LGBT+ People in France and Mental Health: Changing the Boundaries

Studies documenting the health of sexual and gender minorities have mostly relied on practices to define minorities and have failed to examine associations between sexual and gender minorities.

Based on the CSF2023, a national population-based survey on sexuality and sexual health in France, we analyze (i) the multidimensionality of sexual orientation within the lesbian, gay, bisexual, and transgender, queer, or other sexual orientations and gender identities (LGBT+) population, and (ii) their experiences of sexual violence and discrimination and its impact on mental health.

While 8% of women and 7% of men aged 18-89 years reported having a same-sex partner, a higher proportion (23% of women and 15% of men) were not strictly heterosexual, that is, reported same-sex attraction, same-sex practices, or identification as non-heterosexual. Thinking about changing gender remained a rare phenomenon (2% of women and 3% of men). In a linear regression model using the Patient Health Questionnaire-9 (PHQ9) score, the mental health of non-strictly heterosexuals appeared to be worse than that of heterosexuals (c = 0.86 (0.42-1.31) for women; c = 1.00 (0.45-1.55) for men), as was the mental health of those who had thought about changing gender versus those who had not (c = 1.73 (0.63-2.84) for women; c = 2.10 (0.76-3.43) for men).

Considering indicators of sexual orientation and gender identity that go beyond practices significantly expands the boundaries of minority groups whose mental health appears to be impaired. This perspective is essential if we are to reach the target groups of mental health prevention policies.