Disparities in Mental Health Symptoms Among Sexual and Gender Diverse Subgroups in a National Sample of College Students

Mental health disparities experienced by sexual and gender diverse (SGD) young adults are well documented. Yet, few studies have examined mental health disparities between SGD subgroups. Even fewer have investigated disparities that may exist for individuals whose SGD identities are nonmonosexual (i.e., diverse sexual orientations besides gay/lesbian) or gender nonbinary, who may experience exacerbated marginalization and disparities. The present study examines differences in weight and shape concerns and symptoms of depression, anxiety (general, panic, social, and posttraumatic stress), alcohol use disorder, and insomnia among sexually diverse (SD) subgroups (lesbian or gay, bisexual, queer, asexual, pansexual, multiple identities, and questioning), and gender diverse (GD) subgroups (trans man, trans woman, and nonbinary) of college students. We hypothesized that nonmonosexual students would have a greater mental health symptom burden than their monosexual peers and we explored additional subgroup differences among SD and GD subgroups separately. Kruskal-Wallis tests with Mann-Whitney U post hoc tests were conducted to examine associations between mental health symptoms and sexual orientation and gender identity separately. Results show high mental health symptom levels among most subgroups. Some nonmonosexual SD subgroups were at particularly high risk; namely, pansexual students. Questioning and asexual SD subgroups had similar and lower symptom levels than their monosexual peers, respectively. SD subgroup disparities varied by mental health symptom type. No significant differences by GD subgroups were found. Clinicians and institutions should consider these disparities and future research should aim to better understand them.