5 - (SYM 108) Exploring the Impact of Mental Health Concerns for Romantic Relationship Formation Among Cisgender Sexual Minority Couples

Background: Sexual minority individuals face persistent mental health disparities relative to their heterosexual peers. Romantic relationships are a critical context for understanding individual well-being. Given their elevated prevalence of mental health concerns, it is possible that some sexual minority individuals enter new romantic relationships already dealing with significant mental health challenges, which may add stress to early relationship development. This study used qualitative methods to understand how mental health and substance use impact romantic relationship formation for sexual minority couples.

Methods: Sixty cisgender sexual minority couples (30 male couples; 30 female couples) were recruited across the US. Thirty percent of participants identified as racial/ethnic minority. The average age was 30 (SD=10 years) and average relationship length was 60 months (SD = 72). All couples engaged in a ten-minute conversation together about their relationship initiation and early dating, which was recorded via videoconferencing. A codebook was developed based on our research questions and theories of relationship development. Two coders double coded all transcripts using applied thematic analysis.

Results: Mental health and substance use emerged thematically in couples’ relationship narratives in three ways. First, alcohol/substance use facilitated relationship initiation and progression (e.g., “liquid courage”). Second, couples referenced their mental health influencing decisions to start their current relationship; for example, because they perceived their partner as a support against poor mental health (e.g., a “lifeline”). Third, couples described mental health influencing early relationship dynamics negatively and causing strain (e.g., P1: “The beginning of our relationship was nothing I’d ever really want to go back to” P2: “We were both dealing with a lot of personal demons”). Of note, some couples described these mental health influences early in the relationship as lessening over time.

Conclusions: Sexual minority couples noted multiple influences of mental health and alcohol/substance use on their early romantic relationship decisions and interactions, from the very beginning of the relationship. This suggests early intervention to address these challenges and strengthen their relationships may be needed. Future research should also explore potential sources of resilience that appear to help some sexual minority couples navigate these issues naturally as their relationships develop.