Disparities in Physical Health Conditions Among Lesbian and Bisexual Women: A Systematic Review of Population-Based Studies

Abstract

We conducted a systematic review to assess evidence for disparities for lesbian and bisexual women (i.e., sexual minority women [SMW]) in comparison with heterosexual women across a range of nine physical health conditions. Among the k = 11 studies meeting eligibility criteria, almost every comparison (i.e., heterosexual vs. (a) lesbian, (b) bisexual, or (c) both lesbian and bisexual women) was in a direction indicating SMW disparities. Despite limited power due to small samples of SMW, we found evidence of disparities as indicated by a statistically significant adjusted odds ratios for asthma (5 of 7 comparisons), obesity (8 of 12), arthritis (2 of 3), global ratings of physical health (4 of 7), and cardiovascular disease (1 of 1). Evidence was lacking for cancer (1 of 4), diabetes and hypertension (both 1 of 5), and high cholesterol (0 of 3). Future work should confirm findings in more diverse, larger samples and should examine potential explanatory factors.

Alcohol Use, Age, and Self-Rated Mental and Physical Health in a Community Sample of Lesbian and Bisexual Women

“…22 Reviews of the extant literature, however, also support an equivalent risk of hypertension and diabetes among lesbian, bisexual, and heterosexual women. 23,24 In contrast, population-based studies have shown higher rates of obesity among SMW, ages 50 and older, compared with heterosexual women. [23][24][25] Although older SMW consistently report poorer self-rated mental health and heightened physical disability relative to their heterosexual counterparts, 26,27 results of studies are equivocal in regard to sexual identity differences in self-rated physical health among older adult women living in the United States.…”

Health Disparities Among Exclusively Lesbian, Mostly Lesbian, and Bisexual Young Women

“…The IOM report 1 noted that lesbian and bisexual women are at greater risk of obesity, cardiovascular disease, and some types of cancer, and a systematic review has suggested that SMW report poorer health outcomes compared with heterosexual women. 25 A study of Washington state residents also found that lesbian and bisexual women were at greater risk for poor general health and experiencing physical limitations; bisexual women had greater odds of hypertension and diabetes compared with heterosexual women. 17 In another study, bisexual women reported more non-HIV-related health problems compared with heterosexual women.…”

Health Conditions, Access to Care, Mental Health, and Wellness Behaviors in Lesbian, Gay, Bisexual, and Transgender Adults

“…Lesbian and bisexual women report worse global ratings of physical health than heterosexual women [8]. They are less likely to have routine care and cancer screenings including mammography or cervical screenings [5][6][7].…”