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LGBT Identity, Untreated Depression, and Unmet Need for Mental Health Services by Sexual Minority Women and Trans-Identified People.
J Womens Health (Larchmt). 2017 02; 26(2):116-127.JW

Abstract

BACKGROUND

Previous studies have found that transgender, lesbian, and bisexual people report poorer mental health relative to heterosexuals. However, available research provides little information about mental health service access among the highest need groups within these communities: bisexual women and transgender people. This study compared past year unmet need for mental health care and untreated depression between four groups: heterosexual cisgender (i.e., not transgender) women, cisgender lesbians, cisgender bisexual women, and transgender people.

MATERIALS AND METHODS

This was a cross-sectional Internet survey. We used targeted sampling to recruit 704 sexual and gender minority people and heterosexual cisgendered adult women across Ontario, Canada. To ensure adequate representation of vulnerable groups, we oversampled racialized and low socioeconomic status (SES) women.

RESULTS

Trans participants were 2.4 times (95% confidence intervals [CI] = 1.6-3.8, p < 0.01) and bisexual people 1.8 times (95% CI = 1.1-2.9, p = 0.02) as likely to report an unmet need for mental healthcare as cisgender heterosexual women. Trans participants were also 1.6 times (95% CI = 1.0-27, p = 0.04) more likely to report untreated depression. These differences were not seen after adjustment for social context factors such as discrimination and social support.

CONCLUSION

We conclude that there are higher rates of unmet need and untreated depression in trans and bisexual participants that are partly explained by differences in social factors, including experiences of discrimination, lower levels of social support, and systemic exclusion from healthcare. Our findings suggest that the mental health system in Ontario is not currently meeting the needs of many sexual and gender minority people.

Authors+Show Affiliations

1 Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto , Toronto, Canada .2 School of Social Work, York University , School of Social Work, Toronto, Canada .3 Women's Health In Women's Hands , Toronto, Canada .2 School of Social Work, York University , School of Social Work, Toronto, Canada .4 Independent Scholar , Toronto, Canada .5 Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Canada .6 Centre for Addiction and Mental Health & Dalla Lana School of Public Health, University of Toronto , Toronto, Canada .

Pub Type(s)

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

Language

eng

PubMed ID

27898255

Citation

Steele, Leah S., et al. "LGBT Identity, Untreated Depression, and Unmet Need for Mental Health Services By Sexual Minority Women and Trans-Identified People." Journal of Women's Health (2002), vol. 26, no. 2, 2017, pp. 116-127.
Steele LS, Daley A, Curling D, et al. LGBT Identity, Untreated Depression, and Unmet Need for Mental Health Services by Sexual Minority Women and Trans-Identified People. J Womens Health (Larchmt). 2017;26(2):116-127.
Steele, L. S., Daley, A., Curling, D., Gibson, M. F., Green, D. C., Williams, C. C., & Ross, L. E. (2017). LGBT Identity, Untreated Depression, and Unmet Need for Mental Health Services by Sexual Minority Women and Trans-Identified People. Journal of Women's Health (2002), 26(2), 116-127. https://doi.org/10.1089/jwh.2015.5677
Steele LS, et al. LGBT Identity, Untreated Depression, and Unmet Need for Mental Health Services By Sexual Minority Women and Trans-Identified People. J Womens Health (Larchmt). 2017;26(2):116-127. PubMed PMID: 27898255.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - LGBT Identity, Untreated Depression, and Unmet Need for Mental Health Services by Sexual Minority Women and Trans-Identified People. AU - Steele,Leah S, AU - Daley,Andrea, AU - Curling,Deone, AU - Gibson,Margaret F, AU - Green,Datejie C, AU - Williams,Charmaine C, AU - Ross,Lori E, Y1 - 2016/11/29/ PY - 2016/11/30/pubmed PY - 2017/10/31/medline PY - 2016/11/30/entrez KW - depression KW - gender identity KW - mental health treatment KW - sexual orientation KW - unmet need SP - 116 EP - 127 JF - Journal of women's health (2002) JO - J Womens Health (Larchmt) VL - 26 IS - 2 N2 - BACKGROUND: Previous studies have found that transgender, lesbian, and bisexual people report poorer mental health relative to heterosexuals. However, available research provides little information about mental health service access among the highest need groups within these communities: bisexual women and transgender people. This study compared past year unmet need for mental health care and untreated depression between four groups: heterosexual cisgender (i.e., not transgender) women, cisgender lesbians, cisgender bisexual women, and transgender people. MATERIALS AND METHODS: This was a cross-sectional Internet survey. We used targeted sampling to recruit 704 sexual and gender minority people and heterosexual cisgendered adult women across Ontario, Canada. To ensure adequate representation of vulnerable groups, we oversampled racialized and low socioeconomic status (SES) women. RESULTS: Trans participants were 2.4 times (95% confidence intervals [CI] = 1.6-3.8, p < 0.01) and bisexual people 1.8 times (95% CI = 1.1-2.9, p = 0.02) as likely to report an unmet need for mental healthcare as cisgender heterosexual women. Trans participants were also 1.6 times (95% CI = 1.0-27, p = 0.04) more likely to report untreated depression. These differences were not seen after adjustment for social context factors such as discrimination and social support. CONCLUSION: We conclude that there are higher rates of unmet need and untreated depression in trans and bisexual participants that are partly explained by differences in social factors, including experiences of discrimination, lower levels of social support, and systemic exclusion from healthcare. Our findings suggest that the mental health system in Ontario is not currently meeting the needs of many sexual and gender minority people. SN - 1931-843X UR - https://www.unboundmedicine.com/medline/citation/27898255/LGBT_Identity_Untreated_Depression_and_Unmet_Need_for_Mental_Health_Services_by_Sexual_Minority_Women_and_Trans_Identified_People_ L2 - https://www.liebertpub.com/doi/10.1089/jwh.2015.5677?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -