Abstract
Background: Internalized sexual stigma is a significant psychological stressor contributing to depression among
gay men. While resilience and positive sexual identity are known protective factors, their combined roles remain
understudied in non-Western contexts, particularly in East Asian societies like Taiwan.
Purpose: This study investigated whether resilience mediates and positive sexual identity moderates the association between internalized stigma and depressive severity among Taiwanese gay men.
Methods: A cross-sectional online survey was conducted with 234 self-identified gay men in Taiwan. Participants
completed validated measures of internalized stigma, resilience, positive sexual identity, and depressive severity.
Moderated mediation was tested using Hayes' PROCESS macro (Model 8) with 5000 bootstrap samples.
Results: Internalized stigma was positively associated with depressive severity. Resilience significantly mediated
this relationship, while positive sexual identity moderated the direct effect. Specifically, the association between
internalized stigma and depression was weaker among individuals with higher levels of positive identity.
Conclusions: The findings extend the minority stress model to an East Asian context and highlight the protective
roles of resilience and identity in gay men's mental health. Culturally sensitive, identity-affirming care is essential
for psychiatric nurses to reduce the psychological impact of internalized stigma.
gay men. While resilience and positive sexual identity are known protective factors, their combined roles remain
understudied in non-Western contexts, particularly in East Asian societies like Taiwan.
Purpose: This study investigated whether resilience mediates and positive sexual identity moderates the association between internalized stigma and depressive severity among Taiwanese gay men.
Methods: A cross-sectional online survey was conducted with 234 self-identified gay men in Taiwan. Participants
completed validated measures of internalized stigma, resilience, positive sexual identity, and depressive severity.
Moderated mediation was tested using Hayes' PROCESS macro (Model 8) with 5000 bootstrap samples.
Results: Internalized stigma was positively associated with depressive severity. Resilience significantly mediated
this relationship, while positive sexual identity moderated the direct effect. Specifically, the association between
internalized stigma and depression was weaker among individuals with higher levels of positive identity.
Conclusions: The findings extend the minority stress model to an East Asian context and highlight the protective
roles of resilience and identity in gay men's mental health. Culturally sensitive, identity-affirming care is essential
for psychiatric nurses to reduce the psychological impact of internalized stigma.
| Original language | English |
|---|---|
| Journal | Archives of Psychiatric Nursing |
| Volume | 58 |
| State | Published - 2025 |
Keywords
- Internalized stigma
- Resilience
- Positive identity
- Depression
- Sexual minority mental health
- Minority stress model
