PREDICTIVE FACTORS OF LONELINESS AMONG LESBIAN, GAY, BISEXUAL, AND TRANSGENDER (LGBT) POPULATION IN THAILAND
Main Article Content
Abstract
Objective: To examine loneliness levels and its predictors among Thai LGBT populations.
Methods: This cross-sectional research study was conducted in collaboration with the Rainbow Sky Association of Thailand. Data collection was completed using online and in-person surveys. Convenience and snowball samplings were applied for study recruitment. This study selected, translated, and applied standardized measures related to the study framework, guided by the Minority Stress Model. These measures include measures of sociodemographic factors, health risk behaviors, minority-specific stressors, and loneliness inventory. T-test, ANOVA, Pearson Correlation and Multiple Regression were used for data analysis.
Results: There were 410 subjects with an average age of 29.5 years (SD = 7.4, range 18–53). The majority of participants reported being male (90.5%), homosexual (79.3%), and cisgender (76.6%). Almost half of LGBT participants (42.2%) (mean = 1.93, SD = .56) reported moderate to high levels of loneliness. The outcomes of bivariate analyses on loneliness were mixed. Significant correlations of loneliness included the experience of discrimination (ß = .03 p < .01), victimization (ß = .14, p < .05), concealment (ß = -.06, p < .001), and internalized homophobia (ß = .06, p < .05). In multivariate logistic regression, the combined influences of the minority-specific stress variables explained of the variance in loneliness scores (F[12.081] = 20.48, p < .001).
Conclusion: The prevalence of loneliness was common among Thai LGBT individuals. Influencing factors associated with loneliness were related to minority-specific stressors. Study findings have implications for psychiatric nursing practice and the development of intervention research.
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ได้รับการตีพิมพ์แล้ว เป็นลิขสิทธิ์ของสมาคมพยาบาลจิตเวชแห่งประเทศไทย
References
กรมสุขภาพจิต. (28 มีนาคม 2562). ความหลากหลายทางเพศ (sexual diversity). https://dmh.go.th/news/view.asp?id=2256
ปริยศ กิตติธีระศักดิ์, Alicia K. Matthews และ Alana Steffen. (2562). ความตรงเชิงเนื้อหาและการตรวจสอบเชิงภาษาของแบบวัดรสนิยมและอัตลักษณทางเพศฉบับแปลสำหรับใช้ในงานวิจัยในผู้ที่มีความหลากหลายทางเพศในประเทศไทย. พยาบาลสาร, 46(4), 122-137.
ปริยศ กิตติธีระศักดิ์, Alicia K. Matthews และ Chang Park. (2563). คุณสมบัติทางจิตมิติของแบบวัดประสบการณ์การเลือกปฏิบัติในกลุ่มที่มีความหลากหลายทางเพศ ฉบับภาษาไทย. วารสารการพยาบาลจิตเวชและสุขภาพจิต, 34(1).
ปริยศ กิตติธีระศักดิ์, จินต์ณาภัส แสงงาม และ Alicia K. Matthews. (2561). หลักพื้นฐานของการพยาบาลเด็กและวัยรุ่นในการส่งเสริมสุขภาวะทางจิตและจิตสังคมในเด็กที่มีความหลากหลายทางเพศในประเทศไทย. วารสารพยาบาลศาสตร์, 36(1), 4-16.
ปริยศ กิตติธีระศักดิ์, ธนัตตา สุขสกุลวัฒน์, ศุภชัย รักแก้ว และทิพย์สุดา สำเนียงเสนาะ. (2565). การแปลด้วยวิธีกรรมการ: แนวปฏิบัติสำหรับการแปลเครื่องมือที่ใช้ในงานวิจัย. วารสารการพยาบาลและการศึกษา, 15(4), 80-90.
ปริยศ กิตติธีระศักดิ์, และ Alicia K. Matthews. (2562). แบบจำลองความเครียดในคนกลุ่มน้อย: กรอบแนวคิดของภาวะเสี่ยงทางสุขภาพจิตในคนกลุ่มน้อยทางเพศและเพศสภาวะ. วารสารการพยาบาลจิตเวชและสุขภาพจิต, 33(1), 1-17.
