Psychosocial burden of discrimination based on sexual orientation in university students-A cross-sectional analysis.

Introduction: Sexual minority individuals continue to face prejudice and discrimination within medical care and academic settings. This contributes to elevated stress levels, which increases their vulnerability to mental health issues like anxiety and depression. Studies examining the mental health, financial situation, loneliness, and help-seeking behavior of students who have experienced discrimination based on their sexual orientation remain scarce. Therefore, this study aims to address this research gap by assessing mental health outcomes, loneliness, impairment status, income, and help-seeking behavior in a large cohort of university students in eastern Germany, comparing these variables between participants who experienced discrimination due to sexual orientation and those who did not. Methods: An online survey was conducted to assess university students' mental health, as well as to identify relevant risk and protective factors. The questionnaire included questions on various forms of discrimination experienced by participants, including discrimination based on sexual orientation. The final sample comprised 2,625 students, of which 2,569 answered the questionnaire for discrimination experiences and were included in this study. Sociodemographic variables, income, mental health outcomes (assessed via PHQ-9, GAD7, EDE-Q8, and AUDIT-C), help-seeking behavior, impairment status, and loneliness (measured with UCLA-3) were used to examine group differences between participants reporting experiences of discrimination based on sexual orientation and those without discrimination based on sexual orientation. Results: Results indicated that participants reporting discrimination based on sexual orientation had a significantly higher prevalence of diagnosed mental illness, impairment affecting study, and suicidal thoughts, as well as a higher mean PHQ-9 and GAD-7 score compared to the students without experiences of discrimination based on sexual orientation. Students facing discrimination based on sexual orientation reported more frequent impairments affecting their studies. No significant differences between the groups were observed in hazardous alcohol use (AUDIT-C), eating disorder symptoms (EDE-Q8), loneliness (UCLA-3) and monthly income. Discussion: The findings highlight the association between discrimination based on sexual orientation and poorer mental health among sexual minority university students. Moreover, the results emphasize the need for targeted mental health services and more inclusive support structures for sexual minority students at university.