Psychosocial Determinants of Depression, Anxiety, and Stress in LGBTIQ+ Adults

Abstract Introduction Mental health disorders are a pressing public health issue, particularly affecting vulnerable populations such as the LGBTIQ+ community, who face social contexts that facilitate these conditions through discrimination and stigmatization. Objectives To identify factors associated with depression, anxiety, and stress among LGBTIQ+ individuals. Methods A prospective cross-sectional survey was conducted among LGBTIQ+ individuals over 18 years of age residing in Veracruz, Mexico, from August to December 2024. Dependent variables were stress, anxiety, and depression (DASS-21), while independent variables included stigma, discrimination, sexual harassment, and social support (MOS-SSS). Data analysis was performed using SPSS v27, calculating odds ratios (OR), 95% confidence intervals (CI), and p-values (<0.05 for significance). Results A total of 177 LGBTIQ+ participants were included. Depression prevalence was 74%, anxiety 75.7%, and stress 67.8%. Perceived unfair treatment due to sexual or gender identity was associated with depression (OR 2.5, CI 1.2-5.2), anxiety (OR 2.5, CI 1.2-5.1), and stress (OR 2.4, CI 1.2-4.7). Internalized stigma was associated with depression (OR 2.3, CI 1.1-5.0), anxiety (OR 2.8, CI 1.2-6.4), and stress (OR 2.2, CI 1.2-4.7). Sexual harassment was linked to depression (OR 3.1, CI 1.5-6.6) and stress (OR 2.5, CI 1.3-4.8). Belonging to the trans community was not significantly associated with any of the outcomes (p > 0.05). Lack of emotional support, social relationships, affective support, and material aid were associated with depression, with the last two also linked to anxiety (p < 0.05). No support dimensions were associated with stress (p > 0.05). Overall, low social support was only associated with depression. Conclusions Discrimination, stigma, sexual harassment, and inadequate social support are significantly associated with depression, anxiety, and stress among LGBTIQ+ individuals, while trans identity alone is not. Key messages • Discrimination and stigma significantly increase the risk of depression, anxiety, and stress among LGBTIQ+ individuals. • Low social support primarily affects mental health, especially increasing the likelihood of depression.