This is the first Chinese national study which examined discrimination against lesbian, gay, bisexual, and transgender individuals as separate groups. Our results on discrimination were consistent and significantly correlated with those of a previous national study. Between 2014 and 2017, RY Chua, KG Huang and M Jin [22], conducted a study investigating people’s tolerance towards the LGBT community which involved a sample of 11,662 participants across 31 Chinese provinces. We validated these researchers’ previous findings regarding tolerance towards the LGBT community in a larger sample. We also found that the tolerance score in each province perfectly matched that reported by RY Chua, KG Huang and M Jin [22]. They measured tolerance towards the LGBT community from the perspective of provincial residents (e.g., “To what extent are people in your province tolerant towards lesbians, gays, bisexuals and transgender individuals?”) The current study validated their results by directly measuring the attitudes of heterosexual participants. Specifically, the tolerance scores in the current study were calculated from five items, which is a more comprehensive measure than that used in RY Chua, KG Huang and M Jin [22].
In terms of heterosexuals’ acceptance towards the LGBT community, heterosexual participants reported a high level of acceptance of social relationships with LGBT individuals, such as having LGBT friends or colleagues. However, heterosexual participants reported that it was hard to accept their own children identifying as LGBT. This finding is consistent with the self-perceived discrimination in a family setting reported by LGBT participants. For member of the Chinese LGBT community, the greatest source of pressure to conform to societal norms of sexuality and identity comes from family members—particularly parents [9]. The main reason for this might be that Chinese parents have a strong belief in traditional heterosexual marriage, and that they regard marriage as a critical life event and critical aspect of a child’s mandatory duty to carry on the family bloodline [9]. Being LGBT could mean giving up family duty and disappointing parents by not producing offspring [23]. Chinese society places a heavy emphasis on interpersonal relations and community, and Chinese people seldom make individual decisions without evaluating the impact of these decisions on their family [24]. Moreover, based on the cultural expectations of Confucianism, getting married and raising children are considered core values for filial piety [2].
Family acceptance is related to a higher level of self-esteem and positive physical and mental health in LGBT individuals [25]. Chinese LGBT individuals often deal with substantial pressure from their family, instead of receiving their support. It is important to improve the social acceptance of the LGBT community, especially at the family level. It is important to design family interventions to promote parental acceptance of LGBT children in order to improve their health and reduce the pressure they face. Our results show that transgender participants face a greater level of discrimination within their families. Previous research has indicated that family rejection can be predictive of suicide attempts and substance misuse among the transgender population [26]. It is therefore critical to understand the effects of discrimination experienced within families on the mental health of LGBT individuals.
In consistent with previous study in Japan, the current results also showed that LGBT community faced discrimination from various public services settings including the laws and policies [16]. LGBT participants reported severe levels of self-perceived discrimination in social service settings. In China, LGBT couples are not recognized as legal couples with marriage certificates, which consequently leads to a variety of barriers in the context of family law (e.g., inheritance rights, receiving a partner’s life insurance compensation). This could be largely improved with increased support from the government and amendments to existing legislation.
According to Meyer’s minority stress model [27], individuals who are looked down on by society have a higher risk of being discriminated against, which can lead to non-disclosure of their stigmatized status. In China, members of the LGBT community are discriminated against and marginalized by society [18]. As a result, the majority of LGBT individuals tend to conceal their sexual minority identity in order to avoid being discriminated against. The current study found disclosure rates were different for each subgroup, with different disclosure rates in different settings. Of the different settings surveyed, LGBT participants all had the highest disclosure rate in medical service settings, and the lowest disclosure rate in religious group settings. In terms of disclosure to family, we found that less than half (49.4%) of the gay male participants disclosed their sexual orientation to their family members, and the percentages for bisexual, transgender, and lesbian participants were 54.1, 63.8 and 75.1%, respectively. Among the LGBT subgroups, gay male participants were the least likely to disclose to family members, while lesbian participants were the most likely to disclose to family members. The disclosure rates in different settings were consistent with the self-perceived discrimination reported by LGBT participants across those settings. Among the Lesbian, Gay, Bisexual, and Transgender groups, lesbians had the highest disclosure rates in family, school, workplace, and religious groups. This result is consistent with the relatively lower level of self-perceived discrimination reported by lesbian participants compared to gay male, bisexual, and transgender participants.
The results of the present research demonstrate that LGBT individuals in China face discrimination in an array of social settings. Based on the data presented here, we created friendly-hostile maps illustrating the level of discrimination across Chinese provinces. Compared with the economically developed regions (e.g., coastal areas), the economically underdeveloped regions (e.g., north western and central China) showed higher levels of discrimination.
Tolerance towards the LGBT community was positively associated with economic growth [7]. As shown in the friendly-hostile map, LGBT individuals living in areas of lower economic development (e.g., north western) tended to face harsher discrimination. Our findings indicate that higher levels of economic development are associated with a decrease in discrimination towards LGBT individuals. Previous researchers have found that greater inclusion of LGBT individuals in society is positively associated with a country’s economic development, and suggested that LGBT equality should be relevant to economic development programs [7]. The current study confirmed such a relationship, and found that every 100 thousand RMB increase per capita GDP lead to a 6.4% decrease in unacceptable events experienced by LGBT participants. Our findings confirm that economic development is significantly correlated with a decrease in discrimination towards the LGBT community. In addition, substantial evidence from many countries has shown that discrimination and violence against LGBT individuals is harmful to a country’s economy [7]. Reductions in LGBT discrimination and development of the economy are closely linked and can be regarded as harmonious processes.
Furthermore, employment is an important part of the economy. Our results show that transgender and gay male participants are more likely to be unemployed. Organizations should aim to build policies and engage in practices to support LGBT workers. Discrimination in the workplace has negative consequences for workers’ mental and physical health [28]. Organizations have a social responsibility and ethical obligation to provide a friendly and supportive work environment for LGBT workers [28].
There are several limitations of the current study. First, this was a cross-sectional study and causality of the associations cannot be determined. Second, the convenience sampling method used to recruit participants might limit the generalizability of the results. Participants were mainly young people with internet access, and these participants might also be regular users of the LGBT community. Third, we did not cover all aspects of discrimination, for example, views on the legalization of same-sex marriage and child adoption were not assessed. Fourth, measures used in current study were created based on the Chinese cultural context, and the reliability and validity of these measures should be assessed. However, we used expert consultation method to improve the reliability of the measurements in the current study [13, 20, 29]. In future studies, it would be useful to investigate causal relations among perceived discrimination and identifying as LGBT using scales with good psychometric properties.