Introduction: Sexual and gender minority (SGM) adolescents are likely to experience higher levels of stigma, discrimination, and inadequate social support, potentially resulting in adverse mental health outcomes. These stressors can have varying effects across different groups. To enhance our understanding of the intricate relationships between these stressors and their effects on subgroups, we examined these dynamics from the perspectives of gender, race, and ethnicity to inform HIV prevention efforts.

Methods: We conducted a one-time online survey with SGM adolescents residing in Alabama, aged 14-17 years, who were assigned male sex at birth, and who self-reported having sexual interest in men. We conducted bivariate analyses stratified by gender, race, and ethnicity to examine the distribution of key variables: internalized homophobia, discrimination, and social support. With a statistical significance threshold of p < 0.05, we performed independent t-tests to compare continuous variables between groups.

Results: The study included 206 SGM adolescents; we found disparities in internalized stigma, discrimination, and social support across racial, gender, and ethnic groups. Black participants reported higher levels of internalized homophobia compared to White participants (Mean [M] = 12.07, Standard Deviation [SD] = 5.44 vs. M = 10.32, SD = 4.24; p = .023). Transgender and gender non-conforming individuals reported significantly higher discrimination than cisgender males (M = 23.46, SD = 10.99 vs. M = 16.72, SD = 12.19; p = .003). Compared to non-Hispanics, Hispanic SGM adolescents reported significantly higher internalized homophobia (M = 13.95, SD = 5.24 vs. M = 10.47, SD = 4.66; p = .001) and discrimination (M = 24.21, SD = 11.05 vs. M = 16.63, SD = 11.93; p = .004) as well as lower social support (M = 59.09, SD = 15.64 vs. M = 67.87, SD = 16.53; p = .020).

Conclusions: We found significant variations in internalized homophobia, discrimination, and social support by racial, gender, and ethnic groups. These disparities highlight the need for tailored interventions to address the lived experiences specific to racial, ethnic, and gender minority adolescents. Given that SGM adolescents are at heightened risk for adverse mental health outcomes related to discrimination and stigma, potential interventions must be implemented equitably to mitigate the negative effects of these stressors.