Out in Suburbia: Associations between residential location, mental health, and community connectedness among LGBTQ Australians

ABSTRACT

This article critically examines the contemporary applicability of homonormativity in understanding LGBTQ experiences in outer suburban Australia. Representing a departure from urban-rural dichotomies in queer geographical research, this study enriches our understanding of LGBTQ life in suburban areas. Drawing on a comprehensive national survey encompassing 6835 LGBTQ adults in Australia, the research provides novel quantitative insights into the geographic distribution of LGBTQ mental health and wellbeing outcomes. Contrary to assumptions of suburban privilege, the article challenges the notion of homonormativity in the suburbs, shedding light on the unique challenges faced by LGBTQ people in these areas. Findings reveal that LGBTQ people in outer suburban Australia experience higher psychological distress and suicidal ideation compared to their inner suburban and rural counterparts. Additionally, they report lower levels of connection with LGBTQ communities, indicating a dearth of supportive resources in these areas. These insights have crucial policy implications, advocating for changes that foster diversity and inclusion in outer suburban areas. By emphasizing the distinct experiences of LGBTQ individuals in these settings, the research underscores the necessity for targeted interventions and support. This work extends beyond conventional urban-centric studies, offering valuable insights to inform policies, advocacy efforts, and community support initiatives for LGBTQ people in suburban environments.

Resumen

Este artículo examina críticamente el entendimiento homonormativo contemporáneo de las experiencias LGBTQ en los suburbios periurbanos de Australia. Este estudio, que representa un alejamiento de las dicotomías urbano-rurales en la investigación geográfica queer, enriquece nuestra comprensión de la vida LGBTQ en áreas suburbanas. Basándose en una encuesta nacional integral que abarcó a 6835 adultos LGBTQ en Australia, la investigación proporciona información cuantitativa novedosa sobre la distribución geográfica de los resultados de bienestar y salud mental LGBTQ. Contrariamente a los supuestos de privilegio suburbano, el artículo cuestiona la noción de homonormatividad en los suburbios, llamando la atención a los desafíos únicos que enfrentan las personas LGBTQ en estas áreas. Los hallazgos revelan que las personas LGBTQ en los suburbios periurbanos de Australia experimentan una mayor angustia psicológica e ideación suicida en comparación con sus homólogos rurales y urbanos. Además, informan niveles más bajos de conexión con las comunidades LGBTQ, lo que indica una escasez de recursos de apoyo en estas áreas. Estas ideas tienen implicaciones políticas cruciales, ya que abogan por cambios que fomenten la diversidad y la inclusión en las áreas periurbanas. Al enfatizar las distintas experiencias de las personas LGBTQ en estos entornos, la investigación subraya la necesidad de intervenciones y apoyo específicos. Este trabajo va más allá de los estudios convencionales centrados en lo urbano y ofrece conocimientos valiosos para informar políticas, esfuerzos de promoción e iniciativas de apoyo comunitario para personas LGBTQ en entornos suburbanos.

Résumé

Cet article offre une approche critique sur l’applicabilité contemporaine de l’homonormativité pour comprendre les expériences des LGBTQ dans les grandes banlieues australiennes. Il s’écarte de la dichotomie ville-campagne qu’on trouve dans la recherche sur la géographie queer et enrichit nos connaissances sur la vie des LGBTQ dans les zones périurbaines. Reposant sur une enquête approfondie à l’échelle nationale concernant 6 835 adultes LGBTQ en Australie, il offre des données quantitatives inédites sur la distribution géographique des résultats en matière de bien-être et de santé mentale pour ce groupe social. Contrairement à la théorie du privilège urbain, cette recherche remet en question la notion d’homonormativité dans les banlieues et met en évidence les obstacles uniques auxquels se heurte la communauté LGBTQ dans ces environnements. Les résultats révèlent que les LGBTQ qui vivent dans la grande banlieue australienne éprouvent plus de détresse psychologique et plus de pensées suicidaires que ceux qui habitent en province ou en banlieue proche. En outre, ils font état de moins de liens avec les communautés LGBTQ, ce qui indique un manque de ressources de soutien dans ces parties du pays. Ces constatations ont des implications importantes au niveau stratégique, et préconisent des changements qui renforceraient la diversité et l’inclusion dans les zones de grande banlieue. En mettant en avant des expériences individuelles de LGBTQ dans ces environnements, l’étude souligne la nécessité d’interventions et de soutien ciblés. Cette recherche va au-delà des travaux conventionnels focalisés sur les villes et offre des perspectives utiles pour les politiques, les efforts de sensibilization et les initiatives de soutien communautaires pour les LGBTQ dans les grandes banlieues.

