Loneliness, stress, and depression in the US

For the study, researchers analyzed data from the 2022 Behavioral Risk Factor Surveillance System, which collects information on various health risk behaviors, preventive health practices, and healthcare access. The researchers then took the data and examined links between loneliness and a lack of social and emotional support, as well as mental health variables.

Rates of loneliness were highest among people who identified as transgender, ranging from 56.4% among transgender female participants to 63.9% among transgender gender nonconforming participants. By comparison, loneliness rate was only 32.1% for cisgender participants.

In addition, 37.8% of transgender adults reported feelings of stress, compared to just under 14% of cisgender adults, and two-thirds of transgender adults reported a history of depression, compared to 21.4% of cisgender adults.

Meanwhile, among various sexual orientations, rates of loneliness were highest among bisexual participants at 56.7%, compared to 30.3% among straight participants.

More than half of bisexual adults also reported a history of depression, compared to 19.4% of straight adults, and 40.5% of bisexual adults reported frequent mental distress, compared to 14.2% of straight adults.

The researchers also found that women reported higher rates of loneliness, stress, frequent mental distress, and a history of depression than men, but men reported more of a lack of social and emotional support.

Discussion

According to the researchers, the findings "highlight the importance of integrating standardized measures of social connection into existing data systems and public health frameworks and initiatives. Improved surveillance can identify risk factors and help guide interventions to address the impacts of loneliness and lack of social and emotional support."

"Addressing the threat to mental health among sexual and gender minority groups should include consideration of loneliness and lack of social and emotional support," the researchers added. "Providing access to health services that are affirming for sexual and gender minority groups and collecting data to address health inequities might help improve the delivery of culturally competent care."

Adjoa Smalls-Mantey, a psychiatrist in New York, said the results of the study were unsurprising to her because many of her LGBTQ+ patients have discussed feeling lonely and isolated or facing rejection.

"They [often] don't feel comfortable coming out to people that are closest to them and they may hide away, not share that part of themselves, not engaged with people that they used to. So sometimes it can be self-imposed," she said.

Judith Joseph, a board-certified child, adolescent, and adult psychiatrist and clinical assistant professor at NYU Health, said she encourages LGBTQ+ individuals to connect with people outside of their home if they can't find the support they need.

"So that could be the person at the store if you go to buy something, rather than just saying. 'Oh, thank you and have a great day,' ask that store clerk, 'So, how's your day going?'" she said. "You can start a conversation with the barista at the coffee shop. These small interactions really help a lot of my clients who have cut off people because they were not accepted by their parents." (Kekatos/Okulaja, ABC News, 6/20; Robertson, MedPage Today, 6/20)

Loneliness has become a pressing health issue, with significant negative impacts to people's mental and physical health. As loneliness increases among both young people and older adults, health experts say that "rebuilding social connection … has to be a national priority." But how? Advisory Board's Sydney Moondra shares three things stakeholders should consider as they take on loneliness, and shares case studies of how some providers are working toward this goal.