Counting the Cost: The Economic Toll of Discrimination Against LGBTQAI+ Individuals in Italy

Abstract

Abstract This study investigates the financial consequences of perceived discrimination towards LGBTQAI+ people in Italy, focusing on psychological support and medication costs. It highlights the burden of discriminatory experiences, emphasizing the need for policies to minimize costs. A cost analysis was performed according to the NHS perspective. A purposive sample was recruited through a web-based survey spread on Italian researchers’ social networks, asking any LGBTQAI+ readers to answer about discriminatory experiences, access to psychological support, and medication use. Costs of health services use were estimated according to the Italian NHS tariffs and Italian Psychologists’ Board. The time horizon was set at one year and discounting was not necessary. Robustness was checked by a one-way sensitivity analysis. A total of 75 LGBTQAI+ people completed the survey. Most of them (aged 26-35 years, 85%; residing in big cities, 70%; unaffiliated with LGBTQAI+ associations, 88%) reported discriminative actions (60%), with 15% seeking psychological help soon after being victim of a single discriminatory act. Verbal and physical abuse were reported by 88% and 6% respectively. 40% of respondents claimed to have resorted to psychotherapy sessions because of the discomfort felt after acts perceived as discriminatory or violent, amounting to 810 total therapy hours. The total therapy cost was €72,900, of which 60% paid as out-of-pocket expenses, and 40% partially covered by regional Local Health Units. Additionally, 12% of respondents used SSRI or benzodiazepines, costing the National Health System an esteemed €3054. The sensitive analysis confirmed the robustness of results. The study demonstrates the significant economic burden of discrimination against LGBTQAI+ individuals in Italy, emphasizing the need for inclusive policies and accessible mental health support. Further research is required to explore indirect costs, for a comprehensive understanding of the total economic impact. Key messages • Discrimination against LGBTQAI+ individuals in Italy causes significant financial burden due to costs of psychological support and medication. • Inclusive policies and accessible mental health support are needed to address the economic impact of discrimination against LGBTQAI+ individuals in Italy.