Intersections of sexual orientation, gender identity, and race/ethnicity and odds of reporting depression and anxiety symptomology in the Household Pulse Survey.

Purpose: We examined odds of anxiety and depression symptomology among sexual and gender minority (SGM) individuals compared to straight and cisgender individuals, stratified by race.

Methods: Data represented 918,892 households in the Household Pulse Survey from July 2021-October 2022. The Patient Health Questionnaire-2 measured depression symptoms (Scores >3 = depression symptoms). The Generalized Anxiety Disorder Scale-2 measured anxiety symptoms (Scores >3 = anxiety symptoms). Sexual orientation was categorical: "Gay/Lesbian," "Straight," "Bisexual," "Something Else," or "Don't know." Gender identity had 3 levels: "Cisgender Male," "Cisgender Female," or "Transgender/other gender identity." Logistic regression estimated odds ratios(OR) and 95% confidence intervals(CI) for depression and anxiety among sexual minority individuals compared to straight individuals and transgender individuals compared to cisgender males. Intersection of sexual orientation/gender identity was also examined. Models (adjusted for sociodemographic factors) were stratified by race/ethnicity.

Results: Transgender individuals showed doubled odds of depression (OR:2.30 95%CI:1.98,2.67) and anxiety (OR:2.41 95%CI:2.23,2.61) versus cisgender individuals. Bisexual individuals had nearly tripled odds versus straight individuals. Transgender bisexual individuals showed highest odds versus cisgender males (depression OR:6.22 95%CI:5.06,7.64; anxiety OR:7.11 95%CI:6.13,8.24). Non-Hispanic White individuals typically showed highest symptomology.

Conclusion: SGM individuals showed increased anxiety and depression symptomology, with unexpected racial disparities warranting further intersectionality research.