Rural dwelling as a risk factor for mental health and well-being for LGBTQ+ youth: The mechanism of social support

J Rural Health. 2025 Sep;41(4):e70091. doi: 10.1111/jrh.70091.

ABSTRACT

PURPOSE: Existing literature on LGBTQ+ social support often overlooks the experiences of rural dwellers, who may face obstacles related to access to mental health resources and in-person social support. This study seeks to address the gap by examining how social support varies across different geographic areas and how it relates to mental health outcomes for LGBTQ+ emerging adults.

METHODS: This study surveyed LGBTQ+ emerging adults (n = 293) about their demographics, their sources of social support, their mental health and well-being, and their ZIP codes (current and when teenagers). Rurality was determined using Rural-Urban Commuting Area (RUCA) codes.

FINDINGS: Mediation analyses found that the LGBTQ+ youth living in the most rural areas according to RUCA codes reported significantly lower social support as compared to those living in major metropolitan areas. Higher social support was significantly associated with lower depression, lower anxiety, and greater well-being.

CONCLUSIONS: These results suggest that LGBTQ+ individuals living in rural areas may disproportionately receive less social support and experience worse mental health outcomes than their urban peers. This highlights the need for targeted interventions tailored to the unique challenges faced by LGBTQ+ rural dwellers.

PMID:41174992 | DOI:10.1111/jrh.70091