Inequities in depression within a population of sexual and gender minorities

Background:Substantial evidence has demonstrated that sexual minorities (gay, lesbian, and bisexual people) and gender minorities (transgender and gender non-binary people) (SGM) experience poorer mental health than heterosexual and cisgender individuals. Meanwhile, less attention has been given to inequities within SGM populations. Aims:This study investigated depression within a sample of Canadian SGM who took part in an online survey (n = 2778). Methods:Multivariable regression was used to identify social characteristics associated with depression, as measured by the Patient Health Questionnaire (PHQ-9) (p < 0.05). The sample was then stratified by gender and sexual identity and the multivariable analysis was repeated for each stratum. Results:PHQ-9 scores were associated with every social position investigated, with the largest coefficients observed for non-binary and transgender individuals and those with a lower level of educational attainment. In stratified analysis, statistically significant associations were observed for cisgender respondents identifying as bisexual, queer, or pansexual (relative to gay/lesbian) and for transgender women from ethnic minority groups or with lower income. Conclusions:These results provide evidence of depression inequities within SGM along multiple social positions. Interventions to reduce depression should be prioritized for these sub-groups of SGM who experience the highest rates of depression.