Monash analysis puts LGBTQ+ Australians at up to 3.5 times the risk of high psychological distress

If you divide the published distress rates, the cisgender nonheterosexual group comes out at about 2.7 times the cisgender heterosexual rate. The transgender group comes out at about 1.8 times ^[17][18]. The "up to 3.5 times" figure is higher than both, so the researchers did not get it by dividing one percentage by another ^[19]. Group size matters here, because minority groups make up small parts of a national sample. The press account does not say how many respondents fell into each group, or which calculation produced the 3.5 figure.

The transgender group, which includes people of any sexual orientation, scored below the cisgender nonheterosexual group on distress, diagnosis and functional disability ^{[8][9][10][11]}. It still scored above the heterosexual baseline on distress and functioning ^[9][11].

The survey counted subthreshold disorders as well as diagnosed ones. These are cases where people have clinically significant symptoms that fall short of the full criteria for a diagnosis ^[12]. Anxiety disorders were the most common condition in every group ^[13].

The researchers look beyond the individual for causes. "The mental health disparities identified in this study cannot be understood solely through individual-level factors," said Dr. Bernice Hua Ma, the lead researcher, of the Monash School of Public Health and Preventive Medicine ^[3][16]. Dr. Long Le, the senior researcher, pointed to access. "These findings were really startling and show that we still have a long way to go in breaking down the barriers to access and treatment for LGBTQ+ Australians," Le said ^[1][16].

Ma was explicit about treatment. "Reducing these inequities will require more than expanding mental health services," she said ^[4]. Rebecca Smith, a co-author from the umbrella group LGBTIQ+ Health Australia, said the disparities "are not an inherent consequence of being LGBTQ+." She said they are shaped by "discrimination, stigma, minority stress and broader social determinants of health" ^[14][5].

Every figure in the account describes how unwell people are or how much that limits their daily lives ^[9][10][11]. The idea that barriers to care drive the gap is how the authors interpret those figures ^[1]. I think it is a plausible reading, and nothing in the data contradicts it. A survey of who reports distress can show where distress is concentrated. On its own, it cannot tell a shortage of affirming care apart from the stigma that Smith says causes illness in the first place ^[5].