Heterosexism and the self: A systematic review informing LGBQ-affirmative research and psychotherapy

Abstract Heterosexism negatively impacts the mental health of sexual minorities, although the degree to which people are impacted and the nature of how they respond to minority stressors varies. In this systematic review, the authors synthesize literature on heterosexism and three psychodynamic personality factors—attachment style, defense style, and ego identity—and reconceptualize heterosexist stigma as something that not only impairs mental health but also influences personality development. The authors present a theoretical framework that outlines the bidirectional influences between sociocultural contexts and the self, which can inform future research and clinical work with sexual minority clients.