Abstract
BackgroundRecent studies have identified substantial health disparities between lesbian, gay, and bisexual (LGB) individuals compared to heterosexuals. However, possible variation in sexual orientation health disparities by age and according to gender remains largely unexplored.PurposeTo examine physical health disparities between LGB and heterosexual individuals in a general population sample in Sweden, to explore potential age and gender differences in these disparities, and to test potential mechanisms underlying any observed disparities.MethodBetween 2008 and 2013, 60,922 individuals (16–84 years of age) responded to nationwide population-based health surveys. In the sample, 430 (0.7 %) individuals self-identified as gay/lesbian and 757 (1.3 %) self-identified as bisexual. Logistic and negative binomial regression analyses were used to explore health disparities based on sexual orientation.ResultsOverall, LGB individuals were more likely to report worse self-rated health as well as more physical health symptoms (e.g., pain, insomnia, dermatitis, tinnitus, intestinal problems) and conditions (e.g., diabetes, asthma, high blood pressure) compared to heterosexuals. However, these physical health disparities differed by age. Disparities were largest among adolescents and young adults and generally smallest in older age groups. Health behaviors and elevated reports of exposure to perceived discrimination, victimization, and threats of violence among sexual minorities partially explained the sexual orientation disparities in physical health.ConclusionsAge emerged as an important effect modifier of physical health disparities based on sexual orientation. Gender-specific findings suggest that sexual orientation disparities persist into adulthood for women but are gradually attenuated for older age groups; in contrast, for men, these disparities disappear starting with young adults. These results support a developmental model of minority stress and physical health among LGB individuals.
Highlights
During the past several years, public health policy and research have begun to address the substantial health disparities that exist between sexual minority [e.g., individuals who identify as lesbian, gay, and bisexual (LGB) or engage in same-sex sexual behavior] and heterosexual individuals [1]
Gender-specific findings suggest that sexual orientation disparities persist into adulthood for women but are gradually attenuated for older age groups; in contrast, for men, these disparities disappear starting with young adults
Most of this attention has focused on mental health disparities, with population-based studies from both North America and Europe showing that LGB individuals are significantly more likely to be diagnosed with major depression and several anxiety disorders compared to heterosexual individuals and that LGB youths are at greater risk for suicide attempts than non-LGB youths [2,3,4,5]
Summary
During the past several years, public health policy and research have begun to address the substantial health disparities that exist between sexual minority [e.g., individuals who identify as lesbian, gay, and bisexual (LGB) or engage in same-sex sexual behavior] and heterosexual individuals [1]. Most of this attention has focused on mental health disparities, with population-based studies from both North America and Europe showing that LGB individuals are significantly more likely to be diagnosed with major depression and several anxiety disorders compared to heterosexual individuals and that LGB youths are at greater risk for suicide attempts than non-LGB youths [2,3,4,5]. Logistic and negative binomial regression analyses were used to explore health disparities based on sexual orientation
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