Landmark Survey of 7,000 Students Reveals a Persistent Mental Health Gap for LGBTQ+ Youth in Spanish Universities

One of the largest investigations ever conducted into the mental health of sexual and gender minority university students has delivered a sobering verdict: even in a country with some of Europe’s strongest legal protections for LGBTQ+ people, students who identify as part of the community report substantially worse mental health than their cisgender heterosexual peers. The study, published in the journal Current Psychology, surveyed 7,080 students drawn from all twelve universities in the Catalan university system and found consistent, measurable elevations in depression, anxiety, stress, burnout, eating disorder risk, and attention-deficit/hyperactivity disorder (ADHD) symptoms among LGBTQ+ students.

The research formed part of a broader Study on Mental Health in the University System of Catalonia, an ambitious effort to chart psychological well-being across the entire student population. Of the roughly 19,000 students who answered the initial online survey, 16,525 questionnaires were fully completed. From this pool, 3,520 students identified themselves as belonging to the LGBTQ+ community, while a random comparison sample of 3,560 students who did not identify with the community was extracted for analysis. The survey was distributed between March and May 2023 through institutional email lists, and participation was anonymous and voluntary, with ethical approval secured from the review boards of every participating university.

The measurement strategy was thorough. Depression symptoms were screened with the nine-item Patient Health Questionnaire, anxiety with the seven-item Generalized Anxiety Disorder scale, eating disorder risk with the five-item SCOFF questionnaire, and ADHD symptoms with the six-item Adult ADHD Self-Report Scale screener. Perceived stress was captured with the abbreviated Perceived Stress Scale, burnout with the Maslach Burnout Inventory, and positive mental health with the Satisfaction With Life Scale and the WHO-5 Well-Being Index. Because LGBTQ+ students were on average younger than their peers, the researchers statistically controlled for age in all between-group comparisons, and they emphasized effect sizes over raw statistical significance given the very large sample.

The headline numbers are striking. On the depression scale, LGBTQ+ students averaged 12.4 points compared with 9.1 for cisgender heterosexual students, a difference that crosses the clinical threshold of 10 used to flag clinically significant depression. Anxiety scores followed the same pattern, with LGBTQ+ students averaging 10.7 versus 8.3. Stress levels, eating disorder risk scores, and ADHD symptom scores were all significantly elevated in the LGBTQ+ group, and the burnout inventory revealed higher emotional exhaustion and depersonalization alongside lower personal accomplishment. When the researchers applied established clinical cut-off scores, 61.8 percent of LGBTQ+ students exceeded the depression threshold compared with 40.2 percent of their peers, and 55.4 percent exceeded the anxiety threshold compared with 36.4 percent.

Translated into prevalence ratios, LGBTQ+ students faced a 35 to 58 percent higher likelihood of exceeding clinical symptom thresholds for anxiety, depression, eating disorder risk, and ADHD. The disparities grew starker when the researchers examined self-reported formal diagnoses. Students who identified as LGBTQ+ were 70 percent more likely to report a past or current anxiety diagnosis and more than twice as likely to report a past or current diagnosis of depression. The gap for eating disorder diagnoses was the widest of all, with a prevalence ratio of 2.52, meaning LGBTQ+ students reported formal diagnoses at roughly two and a half times the rate of their peers. Even ADHD diagnoses, the least common condition in both groups, were nearly twice as prevalent among LGBTQ+ students.

The study also documented meaningful differences in positive mental health, not merely in symptoms. Life satisfaction scores were significantly lower among LGBTQ+ students, who averaged 19.9 on the Satisfaction With Life Scale compared with 22.3 for their peers, and the WHO-5 well-being index told a similar story, with the LGBTQ+ group averaging 43.3 against 50.9. A well-being score at or below 50 is considered an indicator of poor well-being and potential depression, which means the average LGBTQ+ student in this sample fell below that line while the average cisgender heterosexual student sat just above it. The researchers note that these patterns echo international findings, including a recent 18-country study of first-year students in which gay, lesbian, bisexual, asexual, and questioning students showed the highest prevalence of nearly every assessed mental disorder.

