Prevalence of psychiatric disorders at the intersection of race and sexual orientation: Results from the National Epidemiologic Survey of Alcohol and Related Conditions-III.

Objective: Sexual minority individuals display elevated rates of psychiatric and substance use disorders compared with heterosexuals. Racial/ethnic minority individuals report lower prevalence of disorders compared with White individuals. Research on sexual minority mental health often neglects research on racial/ethnic minority mental health and vice versa. Therefore, at the intersection of sexual and racial/ethnic minority status, the prevalence of disorders remains unclear. Method: In a nationally representative sample (N = 36,309), we compared disorder prevalence between sexual minorities and same-race/ethnicity heterosexuals. We then examined the extent to which differences in disorder prevalence between sexual minorities and heterosexuals can be attributed to differences in discrimination experiences related to sexual minority status. We next compared prevalence of disorders for Black and Hispanic with White sexual minority individuals. We examined whether these patterns of associations were reflective of transdiagnostic factor differences among groups. Results: Regardless of race/ethnicity, sexual minority individuals experience higher prevalence of disorders than heterosexuals. Controlling for discrimination experiences partially negates these disparities. At the intersection of racial/ethnic and sexual minority status, disorder prevalence is more nuanced: Although Black sexual minority individuals experience lower prevalence of disorders than Whites, Hispanic sexual minority individuals experience similar prevalence of disorders to Whites. Similar findings are observed using a transdiagnostic factors framework. Conclusions: These findings reveal important intersectional nuances in the prevalence of psychopathology often overlooked in the race/ethnicity and sexual orientation literatures. These results can inform future scholarship on risk and resilience among marginalized populations, including identifying protective factors associated with possessing certain multiple minority statuses.