Aspects of body image as moderators and mediators in the relationship between minority stress and depression among diverse LGBTQIA+ identities

LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex, Asexual, plus) individuals are at higher risk of adverse mental health outcomes than cisgender heterosexual (cishet) individuals due to experiences of minority stress. In the current study, we compared levels of appearance anxiety, depressive symptoms, body appreciation and self-esteem among LGBTQIA+ and cishet individuals. Further, among LGBTQIA+ individuals, we tested a hybrid theoretical model to examine the protective effects of body appreciation and self-esteem in the relationships between minority stress, appearance anxiety, and depression. A total of 581 participants (aged 16–65) completed demographic and psychometric measures, including the Minority Stress Measure, Body Appreciation Scale-2, Rosenberg Self-Esteem Scale, Physical Appearance State and Trait Anxiety Scale, and Beck Depression Inventory, via an online survey. Results confirmed that LGBTQIA+ individuals had poorer mental health outcomes than cishet participants, characterised by higher levels of depressive symptoms and appearance anxiety, and lower body appreciation and self-esteem. Further, our hybrid model showed that LGBTQIA+ individuals with lower body appreciation and self-esteem were particularly vulnerable to appearance anxiety and depression related to minority stress, whilst body appreciation reduced the impact of minority stress on depression. These findings may inform potential directions for interventions targeted towards LGBTQIA+ populations.