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UBC Theses and Dissertations

Sexual identity, minority stress, and the mental health of lesbian, gay, bisexual, and heterosexual Canadians Pakula, Barbara (Basia) Joanna


Background: Addressing mental health has emerged as a priority in Canada. The mental illness burden is thought to disproportionately affect some subgroups, including those self-identifying as lesbian, gay, and bisexual (LGB). Yet, to date, no reliable population estimates are available to characterize the prevalence of common mental health disorders amongst LGB Canadians. Objectives: (1) Investigate the prevalence and correlates of anxiety, mood, and anxiety-mood disorders, heavy drinking, and co-occurring anxiety or mood disorders and heavy drinking among Canadians self-identified as LGB. (2) Examine whether life stress mediates and sense of community belonging moderates the relationship between sexual identity and the study outcomes. (3) Assess the heterogeneity in the prevalence of the study outcomes by sexual identity at intersections with other social positions (i.e., sex, age, income, education, and racialized minority status). Methods: Pooled data from the 2007–2012 cycles of the Canadian Community Health Survey (N = 222,548) were used to obtain a multi-year sample of Canadians aged 18–59 years, who self-identified as LGB or heterosexual. Analyses included a series of logistic regression models, stratified binary mediation models, and models with multiple interaction terms. Bootstrapping was used to obtain standard errors and confidence intervals. Results: LGB-identified Canadians reported substantially greater odds of mental health disorders compared with heterosexual peers: the odds of anxiety, mood, anxiety-mood, and co-occurring disorders were double for gay/lesbian-identified respondents, and more than triple for bisexual-identified respondents. Perceived life stress partially mediated the effects of sexual identity on the outcomes, and the greatest odds were observed for bisexual respondents. Combinations of disadvantaged positions of reporting a gay/lesbian or bisexual identity (vs. heterosexual) with vulnerabilities related to income, age and sex were found to have multiplicative effects on the rates of mood and anxiety disorders. Discussion: The results provide the first national estimates for common mental health disorders reported by LGB-identified Canadians. They suggest that universal interventions (thought to be applicable to all sexual identities) may ameliorate some, but not substantially diminish all, observed mental health disparities. Informed by these results, future interventions tailored to meet the specific needs of LGB people, particularly bisexual-identified, may hold promise.

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