David H. Chae ^1* Karina L. Walters ²

¹ University of California, San Francisco
² University of Washington

^* To whom correspondence should be addressed. E-mail: dhchae{at}post.harvard.edu.

	Abstract

Objectives. We examined associations between racial discrimination and actualization, defined as the degree of positive integration between self-identity and racial group identity, and self-rated health and physical pain and impairment.

Methods. We used logistic regressions to analyze data from 447 gay, lesbian, bisexual, and other sexual-minority American Indians/Alaska Natives.

Results. Greater self-reported discrimination was associated with higher odds of physical pain or impairment (odds ratio [OR]=1.42; 95% confidence interval [CI]=1.13, 1.78); high levels of actualization were associated with lower odds of physical pain or impairment(OR=0.59; 95%CI=0.35, 0.99) and self-rated fair or poor health (OR=0.54; 95% CI=0.32, 0.90). Actualization also moderated the influence of discrimination on self-rated health (t=–2.33; P=.020). Discrimination was positively associated with fair or poor health among participants with low levels of actualization, but this association was weak among those with high levels of actualization.

Conclusions. Among two-spirit American Indians/Alaska Natives, discrimination may be a risk factor for physical pain or impairment and for fair or poor self-rated health among those with low levels of actualization. Actualization may protect against physical pain or impairment and poor self-rated health and buffer the negative influence of discrimination.

Key Words: Lesbian/Gay/Bisexual/Transgender Persons, Native Americans