Mental Health Disparities and Suicidal Behavior Among Sexual Minority Young Adults in Delhi National Capital Region, India

Background: International studies consistently document elevated mental health risk in sexual minority populations; however, empirical evidence from India is limited. Objectives: This study aimed to assess the link between sexual orientation and current common mental disorders (depression, anxiety, and stress) and suicidal behavior, with sequential adjustment for sociodemographic factors, childhood experiences, and current psychopathology. Methods: Data were drawn from 1,427 college-going young adults, aged 18–25 years, from the Delhi National Capital Region, India. Depression, anxiety, stress, and suicidal behavior were each assessed with validated instruments. Adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) were captured through standardized scales. Results: Lesbian, gay, and bisexual (LGB) participants, compared with heterosexuals, reported higher prevalence of moderate-to-severe depression (40.0% vs. 23.7%), moderate-to-severe anxiety (61.8% vs. 46.6%), high stress (21.8% vs. 8.5%), and suicidal behavior (56.4% vs. 17.3%). In models adjusted for sociodemographic variables, LGB identification carried higher odds of moderate-to-severe depression (aOR = 2.55), moderate-to-severe anxiety (aOR = 2.65), and suicidal behavior (aOR = 5.64). Adjustment for ACEs and PCEs substantially attenuated associations with depression, anxiety, and stress. In contrast, the association with suicidal behavior remained statistically significant after adjustment for childhood experiences and current mental health conditions (aOR = 3.54). Conclusions: Substantial mental health disparities separate sexual minority from heterosexual young adults in India. Childhood experiences appear to explain much of the excess burden of common mental disorders, but do not fully account for elevated suicide risk. Effective suicide prevention among sexual minority populations will likely require approaches that extend beyond the treatment of current psychopathology.