KEYWORDS:

• Australia
• gender
• mental health
• place
• sexuality

PALABRAS CLAVE:

• Australia
• género
• salud mental
• lugar
• sexualidad

MOTS CLEFS:

• Australie
• genre
• santé mentale
• lieu
• sexualité

Introduction

Wellbeing patterns among lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations are profoundly spatialized, with cities often assumed as spaces of greater tolerance and community for sexual minorities (Gorman-Murray, 2007b; Knopp & Brown, 2003). LGBTQ community spaces, events, and services have long been centred in inner city areas (Brown, 2008; Gorman-Murray & Waitt, 2009). Yet, these realities are changing alongside the rapid growth and increasing diversity of urban populations in the Global North (Hanlon & Vicino, 2018). LGBTQ people in the United States, Canada, and Australia are now more likely to live in suburbia than in inner city areas (Callander et al., 2020; Forrest et al., 2019). Indeed, Brown (2008) has called for social geographers to consider a wider range of sexualities and spaces in ‘ordinary cities’ rather than just ‘gay world cities’. Despite this, most scholarship on LGBTQ health explores how either inner city or rural areas contribute to or detract from LGBTQ wellbeing and belonging (Bell & Valentine, 1995; Gorman-Murray et al., 2012; Herring, 2007; Weston, 1995). In contrast, there remains little consideration of the specific experiences of LGBTQ people living in the suburbs. Often represented in popular culture as sites of conformity, traditional heteronormative gender roles and the nuclear family (Johnson, 2006), the suburbs may present tensions for LGBTQ health, community connection, and belonging. Therefore, in this article, we aim to address a critical gap in both public health and social geographies of sexualities by examining the associations between LGBTQ residential location, mental health outcomes, and community connectedness. Drawing on data from a major Australian survey of LGBTQ adults, we are particularly interested in the mental health and wellbeing experiences of those living in outer suburbs.

Australia is a distinctly suburban nation, with approximately 71% of the population living in the outer suburbs of its capital cities (Australian Bureau of Statistics [ABS], 2022). While definitions of what constitutes a suburb vary across historical, disciplinary, and geographical contexts (Dodson, 2016; Johnson, 2006), for the purposes of this article an outer suburb refers to residential or mixed-use areas that are located on the outer-urban fringe of major cities, often between 30-50 km from the central business district (Johnson et al., 2017). The outer suburbs are the fastest growing municipalities in Australia, often consisting of new build detached or semi-detached single dwellings with limited private outdoor space and centralized shopping malls clustered around freeway junctions (Walters, 2021). Walters (2021) describes these areas as spatially and culturally characteristic of ‘suburbia’. While earlier US research linked suburban living with greater happiness, safety, and wellbeing compared with inner city areas (Adams, 1992), this is not necessarily the case in Australia. With housing affordability decreasing in Australia’s major cities (Grant et al., 2023), the more affordable outer suburban areas are home to diverse, often disadvantaged communities (Freestone et al., 2018). Living in Australia’s outer suburbs has been associated with a range of health impacting factors, including inadequate housing, limited public transport options, lack of access to healthy food and greenspaces, and proximity to undesirable land use and environmental risks (Berry, 2007). Furthermore, despite being incredibly diverse, communities in the outer suburbs may be less accepting of LGBTQ communities. For example, during the 2017 marriage equality debate, opposition to same-sex marriage was highly represented in outer suburban areas (Wilson et al., 2020). However, current research focusing on LGBTQ health and wellbeing in suburbia is limited, particularly in Australia.

Literature review: from the gaybourhood to queer suburbia and beyond

Scholars have extensively examined the concept of the ‘gaybourhood’, which refers to inner city areas that are known for their concentration of LGBTQ businesses such as bars, clubs, and shops (Cant, 1997; Chauncey, 1994; D’Emilio, 1989; Gieseking, 2016; Reynolds, 2009). Historically, these spaces have served as sites of safety and solidarity for LGBTQ communities, but research has shown that their role is changing, with many urban gaybourhoods experiencing a decline due to factors such as gentrification and the increasing acceptance of LGBTQ people in mainstream venues (Casey, 2004; Ghaziani, 2015; Lea et al., 2015; Nash, 2013; Pritchard et al., 2002). More recent work challenges the centrality of the gaybourhood. For example, Ghaziani’s (2019) notion of ‘cultural archipelagos’ and Gorman-Murray and Waitt’s (2009) ‘queer-friendly neighbourhoods’ illustrate more dynamic understandings and experiences of queer space within cities. As Doan (2019, p. 30) outlines, LGBTQ people and communities are often in a state of flux, ‘orbiting around the queer neighbourhoods, sometimes living quite close, sometimes in it, and at other times moving away in search of less expensive housing’. At the same time there has been a push to explore the experiences of LGBTQ communities in rural areas, which were long overlooked in geographical and health research (Bell & Valentine, 1995; Halberstam, 2005). While rural LGBTQ populations can face significant social isolation, rejection, and violence (Lewis, 2009; Swank et al., 2012; Whitehead et al., 2016), other work has also highlighted the positive aspects of rural life for LGBTQ people, including access to natural environments and community support (e.g. Brickell et al., 2018; Browne, 2011; Gorman-Murray et al., 2012; Grant & Walker, 2021; Herring, 2007; Parr & Philo, 2003). However, experiences of belonging and inclusion for LGBTQ people in rural areas are often mediated by the extent to which they can conform to the dominant gendered, classed, and ethno-cultural norms of rural communities (Abelson, 2016; Grant & Nash, 2020; Kazyak, 2012).

