Inequities in depression within a population of sexual and gender minorities

Abstract

Background: Substantial evidence has demonstrated that sexual minorities (gay, lesbian, and bisexual people) and gender minorities (transgender and gender non-binary people) (SGM) experience poorer mental health than heterosexual and cisgender individuals. Meanwhile, less attention has been given to inequities within SGM populations.

Aims: This study investigated depression within a sample of Canadian SGM who took part in an online survey (n = 2778).

Methods: Multivariable regression was used to identify social characteristics associated with depression, as measured by the Patient Health Questionnaire (PHQ-9) (p < 0.05). The sample was then stratified by gender and sexual identity and the multivariable analysis was repeated for each stratum.

Results: PHQ-9 scores were associated with every social position investigated, with the largest coefficients observed for non-binary and transgender individuals and those with a lower level of educational attainment. In stratified analysis, statistically significant associations were observed for cisgender respondents identifying as bisexual, queer, or pansexual (relative to gay/lesbian) and for transgender women from ethnic minority groups or with lower income.

Conclusions: These results provide evidence of depression inequities within SGM along multiple social positions. Interventions to reduce depression should be prioritized for these sub-groups of SGM who experience the highest rates of depression.

Keywords:

• Depression
• gay
• lesbian
• bisexual
• transgender
• intersectionality

Acknowledgements

The authors are extremely grateful to the thousands of SGM that shared their experience. The authors would like to thank Jody Jollimore and Keith Reynolds at the Community-Based Research Centre and Alex Dumont Blais at Rezo for their support in promoting the survey. This work was supported by a grant from the School of Nursing at the University of British Columbia. The postdoctoral funding for Olivier ferlatte was provided by Movember Canada (grant # 11R18296), the Canadian Institues for Health Research (Grant #11R06913) and the Michael Smith Foundation for Health Research (Grant #17945) .

Disclosure statement

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Additional information

Funding

This work was funded by School of Nursing at the University of British Columbia.