Physical and Mental Health Disparities at the Intersection of Sexual and Gender Minority Statuses: Evidence From Population-Level Data

• Published in: Demography 2023-06, Vol.60 (3), p.731-760
• Main Authors: Stacey, Lawrence, Wislar, Wes
• Format: Article
• Language: English
• Subjects: Behavioral Risk Factor Surveillance System; Cisgender; Data collection; Disadvantaged; Disease control; Disease prevention; Economics; Functional impairment; Gender; Gender Identity; Gender inequality; Health disparities; Health status; Heterosexuality; Humans; Measurement; Mental depression; Mental Health; Minority & ethnic groups; Minority groups; Multivariable control; Population Studies; Prevention programs; Regression analysis; Regression models; Risk behavior; Risk factors; Risk taking; Self evaluation; Sexual and Gender Minorities; Sexual Behavior; Sexual orientation; Sociodemographics; Sociology; Surveillance; Surveillance systems; Well being
• ISSN: 0070-3370; 1533-7790
• DOI: 10.1215/00703370-10708592

Sexual and gender minorities (SGM) experience detriments across many physical and mental health outcomes compared with heterosexual and cisgender people. But little is known about health outcomes for those who are both gender minorities and sexual minorities. Motivated by theories of double disadvantage and leveraging advancements in data collection and measurement, we examine physical and mental health disparities across sexual and gender minority statuses: cisgender heterosexuals, gender minority heterosexuals, cisgender sexual minorities, and people who are both gender and sexual minorities. Using Gallup's National Health and Well-Being Index (  = 93,144) and the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (  = 543,717), we estimate multivariable logistic regression models to examine how sexual and gender minority statuses are associated with poor/fair self-rated health, functional limitations, and diagnosed depression. Regression models adjusting for sociodemographic characteristics show marked physical and mental health disparities: people who are both gender and sexual minorities report greater odds of poor/fair self-rated health, functional limitations, and depression relative to cisgender heterosexuals and, in some cases, relative to gender minority heterosexuals and cisgender sexual minorities. Our results add to a growing body of research documenting the association between multiple disadvantaged statuses and health and provide novel information on SGM health disparities.