The Effects of Emotion Regulation on Experiences of Pride and Shame, and Subsequent Self-Disclosure Among Lesbian, Gay, and Bisexual Adults

Regulating Discrimination: The Effects of Emotion Regulation on Experiences of Pride and Shame, and Subsequent Self-Disclosure among Lesbian, Gay, and Bisexual Adults

THESIS

Presented in Partial Fulfillment of the Requirements for the Degree Master of Arts in the Graduate School of The Ohio State University

Ilana Seager, B.A.

Graduate Program in Psychology

The Ohio State University

2016

Master's Examination Committee:

Amelia Aldao, Ph.D., Advisor

Jennifer Cheavens, Ph.D.

Jennifer Crocker, Ph.D.

Copyrighted by

Ilana Seager

2016

Abstract

A growing number of epidemiological studies have highlighted the disproportionately high rates of mental illness that lesbian, gay, and bisexual (LGB) individuals experience relative to their heterosexual peers (e.g., Gilman et al., 2001). One explanation for these alarming statistics may lay with the sexual orientation-related discrimination that LGB individuals experience in almost all aspects of their lives (e.g., Bostwick et al., 2014;

Hatzenbuehler et al., 2010). Such discrimination may alter LGB individuals’ sense of self and of group and may interfere with behavioral expressions of their sexuality, eventually leading to the development of mental health problems (Bostwick et al., 2014; McCabe et al., 2010). However, very few studies to date have experimentally examined how discriminatory events influence the decision to self-disclose one’s sexual orientation and the role emotion regulation might play in buffering against some of the negative mental health outcomes associated with discrimination. With the present studies, I sought to answer this question by using an affective science framework. In Study 1, I validated four two-minute film clips as valid procedures for inducing group-based emotions (including pride and shame) in LGB Americans (N = 80) in an online study. I used two of these clips in a second online study (Study 2; N = 148) and found that participants who viewed the discriminatory clip were significantly less likely to spontaneously disclose their sexual orientation in a written reflection task than those who viewed the affirming clip.

However, I found no differences in sexual orientation disclosure between participants instructed to immerse themselves in the content of the film and those instructed to distance themselves. These studies comprise a first step towards understanding the affective and cognitive mechanisms underlying discrimination’s immense effects on LGB mental health and thus provide future directions for interventions with this population.

iii

Acknowledgments

I would first like to sincerely thank my advisor, Amelia Aldao, as well as my colleagues,

Kara Christensen, Emily Dunn, Andre Plate, and Anne Wilson, for all of their guidance and support throughout this project. In addition, I am much indebted to our hardworking undergraduate research assistants who allowed us to collect these data, in particular

Thomas Parsons and Sarah Gobrial. I would like to gratefully acknowledge my committee members, Jennifer Cheavens and Jennifer Crocker, and also Lisa Cravens-

Brown, for their thoughtful feedback and advice on this thesis. Finally, I must express my profound gratitude to my partner and family for their unwavering support throughout the process of designing, executing, and writing this thesis.

Vita

2007...... Westlake Girls High School

2012...... B.A., Psychology & History of Science,

History of Medicine, Yale University

2014 to present ...... University Fellow, Department of

Psychology, The Ohio State University

2015 to present ...... Graduate Teaching Associate, Department

of Psychology, The Ohio State University

Publications

Seager, I., Rowley, A., & Ehrenreich-May, J. (2014). Targeting Common Factors across

Anxiety and Depression using the Unified Protocol for the Treatment of

Emotional Disorders in Adolescents. Journal of Rational-Emotive & Cognitive-

Behavioral Therapy, online. DOI: 10.1007/s10942-014-0185-4.

Britton, J., Kennedy, S., Seager, I., Queen, A. H., Hernandez, M. V., Spiro, C., &

Ehrenreich-May, J. (2015). Pediatric Depression: Neurocognitive Function and

Treatment Implications. In J. Mohlman, T. Deckersbach, & A. Weissman (Eds.),

From Symptom to Synapse: A Neurocognitive Perspective on Clinical Psychology

(pp. 211-246). New York, NY: Routledge.

Fields of Study

Major Field: Psychology

Table of Contents

Abstract ...... ii

Acknowledgments ...... iv

Vita ...... v

Publications ...... v

Fields of Study ...... vi

List of Tables ...... x

List of Figures ...... xi

Chapter 1: Introduction ...... 1

The Present Thesis ...... 9

Chapter 2: Study 1 ...... 13

Methods ...... 13

Participants ...... 13

Procedure ...... 15

Discrimination and Affirmation Film Clips ...... 16

vii

Mood Ratings ...... 18

Attention Questions ...... 18

Distraction Task ...... 18

Statistical Analyses ...... 19

Results ...... 20

Positive Affective Reactivity ...... 20

Pride Reactivity ...... 22

Negative Affective Reactivity ...... 23

Shame Reactivity ...... 24

Discussion ...... 25

Chapter 3: Study 2 ...... 28

Methods ...... 28

Participants ...... 28

Procedure ...... 29

Emotion Regulation Instructions ...... 30

Written Reflection Task ...... 32

Decision-Making Task ...... 32

Statistical Analyses ...... 33

viii

Results ...... 34

Manipulation Checks ...... 34

Main Analyses Predicting Affect with Film and Emotion Regulation Conditions ... 38

Main Analyses Predicting Disclosure with Film and Emotion Regulation Conditions

...... 40

Discussion ...... 42

Chapter 4: General Discussion ...... 47

References ...... 55

Appendix A: Written Reflection Task Instructions ...... 64

Appendix B: Decision-Making Task ...... 65

Appendix C: Lesbian, Gay, and Bisexual Library for Linguistic Inquiry and Word Count

(LIWC) Program ...... 67

List of Tables

Table 1. Means and Standard Deviations of Affective Reactivity to Four LGB-Relevant

Film Clips ...... 21

Table 2. Means and Standard Deviations of Affective Reactivity to Film Clips...... 35

Table 3. Means and Standard Deviations of Emotion Regulation Strategy Use in

Response to Film Clips...... 38

Table 4. Means and Standard Deviations of Affective Reactivity by Emotion Regulation and Film Condition...... 39

Table 5. Descriptive Characteristics of Disclosure Variables by Emotion Regulation and

Film Condition...... 42

List of Figures

Figure 1. Theoretical model of the relationship between discriminatory events and subsequent sexual orientation self-disclosure, sexual minority identity, and mental health.

...... 3

Figure 2. Theoretical role of emotion regulation in moderating the relationship between discriminatory events and subsequent sexual orientation self-disclosure, sexual minority identity, and mental health outcomes...... 7

Figure 3. Study 1 participant flow diagram...... 15

Figure 4. Study 1 procedures...... 16

Figure 5. Screenshots from the final affirming (top) and discriminatory (bottom) film clips...... 17

Figure 6. Positive affective reactivity in response to four LGB-relevant film clips as measured by the PANAS-Positive subscale ...... 21

Figure 7. Pride reactivity in response to four LGB-relevant film clips as measured by the

PANAS ...... 22

Figure 8. Negative affective reactivity in response to four LGB-relevant film clips as measured by the PANAS-Negative subscale ...... 24

Figure 9. Shame reactivity in response to four LGB-relevant film clips as measured by

xi the PANAS ...... 25

Figure 10. Study 2 participant flow diagram ...... 29

Figure 11. Study 2 procedures and timing of mood ratings...... 30

Figure 12. Self-reported immersion during the film clips by emotion regulation condition.

...... 36

Figure 13. Self-reported distancing during the film clips by emotion regulation condition.

...... 37

xii

Chapter 1: Introduction

Despite recent increases in the acceptance of lesbian, gay, and bisexual (LGB) individuals in North American society (e.g., through the legalization of same-sex marriage, by the inclusion of LGB characters in popular television shows and films),

LGB people continue to experience high rates of sexual orientation-related stigmatization and discrimination (e.g., in the workplace, lack of legal protections; Bernstein, 2013;

Bostwick et al., 2014; Hatzenbuehler et al., 2010). Such discrimination can have wide- reaching effects, impairing physical and mental health (e.g., Bostwick et al., 2014;

Haldeman, Pantalone, & Martell, 2007; McCabe et al., 2010). For example, LGB people experience disproportionately higher rates of mental illness compared to their heterosexual peers, and numerous studies have tied discrimination experiences to these mental health outcomes (e.g., Bostwick et al., 2014; Hatzenbuehler et al., 2010; Mays &

Cochran, 2001; McCabe et al., 2010; Plöderl & Tremblay, 2015). Furthermore, data from the National Comorbidity Survey found that, compared to individuals with opposite-sex sexual partners, women with same-sex sexual partners have higher 12-month prevalence rates of mood (35.1% vs. 13.9%), anxiety (40.0% vs. 22.4%), and substance use disorders

(19.5% vs. 7.2%), as well as suicidal thoughts (13.9% vs. 3.9%) and plans (15.2% vs.

4.8) (Gilman et al., 2001). Another study found that gay and bisexual men experience

higher rates of depression (31.0% vs. 10.2%), panic attacks (17.9% vs. 3.8%), and general psychological distress (33.1% vs. 12.5%) compared to their heterosexual counterparts (Cochran, Sullivan, & Mays, 2003). Evidence of mental health impairment spans across age groups, including LGB youth, adolescents, and young adults — for example, LGB youth are four times more likely to attempt suicide than heterosexual youth (Kann et al., 2011).

One mechanism by which discrimination likely impairs physical and mental health most proximally is by hindering the disclosure of sexual orientation (e.g., Connell,

2012; Day & Schoenrade, 1997; Dewaele, Van Houtte, Cox, & Vincke, 2013; Rhoads,

1995). Indeed, Pachankis (2007) proposed a model that highlights numerous maladaptive effects of concealing stigmatized identities, which includes cognitive (e.g., increased vigilance and suspiciousness), affective (e.g., increased anxiety, guilt, shame, and depression), and behavioral (e.g., social avoidance and isolation, impression management) components. Critically, this model also stresses the impact of these components on individuals’ self-evaluations, and proposes that concealing a stigmatized identity leads to identity ambivalence (i.e., an inconsistent view of the self across situations; Granfield, 1991) and decreased access to self-protective attributions about one’s identity group (e.g., attributing insults to one’s group membership, rather than one’s personal flaws; Crocker & Major, 1989). In so doing, Pachankis’s model underscores the pivotal role of sexual orientation self-disclosure on more distal processes like adaptive sexual minority identity (See Figure 1).

Figure 1. Theoretical model of the relationship between discriminatory events and subsequent sexual orientation self-disclosure, sexual minority identity, and mental health.

In line with this notion, Meyer’s (2003) minority stress theory places sexual minority identity as a critical moderator in the link between discrimination and mental health. In particular, Meyer’s theory postulates that characteristics of minority identity such as prominence (i.e., how central it is to one’s sense of self) and integration (i.e., how well one’s sexual minority identity has been assimilated into other aspects of one’s identity) interact with proximal minority stressors such as expectations of rejection, concealment, and internalized homophobia, to predict mental health outcomes. For example, one study found an inverse relationship between depression and identity synthesis among gay men (Bybee, Sullivan, Zielonka, & Moes, 2009), suggesting that the more integrated one’s sexual minority identity is with the rest of their identity, the better mental health outcomes (i.e., less depression). Another study found that LGB individuals who had disclosed their sexual orientation to loved ones (which possibly reflects their

being more accepting of their own minority identity) reported less anxiety, depression, and burnout, and had lower morning cortisol levels, compared to those LGB individuals who had not disclosed their sexual orientation (Juster, Smith, Ouellet, Sindi, & Lupien,

2013).

It is clear from Pachankis’s and Meyer’s models that sexual orientation disclosure plays a crucial role in facilitating positive mental health outcomes by enabling the acceptance and integration of sexual minority identities into LGB individuals’ broader sense of self. Furthermore, these models suggest that self-disclosure may also facilitate social connection. Support for this notion comes from a recent experimental study in which concealing a stigmatized identity (in this case, history of mental illness) during a dyadic social interaction was associated with a reduced sense of belonging for participants and impaired experiences of intimacy for their conversation partners, compared to disclosure conditions (Newheiser & Barreto, 2014). This finding indicates that while many LGB people may choose to hide their sexual orientation due to fears of potential consequences (including discrimination, loss of social support, among others;

Harris & Bliss, 1998; Hillier, 2002), they may in fact experience more social acceptance and improved overall well-being if they choose instead to disclose their orientation.

However, while we have a relatively good understanding of the associations among discrimination disclosure, identity, and mental health, our knowledge of the causal mechanisms driving these relationships is sparse. Thus, I propose to experimentally examine the mechanisms by which discrimination affects identity disclosure.

