Review finds higher depression and suicide risk among LGBTQIA+ people
An umbrella review found its strongest evidence for disparities in depression, suicidal behavior and eating disorder symptoms.
Editorial illustration — not from the study.
Researchers combined findings from 22 systematic reviews with meta-analyses covering 398 individual studies and 162 associations. Eight associations met the review’s highest evidence category, while 46 had highly suggestive evidence.
The strongest findings involved depression, suicidal behavior and eating disorder-related symptoms. The review also found differences within LGBTQIA+ populations, including higher odds of anxiety symptoms and non-suicidal self-injury among bisexual people compared with lesbian and gay people.
Where the gaps were largest
Compared with cisgender heterosexual populations, lesbian, gay and bisexual populations had about twice the risk of depressive disorders (risk ratio 2.05). Their risk of suicide attempts was 2.51 times higher, and their odds of suicidal ideation or suicide attempts combined were 3.20 times higher.
Among adolescents, gay populations had higher odds than heterosexual peers of eating disorder-related behaviors, including dieting (odds ratio 3.10) and purging (5.40). Within LGBTQIA+ populations, bisexual people had higher odds than lesbian and gay people of anxiety symptoms (1.73) and non-suicidal self-injury (2.24).
Eight of the 162 associations had convincing evidence, and 46 had highly suggestive evidence. The review also found a pattern in body-image disturbance across sexual-orientation groups, with the highest levels among heterosexual women, followed by lesbian women, gay men and heterosexual men. No included systematic review examined access to mental-health care services.
Why these findings matter
The findings show that disparities are especially well supported for depression, suicidal behavior and eating disorder symptoms, rather than resting on isolated studies. The authors say the results support inclusive prevention strategies, targeted interventions and structural changes that address stigma and discrimination in health care.
What the evidence can show
This was an umbrella review, meaning the researchers assessed existing systematic reviews with meta-analyses rather than collecting new participant data. They searched PubMed, Scopus and PsycINFO from their beginnings through April 23, 2025, without language restrictions, and rated the credibility of each association using five evidence categories.
The underlying evidence came from observational research, so the review identifies disparities but does not test treatments or establish that any single factor caused them. Of the 268 studies with available geographic information, 72.8% were conducted in North America; among 251 studies with available design information, 90.0% were cross-sectional and 10.0% longitudinal. Evidence for non-binary populations was more limited, with one association reaching the highly suggestive category, and access to mental-health care was not covered by the included reviews.
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