Mental health in people with minority sexual orientations: A meta‐analysis of population‐based studies

Wittgens, Charlotte; Fischer, Mirjam M.; Buspavanich, Pichit; Theobald, Sabrina; Schweizer, Katinka; Trautmann, Sebastian

doi:10.1111/acps.13405

Cited by 131 publications

(84 citation statements)

References 71 publications

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“…The former finding is consistent with a US study reporting a higher prevalence of ACEs and a higher mean ACE score among bisexuals compared to both heterosexuals and homosexuals 11 . The observed greater burden of mental health problems in Danish bisexuals also accords well with other findings from the US, Australia and a recent metaanalysis, where bisexuality was more strongly associated with a range of mental health problems than heterosexual and homosexual orientations 13,15,26 .…”

Section: Discussionsupporting

confidence: 90%

“…A markedly higher prevalence of mental health problems among non-heterosexual than heterosexual individuals has also been previously reported in other datasets [12][13][14]25,26 . This increased mental morbidity may be interpreted within the frame of "minority stress", where adverse phenomena such as stigma, prejudice, discrimination and exclusion produce a hostile and distressing social environment for non-heterosexuals, leading to higher rates of mental health problems 13,26 . In a Danish context, we observed that stigma-related experiences are remarkably common in nonheterosexual persons.…”

Section: Discussionsupporting

confidence: 81%

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Adverse childhood experiences and mental health problems in a nationally representative study of heterosexual, homosexual and bisexual Danes

et al. 2022

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Non-heterosexual persons more often report adverse childhood experiences (ACEs) than heterosexuals, and they generally bear a greater burden of mental health challenges. However, population-based data on this topic are scarce. In a nationally representative study within the Project SEXUS, one of the world's largest cohort studies on sexual health, we used data from 57,479 individuals in Denmark to explore the interplay between ACEs and mental health problems among self-identified heterosexual, homosexual and bisexual persons, and among self-identified heterosexuals with or without same-sex sexual experience. Compared to heterosexuals, non-heterosexual persons were more likely to report most of the studied ACEs, with odds ratios (ORs) for the ACE category "abuse" ranging from 1.38 to 1.75 for homosexual women, from 1.76 to 2.65 for homosexual men, from 2.52 to 3.64 for bisexual women, and from 1.58 to 6.07 for bisexual men. Furthermore, non-heterosexual persons had consistently and statistically significantly higher odds for mental health problems (ORs: 1.50 to 4.63). Combinations of ACEs with a non-heterosexual identity resulted in markedly elevated odds for mental health problems, particularly among bisexual individuals. This included high odds for suicidal thoughts/attempts among bisexual persons with a history of "neglect" (women: OR=12.82; men: OR=35.24) and "abuse" (women: OR=11.81; men: OR=11.65). Among self-identified heterosexuals, combinations of ACEs with same-sex sexual experience were associated with consistently elevated odds for mental health problems (ORs: 2.22 to 12.04). The greater burden of ACEs among self-identified homosexuals and, most notably, bisexuals may account for part of their excess risk of mental health problems. These findings emphasize the public health importance of preventive measures to minimize the burden of ACEs and avert their harmful long-term effects. Moreover, they highlight the need to safeguard the welfare of children and adolescents with non-conforming expressions of sexuality.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 81%

Adverse childhood experiences and mental health problems in a nationally representative study of heterosexual, homosexual and bisexual Danes

et al. 2022

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“…LGBT persons have previously been described to be more vulnerable for mental health problems compared to non‐LGBT population, experiencing higher levels of psychological distress, social anxiety, depression, and loneliness (Almeida et al, 2009 ; Anderssen et al, 2020 ; Eres et al, 2021 ; Hsieh & Liu, 2021 ; Hughes, 2018 ; Valentine & Shipherd, 2018 ; Wittgens et al, 2022 ). Also during the pandemic, lower levels of well‐being in LGBT compared with cis‐heterosexuals have been reported, as well as a higher risk for depressive symptoms in asexual, bisexual, non‐binary, and trans individuals (Buspavanich et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Loneliness and depressive symptoms differ by sexual orientation and gender identity during physical distancing measures in response to COVID‐19 pandemic in Germany

