly across countries largely due to the structural stigma of those countries and associated demands to conceal one's sexual orientation. Findings highlight the importance of reducing structural stigma to promote equitable life satisfaction and tailoring affirmative psychotherapies to address the structural context surrounding sexual minorities who seek treatment. (PsycINFO Database Record
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