Mental Health of Medical Students in Portugal: The Role of Sexual Orientation

Background/Objectives: Depression and burnout are common among medical students, leading to serious academic and professional consequences. LGBTQ+ students are especially vulnerable to mental health issues. This study aims to help understand the associations between sexual orientation and distress levels among Portuguese medical students. Methods: An observational, analytical, cross-sectional study was conducted with participants from Portuguese medical schools. Data collection took place between 2022 and 2025 through electronic questionnaires. Assessment tools included the Multidimensional Scale of Perceived Social Support, the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Maslach Burnout Inventory Student Survey. Statistical significance was set at p < 0.05 (95% confidence interval). Group comparisons by sexual orientation were conducted using chi-square/Fisher’s exact tests, Mann–Whitney U tests, and independent samples t-tests. Predictors of depression and state anxiety were assessed using multiple linear regression. Results: The sample included 1668 (83.2%) heterosexual students and 336 (16.8%) LGBTQ+ students. The rates of depression and anxiety were 43.2% and 25.7%, respectively. LGBTQ+ students reported more difficulties in personal, academic, social, and financial areas and showed higher levels of distress than heterosexual students. Key factors linked to distress included burnout, social support, and grade satisfaction. Additionally, burnout, low-grade satisfaction, and substance abuse were associated with anxiety and depression levels differently depending on sexual orientation. Conclusions: This study’s findings confirm higher distress levels among the LGBTQ+ group compared to the heterosexual group, helping us identify students who are more vulnerable to developing mental illness and prompting us to reconsider which aspects of medical training and culture contribute to this distress.