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Bisexual individuals are at greater risk of poor mental health than lesbians and gay men: The mediating role of sexual identity stress at multiple levels.
J Affect Disord. 2020 01 01; 260:292-301.JA

Abstract

BACKGROUND

Although earlier studies have indicated that lesbian, gay, and bisexual (LGB) individuals are at greater risk of psychiatric symptoms than heterosexual individuals, limited attention has been paid to the mental health disparities within LGB populations, especially in non-Western societies. This study examined the disparities in depression, anxiety, and mental well-being between gay/lesbian and bisexual individuals and investigated how the disparities are explained by the greater sexual identity stress experienced by bisexual individuals compared to their gay and lesbian counterparts.

METHODS

The study sample included 931 cisgender LGB individuals in Hong Kong, with 70.1% identifying as gay/lesbian and 29.9% identifying as bisexual. They completed a self-report questionnaire on sexual identity stress and mental health.

RESULTS

Bisexual individuals showed higher levels of depressive and anxiety symptoms than lesbians and gay men. Structural equation modeling showed that, compared with lesbians and gay men, bisexual individuals were more likely to report identity uncertainty, conceal their sexual orientation, and have a weaker sense of connection to the LGBT community, which were in turn associated with greater affective symptoms and poorer mental well-being.

LIMITATIONS

The use of cross-sectional data does not allow conclusions on causal relationships among variables.

CONCLUSIONS

Given the greater vulnerability of bisexual individuals to common mental health problems, evidence-based psychological interventions that strategically target their identity stress at multiple levels should be developed and made available to those in need. Social and psychoeducational interventions are also necessary to transform the monosexist culture and eradicate binegativity in the LGBT and wider communities.

Authors+Show Affiliations

Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong. Electronic address: rchchan@eduhk.hk.Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA. Electronic address: don_operario@brown.edu.Department of Psychology, The Chinese University of Hong Kong, Hong Kong. Electronic address: wwsmak@cuhk.edu.hk.

Pub Type(s)

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

Language

eng

PubMed ID

31521866

Citation

Chan, Randolph C H., et al. "Bisexual Individuals Are at Greater Risk of Poor Mental Health Than Lesbians and Gay Men: the Mediating Role of Sexual Identity Stress at Multiple Levels." Journal of Affective Disorders, vol. 260, 2020, pp. 292-301.
Chan RCH, Operario D, Mak WWS. Bisexual individuals are at greater risk of poor mental health than lesbians and gay men: The mediating role of sexual identity stress at multiple levels. J Affect Disord. 2020;260:292-301.
Chan, R. C. H., Operario, D., & Mak, W. W. S. (2020). Bisexual individuals are at greater risk of poor mental health than lesbians and gay men: The mediating role of sexual identity stress at multiple levels. Journal of Affective Disorders, 260, 292-301. https://doi.org/10.1016/j.jad.2019.09.020
Chan RCH, Operario D, Mak WWS. Bisexual Individuals Are at Greater Risk of Poor Mental Health Than Lesbians and Gay Men: the Mediating Role of Sexual Identity Stress at Multiple Levels. J Affect Disord. 2020 01 1;260:292-301. PubMed PMID: 31521866.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bisexual individuals are at greater risk of poor mental health than lesbians and gay men: The mediating role of sexual identity stress at multiple levels. AU - Chan,Randolph C H, AU - Operario,Don, AU - Mak,Winnie W S, Y1 - 2019/09/04/ PY - 2019/02/03/received PY - 2019/08/02/revised PY - 2019/09/03/accepted PY - 2019/9/16/pubmed PY - 2020/12/22/medline PY - 2019/9/16/entrez KW - Anxiety KW - Bisexuality KW - Depression KW - Mental health disparities KW - Mental well-being KW - Sexual identity stress SP - 292 EP - 301 JF - Journal of affective disorders JO - J Affect Disord VL - 260 N2 - BACKGROUND: Although earlier studies have indicated that lesbian, gay, and bisexual (LGB) individuals are at greater risk of psychiatric symptoms than heterosexual individuals, limited attention has been paid to the mental health disparities within LGB populations, especially in non-Western societies. This study examined the disparities in depression, anxiety, and mental well-being between gay/lesbian and bisexual individuals and investigated how the disparities are explained by the greater sexual identity stress experienced by bisexual individuals compared to their gay and lesbian counterparts. METHODS: The study sample included 931 cisgender LGB individuals in Hong Kong, with 70.1% identifying as gay/lesbian and 29.9% identifying as bisexual. They completed a self-report questionnaire on sexual identity stress and mental health. RESULTS: Bisexual individuals showed higher levels of depressive and anxiety symptoms than lesbians and gay men. Structural equation modeling showed that, compared with lesbians and gay men, bisexual individuals were more likely to report identity uncertainty, conceal their sexual orientation, and have a weaker sense of connection to the LGBT community, which were in turn associated with greater affective symptoms and poorer mental well-being. LIMITATIONS: The use of cross-sectional data does not allow conclusions on causal relationships among variables. CONCLUSIONS: Given the greater vulnerability of bisexual individuals to common mental health problems, evidence-based psychological interventions that strategically target their identity stress at multiple levels should be developed and made available to those in need. Social and psychoeducational interventions are also necessary to transform the monosexist culture and eradicate binegativity in the LGBT and wider communities. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/31521866/Bisexual_individuals_are_at_greater_risk_of_poor_mental_health_than_lesbians_and_gay_men:_The_mediating_role_of_sexual_identity_stress_at_multiple_levels_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(19)30312-X DB - PRIME DP - Unbound Medicine ER -