Holistic Mapping of Psychosocial Stress Patterns for Personalized Mental Health Solutions Among Sexual Minority Men in China.

Sexual minority men in China are at heightened risk for internalizing problems, including depression, anxiety, and somatization. Prior research has often focused on minority stressors (related to sexual minority status) while overlooking general stressors or relying on Western-informed measures, hindering a comprehensive understanding in the Chinese context. This study examined a wide range of stressors and within-group diversity using a large, heterogeneous sample (N = 4,310) recruited from a geosocial networking app. Variable-centered regression analysis revealed that both minority stressors (e.g., self homonegativity, discrimination, situational stress) and general stressors (e.g., financial stress and interpersonal problems) predicted increased internalizing problems. Moreover, perhaps culturally relevant to China, LGBTQ+ affirmation and outness were positively associated with internalizing problems. Person-centered latent class analysis revealed four psychosocial stress patterns: Class 1 participants (29.3%) experienced high minority and general stress; Class 2 participants (40.0%) reported high outness and LGBTQ+ affirmation but also high general stress including work-related and financial stress; Class 3 participants (17.1%) had high self homonegativity but low general stress; and Class 4 participants (13.6%) reported low stress overall. These patterns varied by age, socioeconomic status, and bisexual status, suggesting diverse stress burdens depending on sociodemographic characteristics, which further contribute to different levels of internalizing problems. The findings highlight the need for holistic interventions tailored to the diverse needs of Chinese sexual minority men beyond addressing minority stress alone.