Internalized Phobia, Community Connectedness, Outness, and Mental Health Risk and Protection in LGBTQ Persons

Community connectedness, outness, and internalized phobia are potential protective and risk factors for mental health in lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. However, these interrelated factors have generally been examined in isolation and for the LGBTQ community in aggregate. As such, there may be undetected effects of factors on mental health for each LGBTQ group.

We examined the associations between mental health (i.e., depression and anxiety) and risk/protective factors (i.e., internalized phobia, community connectedness, outness) in each LGBTQ subgroup separately.

A large national U.S. sample ( N = 1,030) of individuals who identified as LGBTQ completed an anonymous Internet survey during fall 2019. Participants answered questionnaires about community connectedness, outness, internalized homophobia or transphobia, anxiety, and depression.

On average, most subgroups reported symptoms of depression and anxiety above clinical cutoffs. Less outness and greater internalized phobia were associated with more severe depression and anxiety, but this pattern was not consistent across LGBTQ subgroups. Greater community connectedness was generally associated with more severe anxiety and depression.

LGBTQ subgroups vary in how risk and protective factors relate to mental health outcomes. Our findings highlight the importance of examining LGBTQ subgroups separately and examining risk/protective factors simultaneously to identify the unique contribution of each factor. More research is needed to understand potential LGBTQ mental health risks and protective factors, and future researchers should examine the unique roles of risk and protective factors in separate LGBTQ subgroups.