A Description of the Social, Cultural, and Historical Context for Sexual and Gender Minority Individuals Living in a Selection of High, Low, and Middle–Income ASEAN Countries

Abstract

This literature review examines mental health disparities among sexual and gender minorities (SGM) in Thailand, Japan, the Philippines, Indonesia, and Vietnam, highlighting the unique social, cultural, and historical factors that influence SGM experiences across these Asian countries. Most research on SGM mental health has come from liberal Western countries. This review addresses an important gap by analyzing SGM community prevalence (estimated between 2.8% and 10%), mental health challenges, societal attitudes, legal rights, and historical recognition within these contexts. The analysis draws on country-specific literature, national surveys, peer-reviewed studies, unpublished reports, and historical documents. The findings underscore serious mental health issues, notably depression and suicidality, prevalent in all five countries, compounded by persistent stigma and discrimination. Social acceptance has shown progress in Thailand and Japan, yet stigma remains strong throughout the region, often rooted in religious beliefs. Indonesia uniquely enforces legal restrictions on SGM individuals, although legal protections are limited in all countries examined. Despite some historical acknowledgment of SGM identities, these longstanding cultural legacies offer limited protection against current social challenges. Insights from this review can guide future research in creating mental health interventions and policy development to address the specific needs of SGM communities across diverse Asian contexts.