Effects of Sexual Orientation and Gender on Perceived Need for Treatment by Persons With and Without Mental Disorders

Research has shown that sexual minority groups have higher prevalence rates of psychiatric disorders (both mental and substance use disorders) and that they may seek treatment at higher rates than heterosexuals. However, relationships between treatment need and treatment use are not well understood. This study examined the relationship of sexual orientation and gender to perceived need for treatment and treatment use among individuals with and without mental or substance use disorders.

Data were obtained from a probability sample of California residents that oversampled for persons from sexual minority groups (unweighted N=2,079). Bivariate analyses compared perceived treatment need and treatment use among groups defined by sexual orientation, gender, and presence of a mood, anxiety, or substance use disorder. Logistic regression models that controlled for sociodemographic factors were used to predict no use of treatment among those who perceived a need for it (unmet need), testing the interactive effects of gender, disorder, and sexual orientation.

Women from sexual minority groups had about half the odds of unmet treatment need as heterosexual women, but no interaction was found for men between sexual minority status and unmet need. Among individuals without any of the disorders assessed, men and women from sexual minority groups had lower odds of unmet need for treatment than heterosexual men and women.

Sexual orientation and gender differentially influenced treatment utilization, particularly among those who did not have a diagnosed disorder but perceived a need for treatment. Diagnostic criteria appear to be less relevant to understanding treatment use in sexual minority populations. (Psychiatric Services 62:404–410, 2011)