Keywords

Barriers; Disparities; Intersectionality; Health; Psychology; Discrimination

Abstract

Emerging adulthood is a developmental period characterized by increasing mental health concerns, yet many young adults do not seek professional psychological services. The present study examined barriers to mental health care among undergraduate women, with particular attention to the intersecting identities of sexual minority status and racial/ethnic minority status. Guided by intersectionality theory, the study investigated whether LGBTQ+ women, women of color, and individuals holding both identities reported greater perceived barriers to treatment, higher levels of medical mistrust and discrimination in healthcare settings, and lower mental health service utilization. Participants included 373 undergraduate women between the ages of 18 and 25 who completed an online survey assessing perceived barriers to psychological treatment, group-based medical mistrust, discrimination in medical settings, mental health service utilization, and psychological functioning. Multivariate analyses of variance and hierarchical logistic regression analyses were conducted to test study hypotheses.

Results indicated that racial/ethnic minority status was significantly associated with greater medical mistrust, while sexual minority status was associated with higher reported discrimination in healthcare settings. Contrary to expectations, identity variables were not significantly associated with overall perceived barriers to psychological treatment. However, follow-up analyses of PBPT subscales revealed that sexual minority participants and women of color reported greater motivational barriers to treatment. Logistic regression analyses indicated that medical mistrust and discrimination were not significant predictors of mental health service utilization. Sexual minority participants reported lower odds of mental health service utilization, whereas women of color reported higher odds of lifetime utilization. A significant interaction between sexual minority status and racial/ethnic minority status emerged in the lifetime utilization model, suggesting distinct help-seeking patterns among individuals with intersecting marginalized identities. Exploratory analyses further indicated that sexual minority participants reported lower PROMIS Global Mental Health scores and higher levels of depressive and anxiety symptoms relative to heterosexual participants.

These findings highlight the importance of considering both identity-based experiences and intersectionality when examining mental health disparities among emerging adult women. Although broad perceptions of barriers to treatment did not differ substantially across identity groups, disparities in psychological distress, medical mistrust, and patterns of service utilization suggest that culturally responsive and intersectionally informed mental health services may improve engagement and outcomes for marginalized populations.

Thesis Completion Year

2026

Thesis Completion Semester

Spring

Thesis Chair

Cassisi, Jeffrey

College

College of Sciences

Department

Psychology

Thesis Discipline

Psychology

Language

English

Access Status

Open Access

Length of Campus Access

None

Campus Location

Orlando (Main) Campus

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