One way of doing so is by considering the emotional impact of discriminatory

events. Indeed, research suggests that evaluations of prior emotionally-laden experiences

(e.g., discrimination) are most strongly predicted by the person’s emotions at the peak and end of the emotional experience (i.e., the "peak-and-end" rule; Fredrickson, 2000). In other words, the impact of discrimination on self-disclosure, identity, and physical and mental health may be determined by an individual’s emotions during the discriminatory event.

Self-conscious emotions are particularly relevant in the context of discriminatory social interactions, as they involve both self-awareness and self-evaluation, and tend to arise when one is aware of one’s evaluation by others, whether that be during the course of a direct social interaction, or more indirectly through the violation of social norms and expectations (e.g., Beer, Heerey, Keltner, Scabini, & Knight, 2003; Lewis, 2000;

Tangney, 2003). Shame, for example, occurs when a person feels that they have failed to live up to social norms and/or values and view themselves (through the eyes of others) as fundamentally and unacceptably flawed (e.g., Eisenberg, 2000; Turner, 2014). It is distinct from embarrassment, which results from trivial social transgressions (e.g.,

Eisenberg, 2000; Miller & Tangney, 1994), and from guilt, which primarily entails concern with having committed transgressive behaviors (e.g., Eisenberg, 2000; Ferguson,

Stegge, & Damhuis, 1991). Shame is experienced by LGB individuals in a wide range of contexts, including school bullying (e.g., Greene, Britton, & Fitts, 2014), internalized homophobia (wherein individuals adopt anti-LGB societal attitudes into their self- concept; e.g., Brown & Trevethan, 2010; Greene & Britton, 2013) and poor familial and peer responses to sexual orientation disclosure (e.g., Brown & Trevethan, 2010). In

addition to being a strong and highly distressing emotion to experience (e.g., Eisenberg,

2000), shame is associated with impaired intimate relationships (e.g., Black, Curran, &

Dyer, 2013), social and general anxiety (e.g., Muris, Meesters, Bouwman, & Notermans,

2014; Zimmerman, Morrison, & Heimberg, 2014) and decreased self-disclosure (e.g.,

DeLong & Kahn, 2014).

Pride, on the other hand, is considered a positive self-conscious emotion that occurs when one believes that one is “responsible for a socially valued outcome or for being a socially valued person” (Mascolo & Fischer, 1995). Authentic pride is usually achievement-based, stems from a specific event, and has been tied to building social currency and navigating difficult social situations (e.g., Tracy & Robins, 2007a, 2007b;

Williams & DeSteno, 2008). Williams and DeSteno (2009), for example, found that participants who had undergone an authentic pride induction (wherein they were given fake positive feedback on a visuospatial task) tended to take on more of a leadership role in a group task compared to controls, and were also perceived by other group members as the most likable interaction partners. No prior research has experimentally investigated authentic pride in the context of a sexual minority identity.

Given both the negative consequences of having shameful experiences and the potential benefits of increasing prideful ones (especially given the importance of social interactions in LGB identity formation), it is important to examine the mechanisms by which self-conscious emotions can be regulated (See Figure 2). Emotion regulation encompasses the processes by which individuals modulate which emotions they have, when they have those emotions, and how they express them (Gross, 1998). Germane to

this investigation, emotion regulation has been utilized as a framework to understand

LGB identity (e.g., Hatzenbuehler, Nolen-Hoeksema, & Dovidio, 2009), motivated behavior (e.g., Aldao & Christensen, 2015), and mental health (e.g., Aldao, Nolen-

Hoeksema, & Schweizer, 2010; Kring & Sloan, 2009).

The few studies investigating emotion regulation in LGB samples, while illuminating, have focused on the broad impairments resulting from discrimination (e.g., increased depressive symptoms) but not the mechanisms underlying these processes. The role of self-conscious emotions like pride and shame is a particularly glaring omission in the literature given the inherently social nature of discrimination. In addition to these more theoretical concerns, the extant research has also been primarily correlational or

qualitative (e.g., Borders, Guillén, & Meyer, 2014; Szymanski, Dunn, & Ikizler, 2014).

For example, McDavitt et al. (2008) used interview data to map young gay and bisexual males’ responses to heterosexism (i.e., discrimination against non-heterosexuals based on the assumption that heterosexuality is the normal sexual orientation) on to Gross' (1998) process model of emotion regulation. Researchers found that, in the face of heterosexism, gay and bisexual youth primarily relied on support from other members of the LGB community (situation selection), avoided revealing their own sexual minority status by keeping a low profile and/or telling half-truths (situation modification), and selectively attended to stigmatizing behaviors (attentional deployment; McDavitt et al., 2008). They also reframed and/or deconstructed heterosexist encounters to change the meaning of the encounter (common cognitive change strategies used in cognitive behavioral therapies, see Beck, 1995), and vented or suppressed their emotions, or used substances to cope with their feelings (response modulation; McDavitt et al., 2008).

One daily diary study found that on days in which LGB individuals experienced a stigma-related stressor (on average, four out of the 10 days), they reported using more putatively maladaptive emotion regulation strategies (i.e., rumination and suppression) compared to days without stigma-related stressors (Hatzenbuehler, Nolen-Hoeksema, et al., 2009). A follow-up investigation revealed that LGB individuals’ self-concept plays a large role in the emotion regulation strategies they utilize — LGB participants who rated themselves higher on a scale of implicit anti-gay attitudes reported more psychological distress (e.g., depression) and more use of rumination, compared to those who scored low on anti-gay attitudes (Hatzenbuehler, Dovidio, Nolen-Hoeksema, & Phills, 2009).

Although these studies provide an excellent foundation, future research on emotion regulation in LGB samples needs to clarify the mechanisms by which discriminatory experiences impair LGB individuals’ mental health and wellbeing. Thus, it becomes important that researchers develop novel experimental paradigms to explore important facets of this topic, including the role of social emotions like pride and shame, as well as the role of emotion regulation strategies in mediating the effects of sexual orientation- related stigma.

The Present Thesis

The primary goal of the present two-study thesis was to adapt experimental paradigms commonly used in the field of affective science to better understand how emotions (i.e., pride, shame) experienced during an LGB-relevant event (either discriminatory or affirming) influence an individual’s willingness to disclose their sexual orientation. Further, I wanted to examine whether emotion regulation strategies (i.e., distancing, immersion) could be utilized to alter these affective and behavioral experiences.

In Study 1, I sought to validate both discriminatory and affirming film-clips intended to induce shame and pride related to LGB identity. I used a within-subjects design in order to control for individual variability in pride and shame experiences, as well as to increase the statistical power of my analyses. I predicted a main effect of film type, such that, after watching an affirming film clip, LGB participants would report higher levels of positive affective (and pride) reactivity and lower levels of negative affective (and shame) reactivity than after watching a discriminatory film clip.

In Study 2, I built upon the work on stigma and internalized anti-LGB attitudes by

Hatzenbuehler and colleagues (2009) by investigating how feeling pride or shame about one’s identity as a member of a sexual minority can influence the way one experiences thoughts, feelings, and identity, and how one makes decisions. In particular, I sought to examine the effects of pride and shame on one’s willingness to disclose his or her sexual orientation. I induced pride and shame using the discriminatory and affirming film-clips validated in Study 1 as part of a between-subjects design and I assessed self-disclosure by administering two behavioral tasks I developed for this study: 1) an open-ended written reflection task (to tap into spontaneous disclosure), and 2) a forced-choice decision- making task (to examine deliberative disclosure). To examine the role of emotion regulation, I built on the work by McDavitt and colleagues (2008), which found that gay and bisexual individuals routinely use cognitive change strategies to cope with heterosexist events. Given the utility of these strategies in addressing maladaptive thoughts in therapeutic situations (e.g., Beck, 1995; Butler, Chapman, Forman, & Beck,

2006; Gloaguen, Cottraux, Cucherat, & Blackburn, 1998), I examined the impact of emotion regulation strategies by randomly assigning half of the participants to utilize distancing (i.e., the process of mentally removing oneself from a given situation — in this case, distancing themselves from the events and people depicted in the film clips) and the other half to use immersion (the process of fully engaging oneself in a given situation — opposite from the MacDavitt et al., 2008 findings) during the film clip

(Kross, 2009). In so doing, I hoped to examine how cognitive change in the experience of the film clip may alter responses in the disclosure tasks.

First, I predicted a replication of Study 1 findings with regard to affect, such that when participants watched an affirming film clip they would report higher levels of positive affective (and pride) reactivity than those who watched a discriminatory film clip. Importantly, I predicted a two-way interaction between film type and regulation strategy, such that when participants watched the affirming film clip, those in the immersion condition would report more positive affective (and pride) reactivity than those in the distancing condition. Conversely, for those watching the discriminatory film clip, those in the immersing condition would report lower positive affective (and pride) reactivity than those in the distancing condition.

These same hypotheses also applied to reports of negative emotions. Specifically,

I predicted that participants who watched an affirming film clip and who were also in the immersion condition would report less negative affective (and shame) reactivity than those in the distancing condition. Similarly, I hypothesized that when participants watched the discriminatory film clip, those in the immersion condition would report higher negative affective (and shame) reactivity than those in the distancing condition.

In terms of behavioral outcomes, I hypothesized a main effect of film clip on the disclosure tasks, such that participants who watched an affirming film clip would exhibit greater and more rapid sexual orientation disclosure than those who watch the discriminatory film clip. Specifically, I expected them to: 1) spontaneously disclose their sexual orientation at a higher rate (and earlier, as defined by a fewer number of words used prior to disclosure) during the written reflection task, 2) write more about their identification with the film-based analogue in the open-response task (as defined by

greater LGBT content identified using Linguistic Inquiry and Word Count [LIWC] text analysis software; Pennebaker, Francis, & Booth, 2001), 3) rate the likelihood of sharing their reflection essay to a number of individuals (known and strangers) to be higher, and

4) rate the likelihood of disclosing their sexual orientation to a number of individuals

(known and strangers) to be higher. However, I predicted that these effects would be qualified by a two-way interaction with emotion regulation condition, such that among those who viewed the discriminatory clip, distancing would be associated with more disclosure than immersion. Among those who viewed the affirming clip, I predicted that immersion would be associated with greater disclosure than distancing.

Chapter 2: Study 1

Methods

Participants

I recruited 303 LGB adults online via Amazon’s Mechanical Turk (mTurk).

MTurk has been used by numerous psychology researchers and has been found to yield quality data, especially when “attention questions” designed to catch automated bot programs are used (e.g., Oppenheimer, Meyvis, & Davidenko, 2009; Pennycook, Cheyne,

Seli, Koehler, & Fugelsang, 2012). Because many of the film clips included USA-centric content (e.g., news clips about US laws), the mTurk posting was restricted to participants based in the United States. Eligible participants needed to: 1) be over the age of 18 and,

2) self-identify as a sexual minority (i.e., lesbian, gay, or bisexual). Given that online data collection affords less experimental control, I took numerous measures to ensure maximal data integrity. For example, if participants did not meet the eligibility criteria above, the survey automatically closed out, preventing the collection of any data. Of the initial 303 surveys submitted, I excluded 45 surveys due to incomplete pre-screening data, 125 due to being ineligible during pre-screening (e.g., heterosexual, under 18 years of age), and

39 due to being incomplete (e.g., did not complete questionnaires, only watched one of four videos) (See Figure 3). I then checked each participant’s IP address in order to

ensure that people were not answering the eligibility questions multiple times until they got them right (I excluded five participants for this reason). I also excluded five participants because they completed the study multiple times, and two participants because they failed more than four attention questions. Finally, I excluded two participants due to identifying as an “other” sexual orientation (specifically pansexual).

As noted previously, the goal of this study was to induce emotion based on LGB group membership and thus, I did not include any mention of pansexual individuals in the discriminatory or affirming film clips. Therefore, I decided to exclude these two participants, although future studies should certainly expand the diversity of sexual minority identities represented in their stimuli. In total, I included 80 participants in the data analyses (See Figure 3).

This final sample (N = 80) had a mean age of 30.91 years (SD = 7.92 years). A total of 90.0% identified as Caucasian; 51.2% identified as male, 43.8% as female, 3.8% as genderqueer, and 1.3% as having another gender identity. In addition, 68.8% of participants identified as bisexual (50.9% female), 22.5% as gay, and 8.8% as lesbian.

Participants were relatively well educated, with 45.0% indicating that they had obtained at least a four-year college degree. Furthermore, participants came from a diverse range of locations, with 40.0% living in a suburban area, 25.0% living in a large city, 22.5% living in a small city, 8.8% living in a rural area, and 3.8% living in a small town.

