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

Abstract

Purpose: Health disparities have been identified between groups of diverse young sexual minority women (SMW) and heterosexual women. This approach may generate sufficient group sizes for statistical analyses but obscures important differences. Moreover, some young women may not identify as ''lesbian'' or ''bisexual'' but somewhere in between. This study examined health and sexual minority identity-specific outcomes among three groups of SMW-women who identify as ''exclusively lesbian,'' ''mostly lesbian,'' and ''bisexual.'' Methods: Participants were 990 young (18-30 years old) SMW (exclusively lesbian: n = 305, mostly lesbian: n = 133, bisexual: n = 552) who completed an online survey, including information about mental and physical health symptoms, hazardous drinking, and identity uncertainty. Those who reported alcohol use in the past 30 days responded to questions about their alcohol use and alcohol-related negative consequences. Results: Controlling for demographic differences, health outcomes varied significantly by identity. Mostly lesbian and bisexual women reported the most depression, anxiety, and physical health symptoms; mostly lesbian women reported the highest levels of hazardous drinking. Among those who reported drinking, mostly lesbian women drank the most frequently and reported the most alcohol-related consequences. Mostly lesbian women reported the most identity uncertainty. Conclusion: Mostly lesbian women were similar to bisexual women on several health outcomes. They appear unique, however, in drinking behavior and identity uncertainty. Collapsing across identities in health research may affect outcomes.

Quality of Life and Mental Health of Chinese Sexual and Gender Minority Women and Cisgender Heterosexual Women: Cross-sectional Survey and Mediation Analysis

“…Health-related research on SGMW is growing slowly worldwide [31][32][33], but there is less research on Chinese SGMW. According to published data from Western countries, sexual minority women experience a higher incidence of mental health disorders, including anxiety and depression, and also generally report a worse QOL than cisgender heterosexual women (CHW) [34,35]. A recent scoping review summarizing the holistic health of homosexual and bisexual Chinese over the past 20 years showed that the academic attention given to the male population is much higher than that given to female groups (96.46% vs 1.32%, respectively) [20].…”

Assessing LGBTQ+ stigma among healthcare professionals: An application of the health stigma and discrimination framework in a qualitative, community-based participatory research study

“…These include worse perceived health quality, as well as higher prevalence of chronic conditions and sexually transmitted infections among LGBTQ+ individuals compared to their heterosexual, cisgender counterparts (Centers for Disease Control and Prevention, 2020; Dai and Hao, 2019; Elliott et al, 2015; Simoni et al, 2017; Wanta et al, 2019). Further, within the LGBTQ+ community, unique health experiences and needs exist, with additional disparities apparent between the diverse populations that make up the community (Dai and Hao, 2019; Lewis et al, 2019). Disparities in healthcare access partially explain worse health outcomes observed among LGBTQ+ individuals, fueled by a range of social and structural barriers to care (Lerner and Robles, 2017; Lisy et al, 2018).…”

Disparities in Mortality by Sexual Orientation in a Large, Prospective Cohort of Female Nurses

“…Even though this finding did not achieve statistical significance relative to lesbian women, the magnitude of the disparity was consistent with the study hypothesis, given that bisexual women have higher risks of substance use and have poorer physical and mental health than lesbian women. 1,12,13,[26][27][28][29] The underlying cause of these disparities is thought to be related to unique stressors that bisexual individuals face relative to other LGB groups. Specifically, bisexual orientation may be more concealable than lesbian orientation because many bisexual women have male partners.…”