In contrast to the large body of work on inner urban or rural LGBTQ life, research has rarely examined LGBTQ health and wellbeing in suburbia specifically. Some earlier work has explored suburban gay and lesbian place- and home-making in the US (Brekhus, 2003; Kirkey & Forsyth, 2001; Lynch, 1987; Rothenberg, 1995), Canada (Podmore, 2001), and Australia (Gorman-Murray, 2007a; Gorman-Murray et al., 2012; Hodge, 1995; Power et al., 2014). This work is largely qualitative and considers whether and how the culture of suburbanism shapes gay and lesbian sexual and identity politics. For example, Hodge’s (1995) early work on gay men in Sydney found that suburban gay men were more likely to come out later in life, to ‘pass’ as heterosexual, have fewer relationships, and have less social involvement with LGBTQ communities (see also Brekhus, 2003; Lynch, 1987). More recent work similarly found that LGBT parents living in outer suburban Australia were less likely than those in other areas to be out to their healthcare providers, social and recreational groups, and their children’s school communities (Power et al., 2014).

Lisa Duggan’s (2002) concept of homonormativity has been widely used to explain the spatialization of LGBTQ communities. For Duggan (2002, p. 179) increasing gay rights combined with neoliberal politics, has produced a paradigm where mainstream (white, middle-class, cisgender, monogamous) gay men and lesbians are positioned as ‘ordinary, normal citizens’ who ‘do not contest dominant heteronormative assumptions and institutions, but uphold them while promising the possibility of a demobilised gay constituency and a privatised, depoliticised gay culture anchored in domesticity and consumption’. Thus, increasing gay and lesbian presence in suburbia could be interpreted as evidence of assimilation or homonormativity (Gorman-Murray, 2007a). However, this perspective is not without its critiques. For example, Brown (2012) argues that homonormativity has come to be used as a homogenous global entity, disregarding the specific context in which the concept originated and failing to allow possibility for change (see also, DiFeliciantonio, 2019). Several scholars note that the concept has largely been used to examine gay men’s experiences of identity and place, with less consideration of lesbians’ and bisexual people’s experiences (Browne et al., 2021; Grant & Nash, 2020; Kenttamaa Squires, 2019). Importantly for the purpose of this article, Gorman-Murray (2007a) takes issue with homonormativity often being centred on a critique of queer domesticity, which he argues unfairly negates many LGBTQ people’s complex links to home (see also, Pascual-Bordas, 2023; Schroeder, 2015). Therefore, understanding LGBTQ experiences in contemporary suburbia offers an important opportunity to explore how these spaces contribute to LGBTQ identities, community, and wellbeing.

While this research provides important context for how LGBTQ people may understand and negotiate their identities and relationships in suburban environments, there is relatively little information on the extent to which health and wellbeing differs for LGBTQ people living in outer suburban areas. In one previous Australian study lesbian, gay, and bisexual people living in outer suburbia reported greater social isolation and less connection with LGBTQ communities than those in both inner urban and rural areas (Morandini et al., 2015). Power et al. (2014) also observed that outer suburban LGBT parents were less connected to both their local communities and LGBT groups than those in other areas. Yet, few studies have comprehensively examined the associations between mental health, community connectedness, and residential location among LGBTQ people (Davies et al., 2018; Lewis, 2009), particularly in Australia. Therefore, in this article we address this critical gap, through analysis of one of the largest national surveys of LGBTQ people in Australia to date.

Methods

Sample and procedure

The study sample was drawn from Private Lives 3, a national survey of the health and well-being of 6,835 LGBTQ adults in Australia aged 18 and over (Hill et al., 2020). The survey was created in collaboration with an Expert Advisory Board and a Gender Advisory Board, members of which comprised experts in the field of health and wellbeing for LGBTQ communities in Australia. The survey was open for completion from July to October 2019, and participants were recruited via paid social media advertising, including Facebook and Instagram, and promotion through Australian LGBTQ organizations’ networks. The present study used data collected from 5,276 cisgender participants and 1,506 trans and gender diverse participants (total n = 6,782) who provided complete responses regarding their gender and area of residence. The La Trobe University Human Research Ethics Committee granted ethics approval for the survey.

