Perceived discrimination is disproportionally associated with sexual minority mental health: Implications for non-monosexual sexual minorities

Sexual and Gender Minority Victimization: Base Rates of Assault in College Students Across Sexual and Gender Identities

Past findings have indicated that sexual and gender minority (SGM) individuals experience disproportionate rates of emotional, physical, and sexual assault compared to their heterosexual/cisgender counterparts. While these findings are robust, many studies report homogenous groupings of SGM participants. This practice likely masks important between-group differences. We sought to address this issue by examining reported base rates of emotional, physical, and sexual assault within 12 months of data collection, split across specific sexual (heterosexual, gay/lesbian, bisexual, questioning, queer, pansexual, asexual, and demisexual) and gender (cisgender men, cisgender women, gender nonconforming female assigned at birth [FAB], and gender nonconforming male assigned at birth) identity groups. Our data came from 2020 to 2021 Healthy Minds Study, a large survey of college students living in the United States (N = 119,181). Results indicated most forms of assault were higher in SGM groups compared to heterosexual and cisgender individuals, both on univariate and multivariate (e.g., one or more type of assault) levels. Demisexual individuals reported the highest base rates for emotional assault (45.7%), whereas pansexual individuals reported highest rates of physical assault (12.5%) and sexual assault (17.3%). Demisexual individuals reported the highest multivariate base rate of experiencing at least one form of assault (49.5%), and pansexual individuals reported the highest multivariate base rate of experiencing all three forms of assault (4.7%) within the past 12 months. Gender nonconforming FAB individuals reported the highest univariate and multivariate base rates across assault types compared to all other gender identity groups. With few exceptions, compared to heterosexual and cisgender men (referents), all other sexual and gender identity groups reported significantly higher adjusted odds of experiencing each assault type. These data suggest SGM individuals experience disproportionate levels of assault.

Discrimination experienced by sexual minority males in Australia: Associations with suicidal ideation and depressive symptoms

INTRODUCTION

Discrimination has been under-examined as a social determinant of the higher rates of poor mental health experienced by sexual minorities. The objectives of our study were to: 1) assess whether discrimination was independently associated with poor mental health among sexual minority males, and 2) assess the potential mediation role of discrimination in the associations between sexual minority status and poor mental health.

METHODS

We used cross-sectional data on 13,230 males aged 18-55 years from the Australian Longitudinal Study on Male Health; bisexual and homosexual males comprised 1.5% and 1.6% of the sample, respectively. We fit Poisson regression and zero-inflated negative binomial regression models to examine suicidality, depressive symptoms and perceived discrimination in the past two years as correlates of suicidality and depressive symptoms.

RESULTS

Statistically significant differences were observed in the prevalence of perceived discrimination by sexual orientation (p < 0.001), with the highest prevalence among bisexual (29.3%) and homosexual (40.4%) males, and the lowest prevalence among heterosexual males (18.6%). After adjusting for confounding, bisexual/homosexual males had higher rates of perceived discrimination (IRR = 1.88, p < 0.001), recent suicidal ideation (IRR = 1.51, p = 0.008), lifetime suicide attempt (IRR = 2.09, p < 0.001) and recent depressive symptoms (IRR = 1.34, p < 0.001) than heterosexual males. Analysis of β-coefficients suggested that discrimination may mediate a small to moderate proportion of the association between sexual minority status and poor mental health.

LIMITATIONS

Use of cross-sectional data.

CONCLUSION

Poor mental health is more common among sexual minority males, and discrimination may be a contributor to these mental health disparities. Reducing discrimination should be considered as part of a strategy to improve the mental wellbeing of sexual minority males.