Sexual Orientation, Transgender Identity Not Reported in Psychotherapy Outcome Studies

Despite known mental health disparities on the basis of sexual orientation and nonbinary gender identification, researchers are not reporting sexual orientation and transgender identities of study subjects in psychotherapy outcome studies for anxiety and depression, a new study concluded. The study, “Omitted Data in Randomized Controlled Trials for Anxiety and Depression: A Systematic Review of the Inclusion of Sexual Orientation and Gender Identity,” was published in the June 16, 2016, issue of the American Psychological Association’s Journal of Consulting and Clinical Psychology.

This oversight makes it difficult to conclude whether or not the treatments explored in the studies work for lesbian, gay, bisexual, or transgender (LGBT) people, according to Nicholas Heck, PhD, assistant professor of psychology at Marquette University in Milwaukee, Wisconsin, and colleagues. The team reviewed more than 2400 published journal articles from 2004, 2009, and 2014 in the PubMed and PsycINFO databases, and then identified 232 of these as randomized controlled trials of psychological and behavioral interventions for anxiety and depression. Of the 232 papers, only one study reported participants’ LGBT status and none of the articles included nonbinary gender identities. A total of 52,769 people were included in the trials, 93 of which were conducted in the United States. Forty-three of the studies acknowledged funding by the National Institutes of Health.

Heck said the finding was an important one for mental health professionals to be aware of, because omission of these data pose significant challenges for determining whether our existing interventions are effective for LGBT people.

“Further, that data could lead the field to identify treatments that may require modification to address the unique needs of this population,” he noted.

The finding reflects a larger problem in the behavioral sciences of not enough researchers querying and reporting LGBT identities in their research, said study coauthor Annesa Flentje, PhD, assistant professor at University of California San Francisco. Flentje said the study team hopes that its data will result in more researchers asking study subjects about LGBT status, and will encourage LGBT patients to feel empowered to ask if the treatments for anxiety and depression they are receiving have been shown to work for people in the LGBT community.

The researchers concluded that current reporting practices must change to ensure that our interventions generalize to LGBT persons, who are already an underserved population that, according to the National Alliance on Mental Illness, is almost 3 times more likely than others to experience a mental health condition such as major depression or generalized anxiety disorder.