Measures

Residential location

To determine a participant’s residential location, participants were asked how they would describe the area in which they live. Participants were provided with five options to choose from: ‘Capital city, inner suburban’, ‘Capital city, outer suburban’, ‘Regional city or town’, ‘Rural’, and ‘Remote’. For the purposes of this survey, capital cities referred to Australian state and territory capitals (i.e. Sydney, Melbourne, Brisbane, Adelaide, Hobart, Perth, Canberra, Darwin). Responses for rural and remote were collapsed into a single category due to small sample sizes for these categories.

Other demographics

Additional demographic information collected by the survey included age, gender identity, sexual orientation, weekly income before taxes, level of education achieved, and current employment status.

Mental health

Indicators of mental health included levels of psychological distress and any experiences of suicidal ideation or attempted suicide. These are outlined below.

To measure levels of psychological distress, the 10-item Kessler Psychological Distress Scale (K10) (Kessler et al., 2002) was used. The K10 assesses symptoms of anxiety or depression that participants may have experienced over the previous four weeks. Participants were asked to rate their responses using a 5-point Likert scale ranging from ‘None of the time’ to ‘All of the time’. Total scores on the scale can range from 10–50, with higher scores indicating more severe psychological distress. To analyse the data, we categorized scores into two groups: low or moderate (scores of 10–21) and high or very high (scores of 22–50) levels of psychological distress. These categorizations were based on thresholds used by the Australian Bureau of Statistics (ABS, 2001).

To assess experiences of suicidal ideation and attempted suicide, participants were asked if they had experienced any thoughts related to suicide or wanting to end their life as well as if they had attempted suicide or tried to end their life. Response options included ‘No’, ‘Yes, in the past 12 months’, ‘Yes, more than 12 months ago’, and ‘Prefer not to answer’. Participants were permitted to select multiple responses if they did not choose ‘No’ or ‘Prefer not to answer’. To concentrate on recent experiences of suicidal ideation and attempted suicide, binary variables were generated indicating whether or not participants had experienced suicidal ideation or attempted suicide in the past 12 months.

Community connection

Feeling a part of the LGBTQ community

Feeling a part of the LGBTQ community was assessed by asking participant the extent to which they agreed with the statement ‘You feel you’re part of the Australian LGBTIQ community’. Responses were recorded on a 5-point Likert scale ranging from strongly agree to strongly disagree. For the purpose of the analyses, responses were dichotomized into positive (‘strongly agree’ and ‘agree’) and not positive (‘neither agree nor disagree’, ‘disagree’ and ‘strongly disagree’). This survey item was adapted and localized from the Connectedness to the LGBT Community Scale (Frost & Meyer, 2012).

Positive associations with being a part of the LGBTQ community

Participants were similarly asked the extent to which they agreed with the statement: ‘Participating in Australia’s LGBTQ community is a positive thing for you’. Responses to this item were again categorized into a dichotomous variable indicating those who agreed that participating in the community was a positive thing for them and those who did not.

Local community affirmed gender among trans and gender diverse participants

Participants who indicated they were trans or gender diverse were asked the extent to which they agreed with the statement: ‘My local community has affirmed my gender in ways that support me’. Response options ranged on a 5-point Likert scale from ‘Strongly disagree’ to ‘Strongly agree’, with an additional option to select ‘Not applicable’. Again, these responses were recoded into a dichotomous variable indicating those who agreed that their local community had affirmed their gender and those who did not agree with this.

Statistical analysis

Statistical analyses were conducted using Stata (Version 16.1 SE; StataCorp, College Station, TX). Descriptive statistics were used to present the sociodemographic characteristics of the sample. Multivariable logistic regression analyses were used to explore the association between participants’ residential location and mental health and community connection outcomes. Outcome variables for each multivariable logistic regression were psychological distress, suicidal ideation, suicide attempt, feeling a part of the LGBTQ community, feeling that being a part of the community was a positive thing for them and, among the trans and gender diverse participants only, feeling that the local community had affirmed their gender in supportive ways. Residential location was included in the models as a predictor variable. Each model additionally controlled for the confounding effects of several sociodemographic traits including age, sexual orientation, gender, level of education achieved, income, and employment status. These factors were considered as potentially confounding variables given that many of these may influence mental health and community connectedness in various ways. We therefore controlled for these factors, in order to focus our attention on residential location specifically. Finally, all of the multivariable logistic regression models were run separately between cisgender participants and trans and gender diverse participants. This approach was chosen considering the well-documented differences in mental health outcomes between cisgender and trans people (Hill et al., 2023; Lyons et al., 2022). All collinearity test Variance Inflation Factors (VIFs) were < 2, indicating no issues with multicollinearity. Adjusted (multivariable) odds ratios (AOR) and 95% confidence intervals (CIs) are reported.