วริษา องสุพันธ์กุล.(2567). SDG Updates | ทับซ้อนและทวีคูณ: คลี่ชั้นความรุนแรงที่ LGBTQI ต้องเผชิญ.https://www.sdgmove.com/2023/06/28/sdg-updates-gender-equality-lgbtqi/#[1]
สุพรรณี นันทชัย. (2534). ความสัมพันธ์ระหว่างความว้าเหว่และภาวะสุขภาพของผู้สูงอายุ. [วิทยานิพนธ์ปริญญามหาบัณฑิต]. มหาวิทยาลัยเชียงใหม่.
Akdoğan, R., & Çimşir, E. (2019). Linking inferiority feelings to subjective happiness: Self-concealment and loneliness as serial mediators. Personality and Individual Differences, 149, 14-20.
Chaney, M. P. (2008). Muscle dysmorphia, self-esteem, and loneliness among gay and bisexual men. International Journal of Men's Health, 7(2).
Cocchran, W. G. (1953). Sampling Techniques. (2nd ed). John Wiley and Sons.
Collins, K. M., & Levitt, H. M. (2021). Heterosexism and the self: A systematic review informing LGBQ-affirmative research and psychotherapy. Journal of Gay & Lesbian Social Services, 33(3), 376-405.
de Lange, J., Baams, L., van Bergen, D. D., Bos, H. M. W., & Bosker, R. J. (2022). Minority stress and suicidal ideation and suicide attempts among LGBT adolescents and young adults: A meta-analysis. LGBT health, 9(4), 222-237.
Elmer, E. M., van Tilburg, T., & Fokkema, T. (2022). Minority stress and loneliness in a global sample of sexual minority adults: The roles of social anxiety, social inhibition, and community involvement. Archives of Sexual Behavior: The Official Publication of the International Academy of Sex Research, 51(4), 2269-2298.
Fish, J., & Weis, C. (2019). All the lonely people, where do they all belong? An interpretive synthesis of loneliness and social support in older lesbian, gay and bisexual communities. Quality in Ageing and Older Adults, 20(3), 130-142.
Flentje, A., Heck, N. C., Brennan, J. M., & Meyer, I. H. (2020). The relationship between minority stress and biological outcomes: A systematic review. Journal of Behavioral Medicine, 43(5), 673-694.
Garcia, J., Vargas, N., Clark, J. L., Magaña Álvarez, M., Nelons, D. A., & Parker, R. G. (2020). Social isolation
and connectedness as determinants of well-being: Global evidence mapping focused on LGBTQ youth. Global Public Health, 15(4), 497-519.
Gorczynski, P. P., & Fasoli, P. F. (2022). Loneliness in sexual minority and heterosexual individuals: A comparative meta-analysis. Journal of Gay & Lesbian Mental Health, 26(2), 112-129.
Hamburger, M. E., Basile, K. C., & Vivolo, A. M. (2011). Measuring bullying victimization, perpetration, and bystander experiences; A compendium of assessment tools. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. https://www. cdc.gov/violenceprevention/pdf/bullycompendium-a.pdf
Hoy-Ellis C. P. (2023). Minority stress and mental health: A review of the literature. Journal of Homosexuality, 70(5), 806-830.
Hughes, M. (2016). Loneliness and social support among lesbian, gay, bisexual, transgender and intersex people aged 50 and over. Ageing & society, 36(9), 1961-1981.
Jacobs, R. J., & Kane, M. N. (2012). Correlates of loneliness in midlife and older gay and bisexual men. Journal of Gay & Lesbian Social Services, 24(1), 40-61.
Jadva, V., Guasp, A., Bradlow, J. H., Bower-Brown, S., & Foley, S. (2023). Predictors of self-harm and suicide in LGBT youth: The role of gender, socio-economic status, bullying and school experience. Journal of Public Health, 45(1), 102-108.
Jefferson, R., Barreto, M., Jones, F., Conway, J., Chohan, A., Madsen, K. R., Verity, L., Petersen, K. J., & Qualter, P. (2023). Adolescent loneliness across the world and its relation to school climate, national culture and academic performance. The British Journal of Educational Psychology, 93(4), 997-1016.
