Table 2.

Results of the included studies reporting on depression among LGBTQ+ workers

Author, year	Characteristics of LGBTQ+ workers	Methods for measuring depression	Pertinent findings
Ali, 2023 [41]	91 MSM and transgender community health workers	PHQ-9 ≥ 10	Prevalence: 31.8%. Associations: Previous psychiatric illness (p < 0.001), history of deliberate self-harm (p = 0.022), history of suicide attempts (p = 0.015), increasing SJSS scores (p = 0.011), decreasing GSE scores (p = 0.005).
Amsalem, 2023 [45]	51 transgender essential workers during COVID-19 pandemic	PHQ-9	Other: Mean PHQ-9 scores consistently highest among transgender respondents (range 10.5–11.1) and lowest in cisgender men (range 6.5–6.7).
Bar-Johnson, 2014 [47]	Nine homosexual and 14 bisexual male sex workers	BDI > 10	Prevalence: 33% in homosexuals, 42% in bisexuals, 47% in heterosexuals.
Brogan, 2003 [28]	115 lesbian physicians	Self-report	Prevalence: 33.3% in lesbians, 19.4% in heterosexuals. Comparison: p = 0.01.
Chandler, 2021 [34]	245 Black MSM	CESD-10 ≥ 10	Prevalence: 59.4% in sex workers, 22.2% in other MSM. Comparison: aOR 3.88 (95% CI 2.91–5.19).
Chang, 2019 [42]	198 transgender women sex workers	PHQ-9 ≥ 10	Prevalence: 25.3%. Associations: Marital status (OR 2.36 for divorced or widowed vs. unmarried, 95% CI 1.08–5.15), monthly income (OR 0.34 for >$900 vs. <$450, 95% CI 0.14–0.84), HIV status (OR 0.39 for negative vs. positive. 95% CI 0.19–0.78).
Cuthbertson, 2024 [29]	148 LGBTQ+ farmers	PHQ-8 ≥ 10, self-report	Prevalence: 50.7% self-report, 36.1% PHQ-8. Comparison: Higher prevalence of PHQ-8 depression in transgender vs. non-transgender (p = 0.043), gay vs. non-gay (p = 0.045), queer vs. non-queer (p < 0.001). Other: 25.8% with depression on PHQ-8 had not been diagnosed.
Goldberg, 2013 [43]	47 lesbian and 39 gay dual-earner couples with adopted children	CESD	Associations: Low levels of supervisor support (p = 0.012).
Goldenberg, 2021 [27]	100 transgender women sex workers living with HIV	PHQ-9 ≥ 10	Prevalence: 24%. Associations: Internalised sex work stigma (aOR 1.19, 95% CI 1.03–1.36), social cohesion (aOR 0.81, 95% CI 0.71–0.95).
Griffin, 2023 [89]	215 full-time and 643 part-time employed LGBTQ+ individuals	PHQ-9 ≥ 15	Prevalence: 39.3% in full-time, 35.0% in part-time.
Klare, 2021 [30]	167 LGBTQ+ employed adults	PHQ-9 ≥ 10	Prevalence: 39.5% in LGBTQ+, 19.0% in heterosexual. Comparison: p < 0.001.
Logie, 2017 [35]	42 transgender women sex workers	PHQ-2 ≥ 3	Comparison: aOR 1.7 for sex workers vs. transgender women not in sex work (95% CI 1.1–2.6)
Moya, 2020 [31]	229 LGBTI workers	CESD-7	Comparison: Mean CESD-7 1.90 in LGBTI, 1.86 in heterosexual (p < 0.001). Other: Relationship between sexual orientation and depression entirely accounted for by job discrimination and work stress (p = 0.50 in mediation models).
Nuttbrock, 2014 [36]	Transgender women sex workers aged 19–59 years (number not stated)	MINI	Comparison: aOR 2.50 for sex workers vs. transgender women not in sex work (95% CI 1.58–3.94). Other: Smaller effect size when psychological and physical gender abuse included as covariates (aOR 2.16, 95% CI 1.20–3.91).
Rashid, 2023 [90]	141 full-time or part-time employed transgender women	DASS-21 (cut-off unclear)	Prevalence: 33.3%.
She, 2022 [26]	199 transgender women sex workers at risk of mental health problems (subsample 1, n = 126: scored above cut-off for probable depression or anxiety or had suicidal ideation; subsample 2, n = 109: perceived needs for mental health services; overlap between participants)	CESD ≥ 16	Prevalence: 89.7% in subsample 1, 70.6% in subsample 2.
Smith, 2004 [44]	97 LGB workers	CESD ≥ 16	Associations: Heterosexism (p < 0.01). Positive relationship between blaming responses and depression at low levels of heterosexism (p < 0.05) but not at high levels.
Srivastava, 2022 [37]	952 transgender women and 945 MSM sex workers	CESD-10 ≥ 10	Comparison: aOR 1.41 for transgender women sex workers vs. transgender women not in sex work (95% CI 1.07–1.86), aOR 1.43 for MSM sex workers vs. MSM not in sex work (95% CI 1.18–1.75).
Srivastava, 2023 [38]	952 transgender women sex workers	CESD-10 ≥ 10	Prevalence: 42.1% in transgender women sex workers, 28.9% in transgender women not in sex work. Comparison: aOR 1.40 for transgender women sex workers vs. transgender women not in sex work (95% CI 1.05–1.84).
Sugg, 2021 [32]	20 non-binary and 61 transgender frontline or essential workers during COVID-19 pandemic who engaged with a text-based crisis service	Daily text conversations flagged for depression	Comparison: Non-binary vs. male aOR 2.54 (95% CI 1.04–6.24), transgender vs. male aOR 1.05 (95% CI 0.61–1.82).
Thirunavukkarasu, 2021 [39]	108 MSM sex workers	CESD ≥ 16	Prevalence: 51.9% in sex workers, 39.4% in other MSM. Comparison: p = 0.055.
Wojcik, 2022 [33]	102 SGM frontline healthcare workers	PHQ-9 ≥ 10	Prevalence: 35.9% in SGM, 20.7% in non-SGM. Comparison: aOR 1.887 for SGM vs. non-SGM (95% CI 1.127–3.161).
Yan, 2014 [40]	200 MSM sex workers	CESD-12 ≥ 9	Prevalence: 70.0% in sex workers, 46.1% in other MSM. Comparison: aOR 1.86 for sex workers vs. other MSM (95% CI 1.07–3.24).
Yasami, 2023 [46]	270 gay men and transgender women sex workers	DASS-21 ≥ 10	Prevalence: 86.7%.

aOR = adjusted odds ratio; BDI = Beck’s Depression Inventory; CESD = Centre for Epidemiological Studies Depression Scale; CI = confidence intervals; DASS-21 = 21-item Depression, Anxiety, and Stress Scale; GSE = General Self Efficacy questionnaire; HIV = human immunodeficiency virus; LGB = lesbian, gay, and bisexual; LGBT = lesbian, gay, bisexual, and transgender; LGBTI = lesbian, gay, bisexual, transgender, and intersex; LGBTQ+ = lesbian, gay, bisexual, transgender, queer, and other sexual and gender minorities; MINI = Mini International Neuropsychiatric Interview; MSM = men who have sex with men; OR = odds ratio; PHQ = Patient Health Questionnaire; SGM = sexual and gender minority; SJSS = Subjective Job Stress Scale