Abstract

Purpose: This study examined the health profile of a national probability sample of three cohorts of sexual minority people, and the ways that indicators of health vary among sexual minority people across age cohorts and other defining sociodemographic characteristics, including sexual identity, gender identity, and race/ethnicity.
Methods: The Generations Study, the first national probability sample of three age cohorts of sexual minority people (n = 1507) in the United States collected in 2016–2017, was used to examine general health profiles across several broad domains: alcohol and drug abuse; general health, physical health, and health disability; mental health and psychological distress; and positive well-being, including general happiness, social well-being, and life satisfaction.
Results: There were no cohort differences in substance abuse or positive well-being. The younger cohort was physically healthier, but had worse psychological health than both the middle and older cohorts.
Conclusions: Cohort differences in physical health were consistent with patterns of aging, whereas for mental health, there were distinct cohort differences among sexual minority people. Given that compromised mental health in the early life course creates trajectories of vulnerability, these results point to the need for mental health prevention and intervention for younger cohorts of sexual minority people.

Get full access to this article

View all available purchase options and get full access to this article.

Disclaimers

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or those of the Centers for Disease Control and Prevention.

References

1. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychol Bull 2003;129(5):674–697;.
2. Meyer IH, Russell ST, Hammack PL, et al. Minority stress, distress, and suicide attempts in three cohorts of sexual minority adults: A U.S. probability sample. PLoS One 2021;16(3):e0246827; doi:10.1371/journal.pone.0246827.
3. Kimmel DC. Adult development and aging: A gay perspective. J Soc Issues 1978;34(3):113–130;.
4. Hammack PL, Frost DM, Meyer IH, et al. Gay men's health and identity: Social change and the life course. Arch Sex Behav 2018;47(1):59–74;.
5. McCormack M. The Declining Significance of Homophobia. OUP: USA; 2013.
6. Russell ST, Fish JN. Sexual minority youth, social change, and health: A developmental collision. Res Hum Dev 2019;16(1):5–20;.
7. Cohler BJ, Hammack PL. The psychological world of the gay teenager: Social change, narrative, and “normality.” J Youth Adolesc 2007;36(1):47–59;.
8. Bostwick WB, Boyd CJ, Hughes TL, et al. Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States. Am J Public Health 2010;100(3):468–475;.
9. Gonzales G, Henning-Smith C. Health disparities by sexual orientation: Results and implications from the Behavioral Risk Factor Surveillance System. J Community Health 2017;42(6):1163–1172.
10. McCabe SE, Hughes TL, Bostwick WB, et al. Sexual orientation, substance use behaviors and substance dependence in the United States. Addiction 2009;104(8):1333–1345;.
11. Potter EC, Patterson CJ. Health-related quality of life among lesbian, gay, and bisexual adults: The burden of health disparities in 2016 Behavioral Risk Factor Surveillance System data. LGBT Health 2019;6(7):357–369;.
12. Meyer IH. Resilience in the study of minority stress and health of sexual and gender minorities. Psychol Sex Orientat Gend Divers 2015;2(3):209–213;.
13. Kann L, Olsen EO, McManus T, et al. Sexual identity, sex of sexual contacts, and health-related behaviors among students in grades 9–12—United States and selected sites, 2015. MMWR Surveill Summ 2016;65(9):1–202;.
14. Feinstein BA, Dyar C. Bisexuality, minority stress, and health. Curr Sex Health Rep 2017;9(1):42–49;.
15. Fish JN, Hughes TL, Russell ST. Sexual identity differences in high-intensity binge drinking: Findings from a US national sample. Addiction 2018;113(4):749–758;.
16. Hughes TL. Alcohol use and alcohol related problems among lesbians and gay men. Annu Rev Nurs Res 2005;23(1):283–325;.
17. Hughes TL, Wilsnack SC, Kantor LW. The influence of gender and sexual orientation on alcohol use and alcohol-related problems: Toward a global perspective. Alcohol Res Curr Rev 2016;38(1):121–132.