Kittiteerasack, P., Matthews, A. K., & Park, C. (2021). Psychometric properties of the Thai version of the Internalized sexual stigma scale for research on lesbian, gay, bisexual, and transgender (LGBT) populations. Psychology & Sexuality, 15(3), 305-317.
Kittiteerasack, P., Matthews, A. K., Steffen, A., Corte, C., McCreary, L. L., Bostwick, W., Park, C., & Johnson, T. P. (2021). The influence of minority stress on indicators of suicidality among lesbian, gay, bisexual and transgender adults in Thailand. Journal of Psychiatric and Mental Health Nursing, 28(4), 656-669.
Kittiteerasack, P., Matthews, A. K., & Steffen, A. D. (2022). Loneliness mediates the association of minority stress and depression in sexual and gender minority populations in Thailand. Research in Nursing & health, 45(5), 580-591.
Kotwal, A. A., Fuller, S. M., Myers, J. J., Hill, D., Tha, S. H., Smith, A. K., & M Perissinotto, C. (2021). A peer intervention reduces loneliness and improves social well-being in low-income older adults: A mixed-methods study. Journal of the American Geriatrics Society, 69(12), 3365–3376.
Krieger, N., Smith, K., Naishadham, D., Hartman, C., & Barbeau, E. M. (2005). Experiences of discrimination: Validity and reliability of a self-report measure for population health research on racism and health. Social Science & Medicine, 61(7), 1576-1596.
Lee, H., & Miller, V. J. (2020). The disproportionate impact of COVID-19 on minority groups: A social justice concern. Journal of Gerontological Social Work, 63(6-7), 580-584.
Matthews, T., Caspi, A., Danese, A., Fisher, H. L., Moffitt, T. E., & Arseneault, L. (2022). A longitudinal twin study of victimization and loneliness from childhood to young adulthood. Development and Psychopathology, 34(1), 367–377.
Medina, C., Mahowald, L., & Gruberg, S. (20 April 2021). Millions will gain nondiscrimination protections under the equality act: State-by-state fact sheets. https://www. americanprogress.org/article/millions-will-gain-nondiscrimination-protections-equality-act/
Mereish, E. H., Katz-Wise, S. L., & Woulfe, J. (2017). Bisexual-specific minority stressors, psychological distress, and suicidality in bisexual individuals: The mediating role of loneliness. Prevention Science, 18(6), 716-725.
Mereish, E. H., O'Cleirigh, C., & Bradford, J. B. (2014). Interrelationships between LGBT-based victimization, suicide, and substance use problems in a diverse sample of sexual and gender minorities. Psychology, Health & Medicine, 19(1), 1-13.
Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674-697.
Moallef, S., Salway, T., Phanuphak, N., Kivioja, K., Pongruengphant, S., & Hayashi, K. (2022). The relationship between sexual and gender stigma and suicide attempt and ideation among LGBTQI+ populations in Thailand: Findings from a national survey. Social psychiatry and psychiatric epidemiology, 57(10), 1987-1997.
Mohr, J., & Fassinger, R. (2000). Measuring dimensions of lesbian and gay male experience. Measurement and Evaluation in Counseling and Development, 33(2), 66–90.
Morrish, N., Choudhury, S., & Medina-Lara, A. (2023). What works in interventions targeting loneliness: a systematic review of intervention characteristics. BMC public health, 23(1).
National Academies of Sciences Engineering and Medicine. (2020). Social isolation and loneliness in older adults: Opportunities for the health care system. The National Academies Press (US). https://doi.org/10.17226/25663
Nelson, T., Brown, M. J., Garcia-Rodriguez, I., & Moreno, O. (2023). Gendered racism, anxiety, and depression: The mediating roles of gendered racialized stress and social isolation. Ethnicity & Health, 28(1), 12-28.
Lin, P. C., Chang, Y. P., Chen, Y. L., & Yen, C. F. (2024). Mediating effect of loneliness on the associations of perceived and internalized sexual stigma with suicide in gay and bisexual men. Journal of the Formosan Medical Association.
