Comparisons of anxiety, depression, and general health and well-being in a gender diverse sample of LGBTQ+ adults

Background People who identify as LGBTQ+ report significantly higher rates of mental illness compared to cisgender, heterosexual populations. Transgender and non-binary (TNB) individuals show substantial mental health challenges when compared to non-LGBTQ+ people. However, few studies have explored TNB mental health compared to cisgender sexual minority individuals within a clinical LGBTQ+ sample. Method This observational study examined differences in anxiety, depression, general health and well-being, and psychiatric diagnoses in a sample of adults who identified as LGBTQ+ according to their self-reported gender identity (TNB vs. cisgender). The sample consisted of 100 TNB and 139 cisgender sexual minority adults (n=239 total). Participants were in their early to mid-30s, mostly identified as non-Hispanic/Latino White, and were employed. Self-report measures of anxiety, depression, general health/well-being, and interviewer-administered measures of anxiety, depression, and psychiatric diagnoses were used. Results After adjusting for age, ethnicity, and race in an analysis of covariance (ANCOVA) model, compared to cisgender sexual minority individuals, participants who identified as TNB demonstrated significantly worse anxiety (self-report: d =0.33; interview: d =0.56), depression (self-report: d =0.27; interview: d =0.25), and general health/well-being ( d =-0.34). TNB individuals were also significantly more likely to meet criteria for depressive or anxiety disorders (OR=2.19, 95%CI: 1.17, 4.08, p =.014). Conclusions This is among the first studies to compare mental health and well-being within a LGBTQ+ adult sample according to individuals' gender identity. Results indicate that people who identify as TNB have a particularly high mental health burden, underscoring the importance of careful screening and tailored interventions for this subgroup.