Stigmatization and oppression, including violence, toward people who identify as lesbian, gay, or bisexual (LGB) has been well-documented (e.g., Berrill 1992; Herek 1989, 1996; Herek et al. 1997, 1999; Human Rights Campaign n.d.a, n.d.b). Such victimization includes discrimination in housing, employment, and custody rights; physical, verbal, and sexual assaults; harassment; even murder. In addition to such overt acts of oppression, gay men, lesbians, and bisexual individuals also face less obvious but nonetheless critical environmental factors that marginalize and stigmatize them as "other" in a society that values conformity, such as daily, chronic reminders like anti-gay jokes (Garnets et al. 2003; Rivers and D'Augelli 2001). Such experiences are consistent with Albee's description of exploitation in his incidence formula (Albee 1983, 1995; Albee and Ryan-Finn 1993; Gullotta 1997).
Not surprisingly, such experiences often result in negative physical and mental health consequences, regardless of whether a person is open about his or her sexual orientation (e.g., Garnets et al. 2003; Russell 2000). Such consequences include somatic reactions, increased sense of vulnerability, self-blame, decreased self-worth, internalized homophobia, depression, substance abuse, and suicidal ideation and/or attempts.