Ojanen, T., Ratanashevorn, R., & Boonkerd, S. (2016). Gaps in responses to LGBT issues in Thailand: Mental health research, services, and policies. Psychology of Sexualities Review, 7(1), 41-59.
Peltzer, K., & Pengpid, S. (2017). Loneliness and health risk behaviors among ASEAN adolescents. Iranian Journal of Psychiatry and Behavioral Sciences, 11(3).
Perrenoud, M., Bataille, P., & Elcheroth, G. (2023). Mixed method approaches for data collection in hard-to-reach populations. In D. Spini & E. Widmer (Eds.), Withstanding Vulnerability throughout Adult Life: Dynamics of Stressors, Resources, and Reserves (pp. 337-357). Springer Nature Singapore.
Ramasamy, R. S., Subhi, N., & Rajaratnam, S. (2023). Relationship between minority stress towards loneliness among LGBT adults in Malaysia. International Journal of Academic Research in Business and Social Sciences, 13(12), 312-320.
Ribeiro-Gonçalves, J. A., Pereira, H., Costa, P. A., Leal, I., & de Vries, B. (2022). Loneliness, social support, and adjustment to aging in older Portuguese gay men. . Sexuality Research and Social Policy, 19(1), 207-219.
Russell, D. W. (1996). UCLA loneliness scale (Version 3): Reliability, validity, and factor structure. Journal of Personality Assessment, 66(1), 20-40.
Salway, T., Ferlatte, O., Gesink, D., & Lachowsky, N. J. (2020). Prevalence of exposure to sexual orientation change efforts and associated sociodemographic characteristics and psychosocial health outcomes among Canadian sexual minority men. Canadian Journal of Psychiatry, 65(7), 502-509.
Shepp, K., Drescher, C. F., Griffin, J. A., & Stepleman, L. M. (2023). Loneliness in sexual minority individuals in the Southeastern United States: The role of minority stress and resilience. Journal of Homosexuality, 70(5), 963-988.
Shokoohi, M., Kinitz, D. J., Pinto, D., Andrade-Romo, Z., Zeng, Z., Abramovich, A., Salway, T., & Ross, L. E. (2022). Disparities in alcohol use and heavy episodic drinking among bisexual people: A systematic review, meta-analysis, and meta-regression. Drug and Alcohol Dependence, 235.
Snow, J., & Mann, M. (2012). Qualtrics Survey Software: Handbook for Research Professional. Provo, UT: Qualtrics Labs.
Statista Research Department. (14 December 2022). Share of people experiencing loneliness in Thailand in 2022. https://www.statista.com/statistics/1345950
Surkalim, D. L., Luo, M., Eres, R., Gebel, K., van Buskirk, J., Bauman, A., & Ding, D. (2022). The prevalence of loneliness across 113 countries: Systematic review and meta-analysis. BMJ (Clinical research ed.).
Thoma, B. C., Eckstrand, K. L., Montano, G. T., Rezeppa, T. L., & Marshal, M. P. (2021). Gender nonconformity and minority stress among lesbian, gay, and bisexual individuals: A meta-analytic review. Perspectives on Psychological Science: A Journal of the Association for Psychological Science, 16(6), 1165-1183.
World Health Organization. (2021). Social Isolation and Loneliness. https://www.who.int/teams/social-determinants-of-health/demographic-change-and-healthy-ageing/social-isolation-and-loneliness
World Health Organization. (2023). Loneliness and social isolation are health risks. https://www.who.int/multi-media/details/loneliness-and-social-isolation-are-health-risks
Yadegarfard, M., Ho, R., & Bahramabadian, F. (2013). Influences on loneliness, depression, sexual-risk behaviour and suicidal ideation among Thai transgender youth. Culture, Health & Sexuality, 15(6), 726-737.
Yadegarfard, M., Meinhold-Bergmann, M. E., & Ho, R. (2014). Family rejection, social isolation, and loneliness as Predictors of negative health outcomes (depression, suicidal ideation, and sexual risk behavior) among Thai male-to-female transgender adolescents. Journal of LGBT Youth, , 11(4), 347-363.