Intersections of sexual orientation, gender identity, and race/ethnicity and odds of reporting depression and anxiety symptomology in the Household Pulse Survey

TL;DR

This study found that sexual and gender minority individuals, especially those who are transgender or bisexual, have significantly higher odds of depression and anxiety symptoms compared to straight and cisgender individuals, with notable racial differences.

Contribution

The study introduces a novel intersectional analysis of sexual orientation, gender identity, and race/ethnicity in relation to mental health outcomes.

Findings

Transgender individuals had doubled odds of depression and anxiety symptoms compared to cisgender individuals.

Bisexual individuals had nearly tripled odds of depression and anxiety symptoms compared to straight individuals.

Transgender bisexual individuals showed the highest odds of depression and anxiety symptoms compared to cisgender males.

Abstract

We examined odds of anxiety and depression symptomology among sexual and gender minority (SGM) individuals compared to straight and cisgender individuals, stratified by race.

Data represented 918,892 households in the Household Pulse Survey from July 2021-October 2022. The Patient Health Questionnaire-2 measured depression symptoms (Scores >3=depression symptoms). The Generalized Anxiety Disorder Scale-2 measured anxiety symptoms (Scores >3=anxiety symptoms). Sexual orientation was categorical: “Gay/Lesbian,” “Straight,” “Bisexual,” “Something Else,” or “Don’t know.” Gender identity had 3 levels: “Cisgender Male,” “Cisgender Female,” or “Transgender/other gender identity.” Logistic regression estimated odds ratios(OR) and 95% confidence intervals(CI) for depression and anxiety among sexual minority individuals compared to straight individuals and transgender individuals compared to cisgender males. Intersection of sexual orientation/gender identity was also examined. Models (adjusted for sociodemographic factors) were stratified by race/ethnicity.

Transgender individuals showed doubled odds of depression (OR:2.30 95%CI:1.98,2.67) and anxiety (OR:2.41 95%CI:2.23,2.61) versus cisgender individuals. Bisexual individuals had nearly tripled odds versus straight individuals. Transgender bisexual individuals showed highest odds versus cisgender males (depression OR:6.22 95%CI:5.06,7.64; anxiety OR:7.11 95%CI:6.13,8.24). Non-Hispanic White individuals typically showed highest symptomology.

SGM individuals showed increased anxiety and depression symptomology, with unexpected racial disparities warranting further intersectionality research.