Internalized homophobia and depression in homosexual and bisexual men and women: LGBT plus health survey, 2020

This study aimed to analyze the association between internalized homophobia and its domains and depression in homosexual and bisexual individuals and to quantify its results in depression. This is a cross-sectional online and anonymous study based on the LGBT+ health study conducted in Brazil from August to November, 2020, summing 926 respondents. Depression was self-reported. Internalized Homophobia was measured by the Brazilian Internalized Homophobia Scale for Gays and Lesbians, using 80% percentile to classify elevated total and by domain scores. Statistical analysis was based on Poisson Regression models with robust variance. Depression prevalence was 23.7%. The results revealed that internalized homophobia was positively associated with depression only among homosexuals (Prevalence Ratio (RP) = 1.80; 95% confidence interval (95%CI) 1.12-2.90). We found no statistical association for stigma and oppression domains. Population attributable fraction of depression was 2.3% (95%CI 0.1-4.5) in relation to internalized homophobia. Our findings highlight the need of controlling internalized homophobia to decrease the prevalence of depression among homosexuals.