Today, Tuesday, December 5, the Supreme Court will revisit same-sex marriage. In the case orally argued today, David Mullins and Charlie Craig—a same-sex couple from Colorado—hold that Jack Phillips, the owner of Masterpiece Cakeshop, discriminated against a class of persons by his refusal to create a custom wedding cake for their celebration. Phillips, on the other hand, says he has no objections to doing business with gay or lesbian customers, but he will not violate his conscience concerning the nature and structure of marriage.
Antigay stigma, bullying, and violence are old and lamentable things. When scholars claim that these have, and can still have, an ill effect on individuals’ health and wellness, I don’t have trouble believing it. “Minority stress” is real, and it has been and can be a problem.
The key questions, though, are (1) what is “minority stress,” (2) how big a problem is it, and (3) how is it at work in a case about cake? I wrote a brief on this case about the claims being made that social stress—in particular, the unique stress that one’s sexual minority status can entail—is powerfully at work here, contributing directly to diminished psychological, physical, and relational health. Here’s what I found when I looked into it.
The Minority Stress Model
Stigma, prejudice, and discrimination combine to create a “stressful social environment that can lead to mental health problems in people who belong to stigmatized minority groups,” according to UCLA public health professor Ilan Meyer, whose work is widely cited in studies of LGBT discrimination. This is the “minority stress” model. It concerns “stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes.” An implication of the model is that reducing or eliminating all sources of stress would significantly ameliorate the health challenges experienced by sexual minorities.
But the model is nuanced. Discrimination, Meyer holds, can cause deleterious health effects for LGB individuals when the experience is both repetitive and intense—that is, when “external, objective stressful events and conditions” are chronic and acute. Refusing to design a custom cake for a same-sex wedding seems more annoying than chronic and acute. It is simply not akin to severe behavior such as repeated bullying, interpersonal violence, or the experience of widespread, sustained discriminatory actions.
In his recent brief, Meyer extends his theory of minority stress by suggesting that Mr. Phillips’s inaction “amplifies social rejection and reiterates decades-old stigma and prejudice.” In other words, it’s not so much about what this baker does or doesn’t do. It’s about the social construction of an unbroken connection between Mr. Phillips’s convictions about marriage and the darker history of what others have (sadly) done to gay and lesbian Americans. At the same time, Meyer and his co-authors hold that due to the novelty of same-sex marriage in America, to refrain from baking a cake is “an especially powerful rejection.” Indeed, “even the threat of rejection” is harmful and must be removed, since it is a stressor itself “even in the absence of a specific prejudice event.”
That’s a tall order.
Empirically, it’s difficult to isolate the negative influence of anti-gay discrimination from experiences of sex-, class-, race-, economic-, political-, religious- and ethnicity-based forms of discrimination. In other words, more than just sexual minority status can be at work. But how do you disentangle external sources of stress? It’s not easy, and too many studies lean simply on self-selected samples describing feelings and experiences through the eyes of the beholder. Additionally, some scholars (not Meyer, however) have been content simply to document “differences” between gay and straight populations, chalking up all distinctions to discrimination. For example, higher rates of asthma and allergies have been noted in gay, lesbian, and bisexual populations. An earlier court brief claimed that the disparity was due to “the stress caused by discrimination based on a person’s sexual orientation.” But the brief simply assumed what it could not prove. In reality, the universally recognized epidemiological explanation for the higher rate of asthma is different rates of smoking. Members of the LGB community tend to smoke more than the general population. And yet the brief argued that the science supported an untested proposition that the asthma was caused by unmeasured discrimination.
New Research on How Sexual Minority Stress (Barely) Affects Relationship Well-Being
What my brief did not mention was a new meta-analysis of thirty-two research studies on the implications of sexual minority stress and its effects on same-sex relationship well-being, in data collected before the legalization of same-sex marriage in the United States. It just appeared in the October 2017 issue of the Journal of Marriage and Family. This topic—relationship well-being—is different from personal psychological and physical health, but it is a category of outcome covered in Meyer’s brief. Its results are illuminating.
In a damning indictment of the research in this domain, the article documents the surge in the number of studies and reports about sexual minority stress and relational well-being since 1990, but finds no improvement in the “overall low quality of work in this field to date.” Twenty-five years and an infusion of cash from funding streams both private and federal ought to have spelled better-quality research.
Its authors noted, in sync with Meyer’s theory, that the most proximal (or nearest) stressors to persons are the most influential on them. In fact, only internalized homophobia significantly affected relationship well-being. “Heterosexist discrimination,” the claim of the current Supreme Court case, wasn’t statistically significant. A more thorough assessment of “internalized homophobia” in gay and lesbian populations seems merited, especially since rising social, familial, peer, and political support would predict its certain decline. Moreover, the meta-analysis found that only female couples appeared to suffer relationally from stress. In other words, to suggest that Mullins and Craig suffered relationship damage from their brief interaction with Phillips would, while possible, be unexpected. That the two would break down and cry in the parking lot, as some accounts of the event related, suggests an incommensurate response inconsistent with expectations derived from existing studies. A more convincing case here would involve a more consequential yet mundane event—being refused an application for an apartment or a home purchase, or being denied boarding by an airline. We’re stuck talking about disappointment over a dessert—albeit a very symbolic one.
I still hold that acute, sustained stress can diminish the psychological and physical health of sexual and other minority populations. My own experience with it is now five years old, with no sign of cessation. While mostly online in origin, each day at the office is an experiment in awkwardness. It is stigma, and yes—it can take its toll psychologically and physically. But I don’t wish to force anyone to like me, work with me, or even interact pleasantly with me. They are following their conscience, even while I might wish they were more open-minded about the matter.
But when scholars claim that the episodic inactions of florists or cake bakers directly diminish the psychological and downstream physical health (and dignity) of gay and lesbian Americans, I think they take a leap that is unmerited. The cake incident, which is neither sustained nor acute in nature, may have reminded Mullins and Craig of bullying earlier in life, but that is a different (and regrettable) matter for which Phillips is not at fault.
Some worry that a judgment in favor of Jack Phillips will open up a floodgate of public antigay sentiment. That strains credulity. Gay and lesbian communities are no longer widely alienated from American institutions and social structures. Given that public support for same-sex marriage continues to climb, there is little basis to suggest that civil liberties of gay couples are at risk. We can still accommodate diversity of thought and religious liberty in this country.
Consumers have long voted with their feet and their wallets, and they remain free to do so here. If public opinion about support for same-sex marriage is any indication, the party most vulnerable to judgment here is Jack Phillips. He’s willing to risk it—for the sake of his conscience. It is worth the stress he no doubt feels.