Association of traumatic experiences with depressive symptoms among LGBTQ+ population in China

Abstract

Trauma is a major contributor to mental health disparities among LGBTQ+ individuals, yet evidence from non-Western contexts remains limited. Using baseline data from 8,384 participants in the TREASURE cohort in Chengdu, China, we examined associations between trauma exposure (adverse childhood experiences, lifetime trauma and LGBTQ+-related adversities) and depressive symptoms. Trauma exposure was highly prevalent (92.7%), particularly LGBTQ+-related adversities (87.3%). Depressive symptoms were observed in 30.2% of participants and were associated with trauma exposure (adjusted odds ratio = 11.00, 95% confidence interval, 7.39–16.39), exhibiting a dose–response relationship: each additional traumatic event is associated with 10% higher risk of depressive symptoms (95% confidence interval, 9–11%). Sequential mediation analysis suggested that unfavourable behavioural factors such as smoking (mediated proportions, 14.99–40.23%), lower social support (7.91–33.08%) and negative coping (1.79–37.66%) may mediate these associations. Despite limitations including non-representative, cross-sectional and self-reported data, our findings highlight that trauma exposure is ubiquitous and associated with depressive symptoms among Chinese LGBTQ+ individuals. Yang et al. found that trauma is highly prevalent among LGBTQ+ individuals in China and linked to depression. Unhealthy behaviours, low social support and negative coping partly explain this relationship, highlighting key targets for intervention.