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 non-monosexual (i.e., diverse sexual orientations besides gay/lesbian) or gender non-binary, 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 post-traumatic 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 non-binary) of college students. We hypothesized that non-monosexual 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. A series of multiple linear regressions with robust standard errors and relevant covariates 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 non-monosexual SD subgroups were at particularly high risk; namely, pansexual students. Other non-monosexual SD subgroups had similar or lower symptom levels than their monosexual peers; asexual students had the lowest mental health symptom burden. 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.