Sexual Orientation Minorities in College Counseling: Prevalence, Distress, and Symptom Profiles

Sexual minority group members are at a higher risk for mental health difficulties than are heterosexual individuals. The results of this study showed that college student sexual minorities were common in counseling centers and that they were more likely than heterosexual students to seek counseling. The results also showed that sexual orientation groups differed in meaningful ways from one another, and many sexual orientation groups reported higher levels of psychological symptoms than did heterosexual students. ********** Sexual minority status has been linked to increased risk for mental health symptoms and psychological distress (e.g., Cochran & Mays, 1994, 2000a, 2000b; Cochran, Mays, & Sullivan, 2003; King et al., 2008; Marshal et al., 2008; Mays & Cochran, 2001). One recent meta-analytic review (King et al., 2008) found that nonheterosexuals (N = 11,971) experienced an increased lifetime risk of suicide attempts, depression, anxiety disorders, and substance use disorders. In a British sample, King et al. (2003) found that gay men and lesbian women were more likely than their heterosexual counterparts to express greater overall psychological distress and were also more likely to have recently consulted a mental health professional. Within recent decades, minority stress theory has been applied to the experience of sexual minority populations to help account for this increased risk (e.g., Meyer, 1995, 2003; Meyer, Dietrich, & Schwartz, 2008; Schwartz & Meyer, 2010). There is now a substantial and growing literature base suggesting that this increased mental health risk in sexual orientation minorities is attributable, among other factors, to an increased likelihood of actual and perceived minority discrimination as well as internalized negative attitudes toward sexual minority orientations (Meyer, 2003). However, less empirical work has examined possible heterogeneity of experience and distress between members of different sexual minority populations. Although differences between gay men and lesbian women have been found (e.g., lesbians in the King et al., 2003, study, but not gay men, reported higher incidence of verbal and physical abuse than did their heterosexual comparison group), research on other minority groups is still in its relative infancy. One example of heterogeneity between sexual minority groups is the somewhat inconsistent finding that homosexual men, but not homosexual women, are at increased risk for body image and eating disorder symptoms (see Nelson, Castonguay, & Locke, 2011; this issue). Also, theoretical (e.g., Ochs, 1996) and empirical investigations (e.g., Brewster & Moradi, 2010) of the different experiences of bisexual and homosexual individuals have suggested that bisexual individuals experience discrimination both from heterosexual and homosexual groups and have different health profiles (Russell & Joyner, 2001). Thus, there is good reason to investigate potential differences between homosexual and bisexual individuals' experience of psychological distress, and more research is needed on each of these groups in psychological settings (Bieschke, McClanahan, Tozer, Grzegorek, & Park, 2000). Even less empirical work has been conducted to compare the experiences of individuals who identify as other sexual minority groups such as questioning, queer, and asexual. Given the trend to include more identification labels in research and social settings (e.g., lesbian, gay, bisexual, transsexual, questioning, queer, and asexual; Moradi, Mohr, Worthington, & Fassinger, 2009), and the fast pace of societal change regarding attitudes toward nonheterosexual orientations, understanding the potential variability between these groups may be very important. Counseling psychology, including college counseling, has much to offer in this area of research (Moradi et al., 2009). College students (and college-age individuals) are considered late adolescents, young adults, or, most recently, emerging adults (Arnett, 2000), and as such they are seen as proceeding through the development of individual identity. …