Minority stress among lesbian, gay, bisexual, and transgender (LGBT) university students in ASEAN countries: associations with poor mental health and addictive behavior

Abstract

The goal of the study was to examine health indicators in relation to lesbian, gay, bisexual and transgender (LGBT) among university students in five ASEAN countries (Indonesia, Malaysia, Myanmar, Thailand, and Vietnam). In a cross-sectional survey randomly selected 3262 undergraduate university students (Mean age=20.5 years, SD=1.6) responded to a questionnaire including health indicators, gender identity and sexual orientation. Five percent (153/3262) of eligible participants considered themselves as LGBT youths; 23.5% of them were severely depressed, 31.4% had PTSD symptoms, 40% had suicidal ideation, 35.3% had made a suicide attempt, 28.6% were hazardous or harmful alcohol users, 14.0% had used illicit drugs in the past 12 months, and 46.4% engaged in pathological internet use. LGBT identity predicted severe depression (AOR 2.8, 95% CI 1.9, 4.3), suicide attempt (AOR 2.8, 95% CI 1.1, 2.9), hazardous or harmful alcohol use (AOR 1.7, 95% 1.1, 2.5), illicit drug use (AOR 2.4, 95% CI 1.4, 4.0), and pathological internet use (AOR 1.5, 95% CI 1.1, 2.1), adjusting for age, sex, study year, martial status, religion, subjective economic status, social support, and country. The study confirmed sexual and gender mental health disparity. LGBT university students should be prioritized for mental health and addictive behaviour prevention and intervention.