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The mental health of lesbian, gay, and bisexual adults compared with heterosexual adults: results of two nationally representative English household probability samples

Pitman, A., Marston, A., Lewis, G., Semlyen, J., McManus, S. ORCID: 0000-0003-2711-0819 and King, M. (2021). The mental health of lesbian, gay, and bisexual adults compared with heterosexual adults: results of two nationally representative English household probability samples. Psychological Medicine, https:, doi: 10.1017/S0033291721000052

Abstract

Background: Evidence on inequalities in mental health in lesbian, gay and bisexual people arises primarily from non-random samples.
Aims: To use a probability sample to study change in mental health inequalities between two survey points, seven years apart; the contribution of minority stress; and whether associations vary by age, gender, childhood sexual abuse, and religious identification.
Methods: We analysed data from 10,443 people, in two English population-based surveys (2007 and 2014), on common mental disorder (CMD), hazardous alcohol use, and illicit drug use. Multivariable models were adjusted for age, gender, and economic factors, adding interaction terms for survey year, age, gender, childhood sexual abuse, and religious identification. We explored bullying and discrimination as mediators.
Results: Inequalities in risks of CMD or substance misuse were unchanged between 2007 and 2014. Compared to heterosexuals, bisexual and lesbian/gay people were more likely to have CMD, particularly bisexual people (adjusted odds ratio [AOR]=2.86; 95% CI: 1.83, 4.46), and to report alcohol misuse and illicit drug use. When adjusted for bullying, odds of CMD remained elevated only for bisexual people (AOR=3.21; 95% CI: 1.64, 6.30), whilst odds of alcohol and drug misuse were unchanged. When adjusted for discrimination, odds of CMD and alcohol misuse remained elevated only for bisexual people (AOR=2.91; 95% CI=1.80, 4.72; and AOR=1.63; 95% CI=1.03, 2.57 respectively), whilst odds of illicit drug use remained unchanged. There were no interactions with age, gender, childhood sexual abuse, or religious identification.
Conclusions: Mental health inequalities in non-heterosexuals have not narrowed, despite increasing societal acceptance. Bullying and discrimination may help explain the elevated rate of CMD in lesbian women and gay men but not in bisexual people.

Publication Type: Article
Publisher Keywords: Discrimination; inequalities; LGB; mental health; minority stress; sexual minorities
Subjects: B Philosophy. Psychology. Religion > BF Psychology
H Social Sciences > HM Sociology
H Social Sciences > HN Social history and conditions. Social problems. Social reform
Departments: School of Arts & Social Sciences > Sociology
Date Deposited: 17 Feb 2021 15:46
URI: https://openaccess.city.ac.uk/id/eprint/25687
[img] Text - Accepted Version
This document is not freely accessible until 17 August 2021 due to copyright restrictions.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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