Figure 3. Study 1 participant flow diagram.

Procedure

After providing consent, participants completed a battery of self-report questionnaires. In line with the within-subjects design of this study, each participant then watched four counterbalanced film clips — two affirming and two discriminatory. All participants in Study 1 received immersion instructions for the entire duration of the study in order to determine the maximum emotion elicitation potential of the chosen film clips. Following each film clip, participants completed mood ratings and a brief distraction task. Finally, participants received a debriefing form (See Figure 4 for study flow chart).

Figure 4. Study 1 procedures.

Discrimination and Affirmation Film Clips

I developed the affirmation and discrimination film clips by creating montages of videos (e.g., TV shows, movies, news programs) depicting LGB people. I chose to create montages, rather than using longer clips containing single subjects in order to broaden the appeal of the clips to different genders and sexual orientations, as well as to increase the likelihood of each participant personally identifying with some part of the film clip.

Research assistants identified more than 70 potential clips using search terms such as

“anti-gay discrimination” and “positive coming out experiences” on YouTube and

Google. They then coded potential clips for various content characteristics, including sexual orientations and genders represented, inclusion of people of color, mentions of family, religion, and violence, inclusion of famous people, and humor. Clips were also coded for composition qualities, including the type of media (TV, film, news clip, or

YouTube), whether or not the subject of the clip was talking directly to the camera (as in a confessional-type YouTube clip), and the inclusion of background music. Clips mentioning violence against LGB people were ultimately excluded in order to focus on

LGB identity issues as well as verbal and emotional reactions to self-disclosure. I created four unique final films (two affirming, two discriminatory) approximately two minutes each in length using a compilation of 40 clips that were balanced in the characteristics listed above. The affirming film clips consist of positive depictions of LGB people in the media, at school and/or work, at home, as well as legal victories for LGB equality (e.g., marriage equality, familial support of LGB children, proud LGB individuals, etc.) (See

Figure 5). The discriminatory clips consist of negative depictions of LGB people in the aforementioned settings (e.g., homophobic comments by political commentators, LGB parents being refused service at a restaurant, familial rejection of LGB child, etc.) (See

Figure 5). In addition, I added background music to one film in each category (Affirming:

Same Love by Macklemore and Ryan Lewis; Discriminatory: Mad World by Gary Jules), in order to examine if an additional audio component might intensify the affective effects.

Figure 5. Screenshots from the final affirming (top) and discriminatory (bottom) film clips.

Mood Ratings

Participants rated their mood using items from the Positive and Negative Affect

Schedule (PANAS; Watson, Clark, & Tellegen, 1988). Participants were asked to rate their current level of emotion on a scale of 1 “not at all” to 9 “extremely” in response to

20 single-word prompts. The positive affect composite score included the following items: excited, enthusiastic, proud, inspired, happy, joyful, amused, grateful, surprised, hopeful, and optimistic. The negative affect composite score included: irritable, distressed, ashamed, upset, hostile, nervous, afraid, angry, and sad. Participants completed mood ratings before and after watching each film clip.

Attention Questions

After participants completed their post-clip mood ratings, they completed clip- specific attention questions. I used attention questions in this study to maintain data integrity by catching automated responding (e.g., Oppenheimer et al., 2009; Pennycook et al., 2012). In addition to three directive questions mixed in with self-report measures

(e.g., “Please select ‘Strongly Disagree’”), Study 1 employed eight attention questions specifically related to the videos. In particular, I used multiple-choice questions focused on the visual (e.g., “One man in the video talked about building fences. Where was he located during this clip?”) and auditory (e.g., “In the clip where the son comes out to his mother in the kitchen, what does the mother say in response?”) content of the clips in order to ensure that participants were fully engaged with the films.

Distraction Task

Between discrimination and affirmation film clips, participants completed a brief distraction task in order to minimize the effects of one film clip influencing affective ratings on the next. In this task, participants were asked to list as many words starting with a given letter (e.g., ‘A’) as possible during the next 60 seconds. The page was timed such that the screen advanced after one minute elapsed. Similar distraction (or “filler”) tasks have been used successfully in other psychology studies (e.g., Hamilton & Rajaram,

2003).

Statistical Analyses

I tested the hypothesis that there would be a main effect of video type

(discriminatory vs. affirming) on self-reports of positive (i.e., pride) and negative (i.e., shame) affective reactivity. In order to capture affective reactivity, I calculated change scores (post – pre) for each target emotional state (pride, shame) for each film clip. I included both overall positive and negative affect as well as the rating for each pride and shame in order to yield a better overall affective picture of these film clips. In particular, I wanted to determine that in addition to inducing pride specifically, the affirming clips were also inducing positive affect more broadly. Similarly, I predicted that the discriminatory clips would induce shame in particular, but also negative affect more generally. I ran MANOVAs predicting affective reactivity as the dependent variable, with film (Affirming-NoMusic, Affirming-Music, Discriminatory-NoMusic, Discriminatory-

Music) as the independent variable. I applied a Bonferroni correction to account for multiple comparisons.

Results

Positive Affective Reactivity

I found a significant difference in positive affective reactivity between the four

2 different film clips, F(3, 76) = 52.87, p < .001, ηp = .68. In particular, when participants watched Affirming-Music they reported higher positive affective reactivity than when watching Affirming-NoMusic (Cohen’s d = 0.44, p < .01), Discriminatory-NoMusic

(Cohen’s d = 2.28, p < .001), and Discriminatory-Music (Cohen’s d = 2.41, p < .001).

When participants watched Affirming-NoMusic, they also reported higher positive affective reactivity than when they watched Discriminatory-NoMusic (Cohen’s d = 1.94, p < .001) and Discriminatory-Music (Cohen’s d = 2.05, p < .001). There was no significant difference in positive affective reactivity between Discriminatory-NoMusic and Discriminatory-Music (Cohen’s d = -0.07, p = 1.00) (See Figure 6; for descriptive statistics see Table 1).

-1

Aﬀecve Reacvity (PA) -2

-3 Aﬃrming-NoMusic Aﬃrming-Music Discriminatory-NoMusic Discriminatory-Music

Figure 6. Positive affective reactivity in response to four LGB-relevant film clips as measured by the PANAS-Positive subscale

Table 1. Means and Standard Deviations of Affective Reactivity to Four LGB-Relevant

Film Clips

Affirming- Affirming- Discriminatory- Discriminatory- NoMusic Music NoMusic Music Positive affect 1.77 (1.75) 2.57 (1.89) -1.91 (2.04) -1.77 (1.71)

Pride 2.04 (2.46) 3.25 (2.47) -1.67 (2.84) -1.76 (1.39)

Negative affect -1.01 (1.38) -1.17 (1.64) 1.96 (1.57) 2.12 (1.68)

Shame -0.53 (1.60) -0.72 (1.83) 0.89 (2.44) 1.44 (2.22)

Note: Standard deviations are provided in parentheses.

Pride Reactivity

I found a significant difference in pride reactivity between the four different film

2 clips, F(3, 76) = 43.19, p < .001, ηp = .63. Similar to the findings with regard to positive affective reactivity, when participants watched Affirming-Music they reported higher pride reactivity than when they watched Affirming-NoMusic (Cohen’s d = 0.49, p <

.001), Discriminatory-NoMusic (Cohen’s d = 1.85, p < .001), and Discriminatory-Music

(Cohen’s d = 2.50, p < .001). Participants also reported more pride reactivity when they watched Affirming-NoMusic than during Discriminatory-NoMusic (Cohen’s d = 1.40, p

< .001) and Discriminatory-Music (Cohen’s d = 1.90, p < .001). There was no significant difference in pride reactivity between Discriminatory-NoMusic and Discriminatory-

Music (Cohen’s d = 0.04, p = 1.00) (See Figure 7; for descriptive statistics see Table 1).

-1

-2 Affecve Reacvity (Pride) -3 Affirming-NoMusic Affirming-Music Discriminatory-NoMusic Discriminatory-Music

Figure 7. Pride reactivity in response to four LGB-relevant film clips as measured by the

PANAS

Negative Affective Reactivity

I found a significant difference in negative affective reactivity between the four

2 different film clips, F(3, 76) = 44.78, p < .001, ηp = .64. There was no significant difference in negative affective reactivity when participants watched Discriminatory-

NoMusic and when they watched Discriminatory-Music (Cohen’s d = -0.10, p = 1.00).

However, when participants watched Discriminatory-NoMusic or Discriminatory-Music, they reported significantly more negative affective reactivity than when watching

Affirming-NoMusic (Cohen’s d = 2.01, p < .001, and Cohen’s d = 2.04, p < .001, respectively) or when watching Affirming-Music (Cohen’s d = 1.95, p < .001, and

Cohen’s d = 1.98, p < .001, respectively). There were no significant differences in negative affective reactivity between Affirming-NoMusic and Affirming-Music (Cohen’s d = 0.11, p = 1.00) (See Figure 8; for descriptive statistics see Table 1).

2.5 2 1.5 1 0.5 0 -0.5 -1

Affecve Reacvity (NA) -1.5 -2 Affirming-NoMusic Affirming-NoMusic Discriminatory-NoMusic Discriminatory-Music

Figure 8. Negative affective reactivity in response to four LGB-relevant film clips as measured by the PANAS-Negative subscale

Shame Reactivity

I found a significant difference in shame reactivity between the four different film

2 clips, F(3, 76) = 13.12, p < .001, ηp = .34. Similar to the findings with regard to negative affective reactivity, I found no significant difference in shame reactivity between when participants watched Discriminatory-NoMusic and when they watched Discriminatory-

Music (Cohen’s d = -0.24, p = .50). However, when participants watched Discriminatory-

NoMusic or Discriminatory-Music, they reported significantly more shame reactivity than when watching Affirming-NoMusic (Cohen’s d = 0.69, p < .01, and Cohen’s d =

1.02, p < .001, respectively) or when watching Affirming-Music (Cohen’s d = 0.75, p =

.001, and Cohen’s d = 1.06, p < .001, respectively). There was no significant difference

in shame reactivity between Affirming-NoMusic and Affirming-Music (Cohen’s d =

0.09, p = 1.00) (See Figure 9; for descriptive statistics see Table 1).

1.5

0.5

-0.5

-1 Affecve Reacvity (Shame) -1.5 Affirming-NoMusic Affirming-Music Discriminatory-NoMusic Discriminatory-NoMusic

Figure 9. Shame reactivity in response to four LGB-relevant film clips as measured by the PANAS

Discussion

In Study 1, I found that four novel LGB-relevant film clips induced affective reactivity, both positive and negative, in the predicted directions. In particular, I found that the two affirming film clips induced greater overall positive affective reactivity and pride reactivity compared to the discriminatory clips, while the discriminatory clips induced greater negative affective reactivity and shame reactivity compared to the affirming clips. In particular, I found small-to-moderate effect sizes (Cohen, 1988) between Affirming-Music and Affirming-NoMusic on both positive affect and pride, as

well as the small, albeit non-significant, effect size between Discriminatory-Music and

Discriminatory-NoMusic on self-reports of shame. Since both Affirming-Music and

Discriminatory-Music contained music, while Affirming-NoMusic and Discriminatory-

NoMusic did not, it is possible that the stronger affective reactivity elicited by these clips was a result of this additional auditory component. Indeed, music has been shown in numerous studies to be a strong elicitor of affect (e.g., Eich, Ng, Macaulay, Percy, &

Grebneva, 2007). As a result of both the group differences described above (particularly between Affirming-Music and Affirming-NoMusic) as well as the common musical content, I decided to use Affirming-Music and Discriminatory-Music in Study 2.

This study extends the literature by validating a novel group-based emotion induction procedure for LGB individuals and thus constitutes an important step in the nascent work on affective functioning in LGB populations. These findings demonstrate that it is possible to conduct group-based social emotion inductions with LGB individuals online using traditional film-based methods. While it will be important in future studies to explore other types of emotion induction (e.g., idiographic methods, social methods;

Coan & Allen, 2007), it is notable that this low-cost, time efficient method was so effective at inducing pride and shame in these participants. In addition to opening doors for affective science research, these emotion inductions may be useful in new treatment protocols currently being developed for sexual minorities with emotional disorders (e.g.,

Pachankis, Hatzenbuehler, Jonathon, Safren, & Parsons, 2015). For example, in line with exposure and emotion regulation principles used in other cognitive behavioral therapies

(Ellard, Fairholme, Boisseau, Farchione, & Barlow, 2010), the ESTEEM (Effective Skills

to Empower Effective Men) program for sexual minority men incorporates videos of gay and bisexual men experiencing discrimination. By doing so, clients are exposed to minority stressors in session and are able to practice their emotion regulation skills with the help of their therapist. In this way, stimuli such as those developed in this study could prove useful not only in experiments, but also in treatment settings as tools for exposure.

