Mental Health, Resilience, and Well-Being Among Sexual Minority College Students: A Study Framed by the Minority Stress and Minority Resilience Models

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

See attached document

Comments for author File: Comments.pdf

Author Response

Reviewer #1

I appreciate the opportunity to review the manuscript entitled, “Mental health, resilience, and well-being among sexual minority college students: A study framed by the minority stress and minority resilience models” submitted to Social Sciences for consideration in the special issue on Foundational Social Science Research on LGBTQ+ Communities andPopulations. The focus on

mental health among college students, especially once that is more comprehensive, is an important one and I appreciate the author(s) for engaging such a focus. Below, I offer some suggestions that I believe can help strengthen this work.

 

1. It could be helpful to add a discussion of proximal-distal stressors to the theoretical foundation section on the minoritystress model of the manuscript and carry that across all sections of the manuscript including findings and their How might this add some additional understanding and nuance.

 

Response: We appreciate the suggestion and added a discussion of proximal and distal stressors when we introduce the minority stress model. We carried this thread of discussion into the results section and the discussion section. Here is what we have added:

 

In theory and literature review sections:

“Research has examined various stressors affecting sexual minorities, including proximal subjective stressors such as internalized homophobia, identity concealment, and expectations of rejection (Meyer, 2003; Newcomb & Mustanski, 2010; Pachankis, 2007) to distal objective stressors including homophobic stigma and bullying, workplace discrimination, economic hardship, and relationship difficulties.”

 

“Previous studies using Kwon’s (2013) resilience model often aimed to detect protective factors and mechanisms possessed by some sexual minorities contributing to their resilience or better mental well-being than others facing the same sexual minority stress. Although informative, these within-group investigations need to be balanced by comparisons between sexual minority and heterosexual groups to avoid over-emphasizing internal and proximate factors while making the external systemic health disparities less visible.”

 

In the discussion section:

“Our study contributes to the literature by examining a broad range of mental health indicators, including both negative and positive aspects of mental health among sexual minority college students in contrast with heterosexual students. In doing so, our study provides a fuller picture of the mental health profile of sexual minority college students in comparison with heterosexual students. We believe the comparisons are important to reveal mental health disparities on multiple spectra of mental health. Although this kind of comparison provides us less chances to explore the effects of proximate internal stressors (e.g., internalized homophobia) experienced only by sexual minority students, they highlight the importance of sexual minority status as a distal or structural factor shaping a broad range of mental health outcomes. Our research also enriches the literature on the minority resilience model by directly measuring resilience and considering resilience as a mental health outcome of minority stress. The current literature on minority resilience focuses on within-sexual-minority-group comparisons, and this can unintentionally emphasize resilience as internal and individual-oriented without also emphasizing external or structural factors. By comparing resilience and positive mental health outcomes between sexual minority and heterosexual students, this study highlights the mental health disparities at the structural level even though some sexual minority students were highly resilient and enjoy high levels of well-being.”

 

 

2. I appreciate the section on the minority mental health I encourage the author(s) to also consider (a)how the very notion of mental health might be a

Eurocentric and cis-heteronormative construct and how that might account for some of the findings and the paradox ideaand (b) more critique of the idea that these groups can or should be compared.

 

Response:

We appreciate the insights shared by the reviewer, and we added this discussion in the discussion section of the revised manuscript:

“Viewing the results more critically, it is possible that the very notion of mental health might be a Eurocentric and cis-heteronormative construct which may fail to capture what is truly important and essential to the health and well-being of sexual minorities defined in their own terms.”

 

We do believe that comparisons between sexual minority and heterosexual groups can balance the over-emphasizing of internal and proximate factors in current literature focusing on minority resilience and make the external systemic health disparities visible.

 

3. I also appreciate the author’s section on the minority resilience model and bringing in a more strengths based At the same time, it could be helpful for the authors to consider some of the current theorizing about the problem with using the concept of resilience- it assumes that is internal to the person which means it could a person’s

resilience can be strengthened. This focus, however, completely makes it invisible that the need for resilience is a systemic issue and puts the onus on the person to be resilient rather than the system to stop causing harm. It we want tomove away from a deficit approach a more critical lens added to a strengths-based framing would be helpful to consider.

