Mental Well-Being, Sexual Orientation, and Interpersonal Stigma in Cisgender Adolescents in Catalonia, From a Gender and Territorial Perspective

Lesbian, gay, and bisexual adolescents have less mental well-being than heterosexual adolescents, which is partly explained by experiencing stigma in the form of school bullying or bad family relationships. However, it is unclear whether this association is different according to specific sexual orientations (lesbian, gay, bisexual), gender (cisgender boys, cisgender girls), and in different types of municipality (small towns, intermediate cities, and a metropolis). The aim of this study was to analyze the association between mental well-being and specific sexual orientations, taking into account the role of school bullying and family relationships, among cisgender adolescents in Catalonia (Spain), from a gender and territorial perspective. Data were collected using two cross-sectional questionnaires in secondary school students aged 15-19 years from Central Catalonia (N = 5,962) and the Catalan metropolis of Barcelona (N = 1,601) during 2021-2022. First, linear regression models showed an inverse association between mental well-being and being gay or bisexual among boys in small towns. In intermediate cities and the metropolis, this inverse association was observed only with being bisexual. In girls, there was a weaker inverse association between mental well-being and being bisexual across all three types of municipality. Second, school bullying and family relationships had an indirect effect on mental well-being. Our results suggest that having a lesbian, gay, and bisexual sexual orientation is more penalized in cisgender boys than in cisgender girls and that despite the progressive acceptation of gay identities in intermediate cities and a metropolis compared to small towns, stigma toward bisexuality persists in all types of municipality.