These findings pave the way for providing experimental support for Goldenberg and colleagues’ (2016) model of group-based process emotion, in which they argue for the important role of self-categorization (i.e., in this case, identifying as an LGB person) in modifying one’s appraisal of a situation and subsequent response. Given the narrow goals of Study 1 (i.e., to develop stimuli for Study 2), I did not include a control group of heterosexual individuals; however, future studies should include such a control in order to tease apart the role of self-categorization in magnifying the affective impact of the film clips.

Chapter 3: Study 2

Methods

Participants

I recruited 217 sexual minority adults through online postings in social media,

Craigslist, listservs, and emails to special interest groups. Participants met the same eligibility criteria as Study 1. All study participation was completed online via Qualtrics.

As in Study 1, I excluded certain participants in order to maximize data integrity given the variable administration conditions of an online study. I removed 21 participants for incomplete task data (e.g., did not write reflection), 13 participants for responses consistent with inattentive responding (i.e., all answers given were “1”), three participants for problematic open-response reflections (e.g., off-topic, low-effort), and 11 participants for failing to follow emotion regulation instructions (operationalized as answering 1 “not at all” in response to a question about whether they used their assigned strategy while watching the film clip). Finally, given that 1) the film clips only included content relevant to LGB individuals and 2) the goal of said clips was to induce emotion based on one’s sexual minority identity that they see reflected in that clip, I excluded 21 participants who identified an “other” sexual orientation (e.g., queer, homoflexible, biromantic, pansexual, asexual) (See Figure 10).

The final sample (N = 148) had a mean age of 24.95 years (SD = 7.45 years). A

total of 83.8% identified as Caucasian; 29.1% identified as male, 60.1% as female, 8.1% as genderqueer, and 2.7% as having another gender identity; and 49.3% identified as bisexual (69.9% female), 30.4% as lesbian, and 20.3% as gay. Participants were relatively well-educated, with 42.6% indicating that they had obtained at least a four-year college degree. Furthermore, they came from a diverse range of locations, with 45.3% living in a large city, 29.1% living in a small city, 14.2% living in a suburban area, 10.1% living in a rural area, and 1.4% living in a small town.

Figure 10. Study 2 participant flow diagram

Procedure

After providing consent, participants completed demographic questions. They were then randomized to a 2 x 2 between-subjects design, where they: 1) received either distancing or immersion emotion regulation instructions and 2) viewed either an affirming or a discriminatory film clip. Participants completed mood ratings (pre-clip), followed by the film clip, and then additional mood ratings (post-clip). Participants then completed a written reflection task followed by mood ratings (post-reflection task), and a decision-making task, also followed by mood ratings (post-decision-making task). As in

Study 1, study participation ended upon the receipt of the debriefing form (See Figure 11 for study flow chart).

Figure 11. Study 2 procedures and timing of mood ratings.

Emotion Regulation Instructions

Participants randomly received either distancing (n = 78) or immersion (n = 70)

instructions directly prior to their assigned film clip. These emotion regulation strategies were selected to complement both the target self-conscious emotions (distraction or mindfulness, for example, might be less simple to implement in a social setting) and the analogue medium (film clips should be possible to both immerse in and distance from) in this study. Immersion instructions were adapted from Batson, Early, and Salvarani (1997) and Davis et al.'s (2004) experimental paradigms on perspective-taking, specifically imagining oneself in another person’s position or situation:

As you watch this video, try to embrace the thoughts and feelings you are having.

Concentrate on the way you would feel if you were experiencing the events in this

video, or if the people in this video were talking to you. Think about how the

things you are seeing and hearing relate to who you are as a person, and how you

would feel during the rest of your day if you had experienced these events.

Imagine as clearly and vividly as possible everything that you would experience

— the thoughts, the feelings, everything.

Distancing instructions followed the same format and length:

As you watch this video, try to be as mentally removed as possible about the

events and people you see. Remind yourself that you are not being spoken to by

the people in the video. Remind yourself that the opinions and events you are

seeing and hearing have no bearing on who you are as a person, on your

relationships and friendships, or on how you view yourself. Whatever emotions

you are experiencing right now will come and go — they are only temporary and

will have no impact on how you feel for the rest of the day.

Written Reflection Task

Participants completed a three-minute written reflection task in which they reflected on their thoughts and feelings about the film (either affirming or discriminatory) they watched. I adapted instructions for this task from Iacovelli and Johnson's (2012) study investigating differences in self-disclosure between face-to-face interactions and those executed more remotely (e.g., through the internet). I also asked participants to write about how they did or did not identify with the film. This allowed me to provide them with an opportunity to spontaneously disclose their sexual orientation. In order to minimize demand characteristics, I asked participants distracter questions (e.g., “What parts of the video (if any) made you feel physical sensations in your body?”). See

Appendix A for full text of the written reflection task.

Decision-Making Task

I designed this task as a measure of deliberate sexual orientation self-disclosure.

To do so, I provided participants with a generic list of people (e.g., teacher, friend, sibling), and asked them to indicate how likely they were to 1) share their written reflection and 2) disclose their sexual orientation to each person on a scale of 1 “not at all likely” to 7 “definitely”. In addition, participants were asked how difficult it would be for them if they had to do the above tasks. In order to control for prior disclosure, participants indicated whether or not they have previously disclosed their sexual orientation with that person in real life. In compiling the list of people prompts (e.g., teacher, friend), I considered numerous social dimensions, including: intimacy/closeness

(stranger vs. family member), trustworthiness (workplace gossip vs. therapist), authority dynamic (professor vs. close friend), sexual orientation and gender (same as respondent vs. other), age (older than the respondent vs. same age vs. younger), and religion

(capturing both same vs. other dynamics, as well as the effects of potentially anti-LGB perspectives). See Appendix B for full text of the decision-making task.

Statistical Analyses

First, as previously noted, I removed 13 participants for responses consistent with inattentive responding (i.e., all answers given were “1”). Second, I ran participants’ written reflections through emotional content analyses using Linguistic Inquiry and Word

Count text analysis software (Pennebaker, Francis, & Booth, 2001). In order to determine whether participants spontaneously disclosed their sexual orientation during the reflection task, I recruited two undergraduate research assistants to code each written reflection. In particular, I asked the assistants to code 1) whether or not the participant disclosed during the course of the reflection, 2) the number of words until it became irrefutable that the participant was disclosing their sexual orientation, and 3) the total number of words in the reflection. I also asked the assistants to record all LGB-relevant terms and words they found in the reflections for inclusion in a novel LIWC dictionary (e.g., bornthisway, bisexual*, see Appendix C for full dictionary). This dictionary, which also included terms drawn from Internet searches for sexual minority slang terms, was created in order to capture the proportion of LGB content in the reflections.

Next, I repeated the MANOVAs from Study 1 to ensure that the films yielded the

same affective responses as in Study 1. Then I used MANOVAs to predict the effects of film type and emotion regulation strategy (independent variables) on self-reported affect

(dependent variable). To test my hypotheses regarding disclosure, I ran MANOVAs predicting the effects of film type and emotion regulation strategy (independent variables) on disclosure on each of the behavioral tasks (dependent variable). I used a logistic regression to predict the effects of film and emotion regulation conditions on whether or not participants disclosed their sexual orientation during the reflection task

(i.e., dichotomous outcome variable).

Results

Manipulation Checks

Affect.

Positive affect. I found a significant difference in positive affective reactivity between the discriminatory and affirming film clips, F(1, 146) = 73.06, p < .001, Cohen’s d = 1.41, such that those participants who viewed the affirming film clip reported significantly more positive affective reactivity compared to those who viewed the discriminatory film clip (for descriptive statistics see Table 2). This replicates the findings from Study 1, wherein the affirming clip (then dubbed Affirming-Music) yielded significantly higher positive affective reactivity compared to the discriminatory clip (then dubbed Discriminatory-Music).

Pride. I found a significant difference in pride reactivity between the discriminatory and affirming film clips, F(1, 146) = 20.30, p < .001, Cohen’s d = 0.74,

such that those who viewed the affirming film clip reported significantly more pride reactivity compared to those who viewed the discriminatory film clip (for descriptive statistics see Table 2). This replicates the findings from Study 1, although the effect size is more modest than that seen between the affirming and discriminatory clips in Study 1

(Cohen’s d = 2.50, p < .001).

Table 2. Means and Standard Deviations of Affective Reactivity to Film Clips.

Affirming Discriminatory

Positive affect 1.48 (1.69) -0.90 (1.70)

Pride 2.26 (2.83) 0.24 (2.62)

Negative affect -0.59 (1.16) 1.31 (1.81)

Shame -0.22 (1.92) 0.23 (2.01)

Note: Standard deviations are shown in parentheses.

Negative affect. I found a significant difference in negative affective reactivity between the discriminatory and affirming film clips, F(1, 146) = 56.98, p < .001, Cohen’s d = 1.25, such that those who viewed the discriminatory film clip reported significantly more negative affective reactivity compared to those who viewed the affirming film clip

(for descriptive statistics see Table 2). Again, this replicates the findings from Study 1, in which there was a similar effect size between the discriminatory and affirming clips in terms of negative affective reactivity (Cohen’s d = 1.98, p < .001).

Shame. I found no significant difference in shame reactivity between the discriminatory and affirming film clips, F(1, 146) = 1.90, p = .17, Cohen’s d = 0.23) (for descriptive statistics see Table 2). This finding is in contrast to those of Study 1, where the discriminatory clip (then dubbed Discriminatory-Music) yielded significantly greater shame reactivity compared to the affirming clip (then dubbed Affirming-Music; Cohen’s d = 1.06, p < .001). Given this failure to replicate the findings of Study 1 in manipulating shame using affirming and discriminatory film clips, I decided not to examine my hypotheses regarding the interaction between emotion regulation and film condition on shame reactivity.

Emotion regulation.

Immersion. I found a significant difference between the immersion and distancing conditions in the degree to which participants thought about events depicted in the film as though they were happening to themselves, F(1, 146) = 18.55, p < .001,

Cohen’s d = 0.72, such that those in the immersion condition reported greater immersion than those in the distancing condition (See Figure 12; for descriptive statistics see Table

3).

9 8 7 6 5 4 immersion

Self-reported 3 2 1 Immersion Distancing Figure 12. Self-reported immersion during the film clips by emotion regulation condition.

Distancing. I found a significant difference between the immersion and distancing conditions in the degree to which participants thought about events depicted in the film as though they were happening to someone else, F(1, 146) = 8.52, p < .01,

Cohen’s d = 0.48, such that those in the distancing condition reported greater distancing than those in the immersion condition (See Figure 13; for descriptive statistics see Table

3).

9 8 7 6 5 distancing

Self-reported 4 3 2 1 Immersion Distancing Figure 13. Self-reported distancing during the film clips by emotion regulation condition.

Table 3. Means and Standard Deviations of Emotion Regulation Strategy Use in

Response to Film Clips.

Immersion Condition Distancing Condition

Self-Reported Immersion 6.49 (2.13) 4.82 (2.53)

Self-Reported Distancing 5.44 (2.61) 6.55 (2.00)

Note: Standard deviations are shown in parentheses.

Main Analyses Predicting Affect with Film and Emotion Regulation Conditions

Positive affect.

When predicting positive affective reactivity with film and emotion regulation

2 condition, I found a significant main effect of film, F(1, 144) = 73.62, p < .001, ηp = .34, such that such that those who viewed the affirming film clip reported significantly more positive affective reactivity compared to those who viewed the discriminatory film clip, p

< .001. Contrary to expectations, I found no effect of emotion regulation, F(1, 144) =

2 0.39, p = .54, ηp = .01, and the interaction was non-significant, F(1, 144) = 1.34, p = .25,

2 ηp = .01 (for descriptive statistics see Table 4).

Pride.

When predicting pride reactivity with film and emotion regulation condition, I

2 found a significant main effect of film, F(1, 144) = 20.51, p < .001, ηp = .13, such that such that those who viewed the affirming film clip reported significantly more pride

reactivity compared to those who viewed the discriminatory film clip. Contrary to

2 expectations, I found no effect of emotion regulation, F(1, 144) = 0.16, p = .69, ηp = .01,

2 and the interaction was non-significant, F(1, 144) = 0.86, p = .36, ηp = .01 (for descriptive statistics see Table 4).

Negative affect.

When predicting negative affective reactivity with film and emotion regulation

2 condition, I found a significant main effect of film, F(1, 144) = 57.71, p < .001, ηp = .29, such that such that those who viewed the discriminatory film clip reported significantly more negative affective reactivity compared to those who viewed the affirming film clip.

