PURPOSE

Existing literature has provided limited and inconsistent findings regarding disparities in mental health and mental health care utilization among racial and ethnic subgroups of sexual and gender minority adolescents (SGMA). This study aimed to investigate racial and ethnic disparities in mental health and care utilization among SGMA.

METHODS

Data from a large national sample of SGMA who participated in the 2022 Lesbian, Gay, Bisexual, Transgender and Queer National Teen Survey (N = 9,691) were analyzed. Symptoms of depression and anxiety were assessed using the patient health questionnaire-4. Mental health care utilization was classified as follow: (1) received; (2) wished for but not received (indicating unmet mental health care needs); and (3) neither wished for nor received.

RESULTS

Compared to White SGMA, Black/African American SGMA were less likely to report anxiety symptoms (adjusted prevalence ratio = 0.89, 95% confidence intervals [CIs] = 0.82-0.97). No significant racial and ethnic differences in depression symptoms were observed among SGMA. Regarding mental health care utilization, Asian or Asian American (adjusted relative risk ratio [ARRR] = 2.07, 95% CIs = 1.62-2.64), Black/African American (ARRR = 1.80, 95% CIs = 1.41-2.28), and Hispanic/Latino SGMA (ARRR = 1.32, 95% CIs = 1.16-1.51) were more likely to report unmet mental health care needs than White SGMA.

DISCUSSION

Despite the lack of major and consistent racial and ethnic differences in anxiety and depression symptoms documented in our sample, Asian or Asian American, Black/African American, and Hispanic/Latino SGMA were more likely to report unmet mental health care needs than their White counterparts. This finding highlights the need to address barriers to mental health care for racially and ethnically minoritized SGMA.