Effects of perceived discrimination on mental health and mental health services utilization among gay, lesbian, bisexual and transgender persons.
ABSTRACT Previous research has found that lesbian, gay, bisexual and transgender (LGBT) individuals are at risk for a variety of mental health disorders. We examined the extent to which a recent experience of a major discriminatory event may contribute to poor mental health among LGBT persons.
Data were derived from a cross-sectional strata-cluster survey of adults in Hennepin County, Minnesota, who identified as LGBT (n=472) or heterosexual (n=7,412).
Compared to heterosexuals, LGBT individuals had poorer mental health (higher levels of psychological distress, greater likelihood of having a diagnosis of depression or anxiety, greater perceived mental health needs, and greater use of mental health services), more substance use (higher levels of binge drinking, greater likelihood of being a smoker and greater number of cigarettes smoked per day), and were more likely to report unmet mental healthcare needs. LGBT individuals were also more likely to report having experienced a major incident of discrimination over the past year than heterosexual individuals. Although perceived discrimination was associated with almost all of the indicators of mental health and utilization of mental health care that we examined, adjusting for discrimination did not significantly reduce mental health disparities between heterosexual and LGBT persons.
LGBT individuals experienced more major discrimination and reported worse mental health than heterosexuals, but discrimination did not account for this disparity. Future research should explore additional forms of discrimination and additional stressors associated with minority sexual orientation that may account for these disparities.
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ABSTRACT: Background: Lesbian and bisexual (LB) women encounter numerous barriers to equitable health care services, such as lack of quality care and discriminatory health care settings. These barriers affect the well-being of LB women, presumably leading to disparities in health and health care. Despite these disparities, few published research studies explore health services of LB women. This qualitative, grounded theory study addressed that gap. Methods: Purposive sampling was used to recruit 18- to 24-year-old women who identified as LB and who reported using health services as an adult. Participants (n = 9) were recruited from lesbian, gay, bisexual, and transgender student groups at universities in the Southwestern United States, and in-depth audio recorded interviews were performed. The nine participants represent 29 unique health care experiences. The transcriptions were uploaded into NVivo, and the constant comparison method was used to analyze the data. Findings: Six themes were identified, including seeking health care, expectations, disclosure of sexual orientation, moment of truth (provider attributes), proximal outcomes, and health outcomes. These themes were sorted into an explanatory conceptual framework that represents three distinct phases of the health care experience: Pre-interaction,health care interaction, and outcomes. Conclusions: The women in this study identified disclosure of sexual orientation and provider attributes as major points in the health care experience. Creating health care environments that facilitate disclosure of sexual orientation and educating providers about LB-appropriate care are strategies that may impact health and health care disparities of LB women.Women s Health Issues 10/2014; 24(6):635-640. DOI:10.1016/j.whi.2014.08.003 · 1.61 Impact Factor
- 05/2013; 22(1):3-14. DOI:10.7764/psykhe.2013.22.10