"Does Sexual Orientation Matter?": A Comparative Analysis of the Prevalence and Determinants of Depression and Anxiety Among Heterosexual and Non-Heterosexual College Students in a University in Metro Manila

Incorporating LGBT+ mental health into psychiatric residency and training: perspectives from the Philippines

The Philippine Mental Health Act upholds the rights and inclusivity of all people, regardless of gender and sexual orientation, within mental health services and programmes. Nevertheless, a noteworthy challenge lies in the inadequate attention given to the needs of LGBT+ individuals within the medical and health professions education in the country. Therefore, it is imperative to integrate LGBT+ mental health into psychiatric residency training. To address this gap, this paper proposes the inclusion of concepts relevant to LGBT+ mental health, including minority stress, intersectionality, identity concealment and LGBT+-affirming practices, to enhance the understanding and response to the needs of LGBT+ Filipinos.

Sociodemographic characteristics, social support, and family history as factors of depression, anxiety, and stress among young adult senior high school students in metro Manila, Philippines, during the COVID-19 pandemic

Introduction

Academic institutions must consider the students at risk for developing poor mental health and the factors influencing them. With the scarcity of literature concerning student mental health in the Philippines, this study determined the factors influencing the risk of anxiety, depression, and stress among senior high school students in metro Manila.

Methods

This cross-sectional study explored the influence of sociodemographic characteristics, social support, and family history on depression, anxiety, and stress among young adult senior high school students using the Depression, Anxiety, and Stress Scale-21 (DASS-21) and the Multidimensional Scale of Perceived Social Support (MSPSS). After describing the data, regression analyses were performed.

Results

A total of 187 participants were recruited. Three out of five participants have a significant risk for depression. Four out of five participants were at significant risk for anxiety. One out of four participants was at risk for significant stress. Social support from a significant other and one's family may be protective factors for significant depression among the participants. Having female sex may be a risk factor for significant anxiety. In addition, having female sex and a family history of mental disorders may be risk factors for significant stress.

Discussion

Social support should be strengthened among senior high school students to improve their mental well-being. Students at risk for poor mental health, including females and those with a family history of mental disorders, may need additional support in school mental health programs. Finally, further research is recommended to fully understand mental health among Filipino students.

Neglected gaps in improving the health, wellbeing, and care for sexual and gender minority young people living in low- and lower-middle- income countries: a scoping review

BACKGROUND

There is a lack of reliable data on the size, characteristics, and experiences of sexual and gender minority (SGM) young people (ages 10-24) in low- and lower-middle- income countries (LMICs). This review examines the research conducted in the last thirteen years with and about SGM young people living in low-income settings and seeks to answer the question: What is known about the mental and physical health needs, safety, and wellbeing of SGM young people living in LMICs?

METHODS

We conducted a scoping review informed by the methodological frameworks put forth by Arksey and O'Malley and the Joanna Briggs Institute. We systematically searched two general social science databases and one topic-specific database for peer-reviewed papers, of any research design, that included SGM young people or explored attitudes toward SGM young people in LMICs. We included papers that reported on factors influencing the health and wellbeing of SGM populations, including physical and mental health, healthcare-seeking behaviors, substance use, experiences of discrimination and/or stigma, experiences of violence and abuse (emotional, physical, and/or sexual), economically motivated paid sex practices, housing or economic security, and attitudes of others toward SGM populations.

RESULTS

Of the 5,409 unique records identified, 79 papers drawing from data collected from 74 unique studies met the inclusion criteria. Only 50 of the 79 papers included SGM young people as participants, with just 13 focusing exclusively on SGM young people ages 10-24. The included papers were classified into three thematic groupings: attitudes toward SGM populations (n = 26), risks to health (n = 40), and experiences of stigma and discrimination (n = 13).

CONCLUSION

The findings indicate that the health and wellbeing of SGM young people in LMICs has been historically under-researched. While SGM young people have received more attention from researchers in recent years, the body of literature as a whole is disjointed and sparse, and often studies are about SGM young people, rather than with and for them. Our review highlights the need for more and better research, more accurate and disaggregated demographic data, and leadership and participation of SGM-led community-based organizations in the co-design of studies that focus on SGM young people.

From the bathroom to a national discussion of LGBTQ+ rights: a case of discrimination in the Philippines

