Mental health status of LGBT in Kathmandu, Nepal and the role of victimisation, discrimination, connectedness and identity affirmation: a cross-sectional study
Puja Bisunke, Laxmi Gautam, Bikash Bahadur BistBackground
Lesbian, gay, bisexual and transgender (LGBT) individuals are among the most oppressed, least visible and marginalised groups in Nepal. They endure persistent social marginalisation, harsh discrimination and violence in both public and private settings. Gender-related discrimination, victimisation, rejection, non-affirmation, internalised transphobia, negative expectations and non-disclosure have been linked with mental health problems among LGBT people throughout the world.
Methods
This study used a quantitative research method with a cross-sectional, descriptive and analytical design to study the LGBT population in the Kathmandu Valley. The standard tools, Gender Minority and Stress Resilience Measure and Depression, Anxiety and Stress Scale (DASS-21) were used to collect the data of 115 LGBT people through snowball sampling. The collected data were entered and analysed using SPSS IBM V.22.
Result
The participants in the study reported experiencing normal, mild, moderate, severe and extremely severe forms of stress (68.7%), anxiety (81.7%) and depression (82.6%) based on DASS-21 severity classification (normal, mild, moderate, severe and extremely severe). The research shows that more than 78% LGBT people faced gender-related discrimination, more than 87% LGBT people faced gender-related rejection and 94.8% faced gender-related victimisation at some point in their lives. The binary and multiple logistic regression analysis found that internalised transphobia is significantly associated with increased odds of stress (adjusted OR (AOR)=2.79, 95% CI 1.14 to 6.83, p=0.024). Similarly, experiencing discrimination (AOR=3.83, 95% CI 1.415 to 10.346, p=0.01), rejection (AOR=4.610, 95% CI 1.129 to 18.818, p=0.033) and stigmatisation (AOR=8.907, 95% CI 0.894 to 88.756, p=0.062) is significantly associated with anxiety. Additionally, experiencing rejection (AOR=6.081, p=0.010, 95% CI 1.541 to 23.992) and stigmatisation (AOR=5.113, p=0.009, 95% CI 1.506 to 17.366) is significantly associated with increased odds of depression.
Conclusion
Based on the results of this research, it can be concluded that a high percentage of LGBT individuals experience stress, anxiety and depression, and it is associated with gender-related discrimination, rejection, victimisation and internalised transphobia.