active men and women using data from the National Household Survey of Drug Abuse. Men who have sex with men were more likely than exclusively heterosexual men to be diagnosed with major depression. Homosexually active women were no more likely than exclusively heterosexual women to evidence major depression syndrome.

Cochran and colleagues (2003), using data from the MIDUS survey, found that the sample of self-identified gay and bisexual men (combined for analysis) showed a higher prevalence of depression than heterosexual men. Gilman and colleagues (2001), using data from the National Comorbidity Survey, found that women with any same-sex partner had a significantly higher 12-month prevalence of major depression than women with only different-sex partners. Conron and colleagues (2008), using data from the Massachusetts Behavioral Risk Factor Surveillance System survey of adults aged 18–64 (n = 38,910), found that bisexual adults were significantly more likely to report feeling “sad or blue” than either heterosexual or lesbian and gay adults.

Cochran and colleagues (2007c) also looked at differences in mental health disorders using data from the National Latino and Asian American Study (n = 4,488). Sexual orientation was defined based on self-identity and past-year history of sexual experiences. Those who identified as gay, lesbian, or bisexual and/or reported any same-sex sexual experiences in the past year (n = 245) were compared with the rest of the sample. Results showed that lesbian/bisexual women were significantly more likely than heterosexual women to meet criteria for depressive disorders, either in the past year or in lifetime histories. Similarly, gay/bisexual men were significantly more likely than heterosexual men to report a recent suicide attempt. The authors note that the prevalence of mental health disorders found in sexual-minority Latinos and Asian Americans was similar to or lower than that found in population-based studies of lesbian, gay, and bisexual adults in general.

Rates of depression among transgender people are far less well studied. In a convenience sample of 392 transgender women and 123 transgender men aged 18–67 in San Francisco, rates of depression ranged from 5 percent among transgender men to 62 percent among transgender women (Clements-Nolle et al., 2001). Among LGBT participants in a sexual health seminar intervention, 52 percent of transgender participants (n = 207) reported depression. This was a higher percentage than that among men who have sex with men (n = 480, 38 percent) or bisexually active women (n = 122, 40 percent) (Bockting et al., 2005a). In their meta-analysis of 29 transgender studies, Herbst and colleagues (2008) found that a large percentage (weighted mean 43.9 percent) of transgender respondents indicated a desire for mental health counseling to address transgender-specific issues.

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