Results

Table 1 presents a breakdown of the sample characteristics for both the cisgender (n = 5,276) and trans and gender diverse participants (n = 1,506). For both groups, the majority of participants were aged 18–34 years old, while a greater proportion of trans and gender diverse participants identified as bisexual, pansexual, or queer and considerably less as lesbian or gay compared to the cisgender participants. A substantial proportion of trans and gender diverse participants identified as nonbinary (60.8%). Notably, trans and gender diverse participants were highly represented among those in the lowest weekly income brackets and those without paid employment. Distribution of these groups across residential location only marginally differed (χ² = 10.2, p = 0.017), with 44.6% of cisgender and 40.7% of trans and gender diverse participants residing in inner suburban areas; 27.0% of cisgender participants and 29.8% of trans and gender diverse participants residing in outer suburban areas, 21.9% of cisgender and 23.7% of trans and gender diverse participants residing in regional cities or towns; and 6.5% of cisgender and 5.7% of trans and gender diverse participants residing in rural or remote areas.

Table 1. Sample characteristics.

	Cisgender (n = 5,174)		Trans and gender diverse (n = 1,466)
	n	%	n	%
Age group
18–24	1530	29.6	544	37.1
25–34	1435	27.7	501	34.2
35–44	894	17.3	220	15
45–54	690	13.3	107	7.3
55+	625	12.1	94	6.4
Sexual orientation
Lesbian	1186	23	176	12.1
Gay	1810	35	102	7
Bisexual	1074	20.8	273	18.7
Pansexual	270	5.2	217	14.9
Queer	399	7.7	411	28.2
Asexual	116	2.2	91	6.2
Something else	312	6	189	13
Gender
Cisgender man	2281	44.1	-	-
Cisgender woman	2893	55.9	-	-
Trans man	-	-	297	20.3
Trans woman	-	-	277	18.9
Non-binary	-	-	892	60.8
Educational attainment
Secondary or below	1297	25.1	436	29.8
Non-university tertiary	1086	21	379	25.9
University-undergraduate	1512	29.2	373	25.5
University-postgraduate	1279	24.7	277	18.9
Weekly income (AUD)
0–$399	1387	27.1	652	44.9
$400–$999	1285	25.1	411	28.3
$1,000–$1,999	1698	33.2	303	20.9
$2,000+	742	14.5	85	5.9
Paid employment
No	1178	22.8	538	36.7
Yes	3996	77.2	928	63.3
Residential location
Capital city, inner suburban	2277	44.5	590	40.5
Capital city, outer suburban	1390	27.2	438	30.1
Regional city or town	1118	21.8	345	23.7
Rural/remote	334	6.5	83	5.7

Residential location and mental health

Table 2 presents the multivariable logistic regression results exploring associations between residential location and mental health outcomes.

Table 2. Associations between residential location and mental health and community connection.

	High/very high psychological distress (past 4 weeks)				Suicide ideation (lifetime)				Suicide attempt (lifetime)
	Adjusted multivariable				Adjusted multivariable				Adjusted multivariable
	n	%	AOR(95% CI)	P	n	%	AOR(95% CI)	P	n	%	AOR(95% CI)	P
Cisgender
Residential location
Capital city, inner suburban	1035	45.5	Ref	-	1536	67.9	-	-	360	21.6	-	-
Capital city, outer suburban	830	60.3	1.28 (1.10–1.49)	0.002	1057	76.8	1.28 (1.09–1.51)	0.003	295	28.7	1.28 (1.06–1.55)	0.010
Regional city or town	640	57.4	1.24 (1.05–1.46)	0.010	842	76.1	1.29 (1.08–1.53)	0.005	265	32.2	1.47 (1.20–1.79)	0.000
Rural/Remote	168	50.9	1.04 (0.80–1.35)	0.780	234	70.3	1.04 (0.80–1.36)	0.746	81	34.9	1.78 (1.30–2.42)	0.000
Trans and gender diverse
Residential location
Capital city, inner suburban	417	70	Ref	-	534	90.5	-	-	221	44.3	-	-
Capital city, outer suburban	335	76.1	1.18 (0.86–1.61)	0.306	402	92.2	1.34 (0.83–2.17)	0.235	175	47.8	1.1 (0.82–1.47)	0.523
Regional city or town	263	75.8	1.12 (0.79–1.59)	0.516	314	92.4	1.35 (0.79–2.29)	0.271	132	45.1	0.87 (0.63–1.20)	0.391
Rural/Remote	61	74.4	1.17 (0.62–2.21)	0.631	79	95.2	2.5 (0.81–7.69)	0.111	40	58.8	1.75 (0.98–3.12)	0.058

AOR: Adjusted odds ratio; CI: Confidence interval; Ref: Reference category.