 

Response: We saw this limitation of the current literature, and we appreciate the reviewer helping us bring it to clarity. As can be seen in our response to the first comment, in the revised manuscript, we clearly pointed out this need for looking beyond the within-group comparison on proximal and internal factors and considering external systemic inequalities when studying resilience and positicve mental experiences. (Please see our response to comment #1)

 

4. Some additional information about studies in the lit review would be For example, more information about samples, methods, theoretical framing, etc would be good to include so the reader has a sense of the strength of the extant literature. Some critique of comparative studies is important generally and since the currentstudy is

comparative it is important more specifically. In the lit review and/or methods a case needs to be made that the groupsare comparable and that biases that can make their way into comparative studies were mitigated to the extent possible. Related, even using

the term “non-heterosexual categories” centers heterosexuality. Additionally, a rationale is needed for treating the queer-identified sample as monolithic and putting them into a single group beyond sample size limitations- that is, maybe some should be deleted from the sample and not used or else the validity of the results is significantly lowered. 

 

Response: We have deleted the term “non-heterosecual” completely from the manuscript. We used “minoritized sexualities”, “sexual minorities”, and “queer sexual identities,” instead.

 

We provided a justification for the dichotomization of sexual identity groups:

“Due to the low sample size of students who selected each category except straight, we combined all students who identified with at least one of the minoritized sexualities into sexual minority identity. This categorization is consistent with Mandatori et al.’s (2025) definition of sexual minority people, which includes all those whose sexual orientations differ from the heterosexual majority, including but not limited to lesbian, gay, bisexual, pansexual, and asexual people.”

 

Given the fluid nature of gender and sexuality, some might criticize our separation and comparison of the two groups.  We nevertheless think it is important to understand the state of wellness for these two groups (heterosexual and sexual minorities) because these two groups experience discrimination and stigma in very different ways. We need to understand the different needs of populations by virtue of their standing in society. This dose allow for a more critical review of the literature and the conceptual foundation of the current study.

 

We emphasized throughout the manuscript that comparisons between sexual minority and heterosexual groups can balance the over-emphasizing of internal and proximate factors in current literature and make the external systemic health disparities visible. Although a finer comparison among all distinctive sexual identity groups is highly desirable, we don’t have enough sample size to do so.

 

We added some more information in the literature review on sample size and research design of the cited research. Due to the large amount of research cited in this study, we didn’t add details in a systematic way, but only when we saw appropriate.

 

 

5. If some instructors provided extra credit and others didn’t how should be consider this inequity among the samplefrom an ethics perspective?

 

Response: Most instructors provided extra credit for participating in the survey. The possibility of getting extra credit depended on the decision of each individual instructor. This point was stated clearly in the informed consent form. The survey was completely anonymous and students took it at the location and time they chose. To claim extra credit, students needed to screenshot the generic “Thank you” message when they completed the survey. We don’t believe offering extra credit would cause significant ethical concerns, given IRB approval for our study.

 

6. I suggest the authors redo table 1 so that one side presents variable information for the queer-identified (used as anumbrella term) sample and the other column provides it for heterosexually-identified sample.

 

Response:  We created a new table presenting descriptive statistics for the queer-identified sample and the heterosexually-identified sample separately. We don’t think we should delete the descriptive statistics for the total sample upon which our main analyses were conducted. To avoid that Table 1 gets too big, we put the group-specific descriptive table in Appendix A.

 

7. I would alphabetize all variable responses rather than list them based on largest to smaller percent (e.g.,race).

 

Response:  We adopted the suggestion for nominal-level variables in the tables.

