Erik Lamontagne, Vincent Leroy, Sean Howell, Sylvie Boyer, B. Ventelou, Nature Human Behaviour, 12/2025
Abstract
Here we explore the well-being of sexual and gender diverse (LGBTQ+) people using three socioecological dimensions of homophobia, family, community and national and their socioeconomic status via a convenience sample of 82,324 participants. Participants from the Middle East and North Africa reported the lowest subjective well-being (mean 4.78, s.d. of 2.70), followed by Eastern Europe and Central Asia (mean 5.22, s.d. of 2.13). The Structural Homophobic Climate Index (β = -1.68, 95% confidence interval (CI) -2.38 to -0.99) and family-level homophobia (β = -0.84, 95% CI -0.87 to -0.81) were negatively related to LGBTQ+ well-being. Economic precarity significantly interacted with the negative association between homophobia and participants' well-being. The weight of a country's homophobic climate on well-being was nearly halved for economically secure participants compared with those economically deprived. Participants unaware of their human immunodeficiency virus status reported the lowest well-being (β = -0.20, 95% CI -0.23 to -0.16) controlling for homophobia. Public health measures should address homophobic stigma and discrimination, focusing on the lowest socioeconomic strata.