Cisgender participants

When controlling for age, sexual orientation, gender, level of education achieved, income, and employment status, among cisgender participants, residential location was associated with psychological distress, lifetime suicidal ideation and lifetime suicide attempt. Specifically, compared to those in inner suburban areas, participants in outer suburban areas (AOR = 1.28, CI = 1.1–1.49, p = 0.002) and regional cities or towns (AOR = 1.24, CI = 1.05–1.46, p = 0.010) were more likely to report high or very high levels of psychological distress. Participants living in outer suburban areas (AOR = 1.28, CI = 1.09–1.51, p = 0.003) or in regional cities or towns (AOR = 1.29, CI = 1.08–1.53, p = 0.005) were also more likely to report ever experiencing suicidal ideation. Finally, participants living in outer suburban areas (AOR = 1.28, CI = 1.06–1.55, p = 0.010), regional cities or towns (AOR = 1.47, CI = 1.2–1.79, p < 0.001) or rural or remote areas (AOR = 1.78, CI = 1.3–2.42, p < 0.001) were all more likely than those in living in inner suburban areas to have ever attempted suicide.

Trans and gender diverse participants

Among trans and gender diverse participants, residential location was not associated with psychological distress, lifetime suicidal ideation, or lifetime suicide attempt.

Community connection

Table 3 presents the multivariable logistic regression results exploring associations between residential location and community connection as well the feeling that the local community had affirmed their gender for the trans and gender diverse participants.

Table 3. Associations between residential location and mental health, community connection and feeling that community has affirmed gender (trans and gender diverse only).

	Feel a part of the LGBTIQ community				Being a part of the LGBTIQ community is a positive thing for me				Local community has affirmed gender in supportive ways
	Adjusted multivariable				Adjusted multivariable				Adjusted multivariable
	n	%	AOR(95% CI)	P	n	%	AOR(95% CI)	P	n	%	AOR(95% CI)	P
Cisgender
Residential location
Capital city, inner suburban	1420	61	Ref	-	1537	66.3	-	-	-	-	-	-
Capital city, outer suburban	682	48.4	0.63 (0.55–0.73)	0.000	788	56.2	0.66 (0.57–0.76)	0.000	-	-	-	-
Regional city or town	572	50.2	0.68 (0.58–0.79)	0.000	676	59.5	0.77 (0.66–0.90)	0.001	-	-	-	-
Rural/Remote	170	50.1	0.67 (0.53–0.86)	0.001	188	55.3	0.65 (0.51–0.84)	0.001	-	-	-	-
Trans and gender diverse
Residential location
Capital city, inner suburban	413	68	Ref	-	416	68.4	-	-	208	42.5	-	-
Capital city, outer suburban	266	59.9	0.78 (0.59–1.02)	0.065	277	62.1	0.84 (0.64–1.11)	0.213	107	30.1	0.54 (0.40–0.74)	0.000
Regional city or town	195	55.1	0.68 (0.51–0.91)	0.011	212	59.9	0.84 (0.62–1.13)	0.240	87	31	0.54 (0.39–0.76)	0.000
Rural/Remote	45	52.3	0.58 (0.36–0.93)	0.023	42	49.4	0.47 (0.29–0.77)	0.003	14	23.3	0.36 (0.19–0.70)	0.003

AOR:Adjusted odds ratio; CI: Confidence interval; Ref: Reference category.

Cisgender participants

Among cisgender participants, residential location was associated with feeling a part of the LGBTQ community in Australia. Compared to those who were living in inner suburban areas, participants were less likely to feel connected to the LGBTQ community if they were in outer suburban areas (AOR = 0.63, CI = 0.55–0.73, p < 0.001), in regional cities or towns (AOR = 0.68, CI = 0.58–0.79, p < 0.001), or in rural or remote areas (AOR = 0.67, CI = 0.53–0.86, p = 0.001). Participants living outside of inner suburban areas were also less likely to feel that connection to the LGBTQ community was a positive thing for them (outer suburban: AOR = 0.66, CI = 0.57–0.76, p < 0.001; regional city or town: AOR = 0.77, CI = 0.66–0.9, p = 0.001; rural or remote: AOR = 0.65, CI = 0.51–0.84, p = 0.001).

Trans and gender diverse participants

No significant difference was observed for community connection between inner and outer suburban areas among trans and gender diverse participants. However, trans and gender diverse participants living in regional cities or towns (AOR = 0.68, CI = 0.51–0.91, p = 0.011), or in rural or remote areas (AOR = 0.58, CI = 0.36–0.93, p = 0.023) were less likely than those in inner suburban areas to feel a part of the LGBTQ community. Additionally, participants living in rural or remote areas were less likely than those in inner suburban areas to feel that a connection to the LGBTQ community was a positive thing for them (AOR = 0.47, CI = 0.29–0.77, p = 0.003).