 

8. Which orientation were put into which groups and provide a rationale for

 

Response:  “Students were provided a list of sexual identities (Lesbian, gay, straight/heterosexual, asexual, bisexual, fluid, pansexual, queer, questioning or unsure, or prefer not to disclose) and asked to select as many categories as applicable. We combined all students who identified with at least one of the minoritized sexualities into a sexual minority identity. This categorization is consistent with Mandatori et al.’s (2025) definition of sexual minority people, which includes all those whose sexual orientations differ from the heterosexual majority, including but not limited to lesbian, gay, bisexual, pansexual, and asexual people. A dummy variable was created with the sexual minority identity coded as 1 and the heterosexual identity as 0.”

 

9. How were control variables determined?

 

Response: Control variables include commonly used basic demographic variables that were available in our survey data. Other control variables include being a freshman (yes=1) and being a commuter (yes=1) due to their mental health impacts on college students documented in the literature (Merlin and Hu, 2023; Stolzenberg, 2018). We added this justification in the revised manuscript.

  

10. Was gender assessed based on being cis and trans? Could there be some trans-identified respondents mixed acrosssexual orientation categories and how might this have an impact on the results is some significant ways?

 

Response: “The survey didn’t contain information on gender based on being cis- or transgender status. The survey only asked participants whether they self-identify as female, male, non-binary, or prefer not to say. We created a dummy variable (0=male, 1=female and non-binary/prefer not to say) to denote gender minority status.” We added this information in the revised manuscript.

 

11. Additional clarity about the sampling procedures is needed. The authors seems to imply only sociology andanthropology courses were sampled and in the next sentence is states gen ed courses that also included Intro to Soc and Ant specifically were sampled. A specific sampling approach is never named and I am sure it was convenience yet naming it is important as well as providing a rationale for why that was How many coursesreceived info and how many shared it will students and how many

potential respondents were there, etc.

 

Response: The anonymous survey was distributed via the Qualtrics platform to students enrolled in Introduction to Sociology and Introduction to Anthropology courses, which attract students from a diverse range of majors. The survey was also distributed to students enrolled in other sociology and anthropology courses. The sampling strategy was based on convenience and availability rather than probability. Unfortunately, we don’t have the full list of classes in which the survey link was shared, nor the number of potential respondents. We clarified the sampling design in the revised manuscript.

 

12. I would like a stronger link between the lit review and the operationalization of variables (e.g., inner peace,environmental mastery) especially hope this variables work with historically minoritized

 

Response: “Besides happiness, life satisfaction, social connectedness, and self-esteem, the well-being literature has emphasized other dimensions of positive mental health such as the purpose of life (Ryff, 1989; Xi et al., 2022), mastery over one’s life circumstances (Ryff, 1989), and inner peace (Xi & Lee 2021). Little research intention has been paid to these various aspects of positive mental health among sexual minority populations.” We added this information in the revised manuscript.

 

13. The analytic strategy does not include all analyses so additional context is needed for Part of thisshould address sample size differences and how that was

considered, where appropriate as well as how controls were used/entered. For example, table 3 makes it appearthat results are from model 2 (model is spelled wrong in the

table, I assume the word is supposed to be model) so my guess is the controls were entered in step 1 but it is notclear.

 

Response: We provided the following information in the revised methods section:

“Our statistical analyses include bivariate t-tests comparing means of symptoms of mental health disorders and positive mental health and well-being between sexual identity groups. Because all the dependent variables are measured at the interval level, we use ordinal least square regression analysis to test our hypotheses and control for other minority status, socioeconomic status, and demographic variables. We analyze the data using STATA 17.”

 

“After excluding 30 incomplete surveys, the final sample consisted of 521 fully completed responses, with no missing data.”

 

We deleted the subtitle containing the typo in Table 3. We recognized that the subtitle with the model number was not necessary. The step-wise regression was not needed for our analysis. The regression model for each outcome variable contained all control variables.

 

14. Although there is a significant difference in some of the means scores, they are higher for both groups and the narrativeseems to focus on the queer group and the disparity between groups yet the heterosexual group is also really high,particularly for depression. It should be made clear when controls were used and not, specifically for the t-tests as theregression reports For example, how were the used for the t- tests since t-tests typically don’t include controls directly. How were analyses for table 4 conducted? The treatment of gender is unclear and this relates to me earlier comments about how gender was conceptualized and measured.

