State-level discrimination policies: Environmental risk factors for psychiatric morbidity in LGB populations

Abstract

Objectives: Despite the high prevalence of discriminatory policies against lesbian, gay, and bisexual (LGB) individuals, few studies have examined the impact of such policies on the mental health of LGB populations. The current study investigated whether state-level discrimination policies moderate the relationship between LGB status and 12-month prevalence of psychopathology in the general population.

Methods: Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N=34,653; 577 LGB individuals), a nationally representative study of noninstitutionalized U.S. adults. State-level anti-discrimination variables included: (1) recognition of same-sex unions, including marriage, civil unions, or domestic partnerships; (2) hate crime laws that specify sexual orientation as a protected category; and (3) state policies banning sexual orientation employment discrimination.

Results: Compared to living in states with policies extending protection and rights to LGB individuals, living in states without these policies predicted a significantly stronger association between LGB status and psychopathology, including: generalized anxiety disorder (F=3.87, DF=2, P=0.02); post-traumatic stress disorder (F=3.42, DF=2, P=0.04); and dysthymia (F=5.20, DF=2, P=0.02). Living in states with policies that did not extend protections and rights to LGB individuals also predicted a stronger relation between LGB status and psychiatric comorbidity (F=2.47, DF=2, P=0.04).

Conclusions: State-level discriminatory legislation modifies the effect of LGB status on psychopathology. Policies and laws that reduce discrimination against gays and lesbians (e.g., Employment Non-Discrimination Act, Matthew Shepard Act) are urgently needed to protect the health and well-being of this vulnerable population.