Discrimination experienced by sexual minority males in Australia: Associations with suicidal ideation and depressive symptoms

K Balakrishnan; T Haregu; A O Hill; J T Young; G Armstrong

doi:10.1016/j.jad.2022.03.009

Discrimination experienced by sexual minority males in Australia: Associations with suicidal ideation and depressive symptoms

J Affect Disord. 2022 May 15:305:173-178. doi: 10.1016/j.jad.2022.03.009. Epub 2022 Mar 9.

Authors

K Balakrishnan¹, T Haregu², A O Hill³, J T Young⁴, G Armstrong⁵

Affiliations

¹ Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
² Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia.
³ Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia.
⁴ Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia; National Drug Research Institute, Curtin University, Perth, Western Australia, Australia.
⁵ Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia. Electronic address: g.armstrong@unimelb.edu.au.

PMID: 35278485
DOI: 10.1016/j.jad.2022.03.009

Abstract

Introduction: Discrimination has been under-examined as a social determinant of the higher rates of poor mental health experienced by sexual minorities. The objectives of our study were to: 1) assess whether discrimination was independently associated with poor mental health among sexual minority males, and 2) assess the potential mediation role of discrimination in the associations between sexual minority status and poor mental health.

Methods: We used cross-sectional data on 13,230 males aged 18-55 years from the Australian Longitudinal Study on Male Health; bisexual and homosexual males comprised 1.5% and 1.6% of the sample, respectively. We fit Poisson regression and zero-inflated negative binomial regression models to examine suicidality, depressive symptoms and perceived discrimination in the past two years as correlates of suicidality and depressive symptoms.

Results: Statistically significant differences were observed in the prevalence of perceived discrimination by sexual orientation (p < 0.001), with the highest prevalence among bisexual (29.3%) and homosexual (40.4%) males, and the lowest prevalence among heterosexual males (18.6%). After adjusting for confounding, bisexual/homosexual males had higher rates of perceived discrimination (IRR = 1.88, p < 0.001), recent suicidal ideation (IRR = 1.51, p = 0.008), lifetime suicide attempt (IRR = 2.09, p < 0.001) and recent depressive symptoms (IRR = 1.34, p < 0.001) than heterosexual males. Analysis of β-coefficients suggested that discrimination may mediate a small to moderate proportion of the association between sexual minority status and poor mental health.

Limitations: Use of cross-sectional data.

Conclusion: Poor mental health is more common among sexual minority males, and discrimination may be a contributor to these mental health disparities. Reducing discrimination should be considered as part of a strategy to improve the mental wellbeing of sexual minority males.

Keywords: Mental health; Sexual minority; Social discrimination; Suicide.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia / epidemiology
Cross-Sectional Studies
Depression / epidemiology
Female
Homosexuality, Male
Humans
Longitudinal Studies
Male
Sexual Behavior / psychology
Sexual and Gender Minorities*
Suicidal Ideation*