Psychiatric morbidity associated with same-sex sexual behaviour: influence of minority stress and familial factors

Psychol Med. 2010 Feb;40(2):315-24. doi: 10.1017/S0033291709005996. Epub 2009 May 22.


Background: Increased psychiatric morbidity has been widely reported among non-heterosexual individuals (defined as reporting a homosexual/bisexual identity and/or same-sex sexual partners). However, the causes of this psychiatric ill-health are mostly unknown.

Method: We attempted to estimate the influence of minority stress and familial factors on psychiatric disorder among adults with same-sex sexual partners. Self-report data from a 2005 survey of adults (age 20-47 years, n=17,379) in the population-based Swedish Twin Registry were analysed with regression modelling and co-twin control methodology.

Results: Rates of depression, generalized anxiety disorder (GAD), eating disorders, alcohol dependence and attention deficit hyperactivity disorder (ADHD) were increased among men and women with same-sex sexual experiences. Adjusting for perceived discrimination and hate crime victimization lowered this risk whereas controlling for familial (genetic or environmental) factors in within-twin pair comparisons further reduced or eliminated it.

Conclusions: Components of minority stress influence the risk of psychiatric ill-health among individuals with any same-sex sexual partner. However, substantial confounding by familial factors suggests a common genetic and/or environmental liability for same-sex sexual behaviour and psychiatric morbidity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Twin Study

MeSH terms

  • Adult
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Bisexuality / psychology*
  • Bisexuality / statistics & numerical data
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology
  • Depressive Disorder / genetics*
  • Female
  • Homosexuality / psychology*
  • Homosexuality / statistics & numerical data
  • Humans
  • Male
  • Registries
  • Sexual Behavior* / psychology
  • Social Environment
  • Twins / psychology*
  • United Kingdom / epidemiology