Despite the Philippines' progress in gender equality, contemporary evidence suggests that Filipinos continue to possess negative attitudes toward lesbian and gay individuals. Likewise, discrimination and violence toward bisexual, transgender, and queer Filipinos have been documented. Despite cases of sexual orientation and gender identity and expression (SOGIE) based discrimination, national-level anti-discrimination legislation remains unpassed in the Senate. This study explores the national discussions on the SOGIE Equality Bill triggered by a bathroom discrimination experienced by a Filipino transgender woman in 2019. Taking cues from Richardson's sexual citizenship framework, we investigate the diverse rights discourses among sectoral groups, such as local lesbian, gay, bisexual, transgender, queer, and other individuals of marginalized sexualities and genders (LGBTQ+) organizations and their allies, high-ranking Filipino politicians, and religious organizations. Analysis of local discourses showed that those supporting the SOGIE Equality Bill leverage identity-based rights discourses, while those opposed primarily navigate these debates using conduct-based rights discourses. Future policy and advocacy work must leverage the insights from these public proceedings to foster LGBTQ + solidarity in their campaigns for LGBTQ + rights in the country. Particularly, future work must (1) locate the middle ground between the LGBTQ + community and opposed legislators; (2) highlight essential values and common issues shared by all Filipinos; (3) surface how privilege can preclude and advance solidarity within the LGBTQ + community; (4) campaign for the passage of local anti-discrimination ordinances; (5) improve the SOGIE-related competencies of policy implementers; and (6) engage in research that explores public discourses and meanings assigned to sexual rights among Filipinos.

Gender in mental health: Comparison of the rate and social factors of depression, anxiety, and stress among young adult Filipino heterosexual cisgender men and women and LGBT+ individuals

INTRODUCTION

Previous studies showed that Filipino young women have higher rates of certain mental disorders than men, while LGBT+ individuals have higher mental disorders rates than heterosexual cisgender individuals. These differences may be due to their unique social experiences. Despite these, studies that directly compare the rates and social factors of mental health conditions among men, women, and LGBT+ individuals including depression, anxiety, and stress, remain sparse.

OBJECTIVE

This study aimed to compare the rates and social factors of depression, anxiety, and stress among young adult Filipino heterosexual cisgender men and women and LGBT+ individuals.

METHODS

This study utilized a sociodemographic questionnaire, the Daily Discrimination Scale, and the Depression, Anxiety and Stress Scale-21 (DASS-21) to determine the difference between the rates and social factors of depression, anxiety, and stress among the respondents. A total of 959 young Filipino adults completed the questionnaire. Afterward, logistic regression, chi-square, and descriptive statistics were done.

RESULTS

LGBT+ respondents experienced the highest rates of significant depression (92.0%), anxiety (93.8%), and stress (81.3%). Discrimination had the largest effect size among men and LGBT+ individuals. While age may be a risk factor for anxiety among heterosexual cisgender males, it was protective for stress among LGBT+ individuals. Working, studying, and living with peers had protective effects against anxiety and stress among heterosexual cisgender men and women.

CONCLUSION

Rates and factors of depression, anxiety, and stress varied according to gender. This variation may be accounted for by unique social experiences and contexts including violence, discrimination, cultural expectations, and social roles. Thus, gender-sensitive mental healthcare may need to extend beyond binary views limited to men and women.

Emerging From a Two-Year-Long Quarantine: A Retrospective Study on Life Satisfaction Trajectory and Depression Among Young LGBTQ+ Students in the Philippines

Background

Evidence suggests that lesbian, gay, bisexual, trans, queer, and other gender and sexual minorities (LGBTQ+) may experience heightened mental health disparities during the COVID-19 pandemic. Since long periods of confinement and physical restriction due to disease outbreaks can adversely affect mental health, there is a need to explore their effects among LGBTQ+ youth as society recovers from the pandemic.

Aims

This study determined the longitudinal association between depression and life satisfaction trajectory from the beginning of the COVID-19 pandemic in 2020 to pandemic-induced community quarantine in 2022 among young LGBTQ+ students.

Methods

This study surveyed 384 conveniently sampled youths (18-24 years old) who identify as LGBTQ+ from locales under two-year-long community quarantine in the Philippines. Respondents' life satisfaction trajectory was measured for 2020, 2021, and 2022. Post-quarantine depression was measured using the Short Warwick Edinburgh Mental Wellbeing Scale.

Results

One out of four respondents has depression. Those from less than high-income households had a higher risk for depression. Repeated measures analysis of variance revealed that those with more pronounced improvements in life satisfaction throughout and after community quarantine among respondents have a lower risk of depression.

Conclusion

Life satisfaction trajectory can influence the risk for depression among young LGBTQ+ students during extended periods of crisis, such as the COVID-19 pandemic. Thus, there is a need to improve their living conditions as society reemerges from the pandemic. Likewise, additional support should be given to LGBTQ+ students from lower-income households. Moreover, continuous monitoring of LGBTQ+ youths' life conditions and mental health post-quarantine is recommended.

Gender in mental health: Relationship of spirituality, social support, and COVID-19-related fear among heterosexual and LGBTQ+ youth

INTRODUCTION

The youth is a vulnerable population to COVID-19-related fear. Among them, those with LGBTQ+ identities are at higher risk. Given the posited protective effects of spirituality and social support on fear, this study explored their effects on COVID-19-related fear among heterosexual and LGBTQ+ youth.

MATERIALS AND METHODS

This cross-sectional study recruited 137 respondents Filipinos aged 18-30 years old. The respondents answered a survey containing a sociodemographic questionnaire, 12-items Multidimensional Scale of Perceived Social Support (MSPSS), 20-items Core Dimensions of Spirituality Questionnaire (CDSQ), and 7-items Fear of COVID-19 Scale (FCS). After, the data were analyzed using means, frequencies, Mann-Whitney U-tests, and correlation coefficients.