Herrmann

Oeser

Buspavanich

et al. 2022

Applied Psych Health & Well

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During the COVID‐19 pandemic, physical distancing measures to prevent transmission of the virus have been implemented. The effect of physical distancing measures on loneliness especially for vulnerable groups remained unclear. Thus, we aimed to investigate loneliness in relation with depressive symptoms among lesbian, gay, bisexual, trans, inter, asexual, and queer (LGBT) persons compared with cis‐heterosexual persons during the pandemic. We conducted an online survey during the first two waves of the COVID‐19 pandemic in Germany. The survey contained self‐categorizations regarding sexual orientation and gender identity, questions on loneliness, social contacts, depressive symptoms, and healthcare. Descriptive and regression analysis and propensity score matching across cohorts was conducted using R; 2641 participants took part in first wave of the survey and 4143 participants in the second wave. The proportion of lonely people was higher in the second wave compared with the first wave. LGBT persons were more lonely than cis‐heterosexual persons. In both waves, being LGBT was associated with depressive symptoms, but loneliness mediated the effect, even when adjusting for social contacts. Psychologists and other practitioners should be aware that LGBT clients might have an increased risk for loneliness and depressive symptoms and of the potential burden of the pandemic measures.

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“…However, because of cross-national differences in the prevalence of mental disorders generally, it is unclear if cross-national differences in mental health outcomes among LGB individuals are actually specific to LGB individuals or simply reflect more general differences in the prevalence of mental disorders across countries. Some cross-national evidence for disparities in mental health outcomes (specifically depression, anxiety disorders, and alcohol use disorders) between LGB and heterosexual individuals also comes from meta-analyses [ 20 , 21 ]. However, studies assessing mental health disparities between LGB and heterosexual individuals across a broad range of mental disorders in a cross-national sample, including Western and non-Western countries, are lacking [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some cross-national evidence for disparities in mental health outcomes (specifically depression, anxiety disorders, and alcohol use disorders) between LGB and heterosexual individuals also comes from meta-analyses [ 20 , 21 ]. However, studies assessing mental health disparities between LGB and heterosexual individuals across a broad range of mental disorders in a cross-national sample, including Western and non-Western countries, are lacking [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Increased risks for mental disorders among LGB individuals: cross-national evidence from the World Mental Health Surveys

Gmelin

Vries

Baams

et al. 2022

Soc Psychiatry Psychiatr Epidemiol

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Purpose Lesbian, gay, and bisexual (LGB) individuals, and LB women specifically, have an increased risk for psychiatric morbidity, theorized to result from stigma-based discrimination. To date, no study has investigated the mental health disparities between LGB and heterosexual AQ1individuals in a large cross-national population-based comparison. The current study addresses this gap by examining differences between LGB and heterosexual participants in 13 cross-national surveys, and by exploring whether these disparities were associated with country-level LGBT acceptance. Since lower social support has been suggested as a mediator of sexual orientation-based differences in psychiatric morbidity, our secondary aim was to examine whether mental health disparities were partially explained by general social support from family and friends. Methods Twelve-month prevalence of DSM-IV anxiety, mood, eating, disruptive behavior, and substance disorders was assessed with the WHO Composite International Diagnostic Interview in a general population sample across 13 countries as part of the World Mental Health Surveys. Participants were 46,889 adults (19,887 males; 807 LGB-identified). Results Male and female LGB participants were more likely to report any 12-month disorder (OR 2.2, p < 0.001 and OR 2.7, p < 0.001, respectively) and most individual disorders than heterosexual participants. We found no evidence for an association between country-level LGBT acceptance and rates of psychiatric morbidity between LGB and heterosexualAQ2 participants. However, among LB women, the increased risk for mental disorders was partially explained by lower general openness with family, although most of the increased risk remained unexplained. Conclusion These results provide cross-national evidence for an association between sexual minority status and psychiatric morbidity, and highlight that for women, but not men, this association was partially mediated by perceived openness with family. Future research into individual-level and cross-national sexual minority stressors is needed.

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Mental health in people with minority sexual orientations: A meta‐analysis of population‐based studies

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 131 publications

References 71 publications

Adverse childhood experiences and mental health problems in a nationally representative study of heterosexual, homosexual and bisexual Danes

Adverse childhood experiences and mental health problems in a nationally representative study of heterosexual, homosexual and bisexual Danes

Loneliness and depressive symptoms differ by sexual orientation and gender identity during physical distancing measures in response to COVID‐19 pandemic in Germany

Increased risks for mental disorders among LGB individuals: cross-national evidence from the World Mental Health Surveys

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