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Assessing sexual and gender identity interaction with the relationship between caregiving and adverse mental health
G Thomas Wilson1, Gilbert Gimm2, Rodman Turpin1
1Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA.
Background:
Caregivers often report high stress levels, which may be associated with adverse mental health. Less is known about adult sexual and gender minority (SGM) caregivers' experienced stress and/or mental health considering they are likely at increased vulnerability to these outcomes due to social stigma, familial estrangement, and discrimination.
Aims:
We tested relationships between caregiving and adverse mental health and if these associations were modified by SGM identity.
Methods:
Using 2023 national BRFSS data (n = 32,151) we examined relationships between caregiving and two outcomes: depression and 14+ days with poor mental health, testing effect modification by SGM identity. Regression analyses, using both SGM and caregiving cross-categories and interaction term models were also conducted.
Results:
Compared to heterosexual non-caregivers, both caregiving and SGM status were associated with greater depression and having 14+ days of poor mental health, with the highest prevalence of depression among transgender caregivers (aPR = 4.05, CI 3.03-5.00), transgender non-caregivers (aPR = 2.80, CI 2.24-3.25), and cisgender gay caregivers (aPR = 2.52, CI 2.01-2.93). Transgender and cisgender gay and bisexual caregivers also had the highest days with poor mental health. Additionally, interaction term models identified effect modification.
Conclusions:
Disproportionate adverse mental health outcomes exist among caregivers, modified by SGM status. Longitudinal research is needed to understand these mechanisms and related outcomes including substance use and suicidality.
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