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LOS ANGELES — Asian American and Pacific Islander sexual and gender minority young adults are at increased risk of substance use and mental health issues, but research on this group is sparse, a scoping review suggested.
Of 172 articles screened, only six met final inclusion criteria for U.S.-based studies on psychosocial factors — stigma, discrimination, and family and social support — influencing mental health and substance use outcomes among this population of patients, reported Katherine Yin, a medical student at the Texas College of Osteopathic Medicine, University of North Texas Health Science Center at Fort Worth, during a poster presentation at the American Psychiatric Association annual meeting.
“There is a conflict that is rooted between Eastern cultural collectivism of family, family shame, and family honor versus the idea of chasing happiness and having pride in one’s self and pride in the gay community. Everything says ‘no’ to each other,” Yin told MedPage Today.
“That creates a very difficult internal environment and results in a lot of depression and hiding, and a lot of under-reporting of these issues,” she added.
Suicide is the leading cause of death among Asian Americans ages 10-24, but they have the lowest use of mental health services among any racial or ethnic group, the authors noted in their poster.
The studies included in this review suggested that Asian-American and Pacific Islander sexual and gender minorities “experience dual marginalization shaped by cultural stigma and queer exclusion,” they wrote, pointing to identity fragmentation and social isolation as key drivers of risks of substance use and mental health issues.
The problem with even the few studies that were found in the literature review, they noted, was that they were outdated, geographically limited, or aggregated Asian-American and Pacific Islander data with other groups.
“Broader, disaggregated, and contemporary research is urgently needed,” the authors added.
Despite this urgent need, the chances of specific studies are dismal, Jack Drescher, MD, of Columbia University in New York City, told MedPage Today.
This research “falls under the category of a ‘DEI’ [diversity, equity, and inclusion] request, and the reality is that with under-represented groups there is not enough research to tell us what is the extent of the problem and what kind of solutions can be made to help,” he said. “There are many similar areas that we need research, but under this current administration, the chances of getting these studies performed is not going to get any better anytime soon.”
For this study, the authors used JBI methodology and PRISMA for Scoping Reviews guidelines and searched for studies on PubMed, PsycINFO, Medline, and Google Scholar, among other databases, to identify U.S.-based studies on Asian American and Pacific Islander sexual and gender minority patients ages 18 to 29 that reported outcomes related to mental health, including depression, anxiety, and substance use.
Disclosures
Yin and Drescher disclosed no relevant relationships with industry.
Primary Source
American Psychiatric Association
Source Reference: Yin K, et al “Psychosocial drivers of substance use and mental health outcomes in AAPI sexual and gender minority young adults: a scoping review” APA 2025.
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