Epidemiologic Burden of Depressive Episode and Suicidal Ideation Among Older Lesbian, Gay, and Bisexual Adults: A Five-Year National Survey Study
This five-year national survey study reveals that older lesbian, gay, and bisexual adults, particularly bisexual individuals, experience a disproportionate burden of major depressive episodes and suicidal ideation compared to their heterosexual peers, with these mental health indicators worsening significantly during the COVID-19 pandemic.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
The Invisible Backpacks of Growing Up
Imagine that everyone carries a backpack as they walk through life. For most people, this backpack is relatively light, filled with the usual stuff: school, work, family, and hobbies. But for some people, the backpack is much heavier because it's filled with extra stones: the stress of being treated differently, the fear of being rejected, and the constant worry about whether it's safe to be your true self. In the world of science, this is called "minority stress." It's a well-known idea that when society treats a group of people unfairly—whether because of their skin color, where they live, or who they love—it creates a heavy, invisible weight that can make them sicker, both in body and mind.
This weight gets even heavier as people get older. Think of aging like climbing a mountain; everyone gets tired, but if you are already carrying a heavy backpack of stress, the climb becomes much harder. Scientists have long known that people who are lesbian, gay, or bisexual (LGB) often face more mental health struggles, like feeling very sad (depression) or thinking about ending their lives (suicidal ideation), compared to their straight friends. But there was a big gap in our knowledge: we didn't know exactly how this heavy backpack felt for older LGB adults during the massive global event of the COVID-19 pandemic. Did the pandemic make the stones in their backpacks heavier? Did it make the climb impossible for some? This is the question that researchers wanted to answer.
The Heavy Backpacks of Older LGB Adults
A team of researchers decided to take a giant snapshot of the United States to see how the mental health of older adults changed before and during the pandemic. They looked at data from nearly 60,000 people aged 50 and older, asking them about their sexual identity (whether they were straight, gay/lesbian, or bisexual) and how they were feeling. They used a special "mood meter" called the K6 scale to measure depression and asked a simple, serious question: "Have you thought about killing yourself in the last year?"
The results painted a clear, and somewhat sad, picture. Before the pandemic hit (between 2015 and 2019), older LGB adults were already carrying heavier backpacks than their straight peers. Their "mood meter" scores were higher, meaning they were feeling more psychological distress. But when the pandemic arrived (2020–2021), the backpacks got even heavier for everyone, but the weight increased the most for the sexual minority groups.
Here is what the numbers showed:
- Depression Scores: Before the pandemic, the average score for straight adults was 2.88. For gay/lesbian adults, it was 4.09, and for bisexual adults, it was 4.39. During the pandemic, these numbers went up for everyone. Straight adults rose to 2.99, gay/lesbian adults to 4.64, and bisexual adults jumped to 5.38. This suggests that while everyone felt the strain of the pandemic, bisexual older adults were feeling the most intense pressure.
- Thinking About Suicide: The gap here was even starker. Before the pandemic, 6.72% of bisexual adults had thought about suicide, compared to 4.80% of gay/lesbian adults and a much lower number for straight adults. During the pandemic, the percentage for bisexual adults nearly doubled to 12.42%, and for gay/lesbian adults, it rose to 6.56%.
The researchers also looked at men and women separately and found some interesting twists. Generally, older women had higher scores for depression and difficulty functioning in daily life than men. However, when it came to the pandemic, the risk of thinking about suicide spiked dramatically for older men who were sexual minorities. Specifically, bisexual men saw a huge jump in these thoughts, rising from a lower baseline to 16.23% during the pandemic. Gay men also saw a significant increase.
The study suggests that being bisexual might be the "heaviest" backpack of all. The researchers think this is because bisexual older adults often face a unique kind of stress: they might feel misunderstood or unsupported by both straight communities and gay/lesbian communities, leading to a feeling of being stuck in the middle. This "role strain" seems to make them more vulnerable to depression and suicidal thoughts, especially when the world gets scary, like during a pandemic.
The authors also checked if other factors, like drug use, were the main reason for these feelings. They found that while drug use does play a part, it doesn't explain everything. Even after accounting for drugs, money, and family life, the link between being LGB and feeling depressed or thinking about suicide remained strong. This suggests that the stress comes from the identity itself and how society treats it, not just from other life problems.
In short, this study confirms that older LGB adults, and especially bisexual older adults, are carrying a disproportionately heavy load of mental health struggles. The pandemic didn't just add a few more stones to their backpacks; it made the whole journey much more dangerous. The researchers suggest that we need to build better support systems—like special rest stops and lighter backpacks—for these communities, ensuring that their unique challenges are understood and addressed. The data doesn't just tell us that the problem exists; it shows us exactly who is struggling the most, so we can know who needs help the most right now.
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