Toward a Holistic Demographic Profile of Sexual and Gender Minority Well-being

Abstract

Sexual and gender minority (SGM) populations experience disadvantages in physical health, mental health, and socioeconomic status relative to cisgender heterosexual populations. However, extant population research has tended to use objective measures and ignore subjective measures, examined well-being outcomes in isolation, and lacked information on less well studied but possibly more disadvantaged SGM subgroups. In this study, we use Gallup's National Health and Well-Being Index, which permits identification of gay/lesbian, bisexual, queer, same-gender-loving, those who identify as more than one sexual identity, transgender men, transgender women, and nonbinary/genderqueer populations. We estimate bivariate associations and ordinary least-squares regression models to examine differences along five dimensions of well-being: life purpose, residential community belonging, physical and mental health, financial well-being, and social connectedness. The results reveal that most SGM groups experience stark disadvantages relative to heterosexuals and cisgender men, which are most pronounced among bisexual, queer, and nonbinary/genderqueer populations. Intergroup and intragroup variations illuminate even greater disparities in well-being than prior research has uncovered, bringing us closer to a holistic profile of SGM well-being at the population level.

Chronic pain among U.S. sexual minority adults who identify as gay, lesbian, bisexual, or “something else”

“…This finding mirrors results for physical health 33,46 and mental health. 66 It is likely a function of “double discrimination,” which bisexual and other sexual minority adults experience from straight and gay/lesbian communities, resulting in invisibility, 67 identity invalidation, 14 and lack of community support. 66…”

“…This finding mirrors results for physical health 33,46 and mental health. 66 It is likely a function of "double discrimination," which bisexual and other sexual minority adults experience from straight and gay/lesbian communities, resulting in invisibility, 67 identity invalidation, 14 and lack of community support. 66 Parenthetically, in supplemental analyses with 2019 to 2020 data (which had to be analyzed separately because of changes in the NHIS data collection procedures 58 ), the gap between adults identifying as bisexual or "something else" vs straight was as large or larger than in the prior years, whereas gay/lesbian adults had pain prevalence on par with their straight counterparts.…”

“…1,53,70 Indeed, there is evidence that the stigma and social exclusion not only persist but may be increasing, perhaps partly as a backlash to sociolegal victories and partly because of the increasing political hyperpolarization of the United States in recent decades. 21,48,56 Correspondingly, sexual minority adults continue to struggle with worse physical and mental health than straight adults, 33,45,46,60,67 and worryingly, these disparities appear to be largest in younger cohorts. 8,46,51 Although all these factors (stigma, poor physical health, and poor mental health) are known as important correlates of chronic pain, 3,17,74 there are no population-based national analyses of chronic pain among U.S. sexual minority adults.…”

“…31 Not only are these studies few in number, but they often merge unique sexual identity categories into a single group, potentially obscuring important within-group differences. 67 Particularly little is known about pain in bisexual adults, 16 the most common sexual minority identity 56 and the one with the worst health outcomes. 24,38,46,67 Small sample sizes are also common: Studies often include only a few dozen respondents per sexual minority category, limiting statistical power and reliability of results.…”

“…67 Particularly little is known about pain in bisexual adults, 16 the most common sexual minority identity 56 and the one with the worst health outcomes. 24,38,46,67 Small sample sizes are also common: Studies often include only a few dozen respondents per sexual minority category, limiting statistical power and reliability of results. Finally, little attention has been paid to the identification of key covariates that could account for observed differences across groups.…”