Abstract

Highlights: Public health relevance—How does this work relate to a public health issue? LGBTQ<inf>+</inf> adolescents face high rates of depression and mental health challenges. Understanding their experiences highlights opportunities for early support and intervention. Public health significance—Why is this work of significance to public health? Provides evidence on how culture, identity development, and coping shape mental health in LGBTQ<inf>+</inf> youth. Fills a research gap in the Thai context and suggests pathways for effective support strategies. Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health? Highlights the need for affirming schools, family support, and accessible mental health services. Offers guidance for inclusive policies and programs promoting positive outcomes. LGBTQ<inf>+</inf> adolescents experience disproportionately high rates of depression globally, yet little is known about how these experiences are shaped by Thailand’s unique cultural context. This study addresses this gap by examining how Thai LGBTQ<inf>+</inf> adolescents understand and navigate depression, identity development, and culturally shaped support systems. A qualitative phenomenological study was conducted with a sample of 20 Thai LGBTQ<inf>+</inf> adolescents from rural regions. Thematic analysis identified three interrelated themes: (1) struggles with self-discovery, acceptance, and their relationship to depression; (2) living with depression and moving forward; and (3) the need for acceptance and understanding. Findings demonstrate that cultural norms—particularly family obligations, conditional acceptance, and collectivist expectations—intensify depression and shape help-seeking, coping, and identity development. The study highlights the need for culturally responsive mental-health interventions that integrate gender-diversity awareness, family education, LGBTQ<inf>+</inf>-affirming school environments, and confidential support options. These findings suggest new, context-specific evidence for designing culturally responsive mental-health interventions for LGBTQ<inf>+</inf> adolescents in Thailand.