LGBTQ+ communities are more likely to experience stigma-related stressors that lead to poorer mental health compared to cisgender and heterosexual individuals. For LGBTQ+ young adults, navigating the duality of their sexual orientation or gender identity and mental health can be challenging. Digital mental health (DMH) tools offer an alternative form of clinical care that may be useful for LGBTQ+ individuals wishing to remain anonymous, who need to access care from remote locations, or for those who do not have financial means to seek treatment. However, a user’s personal data can be contextualised in a way that perpetuates rigid gender norms. Gender perspectives that encompass the broad and fluid spectrum of gender identities and LGBTQ+ experiences are rarely embedded in design of DMH tools and intersectional differences remain largely underexplored in clinical research and practice. This study aimed to explore the perspectives and preferences of LGBTQ+ end-users on DMH tools, the data that it collects and how they may be developed to promote safety and wellbeing. We employed user-centred design methods in 3 workshops with gay men, lesbian women, and trans and gender diverse people (aged 22-32, n = 16). The study used a socio-cultural lens to consider how data justice can be maintained for LGBTQ+ individuals. We found that participants preferred to keep their identities private and control what and who their mental health data was shared with as a result of historical medicalization of their sexual or gender identities. Participants were concerned that heteronormative healthcare practitioners conflated their sexual or gender orientation with their mental health. Alternative support routes were found to be important for participants who felt their mental health challenges would be burdensome on their families. Socio-structural factors necessitate specialised DMH services and support for LGBTQ+ individuals. We then propose a set of design strategies for the future development of DMH tools for LGBTQ+ communities including the sensitive collection of demographic data, allowing the user to regularly update their gender or sexual identity, and integrated options for in-person or community-based support networks, along with the right for LGBTQ+ users to review and withdraw their data from DMH tools.
Butorac et al. (Tue,) studied this question.
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