Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Arts (MA)


Clinical Psychology

First Advisor

Heidi M. Levitt

Second Advisor

Abbey S. Eisenhower

Third Advisor

Sharon G. Horne


Heterosexism is a cultural system that impacts LGBTQ+ individuals internally, interpersonally, institutionally, and structurally. Exposure to these different levels of heterosexism, whether enacted overtly, covertly, intentionally, or unintentionally, contributes to the well-documented and disproportionate negative mental health outcomes experienced by the LGBTQ+ community (National Academies of Sciences, Engineering, and Medicine [NASEM], 2020). Subsequently, LGBTQ+ individuals seek out professional mental health services at higher rates than cisgender and heterosexual populations, though access to therapeutic care that addresses sexual minority specific stressors, such as experiencing heterosexism directly, is limited (Williams & Fish, 2020). The current study is a secondary analysis of a larger study of an online expressive writing intervention designed to promote healing for LGBTQ+ individuals who have experienced heterosexism. This study examined if and how characteristics of the heterosexist event that participants wrote about predicted healing outcomes. Specifically, I examined if and how the duration, recency, and severity of the distress during the heterosexist experience predicted changes in depressive symptoms and event-related stress among participants from Baseline, Day 4, and at two-month Follow Up as well as participants’ perceptions of change. In addition, I examined if and how participants’ prior disclosure (or non-disclosure) of heterosexist experiences to a therapist was a predictor of those healing outcomes. And, finally, I conducted a grounded theory analysis to understand the reasons why LGBTQ+ clients may or may not disclose their experiences to their therapists. This study can add nuance to the literature in understanding who benefits most from an online, free expressive writing intervention about heterosexism. The results also provide useful information for therapists seeking to foster a safe and comfortable environment for LGBTQ+ clients to discuss their heterosexist experiences.