Local community is affirming of gender identity

Trans and gender diverse people who lived in outer suburban areas (AOR = 0.54, CI = 0.4–0.74, p = 0), regional cities or towns (AOR = 0.54, CI = 0.39–0.76, p = 0), or rural or remote areas (AOR = 0.36, CI = 0.19–0.7, p = 0.003) were considerably less likely than those living in inner suburban areas to report that their local community was affirming of their gender identity.

Discussion

While our results confirm the well-documented challenges that LGBTQ people experience in regional and rural areas (Swank et al., 2012; Whitehead et al., 2016), they uniquely highlight important nuances in relation to LGBTQ people living in outer suburban areas. Compared with inner suburban and rural participants, cisgender LGBQ people in outer suburbs reported higher psychological distress and were more likely to have experienced suicidal ideation and to have attempted suicide in their lifetimes. Although socio-economic status is likely a factor in both residential location and health outcomes in this population, even when controlling for income, living in outer suburban areas and regional cities or towns was associated with greater odds of experiencing psychological distress and suicidal ideation for cisgender LGBQ people. There are a range of explanations for this, with previous research pointing to higher levels of discrimination and perceived surveillance in suburban areas, coupled with greater social isolation (including isolation from LGBTQ community groups) (Gorman-Murray, 2007a; Power et al., 2014). In contrast, we found no significant differences in psychological distress, suicidal ideation, or suicide attempts by geographical location among trans and gender diverse participants. The wide-ranging nature of stigma, discrimination, and abuse that trans people face (Hill et al., 2023; Strauss et al., 2020), along with challenges accessing gender affirming care likely mean that this population’s mental health and wellbeing is poor regardless of location. These findings confirm the need for further investigation of LGBTQ people’s experiences in suburban spaces that attends to the diversity of this population.

Interestingly, we found that participants living in outer suburban areas did not report strong connections with LGBTQ communities. Although isolation from LGBTQ communities is often linked with reduced wellbeing (Lim et al., 2023), cisgender participants living outside inner cities were more likely to report that LGBTQ community involvement was not important to them. Age or life-stage may be a factor here, with those living in outer suburban areas being less involved in or affiliated with LGBTQ community groups, placing greater emphasis on other aspects of their lives. Homonormativity has been previously deployed to explain low levels of LGBTQ community-connectedness or affiliation as a symptom of neoliberal individualism in a ‘post-gay’ era (Grant & Nash, 2020). In Duggan’s (2002) framing, white, middle-class, monogamous, cisgender same-sex couples are increasingly assimilated into consumer capitalist lifestyles typified by the ‘American dream’ of suburban home ownership and domestic bliss. However, the poorer mental health outcomes we observed among outer suburban LGBQ Australians do not necessarily reflect this narrative. Alternatively, an intersectional perspective may highlight more varied reasons for outer suburban participants’ lesser affiliation with LGBTQ communities. For example, financial constraints may force some LGBTQ people to live in more affordable outer areas, requiring them to adapt their social connections accordingly. Australian suburban populations are much more diverse than the ‘white picket fence’ stereotype reflected in popular (often US-centric) imagery of suburbia (Freestone et al., 2018). As literature exploring the decline of gaybourhood shows (Nash & Gorman‐Murray, 2014), mainstream LGBTQ community spaces have been increasingly critiqued as exclusionary to people of colour, bisexual people, trans people, among others (Caluya, 2008; Doan, 2007). As Podmore and Bain (2021, p. 1263) attest, ‘non-metropolitan queers are shown to create a sense of belonging using alternative techniques to navigate queer invisibility and infrastructural absence in peripheral spaces’.

Trans and gender diverse participants living in regional and rural areas reported the lowest levels of LGBTQ community connectedness in the entire sample. These participants were also less likely than those in inner suburban areas to feel that connection to the LGBTQ community was a positive thing for them. Taken together with trans participants’ high levels of psychological distress and suicidal ideation regardless of location (Hill et al., 2023), these findings suggest that there are fewer spaces and communities that are safe, welcoming, and affirming for trans and gender diverse people, including within LGBTQ spaces. To explore this further, trans and gender diverse participants were asked to what extent their local community affirmed their gender identity. In all areas outside inner suburban areas, including outer suburban areas, participants were less likely to feel that their local community affirmed their gender identity. In comparing outer and inner suburban areas, and given the gendered and heteronormative nature of mainstream suburbia in Australia and elsewhere, many socio-spatial aspects of outer suburbs may not be experienced as affirming by those who do not conform to cisnormativity (Podmore & Bain, 2020). Suburban infrastructure and amenities are often designed to serve cisgender, heterosexual nuclear families, which may isolate trans and gender diverse people (Doan, 2007). Debates about gender diversity and public bathrooms are a key example of this (McGuire et al., 2022). In addition, the events and cultural life of outer suburban areas may similarly assume a cis-heteronormative milieu that excludes many trans and nonbinary people living in those areas.