Contrary to expectations, I found no effect of emotion regulation, F(1, 144) = 1.21, p =

2 2 .27, ηp = .01, and the interaction was non-significant, F(1, 144) = 0.75, p = .39, ηp = .01

(for descriptive statistics see Table 4).

Table 4. Means and Standard Deviations of Affective Reactivity by Emotion Regulation and Film Condition.

Affirming Discriminatory Immersion Distancing Immersion Distancing Positive affect 1.74 (1.68) 1.25 (1.69) -0.98 (1.89) -0.83 (1.53)

Pride 2.57 (2.73) 1.97 (2.94) 0.11 (2.74) 0.35 (2.54)

Negative affect -0.56 (1.21) -0.61 (1.14) 1.57 (1.90) 1.08 (1.72)

Shame -0.23 (2.38) -0.21 (1.42) 0.14 (2.26) 0.30 (1.79)

Note: Standard deviations are shown in parentheses.

Main Analyses Predicting Disclosure with Film and Emotion Regulation Conditions

Reflection task.

Whether or not participant disclosed sexual orientation. I found a significant main effect of film, Exp(B) = 4.58, 95% CI for Exp(B): [1.32, 15.93], p = .02, such that those participants in the affirming condition disclosed their sexual orientation during the reflection task more often than those in the discriminatory condition (for descriptive statistics see Table 5). Contrary to expectations, I found no effect of emotion regulation condition, Exp(B) = 0.65, 95% CI for Exp(B) [0.26, 1.65], p = .37, and the interaction was non-significant, Exp(B) = 0.43, 95% CI for Exp(B) [0.09, 2.02], p = .28.

Number of words until disclosure. When predicting the number of words participants wrote before disclosing their sexual orientation with film and emotion

2 regulation condition, I found a marginal main effect of film, F(1, 96) = 3.16, p = .08, ηp

= .03, such that participants who viewed the discriminatory clip took longer on average to disclose than those who viewed the affirming clip (for descriptive statistics see Table 5).

Contrary to expectations, I found no effect of emotion regulation condition, F(1, 96) =

2 0.58, p = .45, ηp = .01, and the interaction was non-significant, F(1, 96) = 0.01, p = .93,

2 ηp = .01.

LGBT content. When predicting LGBT content in the reflection task (as captured by percentages in the LIWC program) with film and emotion regulation condition, I

2 found no significant main effect of film, F(1, 144) = 0.96, p = .33, ηp = .01, or emotion

2 regulation condition, F(1, 144) = 0.03, p = .85, ηp = .01, and the interaction was non-

2 significant, F(1, 144) = 1.55, p = .22, ηp = .01 (for descriptive statistics see Table 5).

Decision-making task.

Average likelihood of sharing reflection essay. When predicting the average likelihood of sharing the essay in the decision-making task with film and emotion regulation condition, there was no significant main effect of film, F(1, 143) = 0.61, p =

2 2 .44, ηp = .01, or emotion regulation condition, F(1, 143) = 0.45, p = .505, ηp = .01, and

2 the interaction was non-significant, F(1, 143) = 0.03, p = .88, ηp = .01 (for descriptive statistics see Table 5).

Average likelihood of sharing sexual orientation. When predicting the average likelihood of sharing sexual orientation in the decision-making task with film and emotion regulation condition, there was no significant main effect of film, F(1, 123) =

2 2 0.01, p = .91, ηp = .01, or emotion regulation condition, F(1, 123) = 0.11, p = .74, ηp =

2 .01. There was a marginal interaction between ER and film, F(1, 123) = 3.91, p = .05, ηp

= .03. However, when running Bonferroni adjusted post-hoc comparisons, there were no significant differences between film clips in each regulation condition (ps > .56) (for descriptive statistics see Table 5).

Table 5. Descriptive Characteristics of Disclosure Variables by Emotion Regulation and

Film Condition.

Affirming Discriminatory Immersion Distancing Immersion Distancing Reflection task

Disclosure (%) 88.6 68.4 62.9 52.5

Number of words until 47.48 (41.20) 55.50 (49.44) 65.14 (41.45) 71.48 (55.66) disclosure

LGBT content 4.45 (2.80) 3.83 (2.70) 3.49 (2.56) 3.95 (2.43)

Decision-making task

Likelihood of sharing essay 3.40 (1.42) 3.60 (1.60) 3.63 (1.35) 3.75 (1.43)

Likelihood of sharing sexual 2.43 (1.36) 3.07 (1.95) 3.01 (1.61) 2.55 (1.27) orientation

Note: Number of words until disclosure includes only those participants who disclosed their sexual orientation during the reflection task. Standard deviation is shown in parentheses.

Discussion

The first aim of Study 2 was to replicate the induction findings from Study 1 in a new sample of LGB adults. Indeed, I found that the study film clips reliably induced positive affect, pride, and negative affect at similar levels to that exhibited in Study 1.

However, the differences in shame reactivity between the discriminatory and affirming

film clips exhibited in Study 1 did not replicate in Study 2. This may be a result of the different recruitment methods used in each study. In Study 1, I recruited participants from

Amazon’s mTurk, while in Study 2 I recruited participants via emails to LGB community organizations, listservs, social media posts and Craigslist. As such, recruitment for Study

2 was targeted much more closely at individuals who had already immersed themselves in LGB culture and community. This kind of restriction in sampling may have made it more difficult to find significant effects, especially since shame was measured using a single item. In addition, perhaps individuals who feel more connected to other members of the LGB community are more likely to avoid negative depictions of LGB people as well as the negative emotions (specifically, social emotions like shame) associated with those depictions. Indeed, in their group-based model of emotions, Goldenberg and colleagues (2016) posit that in-group members tend to avoid negative group-based emotions unless the immediate experience of said emotions allows them to maintain a long-term positive view of the group.

The second aim was to examine whether these affective reactions to the film clips can be regulated. Contrary to my predictions, across all models, I found only main effects of film condition and no significant main effects of emotion regulation or interactions.

Several explanations might help account for this lack of significant findings. First, given the online nature of this study, it was impossible to ensure that participants were fully engaged during the emotion regulation instructions, thus they may not have fully understood or followed through with the prompts. Indeed, during the written reflection task, several participants noted that they struggled to follow the instructions. For

example, one participant who saw the affirming clip wrote, “I was pretty confused, I guess, by the instructions to be mentally removed from the video, and I was, I think

RESENTFUL of those directions. I felt like I should have been able to watch the video freely and feel a part of the joy and share the joy of those in the video.” Another participant who saw the discriminatory clip wrote: “Although given instructions to try to feel mentally removed from the speakers in the video, it's difficult to do so when you know that these are real people who truly believe some terrible things about me and members of my community.” Importantly, participants were provided resources on emotion regulation during debriefing; however, it is clear from these responses that more explicit instruction as to the purpose of regulating one’s emotions (perhaps via an instructional video) may have increased participant engagement with the emotion regulation portion of the study.

In addition to these issues with participant engagement, it is possible that improvements could have been made to the manipulation checks. Importantly, the manipulation checks for emotion regulation did indicate that the manipulation worked; however, my criteria for determining the success of the emotion regulation manipulation in this study were very conservative (i.e., participants had to indicate 1 “not at all” on a nine-item scale asking them how much they used their assigned strategy). Future studies should employ additional, more rigorous manipulation checks to ensure maximal data integrity.

Alternatively, it is possible that the perspective-taking-style manipulation (i.e., distancing vs. immersion) was not strong enough to alter participants’ emotional

responses. Future studies should employ more active emotion regulation strategies such as cognitive reappraisal or emotion suppression (and should also include a control group) to determine whether the passivity of the current manipulation played a role in the lack of significant findings.

In terms of behavioral outcomes, I predicted a main effect of film clip, such that those who viewed the affirming clip would be more likely to disclose their sexual orientation than those who viewed the discriminatory clip. Indeed, in the reflection task, participants in the affirming condition were significantly more likely to disclose, and took marginally fewer words to do so, than those in the discriminatory condition. This finding supports the broader notion that LGB individuals are more likely to disclose their sexual orientation in affirming environments. This finding extends the broader literature on emotions and decision-making into a critical new demographic (e.g., Lerner, Li,

Valdesolo, & Kassam, 2015). It also has the potential to have an immense impact on the lives of young LGB individuals who are in the process of deciding whether or not to share their sexual orientation. In particular, features of this study offer implications for facilitating more affirming environments for LGB individuals around the nation. This study utilized film clips drawn from YouTube, television shows, news channels, and other media, and as such, has high external validity. Its findings also suggest that if mainstream media (which is easily accessible by most LGB Americans) increasingly includes more affirming depictions of LGB individuals and fewer negative depictions, this may help facilitate sexual orientation disclosure in some individuals.

Interestingly, I did not find the predicted main effect of film on LGB content in

the written reflection task, suggesting that although participants who saw the affirming clip disclosed at higher rates compared to those who saw the discriminatory clip, both groups wrote about LGB individuals with similar frequency. Since the LIWC program only counts frequency of word usage, it may be helpful in future studies to utilize independent coders to determine whether the words participants used with regard to LGB individuals varied in valence, arousal, or other characteristics between the groups.

I also did not find the hypothesized main effects of film on disclosure in the decision-making task. It may be that the delay between viewing the film clip and completing the decision-making task (roughly 10-12 minutes) reduced the effects of the film clips on affect and decisions to disclose. Alternatively, it is possible that the composite score used did not fully capture the decisions participants made in this task.

Future iterations of this study should refine the prompts and scoring scheme of this task to allow for better categorization of targets (e.g., family vs. acquaintances).

Finally, I predicted an interaction between emotion regulation and film condition in predicting sexual orientation self-disclosure. I did not find any support for this hypothesis in either the written reflection or decision-making tasks, which may be due to the issues with emotion regulation manipulation I previously discussed.

Chapter 4: General Discussion

In the first study of this two-part thesis, I validated four two-minute film clips as procedures for inducing emotions (both positive and negative) based on sexual minority identity in LGB Americans. Then, in Study 2, I found that participants who viewed a discriminatory clip were much less likely to spontaneously disclose their sexual orientation during the written reflection task and took marginally more words to do so compared to those who viewed the affirming clip. Contrary to predictions, this effect did change as a function of whether participants were instructed to distance or immerse themselves from the content of the film.

This investigation provides some initial evidence that affective science may be an effective lens through which to examine how discrimination is linked with sexual orientation disclosure in LGB individuals. As noted in the introduction, LGB individuals continue to experience disproportionately high rates of mental illness compared to their heterosexual peers (e.g., Gilman et al., 2001; Plöderl & Tremblay, 2015), and researchers have linked those high rates of mental illness to the sexual orientation-related discrimination that this population experiences (e.g., Bostwick et al., 2014;

Hatzenbuehler et al., 2010; Mays & Cochran, 2001; McCabe et al., 2010). In particular, researchers have proposed that discrimination impairs mental well-being by hindering sexual orientation disclosure (e.g., Connell, 2012; Day & Schoenrade, 1997; Dewaele et

al., 2013; Pachankis, 2007; Rhoads, 1995). This thesis provides further experimental support for this notion by demonstrating that when LGB individuals are exposed to discriminatory content, they may be less likely to spontaneously disclose their sexual orientation. Importantly, given that the film clips used in this thesis were drawn from sources that LGB individuals encounter in their everyday lives (e.g., television, YouTube, news programs), it is entirely possible that these clips have influenced (and continue to influence) the disclosure decisions of LGB Americans outside the context of this study.

As previously discussed, it may thus be important, from a public health perspective, for mainstream media to carefully consider the impact of including negative depictions of

LGB individuals in its content, and to also consider increasing positive (i.e., affirming) depictions. In so doing, they may help facilitate improved LGB mental health, in line with Pachankis’s (2007) conceptualization of stigmatized identity concealment.

However, much more work is needed to understand these processes. First, future studies should expand their discrimination analogues to include not only film clips, but also interactive paradigms (e.g., online chat interface, in-person interactions). Given that many of the discriminatory experiences LGB individuals face in their lives occur interpersonally (e.g., in schools and workplaces; Bernstein, 2013; Bostwick et al., 2014), it is critical that future work captures this additional dimension in order to better understand the real-life experiences of LGB individuals and thus their full affective repertoire. In addition to interpersonal discrimination experiences, recent work by

Hatzenbuehler (2014) has shown that structural stigma (i.e., characteristics of a social environment that oppress LGB individuals such as policies excluding sexual minorities

from institutions like marriage) may have an immense impact on the lives and wellbeing of LGB individuals. In fact, one study of LGB young adults found that the stress of growing up in an environment high in structural stigma was associated with blunted cortisol responding following a social stress task in a manner similar to what might be expected following a traumatic life event (Hatzenbuehler & McLaughlin, 2014). As such, it is crucial that future investigations consider the role of structural stigma and the affective and biological processes related to it.

