The Relationship between Intersectional Discrimination and Mental Health Outcomes among LGBTQ+ Asians in New York City: An Exploratory, Mixed-Methods Study.

LGBTQ+ Asians are an under-researched population and face higher risk for mental health problems than heterosexual individuals due to intersectional discrimination and minority stress. This exploratory, mixed-methods study sought to understand associations between minority stress, intersectional discrimination, and mental health outcomes among LGBTQ+ Asians. Between 2022 and 2023, convenience sampling was used to survey 136 LGBTQ+ Asian residents of New York City. Controlling for demographics, logistic regression was used to compare the proportion of individuals with clinically-significant symptoms for major depressive disorder, generalized anxiety disorder, and suicide risk by self-reported measures of discriminatory and microaggressive experiences towards LGBTQ+ people of color. A subsample of 24 individuals participated in semi-structured interviews that were conducted in English. Thematic content analysis was utilized to understand contextual factors and discriminatory experiences influencing LGBTQ+ Asian mental health. Individuals with higher levels of everyday discrimination had higher odds of exhibiting clinically-significant depressive symptoms, anxiety symptoms, and suicide risk. Individuals with higher levels of racialized and LGBTQ-related microaggressions had higher odds of exhibiting clinically-significant depressive and anxiety symptoms. Among interviewed participants, predominant themes include social isolation, anticipated stigma attributed to discriminatory experiences within both LGBTQ+ and Asian communities, and pervasive impacts of racial and LGBTQ+ discrimination on mental health and self-worth. Findings reveal disparities in mental health outcomes among LGBTQ+ Asians, with differences based on levels of self-reported discrimination and targeted microaggressions towards LGBTQ+ racial/ethnic minorities. More research is needed to understand the causal and temporal mechanisms by which intersectional discrimination impacts LGBTQ+ Asians' mental health.