LGBTQ+ community faces greater likelihood of loneliness
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Key takeaways:
- Loneliness was highest in those who identified as bisexual or were transgender gender nonconforming.
- Researchers said there is a need to increase awareness and access to mental health care for LGBTQ+ patients.
People in sexual and gender minority groups were more likely to experience loneliness and have a lack of social and emotional support, results published in MMWR showed.
As Healio previously reported, data show that young transgender people are more likely to have worse mental health compared with the general population, which could contribute to adverse health effects.
Katherine V. Bruss, PsyD, from the CDC’s National Center for Chronic Disease Prevention and Health Promotion, and colleagues wrote that a better understanding of how loneliness and lack of social and emotional support impact mental health outcomes is warranted, “particularly among persons experiencing the most social disconnection, such as those who do not identify as heterosexual and cisgender.”
The current study included 2022 Behavioral Risk Factor Surveillance System (BRFSS) data on 218,915 participants aged 18 years and older who had completed the BRFSS’s Sexual Orientation and Gender and Social Determinants and Health Equity modules.
Bruss and colleagues used data from these modules to assess the prevalence of several mental health measures — including depression, loneliness, stress, a lack of emotional and social support and frequent mental distress.
When looking at sexual orientation, they found that the prevalence of loneliness was:
- 56.7% among those who identified as bisexual;
- 41.2% among those who identified as gay;
- 44.8% among those who identified as lesbian;
- 50.7% among those who identified as something other than gay, lesbian, bisexual or straight; and
- 30.3% among those who identified as straight.
Meanwhile, when looking at gender identify, the prevalence of loneliness was:
- 62.6% among transgender men;
- 56.4% among transgender women;
- 63.9% among those who were transgender gender nonconforming; and
- 32.1% among those who were cisgender.
The prevalence of lack of social and emotional support was higher among participants who identified as gay (29%), bisexual (36.5%) or something other than gay, lesbian, bisexual or straight (39.3%) and those who were transgender women (44.8%), transgender men (34.4%) or transgender gender nonconforming (41.4%) compared with those who identified as straight (22.8%) or were cisgender (23.8%).
Although loneliness was more common among women than men (33.5% vs. 30.7%), men were more likely to report a lack of social and emotional support (26.1% vs. 22.3%).
The prevalence of frequent mental distress, stress and depression were all higher among those who identified as gay, lesbian, bisexual or something other than gay, lesbian, bisexual or straight vs. those who identified as straight, with those who identified as bisexual having the highest prevalence in all three measurements.
Similarly, the prevalence of stress, depression and frequent mental distress were higher in those who were transgender compared with those who were cisgender. Those who were transgender gender nonconforming had the highest prevalence of depression (67.2%).
According to the researchers, only 26 states reported BRFSS data from the specific modules examined, meaning the findings may not be generalizable to the entire United States population.
The results offer further evidence “of the need to increase access to mental health and social services and address mental health outcomes related to loneliness and lack of social and emotional support, especially among sexual and gender minority groups,” Bruss and colleagues wrote.
“The health care system, including hospital settings, outpatient clinics, EDs and other health care settings can play a role in raising awareness, promoting a welcoming environment, using gender-neutral and inclusive language, and reducing the stigma around loneliness,” they concluded.
Perspective
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The most dreaded punishment in the penal system is solitary confinement. The mental health injury of prisoners placed in solitary confinement is measurable through observed increases in anxiety, paranoia, despair and depression. One-half of prison suicides occur in solitary confinement. Physically, solitary confinement can worsen medical conditions such as diabetes mellitus, coronary artery disease and hypertension. Neurons in the brain will decrease in size up to 20% in patients who have experienced solitary confinement. In 2015, the United Nations declared that greater than 15 days of solitary confinement was torture.
It is with ease one can concur with the MMWR abstract regarding the negative impact of loneliness and lack of social and emotional support on mental health. Equally unsurprising is that vulnerable populations (eg, bisexual and transgender) would suffer the greatest injury. Public health must take this into consideration when considering measures to employ to combat the next pandemic.
Perspective
Back to TopRobert G.G. Piccinini, DO, D.FACN
Although the limitations of the study were clearly recognized and reported, the study shows a potential opportunity to make an important impact in our patients’ lives. This is especially true for the most vulnerable of our patients. Asking a few quick and essential questions can make an impact not only on an individual’s mental health, but also as the study alluded to, other aspects of our patients’ physical health. The most impactful part is to recognize that although minority populations are most affected by loneliness, this does indeed cross all demographics or patient populations. No one group should be disregarded during the physician-patient encounter. The limitations of the study shine a light on the need for ongoing and more robust and expanded research in the future.
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