This study examines the role of social integration and social support, a significant yet under-investigated factor in mental health disparities by sexual orientation. By analyzing National Health and Nutrition Examination Survey data from a representative sample of the middle-aged U.S. population, the study shows that bisexual-identified individuals have the lowest levels of social resources and the poorest mental health status of all sexual orientation groups. Lesbian/gay-identified individuals and heterosexual-identified individuals with same-sex sexual experience are less socially integrated or perceive less emotional support than the sexual majority but do not report poorer mental health. Moreover, social integration and social support jointly mediate the link between sexual orientation and mental distress: sexual minorities are less socially integrated, which is related to a lower level of social support and, in turn, a higher level of mental distress. Additionally, minority-identified individuals reap more health benefits from confidants and emotional support. These findings suggest that sexual minorities are among those who most need and most benefit from supportive social relationships. The study therefore reveals the importance of social resource interventions in narrowing the mental health gap by sexual orientation.
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