(041) LGBTQ+ Young Adult Males’ Views on Antidepressants and Conversations About Sexual Dysfunction
Authors: Li O , Rabinowitz M , Eaton C , Haney N , Kohn T , Pil E , Herati A 
Published: May 2023

Abstract

Introduction
Mental illness among US young adults has risen dramatically among LGBTQ+ people. LGBTQ+ young adults are also at a notably higher risk for suicide. Selective Serotonin Reuptake Inhibitors (SSRIs), the first-line treatment for anxiety and depression, are believed to cause sexual dysfunction in many users. Previous studies indicate a low percentage of patients who experience iatrogenic sexual dysfunction discuss these issues with physicians. This lack of open communication is particularly of concern for sexual minority people because of preexisting societal prejudice. Despite this, there is a paucity of research characterizing the willingness of LGBTQ+ people to discuss sexual dysfunction with peers or care providers and their opinions about antidepressants.

Objective
To assess if LGBTQ+ young adult males endorse different attitudes towards disclosure of sexual dysfunction and preference for sexual-sparing antidepressants compared to heterosexual young adult males.

Methods
An anonymous questionnaire was distributed to biological males ages 18 to 35 via social media. The questionnaire assessed demographic information, sexual identity, the Patient Health Questionnaire-8 (PHQ-8), the General Anxiety Disorder-7 (GAD-7), and attitudes towards antidepressants. Participants were asked to indicate their perceptions of three deidentified antidepressants (SSRIs, Bupropion, and Mirtazapine) after being prompted with their most common side effects. Conversations about sexual health were analyzed using a 5-point Likert scale (1= strongly disagree; 5 = strongly agree). Participants also ranked their top three most difficult discussion topics with doctors across seven areas of health (ie. mental, libido, erectile function); a “difficulty score” was given for each selection (unranked = 0; 1st choice = 3).

Results
Of the 665 questionnaires distributed, 505 were received (76% response rate). Nineteen responses were excluded due to extremely low duration of time to completion. Of the 486 responses included, 100 participants identified as LGBTQ+ (Table 1). LGBTQ+ males scored significantly higher on PHQ-8 and GAD-7 surveys compared to heterosexuals and had higher rates of previously diagnosed mental health illness (Table 2). While our overall sample displayed a strong preference for atypical antidepressants over SSRIs, LGBTQ+ males displayed an even greater preference for these sexual-sparing agents compared to heterosexuals (p = 0.023). Compared to heterosexual respondents, LGBTQ+ males were reportedly less embarrassed to talk about general sexual problems with friends and doctors (p = 0.0197; p = 0.0099) yet reported greater difficulty specifically in discussing with a doctor their ability to have sex with a partner (p = 0.0010) (Table 3).

Conclusions
Our data supports previous evidence that LGBTQ+ young adults report greater levels of mental illness and use of antidepressants compared to heterosexual peers. Our LGBTQ+ respondents’ stronger preference for sexual sparing antidepressants and lower levels of embarrassment in talking about sexual problems may reflect the open, sex-positive culture fostered within the LGBTQ+ community. Despite these findings, pervasive societal stigmatization of sexual minority people may contribute to why some topics of sexual function were more difficult to broach with a provider compared to heterosexual respondents.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Dadi, Teleflex, Lina