A Comparison of the Mental Health and Well-Being of Sexual Minority and Heterosexual First-Year Medical Students

Abstract

Purpose Research is lacking on psychological distress and disorder among sexual minority medical students (students who identify as non-heterosexual). If left unaddressed, distress may result in academic and professional difficulties and undermine workforce diversity goals. The authors compared depression, anxiety, and self-rated health among sexual minority and heterosexual medical students. Method This study included 4,673 first-year students with self-reported sexual orientation data in the fall 2010 baseline survey of the Medical Student Cognitive Habits and Growth Evaluation Study, a national longitudinal cohort study. The authors used items from published scales to measure depression, anxiety, self-rated health, and social stressors. They conducted bivariate and multivariate analyses to estimate the association between sexual identity and depression, anxiety, and self-rated health. Results Of the 4,673 students, 232 (5.0%) identified as a sexual minority. Compared with heterosexual students, after adjusting for relevant covariates, sexual minority students had greater risk of depressive symptoms (adjusted relative risk [ARR] =1.59 [95% CI, 1.24–2.04]) anxiety symptoms (ARR = 1.64 [1.08–2.49]), and low self-rated health (ARR = 1.77 [1.15–2.60]). Sexual minority students were more likely to report social stressors, including harassment (22.7% vs 12.7%, P < .001) and isolation (53.7% vs 42.8%, P = .001). Exposure to social stressors attenuated but did not eliminate the observed association between minority sexual identity and mental and self-reported health measures. Conclusions First-year sexual minority students experience significantly greater risk of depression, anxiety, and low self-rated health than heterosexual students. Targeted interventions are needed to improve mental health and well-being.

Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study

“…As well, the study targeted only one medical school, and a broader study is required to be able to assess Canadian medical schools overall. Finally and similar to literature, LGBT students represented a high proportion among respondents (35.9%), likely higher than the true proportion among medical students estimated at 5.0% [1]. The higher response rate noted in our study can be explained by LGBT students showing a higher interest in healthcare issues related to their own community [35].…”

“…A recent study found LGB medical students to be more likely to report social stressors (including harassment) as well as social isolation [1], placing them at greater risk of depression and anxiety. In our study, LGBT students had higher odds for witnessing overt discrimination and for describing a less inclusive environment.…”

“…Despite this, disparities in health based on sexual orientation and gender identity are well documented and researched [1,2]. This inequality is evident in terms of access to the healthcare system and use of preventive health services [3,4].…”

Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate

“…Sexual minority (SM) medical students are more likely than non-SM students to report stress, isolation, verbal insults, and harassment or threats 5 and they are approximately twice as likely to experience depression and related mental health comorbidities. 5,6 Almost one-fifth of lesbian-identified physicians report sexual orientation harassment during residency, and two-fifths report ever experiencing such harassment in a medical setting.…”

“…5,6 Almost one-fifth of lesbian-identified physicians report sexual orientation harassment during residency, and two-fifths report ever experiencing such harassment in a medical setting. 7 Two-thirds of SGM physicians have heard disparaging remarks about SGM at work; one-third have witnessed discriminatory care of an SGM patient; approximately one-quarter have witnessed discrimination against an SGM employee; and approximately one-fifth report experiencing social ostracism because of their SGM identity.…”