Associations Between State Policies and Sexual Minority Mental Health Disparities

Despite growing social acceptance, mental health disparities persist between sexual minorities—people who identify as lesbian, gay, or bisexual—and heterosexuals. A growing body of research demonstrates that the presence of structural stigma in one’s environment may contribute to such disparities. In this study, we examine state-level policy as one form of structural stigma that may help to explain these disparities. Specifically, we conducted a secondary data analysis of a large population-based survey (i.e., the Household Pulse Survey, N = 824,500, including all 50 U.S. states and the District of Columbia) to test whether state-level policies (i.e., religious exemption laws and nondiscrimination laws) were associated with anxiety and depression for sexual minorities and heterosexual adults. We found that both religious exemption laws and nondiscrimination laws were associated in expected directions with both anxiety and depression, though the effect was stronger for sexual minorities compared to heterosexuals. Moreover, these findings persisted after controlling for other individual- and state-level variables. Overall, this demonstrates the role of policy, as one form of structural stigma, in contributing to the mental health of sexual minorities. The limitations and directions for future research also are discussed.