RESULTS

Social support from friends was negatively correlated with COVID-19-related fear among heterosexual respondents, R = -0.219, p = 0.029. Search for meaning positively correlated with COVID-19-related fear among LGBTQ+ respondents, R = 0.395, p = 0.016. Heterosexual respondents also have a higher belief in God (U = 1,004, p < 0.001) and feelings of security (U = 1,110.5, p < 0.001) than their LGBTQ+ counterparts.

DISCUSSION

These findings suggest that social support from friends is protective against COVID-19-related fear among heterosexual youth but not among LGBTQ+. In addition, a high search for meaning can heighten COVID-19-related fear among LGBTQ+. Finally, these findings can be explained by the higher rates of discrimination against LGBTQ+ than heterosexual youth. Thus, gender-responsive mental healthcare is needed to address the youth's fears as society recovers from the pandemic.

Gender and sexuality in mental health: perspectives on lesbians, gays, bisexuals, and transgender (LGBT) rights and mental health in the ASEAN region

This perspective piece focuses on and analyzes several lesbians, gays, bisexuals, and transgender (LGBT) individuals' rights and their limitations in the Association of Southeast Asian Nations (ASEAN) region, including the limited recognition of self-determined gender identity, limited legal provisions for LGBT marriage, inadequate anti-discrimination policies, and the criminalization of homosexuality. These inadequacies in LGBT rights may stem from colonial, religious, and cultural factors. Moreover, these limited LGBT rights and their societal repercussions may contribute to the minority stress of LGBT individuals, leading to their higher rates of mental health problems. Thus, there may be a need to uphold, recognize, and protect LGBT rights as the region pursue equitable mental health. Toward this pursuit, the region may possibly benefit from culturally adapting gender-affirming practices, increasing their social support, opposing the practice of conversion therapy, and decriminalizing homosexuality. It may also be necessary to explore, analyze, and study the intersection of LGBT identity and mental health, especially longitudinal and interventional studies.

Gender in mental health: Comparing the rate and social factors of depression, anxiety, and stress among young heterosexual and sexual minority women in the Philippines

Young sexual minority Filipinos have been found to have a higher level of mental health problems compared to peers. It was also reported that Filipino sexual minority women had twice the odds of ill mental health such as depression compared to sexual minority men. Thus, this study compared the rates and social factors of depression, anxiety, and stress among young adult Filipino heterosexual and sexual minority women. Particularly, this quantitative study utilized a cross-sectional survey design. The Depression, Anxiety, and Stress Scale 21 (DASS-21), Daily Discrimination Subscale of the Perceived Discrimination Scale, and sociodemographic questionnaire were completed by 622 heterosexual and 177 sexual minority women. Afterward, descriptive statistics, chi-square, and logistic regression were done. Depression, anxiety, and stress rates were higher among sexual minority women compared to their peers. The possible risk factor for these mental health issues among heterosexual women was discrimination, while a possible protective factor was living with peers (p <.05). Among sexual minority women, it was found that discrimination is a risk factor, albeit with higher effects compared to their heterosexual counterparts. These may be explained by the reported high level of negative attitudes and discrimination that sexual minorities in the Philippines face daily in their social environment. Thus, anti-discrimination policies, gender-responsive healthcare for sexual minorities, and gender mainstreaming must be instituted and strengthened.

Internet-based interventions to promote help-seeking for mental health in LGBTQ+ young adults: Protocol for a randomized controlled trial

Background

Compared to its cis-heterosexual counterpart, the sexual and gender minority (SGM) population is disproportionately susceptible to mental health problems, including depression, anxiety, and minority stress. They are also facing unique help-seeking barriers when in need of support. Past research has shown promising results in using interventions to promote help-seeking intentions and attitudes of the cis-heterosexual population. However, there were no known help-seeking interventions targeting the SGM population. This protocol illustrates a study design to test the efficacy of a newly-developed internet-based program aimed to promote help-seeking for mental health in LGBTQ+ young adults.

Methods

This study is a randomized controlled trial that aims to promote and improve the SGM young adults' help-seeking by integrating animated psychoeducational videos, group discussion, and the SGM youth help-seeking brochure. Primary outcomes, including help-seeking intentions and attitudes, will be measured at baseline, post-intervention, one-month post-intervention, and three-month post-intervention. The secondary outcomes, including help-seeking stigma, help-seeking literacy, mental health literacy, and help-seeking behaviors, will be measured at the same time points.

Discussion

This is an internet-based, multi-dimensional, and integrative intervention tailored to the needs of the SGM population. It addresses an important gap in the current landscape of mental health promotion for the SGM population. The findings from this trial will provide new knowledge on promoting help-seeking among the SGM population, paving the road for future research that focuses on addressing mental health issues faced by the SGM population.

Trial registration

Chictr.org.cn: ChiCTR2100053248.