Abstract
BackgroundSame sex attracted women (SSAW) are disproportionately affected by depression and anxiety, due to experiences of sexuality and gender based discrimination. They access mental health services at higher rates than heterosexual women, however with lower levels of satisfaction. This study examined the range of professional and social help seeking by same-sex attracted women, and patterns according to sexual orientation and gender identity subgroup.MethodsEight key stakeholders were interviewed, and a convenience sample of 1628 Australian SSAW completed an online survey in 2015. This included several scales to measure mental health, community connectedness and resilience; and measured past 12 month help seeking behaviour, enablers, barriers and preferences for mental health care. Chi-square analyses and binary logistic regression analyses examined demographic associations with mental health. Correlations between help seeking, mental and physical health, and connectedness were run.ResultsA high proportion (80 %) of the total sample had perceived mental health problems over the past 12 months. Over half had depression, and over 96 % had anxiety. Trans and gender diverse participants were twice as likely as female participants to have mental health problems, and lesbians were least likely. High levels of past 12 month help seeking included 74.4 % seeing a GP, 44.3 % seeing a psychologist/counsellor, 74.7 % seeking family/friends support and 55.2 % using internet based support. Professional help was prioritised by those with higher mental health need. Trans participants were most likely to have sought professional help and participated in support groups, but least likely to have sought help from friends or family. The most common barriers to help seeking were discrimination and lack of LGBTI sensitivity of services, particularly for gender diverse, queer and pansexual participants. Enablers included mainstream community connectedness, having a trustworthy GP, and encouragement by friends.ConclusionsMental health services need to be LGBTI inclusive and to understand the emerging diverse sexual and gender identities. Peer support is an important adjunct to professional support, however may not be fully meeting the needs of some identity sub-groups. Mental health promotion should be tailored for diverse sub-groups to build mental health literacy and resilience in the face of ongoing discrimination.
Highlights
Same sex attracted women (SSAW) are disproportionately affected by depression and anxiety, due to experiences of sexuality and gender based discrimination
There were only 24 intersex identified participants, so they were analysed within the ‘other gender’ group, we acknowledge that intersex status is not regarded as a gender identity
There were significant barriers to help seeking including a lack of LGBTI sensitivity and knowledge amongst mainstream services, and internal barriers of self-reliance and lack of readiness
Summary
Same sex attracted women (SSAW) are disproportionately affected by depression and anxiety, due to experiences of sexuality and gender based discrimination. They access mental health services at higher rates than heterosexual women, with lower levels of satisfaction. Same-sex attracted women (SSAW) are more likely than heterosexual women to experience depression, anxiety, and substance use disorders [1, 2]. Among women, bisexual women in the Australian Longitudinal Study on Women’s Health (ALSWH) reported the highest levels of perceived stress, depression symptoms, anxiety symptoms, and the lowest scores on the mental health index and the social support scale [4]. 57.2 % had ever been diagnosed with depression, and 39.9 % ever diagnosed with an anxiety disorder
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