The theoretical framework underlying the work is Minority Stress Theory, which attributes mental health disparities among sexual and gender minorities to chronic, identity-specific stressors such as prejudice, rejection, discrimination, misgendering, and stigma. The Catalan data lend indirect support to this account. LGBTQ+ students reported higher perceived stress, and earlier research cited by the team found that LGB medical students faced more than eight times the odds of burnout linked to perceived mistreatment tied to their sexual orientation. The authors also point to prior meta-analyses showing that lesbian and gay individuals are twice as likely, and bisexual individuals nearly three times as likely, to experience mental health disorders compared with heterosexual people, and that transgender and nonbinary youth show more than double the risk of depressed mood even after accounting for discrimination and victimization.

Perhaps the most consequential finding concerns what protects mental health. Within the LGBTQ+ sample, the researchers ran exploratory regression models asking which variables best predicted depression and anxiety symptoms. Together, higher stress and ADHD symptoms combined with lower life satisfaction and well-being explained 61 percent of the variance in depression scores and 47 percent of the variance in anxiety scores. When the team extended the analysis to the full sample and tested interaction terms, a subtle but important pattern emerged: the protective association between well-being and lower depressive symptoms was actually stronger for LGBTQ+ students than for their peers. For anxiety, the relationships between predictors and symptoms were statistically comparable across groups. The authors interpret this cautiously, suggesting that life satisfaction and well-being function as genuine protective resources that may matter even more where minority stress is present.

This nuance shapes the study’s central policy argument. The researchers caution that overemphasizing group-specific distinctions, particularly when the observed mean differences are small in statistical terms, could inadvertently reinforce stigma or discourage help-seeking. Instead, they advocate for inclusive, university-wide mental health frameworks that promote well-being and life satisfaction across the entire student population while remaining responsive to minority-specific stressors. Such universal approaches, they argue, can normalize psychological distress as a shared student experience rather than framing it as a feature of any single identity group. At the same time, they stress that the mere availability of mental health services is not enough; the perceived safety, affirmativeness, and inclusivity of those services shape whether sexual and gender minority students actually trust and engage with care.

The authors are careful to flag limitations. All data were self-reported, group membership rested on a single yes-or-no identification item that did not distinguish sexual orientation from gender identity, the regression approach was exploratory, and the cross-sectional design rules out any causal claims about why these disparities exist. Yet the scale of the sample, spanning 7,080 students across an entire university system, gives the findings unusual weight, particularly for Spain, where population-based research on LGBTQ+ student mental health has been scarce. The study’s demographics also reveal a sociological picture: LGBTQ+ students were younger, more likely to be pursuing bachelor’s degrees, and overrepresented in arts, humanities, and sciences while underrepresented in engineering and architecture, a pattern consistent with earlier evidence of disadvantage for LGBTQ+ professionals in STEM fields. The overall message is unambiguous. Legal protections and formal inclusion policies, however important, have not been sufficient to erase mental health inequalities. What remains needed, the researchers conclude, are accessible, visible, and affirming support structures within higher education, built on the recognition that well-being itself may be the most powerful protective lever universities can pull.

Subject of Research: Mental health disparities and well-being among LGBTQ+ university students compared with cisgender heterosexual peers in Spain

Article Title: Mental health, well-being and associated factors in LGBTQ+ university students in Spain

Article References: Cañete-Massé, C., Krieger, V., Canals, J., Caparrós, B., Farriols, N., Sanz, A., & Amador-Campos, J. A. (2026). Mental health, well-being and associated factors in LGBTQ+ university students in Spain. Current Psychology, 45(17), Article 1466. https://doi.org/10.1007/s12144-026-09835-7

Image Credits: AI Generated

DOI: 10.1007/s12144-026-09835-7

Keywords: LGBTQ+, mental health, university students, depression, anxiety, minority stress, well-being, life satisfaction, ADHD, eating disorders, burnout, higher education