In addition to expanding the range of types of discrimination considered, future studies also need to examine broader facets of emotion regulation. In the present investigation, I only considered immersion and distancing — two forms of perspective- taking — but as discussed earlier, it is possible that these strategies may have been too passive to see the predicted emotion regulation effects. As such, it will be important for future studies to consider other strategies, such as cognitive change and situation selection techniques. Interestingly, cognitive change strategies (e.g., cognitive reappraisal) may in fact intersect with similar techniques known in social identity theory as “social creativity,” wherein individuals tend to interpret situations in a way that favors their group (Turner, Reynolds, & others, 2001). It would be interesting to examine this phenomenon in the context of Pachankis’s (2007) model of stigmatized identity concealment, which states that individuals who have not disclosed their identity tend to be more ambivalent about their identity and have more negative self-evaluations. In terms of types of cognitive reappraisal to examine, it will be important to investigate both reappraisals of the situation (e.g., “This film clip represents only one viewpoint of LGB

life”) and of the participants’ self-categorization (e.g., “This film clip does not represent my life as a LGB person”). In so doing, it will be possible to determine whether altering cognitions during experiences of discrimination (or during disclosure) may facilitate adaptive affective responding, and thus later mental health.

It will also be crucial to examine emotion regulation strategies that arise earlier in the Gross’ process, namely situation selection. In particular, future studies could examine how decisions to attend events (e.g., pride parade, speeches by homophobic preachers) are associated with later sexual orientation disclosure. By doing so, researchers could investigate whether the early down-regulation of positive emotions related to sexual orientation results in later avoidance of disclosure and thus poorer mental health outcomes. If this is indeed the case, interventions could be created to target engagement with positive emotions related to LGB stimuli. As work on group-based emotion regulation emerges, it may become clear that there are certain strategies that are most effective at helping LGB individuals regulate their emotions during both disclosure and discrimination; however, at present the research remains in its nascent stages

(Goldenberg et al., 2016).

Future research should also examine these affective phenomena in an interpersonal context. Given that discrimination and disclosure are by their nature social processes, it would be interesting to investigate whether emotion regulation strategy effectiveness would differ depending on the presence of an in-group member. To this end, given its online nature, it is impossible to know the social context in which each participant completed the study. It is possible that my null findings with regard to

emotion regulation in Study 2 could have been affected by some participants completing the study alone (i.e., non-social), some participants completing it in public (i.e., potential out-group), and some at home (i.e., potential in-group). Indeed, there is a growing literature on interpersonal emotion regulation that shows, for example, that individuals may mimic the emotion regulation strategies used by others in order to facilitate emotional closeness (Fischer & Manstead, 2010), and that interacting with others may in fact help attempts to regulate emotions in the face of threat (Blascovich, Mendes, Hunter,

& Salomon, 1999).

More broadly, this thesis extends the rapidly expanding literature on the intersection of emotions and decision-making (e.g., Lerner et al., 2015) into the realm of decisions related to sexual orientation. This thesis focused on emotions during the decision to disclose one’s sexual orientation following a discriminatory or affirming film clip; however, future investigations could examine emotions during other sexual orientation-related decisions, such as whether to identify as a sexual minority on a job application (i.e., structural stigma), or whether to correct a colleague about the gender of one’s partner (i.e., inadvertent heterosexism). Perhaps most importantly, studies should consider how emotions impact the decision of LGB youth to disclose their sexual orientation to their parents (e.g., by employing ecological momentary assessments in the weeks leading up to the decision). Given the immense literature demonstrating the critical importance of social and familial support in the development of a healthy sexual minority identity and buffering against mental illness (e.g., Bregman, Malik, Page, Makynen, &

Lindahl, 2013; Goldfried & Goldfried, 2001; Ryan, Huebner, Diaz, & Sanchez, 2009), it

is critical that we increase our understanding of how affect, both leading up to and during the interaction, influences these decisions.

In this vein, the findings of this thesis have important implications for intervention research with LGB individuals. I found that experiences of affirmation led participants to spontaneously disclose their sexual orientation more compared to participants who experienced discrimination. Once future investigations increase our understanding of the underlying affective processes that lead individuals to disclose their sexual orientation, it will be possible to design intervention programs that target both emotion regulation strategies and problem solving skills relevant to promoting disclosure in LGB individuals. As previously mentioned, the ESTEEM program for sexual minority men incorporates videos of gay and bisexual men experiencing discrimination in an attempt to increase emotion regulation skills and expose clients to stressors in session

(Pachankis et al., 2015). The findings of this thesis provide experimental support for this kind of therapeutic approach, and indeed, as noted, the stimuli could be useful tools for both emotion regulation practice and exposure. The findings also suggest that it may be advantageous for treatment interventions targeted towards LGB clients to include positive, affirming depictions of LGB populations since many clients may be surrounded by primarily negative depictions in their daily lives, especially those living in rural areas

(Swank, Fahs, & Frost, 2013). Importantly, therapists working with these clients will need to take into account the safety of sexual orientation self-disclosure with family and immediate peers given the context in which the client lives. However, regardless, it is clear from the findings of this thesis and the extant literature that encouraging connection

with and disclosure to other LGB individuals is critical. An emerging literature describes the central role of technology and online communities in the early stages of decisions regarding disclosure (e.g., Bond, Hefner, & Drogos, 2009; Etengoff & Daiute, 2015;

Harris, 2010; Hillier, Mitchell, & Ybarra, 2012). As such, it will be prudent for therapists working with LGB clients who live in non-affirming environments to encourage engagement with these online resources, after exhausting safe in-person options.

One important facet of sexual minority experience that I did not consider in this thesis comprises sexual minority identities other than LGB. As mentioned earlier, I decided to exclude non-LGB individuals from these studies due to 1) the limited scope of the film stimuli and 2) the goal of the film stimuli to elicit emotion based on LGB identity. However, as conceptualizations of sexual identity rapidly evolve (e.g., Galupo,

Davis, Grynkiewicz, & Mitchell, 2014; Jourian, 2015; Rosario, Schrimshaw, & Hunter,

2011), it becomes increasingly important that research considers a broad range of sexual minority identities. Although research on non-LGB populations is sparse, there is some evidence that these individuals exhibit worse physical and mental health symptoms compared to LGB individuals (Case et al., 2004). As such, it may be even more critical to examine affective functioning in these populations and facilitate disclosure. In order to do so, it will be important to create appropriate affective stimuli that represent a diverse array of sexual identities, and also to recruit participants broadly (i.e., not only from LGB organizations, which tend to be very lesbian and gay-focused (Brewster, Moradi,

DeBlaere, & Velez, 2013).

This thesis provides compelling evidence that an affective lens may reveal

important mechanisms underlying the link between discrimination and mental illness in

LGB individuals. My findings also point to the importance of positive depictions of LGB individuals in facilitating sexual orientation disclosure, a process that is key to the development of a healthy sexual minority identity (Meyer, 2003; Pachankis, 2007). By translating these findings to settings such as the mainstream media or psychological treatments, it may be possible to begin ameliorating the disproportionate mental health burden the LGB community faces.

References

Aldao, A., & Christensen, K. (2015). Linking the Expanded Process Model of Emotion Regulation to Psychopathology by Focusing on Behavioral Outcomes of Regulation. Psychological Inquiry, 26(1), 27–36. http://doi.org/10.1080/1047840X.2015.962399

Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237.

Batson, C. D., Early, S., & Salvarani, G. (1997). Perspective Taking: Imagining How Another Feels Versus Imaging How You Would Feel. Personality and Social Psychology Bulletin, 23(7), 751–758. http://doi.org/10.1177/0146167297237008

Beck, J. S. (1995). Cognitive therapy. Wiley Online Library. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/9780470479216.corpsy0198/full

Beer, J. S., Heerey, E. A., Keltner, D., Scabini, D., & Knight, R. T. (2003). The regulatory function of self-conscious emotion: Insights from patients with orbitofrontal damage. Journal of Personality and Social Psychology, 85(4), 594– 604. http://doi.org/10.1037/0022-3514.85.4.594

Bernstein, M. D. (2013). “The Last Acceptable Prejudice”: Student Harassment of Gay Public School Teachers. Tennessee Journal of Race, Gender, and Social Justice, Forthcoming, 2014–02.

Black, R. S. A., Curran, D., & Dyer, K. F. W. (2013). The Impact of Shame on the Therapeutic Alliance and Intimate Relationships. Journal of Clinical Psychology, 69(6), 646–654. http://doi.org/10.1002/jclp.21959

Blascovich, J., Mendes, W. B., Hunter, S. B., & Salomon, K. (1999). Social“ facilitation” as challenge and threat. Journal of Personality and Social Psychology, 77(1), 68.

Bond, B., Hefner, V., & Drogos, K. (2009). Information-Seeking Practices during the Sexual Development of Lesbian, Gay, and Bisexual Individuals: The Influence and Effects of Coming Out in a Mediated Environment. Sexuality & Culture, 13(1), 32–50. http://doi.org/10.1007/s12119-008-9041-y

Borders, A., Guillén, L. A., & Meyer, I. H. (2014). Rumination, Sexual Orientation Uncertainty, and Psychological Distress in Sexual Minority University Students. The Counseling Psychologist, 42(4), 497–523.

Bostwick, W. B., Boyd, C. J., Hughes, T. L., West, B. T., & McCabe, S. E. (2014). Discrimination and mental health among lesbian, gay, and bisexual adults in the United States. American Journal of Orthopsychiatry, 84(1), 35–45. http://doi.org/10.1037/h0098851

Bregman, H. R., Malik, N. M., Page, M. J. L., Makynen, E., & Lindahl, K. M. (2013). Identity profiles in lesbian, gay, and bisexual youth: The role of family influences. Journal of Youth and Adolescence, 42(3), 417–430. http://doi.org/10.1007/s10964-012-9798-z

Brewster, M. E., Moradi, B., DeBlaere, C., & Velez, B. L. (2013). Navigating the borderlands: The roles of minority stressors, bicultural self-efficacy, and cognitive flexibility in the mental health of bisexual individuals. Journal of Counseling Psychology, 60(4), 543–556. http://doi.org/10.1037/a0033224

Brown, J., & Trevethan, R. (2010). Shame, internalized homophobia, identity formation, attachment style, and the connection to relationship status in gay men. American Journal of Men’s Health, 4(3), 267–276.

Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17–31. http://doi.org/10.1016/j.cpr.2005.07.003

Bybee, J. A., Sullivan, E. L., Zielonka, E., & Moes, E. (2009). Are gay men in worse mental health than heterosexual men? The role of age, shame and guilt, and coming-out. Journal of Adult Development, 16(3), 144–154.

Case, P., Austin, S., Hunter, D., Manson, M., Malspeis, S., Willett, W., & Spiegelman, D. (2004). Sexual orientation, health risk factors, and physical functioning in the Nurses’ Health Study II. Journal of Women’s Health (15409996), 13(9), 1033– 1047 15p. http://doi.org/10.1089/jwh.2004.13.1033

Coan, J. A., & Allen, J. J. (2007). Handbook of emotion elicitation and assessment. Oxford university press. Retrieved from http://psycnet.apa.org/psycinfo/2007- 08864-000

Cochran, S. D., Sullivan, J. G., & Mays, V. M. (2003). Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States. Journal of Consulting and Clinical Psychology, 71(1), 53.

Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. 2nd edn. Hillsdale, New Jersey: L. Erlbaum.

Connell, C. (2012). Dangerous disclosures. Sexuality Research & Social Policy: A Journal of the NSRC, 9(2), 168–177. http://doi.org/10.1007/s13178-011-0076-8

Crocker, J., & Major, B. (1989). Social stigma and self-esteem: The self-protective properties of stigma. Psychological Review, 96(4), 608.

Davis, M. H., Soderlund, T., Cole, J., Gadol, E., Kute, M., Myers, M., & Weihing, J. (2004). Cognitions Associated With Attempts to Empathize: How Do We Imagine the Perspective of Another? Personality and Social Psychology Bulletin, 30(12), 1625–1635. http://doi.org/10.1177/0146167204271183

Day, N. E., & Schoenrade, P. (1997). Staying in the closet versus coming out: Relationships between communication about sexual orientation and work attitudes. Personnel Psychology, 50(1), 147–163. http://doi.org/10.1111/j.1744- 6570.1997.tb00904.x

DeLong, L. B., & Kahn, J. H. (2014). Shameful secrets and shame-prone dispositions: How outcome expectations mediate the relation between shame and disclosure. Counselling Psychology Quarterly, (ahead-of-print), 1–18.

