Abstract

Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, and other (LGBTQ+) adolescents face a higher risk of depression than their heterosexual and cisgender peers, necessitating targeted mental health interventions. This study examined the prevalence of depression and its associated factors among LGBTQ+ adolescents in Southern Thailand, using the Minority Stress Model as a framework to explain how chronic stressors contribute to mental health disparities in this population. Specifically, it explored the association of distal stressors, such as bullying, discrimination, and family relationships, as well as proximal stressors including self-esteem and gender identity confidence, with depression. A cross-sectional study was conducted among 958 adolescents aged 13–18 who openly identified as LGBTQ+. Participants were recruited from four secondary schools through stratified random sampling from the Secondary Educational Service Area Office 11. Data were collected using the Patient Health Questionnaire for Adolescents, the Rosenberg’s Self-Esteem Scale, the Experience of Discrimination Scale, and the Revised Olweus Bully/Victim Questionnaire. Analyses included descriptive statistics, Spearman’s rank correlation test, and ordinal logistic regression. Results showed that 84.8% of participants experienced depressive symptoms ranging from mild to severe. Low self-esteem emerged as a significant risk factor, while supportive family relationships served as a protective factor. These findings underscore the high prevalence of depression in this population and the need to strengthen self-esteem, promote family acceptance, and implement inclusive school and community policies. Culturally sensitive, trauma-informed nursing interventions can reduce mental health disparities and promote resilience among LGBTQ+ adolescents in Thailand and similar contexts by fostering self-esteem, strengthening family support, and promoting inclusivity.