Mortality Among Men and Women in Same-Sex Marriage: A National Cohort Study of 8333 Danes

Mays

2015

Am J Public Health

Objectives-We investigated the possibility that men who have sex with men (MSM) and women who have sex with women (WSW) may be at higher risk for early mortality associated with suicide and other sexual orientation-associated health risks. Methods-We used data from the 1988-2002General Social Surveys, with respondents followed up for mortality status as of December 31, 2008. The surveys included 17 886 persons aged 18 years or older, who reported at least 1 lifetime sexual partner. Of these, 853 reported any same-sex partners; 17 033 reported only different-sex partners. Using gender-stratified analyses, we compared these 2 groups for all-cause mortality and HIV-, suicide-, and breast cancer-related mortality.Results-The WSW evidenced greater risk for suicide mortality than presumptively heterosexual women, but there was no evidence of similar sexual orientation-associated risk among men. All-cause mortality did not appear to differ by sexual orientation among either women or men. HIV-related deaths were not elevated among MSM or breast cancer deaths among WSW.Conclusions-The elevated suicide mortality risk observed among WSW partially confirms public health concerns that sexual minorities experience greater burden from suicide-related mortality.Correspondence should be sent to Susan D. Cochran, Department of Epidemiology, UCLA Fielding School of Public Health, Box 951772, Los Angeles, CA 90095-1772 (cochran@ucla.edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints" link. ContributorsS. Cochran originated the study, conducted analyses, and wrote an initial draft of the article. Both authors conceptualized the ideas for the current article, interpreted the findings, and edited drafts of the article. Human Participant ProtectionBecause of our use of publicly available, anonymous data only, this study was exempt from human participant review by the University of California Los Angeles institutional review board. All participants gave informed consent in the original General Social Survey. NIH Public Access NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author ManuscriptNumerous studies have documented robust sexual orientation-related differences in suicide attempts, 1-12 tobacco smoking, [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] HIV infection risk among men, 29 and problems in health care access. [30][31][32][33][34][35] However, whether these health differences actually translate into overall greater risk for early mortality among sexual minorities, including among men who have sex with men (MSM) and among women who have sex with women (WSW), is not clear. Persistent methodological barriers have posed a nearly insurmountable obstacle to investigating questions of sexual orientation-related differences in mortality risk. 36,37 In the United States, for example, death certificates, a common data source utilized in mortality studies, do not record sexual orientation information. In addition, there are few populationbased data sets in which both mark...

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Mortality Risks Among Persons Reporting Same-Sex Sexual Partners: Evidence From the 2008 General Social Survey—National Death Index Data Set

Mays

2015

Am J Public Health

“…7 Indeed, only one population-based study of mortality risk among sexual minority women worldwide has been published. 20 In that study, Danish women in same-sex RDPs evidenced somewhat elevated all-cause mortality rates over those of the general female population, but the underlying causes of death were not reported.…”

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confidence: 79%

Risk of Breast Cancer Mortality Among Women Cohabiting with Same Sex Partners: Findings from the National Health Interview Survey, 1997–2003

Journal of Women's Health

Mays

2012

Background: Lesbians and bisexual women are more likely than other women to evidence a unique mix of common breast cancer risk factors. It is not known if this results in greater breast cancer mortality risk. We investigate possible sexual orientation-related differences in risk for fatal breast cancer in a large representative U.S. sample of married and cohabiting women. Methods: Between 1997 and 2003, the National Health Interview Survey (NHIS) interviewed married or cohabiting female participants, aged 18-80 years inclusively, who reported either a male (n = 136,174) or female (n = 693) coresidential relationship partner. These records are linked to the National Death Index to provide information on mortality status as of December 31, 2006. Employing these data, we estimated the age-adjusted relative risk (RR) and its 95% confidence interval (CI) for mortality attributed to breast cancer using a Cox proportional hazard model. Results: Women in same-sex couples, compared to women in different-sex relationships, had greater ageadjusted risk for fatal breast cancer (RR = 3.2, CI 1.01-10.21) but did not differ in their overall risk for mortality. Conclusions: Our findings provide tentative support that sexual orientation is differentially linked to risk of fatal breast cancer. These findings underscore the need to investigate further breast cancer morbidity and mortality risk among women with minority sexual orientation.

The association between relationship markers of sexual orientation and suicide: Denmark, 1990–2001

Mathy

Soc Psychiatry Psychiatr Epidemiol

Olsen

et al. 2009

ObjectiveMinority sexual orientation has been repeatedly linked to elevated rates of suicide attempts. Whether this translates into greater risk for suicide mortality is unclear. We investigated sexual orientation-related differences in suicide mortality in Denmark during the initial 12-year period following legalization of same-sex registered domestic partnerships (RDPs).MethodUsing data from death certificates issued between 1990 and 2001 and population estimates from the Danish census, we estimated suicide mortality risk among individuals classified into one of three marital/cohabitation statuses: current/formerly in same-sex RDPs; current/formerly heterosexually married; or never married/registered.ResultsRisk for suicide mortality was associated with this proxy indicator of sexual orientation, but only significantly among men. The estimated age-adjusted suicide mortality risk for RDP men was nearly eight times greater than for men with positive histories of heterosexual marriage and nearly twice as high for men who had never married.ConclusionsSuicide risk appears greatly elevated for men in same-sex partnerships in Denmark. To what extent this is true for similar gay and bisexual men who are not in such relationships is unknown, but these findings call for targeted suicide prevention programs aimed at reducing suicide risk among gay and bisexual men.