 

Response: In the revised discussion section, we pointed out:

“It is noteworthy that the heterosexual students also reported high levels of depressive and anxiety symptoms even though they scored lower than the sexual minority students. This is concerning and is consistent with the literature.”

 

No control variables were used in the t-tests comparing mean scores. We clarified this in the text and in Table 2. Table 4 reports the final model in the regression results with all control variables included. We didn’t focuse on meditaton effects of any sort or comparing effects of different independent variables, and thus saw no need to report models with subsets of variables.

 

We clarified the measurement for gender in our response to #10.

 

15. I am not clear on if the SES related variables were intended to be controls or explanatory based on how they arediscussed in the discussion section and prior

 

Response: We treated them as explanatory variables and revised the measurement section accordingly.

 

16. Given the data came from 2022, it is important to contextualize the findings based on that. For example, we were just“coming out of” covid in many areas and there were significant general and unique stressors related to that which arenever mentioned with the interpretation. I also believe it would strengthen the manuscript to discuss what the numbersactually mean

 

Response: We added the following discussions in the revised manuscript.

“The timing of the survey can be highly relevant in interpreting the results. The breakout of the COVID-19 pandemic in 2020 and the disruptions caused by it were very impactful on students’ mental health (Salerno et al., 2020). After the full lockdown of college campuses in 2020, campus life and class arrangements were constantly changing in accordance with the development of the pandemic and the vaccine. The high prevalence of mental health symptoms found in this study in 2022 was not surprising.

 

It has been suspected that the COVID-19 pandemic would impact the SGM groups more adversely compared to cisgender and heterosexual groups (Salerno et al., 2020). The types of employment for many SGMs are more susceptible to the economic impacts of the pandemic (Gibb et al., 2020). Lack of a supportive family and a safe home might make life hard and dangerous for them under the lockdown policy, especially for young SMG persons (Fish et al., 2020). Many SGM communities suffered a sudden and significant loss of safe space, including support groups and leisure and entertainment spaces, due to social distancing mandates and closures of businesses and gathering places (Anderson & Knee, 2020; Banerjee & Nair, 2020). Social support and meaningful social connections are important protective factors for mental health (Pearlin 1989). The loss of these protective resources can lead to heightened mental health symptoms (Scroggs et al., 2020). Without longitudinal data, it is hard to gauge the impact of the pandemic on sexual minority students. It is possible that the results reported in this study reflected such impacts.”

 

I wish the authors luck with their work and appreciate the much needed focus on mental health.

Response: We appreciate the reviewer’s kindness.

 

 

 

Reviewer 2 Report

Comments and Suggestions for Authors

Paper describes project to investigate a set of positive mental health outcomes and the applicability of the minority resilience model. Methods provide clarity on instrument, scales, and variables. The manuscript is well-cited, provides attention to previous literature and situates the work within the context of that literature. The description of the minority stress model is concise and written with clarity. The following pieces of feedback are meant to further strengthen the manuscript:

 

Section 1.2. The Minority Mental Health Paradox (pages 2-3, lines 83-114): A unclear what this section hopes to advance or assert. I suspect the point is to clarify that while sexuality communities do not experience lower rates of mental health they do have significant resilience. Is that to say that more disorders but better outcomes dealing with those disorders? Is that not the point of section 1.3? Please clarify.

Page 3, line 109, Recent is unnecessarily capitalized

Page 13, lines 437-442: These seem like quit significant assertions. Please take a few more sentences to expound on these statements. Possibly the following paragraphs are meant to serve as such, but seem to only address parts of those major assertions.

Page 14, lines 491-495: There seems to be an absence are actionable steps that should go with these findings. The suggestions listed are now, whether by state legislation and/or federal executive orders, illegal at this moment. This is not the fault of the authors as this likely occured after the manuscript was submitted for review. However, it is imperative to address this now. Additionally, I would encourage the authors to be more specific (recommendations are vague). How should those who work with collegiate sexual minority populations move forward with these findings? How should these findings impact their work and how they advocate for students?

