Creating a scale to measure internalized homophobia among self-identified lesbians

It has been hypothesized that internalized homophobia (IH) is linked to elevated rates of mental health and substance abuse issues among GLBT individuals. However, while previous research suggests IH is a statistically significant factor for gay men, there is a dearth of research regarding other GLBT groups, including lesbians. Methods. Component I involved conducting discussion groups based on the concept mapping model. Specifically, participants generated, ranked, and sorted items they believed to be related to IH. Multidimensional scaling analysis and hierarchical cluster analysis were then used to illustrate the relationships between them and create the survey instrument. In Component II, content and validity testing were conducted with community and expert participants. Finally, Component III involved administering the final survey. Results. A total of 1,011 women took the final survey, with 786 who identified as lesbian, resided in the U.S., and completed all sections of the survey. Confirmatory factor analysis confirmed the internal reliability of four subscales, with Cronbach coefficient alpha values ranging from .74 to .85. Over 98% of the survey respondents reported experiencing mild or greater levels of IH. Variance and regression analyses indicated that IH was significantly related to being in an older age group (p=0.003), urban geographic area of residence (p=0.03), perception of area as conservative (p=0.03), older age of coming out to friends (p=0.008), older age of coming out to self (p=0.0001), lower number of lifetime sexual partners (p=0.0001), lower number of lifetime sexual partners who were women (p=0.0001), and lower frequency of participating in lesbian events or social functions per year (p=0.04). IH was also significantly correlated with previous and current depression (p=0.0005; p=0.0000), previous illegal drug use (p=0.05), current drug addiction (p=0.0002), current eating disorders (p=0.005), previous suicide attempts (p=0.004), and current suicide ideation (p=0.0001) among the study sample. Conclusions. This study addresses the limitations of previous research, utilizes a substantially larger sample than any to date, and resulted in the creation of a valid and reliable survey instrument. Finally, the salience of the scale and need for targeted interventions are underscored by the relationships found between IH and numerous health behaviors and outcomes