Dewaele, A., Van Houtte, M., Cox, N., & Vincke, J. (2013). From coming out to visibility management—A new perspective on coping with minority stressors in LGB youth in Flanders. Journal of Homosexuality, 60(5), 685–710. http://doi.org/10.1080/00918369.2013.773818

Eich, E., Ng, J. T., Macaulay, D., Percy, A. D., & Grebneva, I. (2007). Combining music with thought to change mood. Handbook of Emotion Elicitation and Assessment, 124–136.

Eisenberg, N. (2000). Emotion, regulation, and moral development. Annual Review of Psychology, 51(1), 665–697.

Ellard, K. K., Fairholme, C. P., Boisseau, C. L., Farchione, T. J., & Barlow, D. H. (2010). Unified protocol for the transdiagnostic treatment of emotional disorders: Protocol development and initial outcome data. Cognitive and Behavioral Practice, 17(1), 88–101.

Etengoff, C., & Daiute, C. (2015). Online Coming-Out Communications Between Gay Men and Their Religious Family Allies: A Family of Choice and Origin Perspective. Journal of GLBT Family Studies, 11(3), 278–304. http://doi.org/10.1080/1550428X.2014.964442

Ferguson, T. J., Stegge, H., & Damhuis, I. (1991). Children’s Understanding of Guild and Shame. Child Development, 62(4), 827–839. http://doi.org/10.1111/j.1467- 8624.1991.tb01572.x

Fischer, A., & Manstead, A. (2010). Social functions of emotions. In M. Lewis, J. M. Haviland-Jones, & L. F. Barrett (Eds.), Handbook of Emotions (pp. 456–470). Guilford Press.

Fredrickson, B. L. (2000). Extracting meaning from past affective experiences: The importance of peaks, ends, and specific emotions. Cognition & Emotion, 14(4), 577–606. http://doi.org/10.1080/026999300402808

Galupo, M. P., Davis, K. S., Grynkiewicz, A. L., & Mitchell, R. C. (2014). Conceptualization of Sexual Orientation Identity Among Sexual Minorities: Patterns Across Sexual and Gender Identity. Journal of Bisexuality, 14(3-4), 433– 456. http://doi.org/10.1080/15299716.2014.933466

Gilman, S. E., Cochran, S. D., Mays, V. M., Hughes, M., Ostrow, D., & Kessler, R. C. (2001). Risk of psychiatric disorders among individuals reporting same-sex sexual partners in the National Comorbidity Survey. American Journal of Public Health, 91(6), 933.

Gloaguen, V., Cottraux, J., Cucherat, M., & Blackburn, I.-M. (1998). A meta-analysis of the effects of cognitive therapy in depressed patients. Journal of Affective Disorders, 49(1), 59–72. http://doi.org/10.1016/S0165-0327(97)00199-7

Goldenberg, A., Halperin, E., Zomeren, M. van, & Gross, J. J. (2016). The Process Model of Group-Based Emotion Integrating Intergroup Emotion and Emotion Regulation Perspectives. Personality and Social Psychology Review, 20(2), 118– 141. http://doi.org/10.1177/1088868315581263

Goldfried, M. R., & Goldfried, A. P. (2001). The importance of parental support in the lives of gay, lesbian, and bisexual individuals. Journal of Clinical Psychology, 57(5), 681–693. http://doi.org/10.1002/jclp.1037

Granfield, R. (1991). MAKING IT BY FAKING IT Working-Class Students in an Elite Academic Environment. Journal of Contemporary Ethnography, 20(3), 331–351.

Greene, D. C., & Britton, P. J. (2013). Predicting Relationship Commitment in Gay Men: Contributions of Vicarious Shame and Internalized Homophobia to the Investment Model. Retrieved from http://psycnet.apa.org/psycinfo/2013-44732- 001/

Greene, D. C., Britton, P. J., & Fitts, B. (2014). Long-Term Outcomes of Lesbian, Gay, Bisexual, and Transgender Recalled School Victimization. Journal of Counseling 58

& Development, 92(4), 406–417.

Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271.

Haldeman, D. C., Pantalone, D., & Martell, C. R. (2007). Health care issues facing gay, lesbian, bisexual, and transgender individuals. In O. J. Z. Sahler & J. E. Carr (Eds.), The behavioral sciences and health care (2nd rev. and updated ed.). (pp. 210–216). Ashland, OH, US: Hogrefe & Huber Publishers.

Hamilton, M., & Rajaram, S. (2003). States of awareness across multiple memory tasks: obtaining a “‘pure’”measure of conscious recollection q. Acta Psychologica, 112, 43–69.

Harris. (2010). Gay and lesbian adults are more likely and more frequent blog readers. Harris Interactive.

Harris, M. B., & Bliss, G. K. (1998). Coming out in a school setting: Former students’ experiences and opinions about disclosure. Journal of Gay & Lesbian Social Services, 7(4), 85–100.

Hatzenbuehler, M. L. (2014). Structural Stigma and the Health of Lesbian, Gay, and Bisexual Populations. Current Directions in Psychological Science, 23(2), 127– 132. http://doi.org/10.1177/0963721414523775

Hatzenbuehler, M. L., Dovidio, J. F., Nolen-Hoeksema, S., & Phills, C. E. (2009). An implicit measure of anti-gay attitudes: Prospective associations with emotion regulation strategies and psychological distress. Journal of Experimental Social Psychology, 45(6), 1316–1320.

Hatzenbuehler, M. L., & McLaughlin, K. A. (2014). Structural stigma and hypothalamic– pituitary–adrenocortical axis reactivity in lesbian, gay, and bisexual young adults. Annals of Behavioral Medicine, 47(1), 39–47. http://doi.org/10.1007/s12160-013- 9556-9

Hatzenbuehler, M. L., McLaughlin, K. A., Keyes, K. M., & Hasin, D. S. (2010). The Impact of Institutional Discrimination on Psychiatric Disorders in Lesbian, Gay, and Bisexual Populations: A Prospective Study. American Journal of Public Health, 100(3), 452–459. http://doi.org/10.2105/AJPH.2009.168815

Hatzenbuehler, M. L., Nolen-Hoeksema, S., & Dovidio, J. (2009). How does stigma “get under the skin”? The mediating role of emotion regulation. Psychological Science, 20(10), 1282–1289.

Hillier, L. (2002). “It’s a catch-22”: Same-sex-attracted young people on coming out to

parents. New Directions for Child and Adolescent Development, 2002(97), 75–92.

Hillier, L., Mitchell, K. J., & Ybarra, M. L. (2012). The Internet as a safety net: Findings from a series of online focus groups with LGB and non-LGB young people in the United States. Journal of LGBT Youth, 9(3), 225–246. http://doi.org/10.1080/19361653.2012.684642

Iacovelli, A. M., & Johnson, C. (2012). Disclosure through face-to-face and instant messaging modalities: Psychological and physiological effects. Journal of Social and Clinical Psychology, 31(3), 225–250.

Jourian, T. j. (2015). Evolving Nature of Sexual Orientation and Gender Identity. New Directions for Student Services, 2015(152), 11–23. http://doi.org/10.1002/ss.20142

Juster, R.-P., Smith, N. G., Ouellet, É., Sindi, S., & Lupien, S. J. (2013). Sexual Orientation and Disclosure in Relation to Psychiatric Symptoms, Diurnal Cortisol, and Allostatic Load: Psychosomatic Medicine, 75(2), 103–116. http://doi.org/10.1097/PSY.0b013e3182826881

Kann, L., O’Malley Olsen, E., McManus, T., Kinchen, S., Chyen, D., Harris, W. A., & Wechsler, H. (2011). Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors among Students in Grades 9-12–Youth Risk Behavior Surveillance, Selected Sites, United States, 2001-2009. Morbidity and Mortality Weekly Report. Early Release. Volume 60. Centers for Disease Control and Prevention. Retrieved from http://eric.ed.gov/?id=ED520413

Kring, A. M., & Sloan, D. M. (2009). Emotion regulation and psychopathology: A transdiagnostic approach to etiology and treatment. Guilford Press. Retrieved from http://books.google.com/books?hl=en&lr=&id=Ml- RYut8OlMC&oi=fnd&pg=PR1&dq=Kring+%26+Sloan,+2009&ots=7tBEy8YL4 7&sig=puHqxyLTrteoyMmBOS5x6axBpxg

Kross, E. (2009). When the Self Becomes Other. Annals of the New York Academy of Sciences, 1167(1), 35–40. http://doi.org/10.1111/j.1749-6632.2009.04545.x

Lerner, J. S., Li, Y., Valdesolo, P., & Kassam, K. S. (2015). Emotion and decision making. Psychology, 66. Retrieved from http://www.annualreviews.org/eprint/vVKIPZU5r9dTCzbgdD3M/full/10.1146/an nurev-psych-010213-115043

Lewis, M. (2000). Self-conscious emotions. Handbook of Emotions, 2, 623–636.

Mascolo, M. F., & Fischer, K. W. (1995). Developmental transformations in appraisals for pride, shame, and guilt. Retrieved from http://psycnet.apa.org/psycinfo/1995- 60

97661-002

Mays, V. M., & Cochran, S. D. (2001). Mental Health Correlates of Perceived Discrimination Among Lesbian, Gay, and Bisexual Adults in the United States. American Journal of Public Health, 91(11), 1869–1876. http://doi.org/10.2105/AJPH.91.11.1869

McCabe, S. E., Bostwick, W. B., Hughes, T. L., West, B. T., & Boyd, C. J. (2010). The Relationship Between Discrimination and Substance Use Disorders Among Lesbian, Gay, and Bisexual Adults in the United States. American Journal of Public Health, 100(10), 1946–1952. http://doi.org/10.2105/AJPH.2009.163147

McDavitt, B., Iverson, E., Kubicek, K., Weiss, G., Wong, C. F., & Kipke, M. D. (2008). Strategies Used by Gay and Bisexual Young Men to Cope With Heterosexism. Journal of Gay & Lesbian Social Services, 20(4), 354–380. http://doi.org/10.1080/10538720802310741

Meyer, I. H. (2003). Prejudice as Stress: Conceptual and Measurement Problems. American Journal of Public Health, 93(2), 262–265. http://doi.org/10.2105/AJPH.93.2.262

Miller, R. S., & Tangney, J. P. (1994). Differentiating Embarrassment and Shame. Journal of Social and Clinical Psychology, 13(3), 273–287. http://doi.org/10.1521/jscp.1994.13.3.273

Muris, P., Meesters, C., Bouwman, L., & Notermans, S. (2014). Relations Among Behavioral Inhibition, Shame-and Guilt-Proneness, and Anxiety Disorders Symptoms in Non-clinical Children. Child Psychiatry & Human Development, 1– 8.

Newheiser, A.-K., & Barreto, M. (2014). Hidden costs of hiding stigma: Ironic interpersonal consequences of concealing a stigmatized identity in social interactions. Journal of Experimental Social Psychology, 52, 58–70.

Oppenheimer, D. M., Meyvis, T., & Davidenko, N. (2009). Instructional manipulation checks: Detecting satisficing to increase statistical power. Journal of Experimental Social Psychology, 45(4), 867–872.

Pachankis, J. E. (2007). The psychological implications of concealing a stigma: a cognitive-affective-behavioral model. Psychological Bulletin, 133(2), 328.

Pachankis, J. E., Hatzenbuehler, M. L., Jonathon, H., Safren, S. A., & Parsons, J. T. (2015). LGB-Affirmative Cognitive-Behavioral Therapy for Young Adult Gay and Bisexual Men: A Randomized Controlled Trial of a Transdiagnostic Minority Stress Approach. Journal of Consulting and Clinical Psychology, No Pagination 61

Specified. http://doi.org/10.1037/ccp0000037

Pennebaker, J. W., Francis, M. E., & Booth, R. J. (2001). Linguistic inquiry and word count: LIWC 2001. Mahway: Lawrence Erlbaum Associates, 71, 2001.

Pennycook, G., Cheyne, J. A., Seli, P., Koehler, D. J., & Fugelsang, J. A. (2012). Analytic cognitive style predicts religious and paranormal belief. Cognition, 123(3), 335–346.

Plöderl, M., & Tremblay, P. (2015). Mental health of sexual minorities. A systematic review. International Review of Psychiatry, 27(5), 367–385. http://doi.org/10.3109/09540261.2015.1083949

Rhoads, R. A. (1995). Learning from the coming-out experiences of college males. Journal of College Student Development, 36(1), 67–74.