 

 

Author Response

Reviewer #2

Paper describes project to investigate a set of positive mental health outcomes and the applicability of the minority resilience model. Methods provide clarity on instrument, scales, and variables. The manuscript is well-cited, provides attention to previous literature and situates the work within the context of that literature. The description of the minority stress model is concise and written with clarity. The following pieces of feedback are meant to further strengthen the manuscript:

Section 1.2. The Minority Mental Health Paradox (pages 2-3, lines 83-114): A unclear what this section hopes to advance or assert. I suspect the point is to clarify that while sexuality communities do not experience lower rates of mental health they do have significant resilience. Is that to say that more disorders but better outcomes dealing with those disorders? Is that not the point of section 1.3? Please clarify.

Response:  Your guess is correct. The literature has documented little evidence that the minority mental health paradox is applicable to people identified as sexual minorities, as predominant research findings point to more mental disorder symptoms reported by sexual minority groups. However, it is possible that they develop more resilience from challenges and adversities associated with their sexual minority identity, as argued by the minority resilience model. This is the link between sections 1.2 and 1.3. We used this link to transition from section 1.2 to 1.3, which focuses on the minority resilience model. We revised the manuscript to clarify this point.

We brought in the mental health paradox literature also because members of the sexual minority community include ethno-racial minorities and vice versa. These categories of people are not mutually exclusive. This social complexity makes our understanding of resilience and risk difficult to disentangle. Nevertheless, we include these analytical frameworks together, hoping to further research design and empirical analysis on the relationship between resilience, risk, and minoritized populations to address and reduce human suffering. 

Page 3, line 109, Recent is unnecessarily capitalized

Response: We corrected it.

Page 13, lines 437-442: These seem like quit significant assertions. Please take a few more sentences to expound on these statements. Possibly the following paragraphs are meant to serve as such, but seem to only address parts of those major assertions.

Response:  Sexual minority status and racial minority status are not mutually exclusive. However, it is beyond the scope of this study to fully investigate multiple intersecting minority identities. To avoid confusion, we deleted the paragraph.

Page 14, lines 491-495: There seems to be an absence are actionable steps that should go with these findings. The suggestions listed are now, whether by state legislation and/or federal executive orders, illegal at this moment. This is not the fault of the authors as this likely occured after the manuscript was submitted for review. However, it is imperative to address this now. Additionally, I would encourage the authors to be more specific (recommendations are vague). How should those who work with collegiate sexual minority populations move forward with these findings? How should these findings impact their work and how they advocate for students?

Response: We revised the discussion section and added the following paragraph in the revised manuscript:

“The current political policy stance against diversity, equity, and inclusion efforts gives us pause in suggesting actionable steps to protect and serve vulnerable populations, including the sexual minority community, without risking backlash. Nevertheless, here are some actionable suggestions for college health professionals and administrators based on our findings. For example, providing help to all students with basic needs for food, safety, and housing would benefit some sexual minority students and keep them resilient. Many frameworks, such as retention programs and general mental health and well-being programs that are less politically controversial, can be of great value for students in need, including sexual minority students. We suggest conducting legal reviews to identify protected activities that remain viable even under restrictive policies, which can be another useful endeavor to ensure a welcoming campus for all. We recommend continued anonymous data collection on campus climate and student well-being to document the needs of students while protecting their privacy. Establishing peer mentoring programs that can operate through student organizations can be useful. Creating informal faculty, staff, and student ally networks to provide mentorship and support to students in need can help students but also nurture university community building. Staff, faculty, and administrators can develop connections with community organizations to provide students with resources that are unavailable on campus. Finally, recognize certain protections for sexual minority students remain in place regardless of state policies (Title IX interpretations, institutional non-discrimination policies).”

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

I appreciate the revisions and believe they strengthened the manuscript. A final copyedit would be good.

Author Response

Comment 1: I appreciate the revisions and believe they strengthened the manuscript. A final copyedit would be good.

Response: We did a final copyedit as suggested.