Abstracts Health Sciences

The mental health experiences of LGBTIQA+ people, kink-oriented people, and sex workers in rural and remote Tasmania

by TD Reynish

From penitentials to the medical model, sex, sexual, gender, and erotic difference has long been pathologised resulting in scientific righteousness, criminalisation, and pervasive systemic stigma and discrimination. Over the last two decades, society has become increasingly mutable as people and lexicon evolve. As a result, research into mental health includes lesbian, gay, bisexual, transgender, intersex, queer/questioning, and asexual (LGBTIQA) people, and people with other sexual orientations and gender identities (+). The inclusion of kink-oriented people and sex workers in research into mental health, however, has been a little slower. The foci on whether or not kink is a psychopathology and if sex work is a public health concern were a bit more entrenched, thus, scholarship has been slower to progress. Current research into the mental health of people who are LGBTIQA+, sex workers, and/or kink-oriented is more comprehensive, yet no research could be found that examines these populations in combination, despite their shared, compromised access to the human right of bodily autonomy. Furthermore, no research could be found that examines these populations’ mental health or service use in rural or remote areas. Investigations into the mental health status and related service experiences of LGBTIQA+ people, sex workers, and/or kink-oriented people in rural or remote Australia is absent from national health research and policy. In light of the well-documented impacts of minority stress, social exclusion, stigma, and discrimination, and the health disparities of rural populations, this gap is glaring. The aim of this research was to investigate the mental health of LGBTIQA+ people, kink-oriented people, and sex workers with preexisting mental health issues in rural or remote Tasmania as it pertains to psychological support. The aim was explored via five research questions relating to the target populations: 1) mental health status; 2) risk and protective factors; 3) mental health service uptake; 4) barriers to help seeking; and 5) factors that facilitate uptake. Inclusion criteria required that participants be current or former sex workers, and/or LGBTIQA+, and/or kink-oriented; be 18 years of age or older; be current or past residents of rural or remote Tasmania; have experiences with mental health issues; have used related formal or xix informal support; have functional English literacy; and have access to a telephone, and/or smart device or computer. A mixed-methods research approach consisting of a triangulation design-convergence model was used. Two systematic literature reviews were conducted to identify existing research. Semi-structured interviews and a survey were conducted concurrently. Recruitment was multipronged, consisted of purposive, convenience, and snowball sampling, and was conducted via emails, Facebook, a poster, telephone calls, in-person discussions, third-parties, and self-selection. Interviews (N = 33) were held in person or via telephone and consisted of 26 questions. The online survey (N…