Rosario, M., Schrimshaw, E. W., & Hunter, J. (2011). Different patterns of sexual identity development over time: Implications for the psychological adjustment of lesbian, gay, and bisexual youths. Journal of Sex Research, 48(1), 3–15. http://doi.org/10.1080/00224490903331067

Ryan, C., Huebner, D., Diaz, R. M., & Sanchez, J. (2009). Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults. Pediatrics, 123(1), 346–352. http://doi.org/10.1542/peds.2007-3524

Swank, E., Fahs, B., & Frost, D. M. (2013). Region, social identities, and disclosure practices as predictors of heterosexist discrimination against sexual minorities in the United States. Sociological Inquiry, 83(2), 238–258. http://doi.org/10.1111/soin.12004

Szymanski, D. M., Dunn, T. L., & Ikizler, A. S. (2014). Multiple minority stressors and psychological distress among sexual minority women: The roles of rumination and maladaptive coping. Psychology of Sexual Orientation and Gender Diversity, 1(4), 412.

Tangney, J. P. (2003). Self-relevant emotions. In M. R. Leary & J. P. Tangney (Eds.), Handbook of self and identity (pp. 384–400). New York, NY, US: Guilford Press.

Tracy, J. L., & Robins, R. W. (2007a). Emerging insights into the nature and function of pride. Current Directions in Psychological Science, 16(3), 147–150.

Tracy, J. L., & Robins, R. W. (2007b). The psychological structure of pride: a tale of two facets. Journal of Personality and Social Psychology, 92(3), 506.

Turner, J. C., Reynolds, K. J., & others. (2001). The social identity perspective in 62

intergroup relations: Theories, themes, and controversies. Blackwell Handbook of Social Psychology: Intergroup Processes, 4, 133–152.

Turner, J. E. (2014). Researching State Shame With the Experiential Shame Scale. The Journal of Psychology, (ahead-of-print). Retrieved from http://www.tandfonline.com/doi/abs/10.1080/00223980.2013.818927

Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063.

Williams, L. A., & DeSteno, D. (2008). Pride and perseverance: The motivational role of pride. Journal of Personality and Social Psychology, 94(6), 1007–1017. http://doi.org/10.1037/0022-3514.94.6.1007

Williams, L. A., & DeSteno, D. (2009). Pride Adaptive Social Emotion or Seventh Sin? Psychological Science, 20(3), 284–288.

Zimmerman, J., Morrison, A. S., & Heimberg, R. G. (2014). Social anxiety, submissiveness, and shame in men and women: A moderated mediation analysis. British Journal of Clinical Psychology. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/bjc.12057/full

Appendix A: Written Reflection Task Instructions

In this next task, you will be writing a short essay about the thoughts and feelings you had while watching the previous video.

You will be given 4 minutes to complete your essay. It is important that you write for the whole 4 minutes. The page will advance automatically when your time is up.

Please proceed to the next page when you are ready to begin.

------PAGE BREAK------

Try to be as honest as possible and describe exactly what you were feeling and thinking as you watched the video.

As you write, we would like you to really let go and explore your very deepest emotions and thoughts.

You may write about how you identified with different parts of the video, or about similar experiences in your life.

Everyone responds differently to this video – we want to know what this video means to you. For example, you might consider the following: • What positive or negative feelings (if any) did you experience while watching this video? • What parts of the video (if any) shocked or surprised you? • Which of your thoughts about the video stand out most to you? • What parts of the video (if any) made you feel physical sensations in your body? If at any time you draw a blank, or run out of things to write, just relax and give yourself time to think about something else related to the topic.

Remember: there are no right or wrong answers in this task – all we ask is that you try your best and write from the heart.

Please write your essay in the box below.

You have 4 minutes. Please try to write for the whole 4 minutes.

Appendix B: Decision-Making Task

[NOTE: Each item was presented on a separate page according to the following example. See full list of prompts at the bottom of this page]

Parent

For the following questions, please think of ONE person in the above category, and respond accordingly.

How likely are you to share the essay you just wrote with the person named above?

1 2 3 4 5 6 7 Not at all Definitely would likely to share share

If you had the option right now, how likely would you be to share your sexual orientation with the person/people named above?

1 2 3 4 5 6 7 Not at all Definitely would likely to share share

LIST OF PROMPTS:

Anonymous internet forum Stranger Acquaintance in a class or club Roommate Close friend Extended family member Sibling Parent Professor Therapist / counselor Classroom or workplace gossip

Boss / superior Colleague / peer Assistant / employee Very religious person

Appendix C: Lesbian, Gay, and Bisexual Library for Linguistic Inquiry and Word Count (LIWC) Program

% beingopen 99 catcher 99 95 antiLGBT beingout 99 Charlie 99 97 genderidentity beingread 97 99 chasers 99 99 LGBT bender 99 Chaz* 97 99 % Bent 99 Cher 99 1manand1woman 95 99 berdache 97 99 chosenfamily 99 Abomination* 95 99 bi 99 cis* 97 99 Accept* 99 bicurious 99 closet* 99 ACDC 99 bigender 97 99 CoercivelyAssignedFemaleA Ace 99 bigot* 95 99 tBirth 95 97 99 AceUmbrella 99 bind* 97 99 CoercivelyAssignedMaleAtB adamandeve 95 99 bioboy 97 99 irth 95 97 99 adamandsteve 95 99 biogirl 97 99 comeout 99 advocacy 99 bioman 97 99 comesout 99 affectionalorientation 99 bioqueen 97 99 comingout 99 affirm* 99 biowoman 97 99 community 99 Ag 99 bisexual* 99 comradery 99 agenda 99 boi 99 connoun 97 99 agender* 99 Bonesmuggler 99 controversial 95 99 Aggressive 99 bornthisway 99 crossdresser 99 AllGender 97 99 bottom 99 crosssexual 99 allied 99 bottomsurgery 97 99 cubs 99 ally 99 boydyke 99 currentevents 99 Analassassin 95 99 boyisabottom 99 Curryqueen 95 99 androgyne 97 99 Bufter 99 D/L 99 AnnCoulter 95 99 Bugger 95 99 D&D 99 antigay 95 99 bulldagger 99 DanSavage 99 antiLGBT 95 99 bulldyke 99 deepstealth 97 99 antitrans 95 97 99 Bumbandit 99 defenseofmarriageact 95 Arsebandit 95 99 Bumboy 99 99 asexual 99 bumchum 99 degenerate 95 99 assimilate* 99 Bumdriller 99 demi* 99 attitudes 99 butch 99 deviant 95 99 attraction 99 butchbroad 99 DFAB 99 Backdoorbandit 95 99 Buttpirate 95 99 different 99 Backgammonplayer 99 CAFAB 97 99 Dingequeen 95 99 Battyboy 95 99 CaitlynJenner 97 99 Discrimination* 95 99 BDSM 99 CAMAB 97 99 diversity 99 beanflicker 95 99 cameout 99 DMAB 99 Beanqueen 99 Camp 99 DOMA 95 99 Bear 99 CarloLegaspi 99 downlow 99 beardcover 99 carpetmuncher 95 99 drag* 99 67

dragqueen 99 GRS 97 99 leso 99 DSDs 95 97 99 GSA 99 lesser 99 dyke 99 GSM 97 99 lezzer 99 dysphoria 95 97 99 gurl 99 lezzie 99 EllenDeGeneres 99 Gymqueen 99 LGB* 99 empower* 99 Harryhoofter 95 99 liberal 99 endrab 99 HarveyMilk 99 lifestyle* 95 99 enfemme 99 hatecrimes 95 99 Lightintheloafers 95 99 epicene 97 99 hermaphrodit* 95 99 Lightinthepants 95 99 equality 99 heshe 95 97 99 Limpwristed 95 99 eras* 95 99 hetero* 99 lipsticklesbian 99 F2M 97 99 hir 97 99 livingopenly 99 FAAB 97 99 hirs 97 99 lovers 99 fag 95 99 hitsbothways 99 M2F 97 99 Faggot 95 99 HIVphobia 95 99 MAAB 97 99 faghag 99 Homo* 99 Macklemore 99 Fairy 95 99 hormone 97 99 mainstream 97 99 family 99 hormonereplacementtherapy Maleassignedatbirth 97 familyofchoice 99 97 99 99 familyoforigin 99 hostile 95 99 malebodied 97 99 Femaleassignedatbirth 97 HRC 99 marginalized 95 99 99 HRT 97 99 marriageequality 99 femalebodied 97 99 HST 97 99 Mary 95 97 99 femme 99 identif* 99 masculin* 97 99 Finocchio 99 identit* 99 MatthewShepard 99 flamboyant 99 ideology 99 melancholy 95 99 Flame 99 ignorance 95 99 menlovingmen 99 Flamer 99 ignorant 95 99 metrosexual 99 flaming 99 inclusive 99 MLM 99 Flit 99 intergender 97 99 Mollyandtommy 99 Fluid* 99 internalizedhomophobia 95 monogamous 99 Freak* 95 99 99 movement 99 Fruit 95 99 intersectionality 97 99 MsCoulter 95 99 fruitloop 95 99 Intersex* 97 99 MSM 99 fruitpacker 95 99 IntheLife 99 MTF 97 99 FTM 97 99 ironhoofter 95 99 muffdiver 95 99 Fudgepacker 95 99 itgetsbetter 99 multigender 97 99 gay* 99 Jobbyjabber 95 99 multisexual 99 gayagenda 95 99 justice 99 nancy* 95 99 GayMen'sHealthCrisis 99 Kathoey 99 natalfemale 97 99 gender* 97 99 Katoey 99 natalmale 97 99 geneticgirl 97 99 KimDavis 95 99 natalsex 97 99 gettingread 97 99 king 99 natural 99 GG 97 99 Kinsey 99 NeilPatrickHarris 99 GID 97 99 Knobjockey 95 99 nellie 95 99 Gingerbeer 99 ladyboy 95 97 99 nonbinary 97 99 girlandboy 99 LatriceRoyale 99 nonmonosexual 99 girlyboy 95 99 LBG* 99 nonstraight 99 GLAAD 99 leather 99 nonstraightsexuality 99 GLAD 99 les 99 normative 95 99 GLB* 99 lesbian 99 notstraight 99 GNC 97 99 lesbian* 99 nutjobs 95 99 Greyqueen 99 lesbo 99 Oklahomo 99 68

omnisexual 99 Sausagejockey 95 99 unassignedatbirth 97 99 onemanandonewoman 95 selflove 99 undecided 99 99 sex 97 99 underrepresentation 95 onespirit 97 99 SexReassignmentSurgery 97 99 open* 99 99 understanding 99 oppositesex 99 Sexual* 99 unisexual 99 oppositesexattraction 99 SGL 99 ursula 99 oppression 95 99 shemale 95 97 99 visibility 99 orientation* 99 shim 95 97 99 wintke 97 99 ostracize* 95 99 Shirtlifter 95 99 WLW 99 otherside 99 significantother 99 wolves 99 otters 99 sin 95 99 womanlookingforanotherwo out* 99 singlegender 97 99 man 99 packing 99 skolio* 97 99 womencouples 99 pangender 97 99 socialgender 97 99 womenlovingwomen 99 pansexual 99 socialjustice 99 womyn 99 Pansy 95 99 socialprogress 99 Woollywoofter 95 99 partner* 99 Sod 95 99 WSW 99 pass* 97 99 sodomite 95 99 ze 97 99 PatRobertson 95 99 SOFFA 97 99 zir 97 99 performative 99 spectrum 99 zirs 97 99 pervert* 95 99 SRS 97 99 pitcher 99 stealth 97 99 plaid 99 stem 99 poly* 99 stereotypes 95 99 Poof* 95 99 stigma 95 99 pride 99 stonebutch 99 Princess 99 stonefemme 99 Priscilla 99 stonewall 99 privilege 95 99 straight 99 progress* 99 straightacting 99 pronouns 97 99 stud 99 proposal* 99 subhuman 95 99 proposition8 95 99 supremecourt* 99 proud 99 swingsbothways 99 QPOC 99 switch 99 Queen* 99 TERF 97 99 queer* 99 TG 99 Questioning 99 thirdgender 97 99 QUILTBAG 99 todgerdodger 95 99 radical 99 tolerance 99 rainbow* 99 top 99 read 97 99 topsurgery 97 99 reallifetest 97 99 tranny 95 97 99 represent* 99 trans* 97 99 retrosexism 99 TrevorProject 99 rhetoric 99 true* 99 rights 99 tryke 97 99 rightwing* 95 99 Twink 99 RLT 97 99 twomales 99 samegenderloving 99 twospirited 97 99 samesex* 99 TylerOakley 99 Sapphic 99 UAAB 97 99 69