This article makes an important empirical contribution to social and cultural geography, providing novel quantitative insight into the geographic distribution of LGBTQ mental health and wellbeing outcomes in Australia. By highlighting the specific challenges that LGBTQ people in outer suburban areas face, our work contests urban-rural dichotomies in geographies of sexualities and supports the need for understandings of queer health and place that attend to such nuances within and across different geographic locations. Focusing on Australian suburbia in particular, this article contributes novel perspectives to queer suburban studies that notably critique readings of queer life in the suburbs as homonormative and privileged. The poorer mental health outcomes and lower levels of LGBTQ community-connectedness we observe suggest the need for greater place-based supports for LGBTQ people in outer suburban areas. We recommend that social, health, and urban policy focus on making outer suburban spaces more inclusive of gender, sexuality, relationship, and family diversity. Some strategies may include: developing and implementing policies and programs that promote equality and inclusion of LGBTQ people in the areas within the purview of local and state government, such as housing and employment; providing LGBTQ inclusive practice training to local government employees, community leaders, and local businesses; and creating safe spaces for LGBTQ people of all ages through community centres, youth groups, and other social and recreational programs. However, it is essential that such efforts to promote LGBTQ-inclusivity at a local level do not succumb to the ‘performative progressiveness’ that can occur within neoliberal diversity and inclusion efforts (Bain & Podmore, 2022; Brodyn & Ghaziani, 2018). Meaningful consultation and partnership with local LGBTQ communities, advocates, and organizations is essential to ensure responses genuinely meet the needs of those they are designed to serve.

While this article makes a necessary contribution to existing literature by exploring the relationship between LGBTQ residential location and mental health and wellbeing, it is not without limitations. Notably, we used a convenience sampling methodology, recruiting via targeted social media advertising. As a result, findings may not be representative of all LGBTQ people in Australia, particularly those not closely linked with LGBTQ community organizations or social groups. In addition, this study was cross-sectional and we are therefore unable to ascertain the direction of relationships between residential location, mental health, and community connectedness. Notably, what is meant by being ‘part of the Australian LGBTQ community’ may not have been clear to all participants, or was open to interpretation, making this a somewhat imprecise measure of ‘community-connectedness’. While the survey included a question about LGBTQ community connection, it did not include a question about mainstream community connections, reducing our capacity to explore the relationship between community connectedness and mental health more thoroughly. Moreover, additional intersections within the LGBTQ community, such as ethnicity, are likely to be important for future research in this field. These limitations support the need for further research into the spatial features that prevent and promote LGBTQ wellbeing and belonging.

Conclusion

In this article, we examined whether LGBTQ people living in outer suburban areas of Australia experience poorer mental health, wellbeing, and community connection compared to those living in other areas. We examined links between residential location, psychological distress, and suicidal ideation, as well as feelings of connectedness to LGBTQ community. Uniquely, this article also considered the extent to which trans and gender diverse people feel that their local community is affirming of their gender. Participants from outer suburban areas were more likely to report experiencing high or very high psychological distress compared with those in inner suburban areas. Notably, outer suburban and regional participants also reported higher levels of distress than those in rural/remote Australia. These findings complicate the common research and policy focus on rural areas as sites of isolation and risk for LGBTQ people. In contrast, our results indicate that LGBTQ people in outer suburban areas may require additional, place-based supports that attend to the specific experiences of LGBTQ life on the urban fringe.

This article aimed to provide a deeper understanding of associations between suburban life and the wellbeing and community connectedness of LGBTQ people in Australia. However, it should be noted that further qualitative research is necessary to understand the lived experiences that shape the mental health outcomes we have identified here. In particular, further research is required to identify the socio-spatial features of outer suburban Australia that prevent and promote LGBTQ wellbeing and belonging. It is important to note that our survey was conducted in late 2019, prior to the outbreak of COVID-19, which has had significant implications for LGBTQ mental health, wellbeing, and community-connection (Grant et al., 2021). Shifts in spatial practices precipitated by the pandemic, such as remote working and virtual events, may have altered LGBTQ people’s sense of place and community, with ramifications for those living in outer suburban areas. Thus, further quantitative and qualitative research is necessary to explore these developments. Additionally, it is important for future scholarship to explore gender differences in residential location, particularly to gain a greater understanding of trans experiences. Furthermore, it is crucial to gain more insight into the role of LGBTQ community connection in determining health and wellbeing in certain residential locations. While it is important to continue to address the challenges faced by rural LGBTQ communities, it is also essential to provide place-based supports for those in outer suburbia and regional towns or small cities, particularly given that these are areas where LGBTQ people are increasingly likely to reside, both in Australia and internationally.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Victorian Government Department of Health and Human Services and the Victorian Government Department of Premier and Cabinet.