Disparities in depression and anxiety related to sexual orientation and gender identity among older adults: The role of age discrimination.

Objectives: Sexual and gender minority (SGM) older adults report poorer mental health than their cisgender-heterosexual peers. Age discrimination may be a mechanism underlying these disparities. The current study examined whether SGM older adults reported more age discrimination and, in turn, higher depression and anxiety, compared to cisgender-heterosexual older adults.

Methods: As part of a larger study, 744 older adults (aged ≥ 50; M = 58.4, SD = 6.23) completed an online survey in September 2021. The survey included measures of depression (Patient Health Questionnaire-8), anxiety (Generalized Anxiety Disorder-7), and age discrimination (an adapted version of the Everyday Discrimination Scale). The sample included five sexual orientation and gender identity (SOGI) groups: cisgender sexual minority men (25.3%), cisgender sexual minority women (21.6%), cisgender-heterosexual men (19.8%), cisgender-heterosexual women (18.5%), and gender minorities (14.8%). We tested the indirect effects of SOGI group on depression and anxiety through age discrimination.

Results: Compared to cisgender-heterosexual men and women, all three SGM groups reported more age discrimination which, in turn, was associated with higher depression and anxiety. Further, compared to cisgender-heterosexual women, cisgender-heterosexual men reported more age discrimination which, in turn, was associated with higher depression and anxiety. All indirect effects were significant.

Conclusion: Age discrimination may be a mechanism underlying the mental health disparities affecting SGM older adults and a promising intervention target.