Distress and internalized homophobia among lesbian women treated for early stage breast cancer

A convenience sample of 57 lesbian women who had been recruited for a study of adjustment to breast cancer completed measures of internalized homophobia, degree of disclosure of sexual orientation, social support, self-esteem, and distress. Consistent with our prediction, internalized homophobia related to greater distress. Contrary to our prediction, disclosure did not relate to lower distress. Path models were consistent with the position that internalized homophobia promotes distress through lower self-esteem and perceived unavailability of social support. However, the data were also consistent with a model in which low self-esteem leads to internalized homophobia by way of elevated distress. Internalized homophobia also related inversely to utilization of health care resources. Our discussion centers on the need for more information regarding this understudied population.