18. Plöderl M, Tremblay P. Mental health of sexual minorities. A systematic review. Int Rev Psychiatry 2015;27(5):367–385;.
19. Wilson BDM, Meyer IH. Nonbinary LGBTQ Adults in the United States. Williams Institute; 2021. Available from: https://williamsinstitute.law.ucla.edu/publications/nonbinary-lgbtq-adults-us/ [Last accessed: July 13, 2021].
20. Tuthill Z, Denney JT, Gorman B. Racial disparities in health and health behaviors among gay, lesbian, bisexual and heterosexual men and women in the BRFSS-SOP. Ethn Health 2020;25(2):177–188;.
21. Hsieh N, Ruther M. Sexual minority health and health risk factors: Intersection effects of gender, race, and sexual identity. Am J Prev Med 2016;50(6):746–755;.
22. Rosenkrantz DE, Black WW, Abreu RL, et al. Health and health care of rural sexual and gender minorities: A systematic review. Stigma Health 2017;2(3):229–243;.
23. Barnes D, Hatzenbuehler M, Hamilton A, et al. Sexual orientation disparities in mental health: The moderating role of educational attainment. Soc Psychiatry Psychiatr Epidemiol 2014;49(9):1447–1454;.
24. Meyer IH, Marken S, Russell ST, et al. An innovative approach to the design of a national probability sample of sexual minority adults. LGBT Health 2020;7(2):101–108;.
25. Bush K, Kivlahan DR, McDonell MB, et al. The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking. Arch Intern Med 1998;158(16):1789–1795;.
26. Berman AH, Bergman H, Palmstierna T, et al. Evaluation of the drug use disorders identification test (DUDIT) in criminal justice and detoxification settings and in a Swedish population sample. Eur Addict Res 2005;11(1):22–31;.
27. Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Questionnaire. Department of Health and Human Services, Centers for Disease Control and Prevention; 2014. Available from: https://www.cdc.gov/brfss/annual_data/annual_2014.html [Last accessed: 06/29/2019].
28. Kessler RC, Barker PR, Colpe LJ, et al. Screening for serious mental illness in the general population. Arch Gen Psychiatry 2003;60(2):184–189;.
29. Pew Research Center. A Survey of LGBT Americans. Pew Research Center's Social & Demographic Trends Project; 2013. Available from: https://www.pewsocialtrends.org/2013/06/13/a-survey-of-lgbt-americans/ [Last accessed: 12/07/2020].
30. Keyes CLM. Social well-being. Soc Psychol Q 1998;61(2):121–140;.
31. Diener E, Emmons RA, Larsem RJ, et al. The satisfaction with life scale. J Pers Assess 1985;49(1):71–75;.
32. Lumley T, Diehr P, Emerson S, et al. The importance of the normality assumption in large public health data sets. Annu Rev Public Health 2002;23(1):151; doi:10.1146/annurev.publhealth.23.100901.140546.
33. Buuren S van, Groothuis-Oudshoorn K. mice: Multivariate imputation by chained equations in R. J Stat Softw 2011;45:1–67; doi:10.18637/jss.v045.i03.
34. Blanchflower DG, Oswald AJ. Is well-being U-shaped over the life cycle? Soc Sci Med 2008;66(8):1733–1749;.
35. Thomas ML, Kaufmann CN, Palmer BW, et al. Paradoxical trend for improvement in mental health with aging: A community-based study of 1,546 adults aged 21–100 years. J Clin Psychiatry 2016;77(8):e1019-25;.
36. Toomey RB, Russell ST. The role of sexual orientation in school-based victimization: A meta-analysis. Youth Soc 2016;48(2):176–201;.
37. Fish JN, Exten C. Sexual orientation differences in alcohol use disorder across the adult life course. Am J Prev Med 2020;59(3):428–436;.
38. Rosser BRS, West W, Weinmeyer R. Are gay communities dying or just in transition? Results from an international consultation examining possible structural change in gay communities. AIDS Care 2008;20(5):588–595;.
39. Wardecker BM, Matsick JL, Graham-Engeland JE, et al. Life satisfaction across adulthood in bisexual men and women: Findings from the Midlife in the United States (MIDUS) study. Arch Sex Behav 2019;48(1):291–303;.
40. Hyde JS. Gender similarities and differences. Annu Rev Psychol 2014;65(1):373–398;.
41. Read JG, Gorman BK. Gender and health inequality. Annu Rev Sociol 2010;36(1):371–386;.
42. Iceland J, Ludwig-Dehm S. Black-white differences in happiness, 1972–2014. Soc Sci Res 2019;77:16–29; doi:10.1016/j.ssresearch.2018.10.004.
43. Zajacova A, Lawrence EM. The relationship between education and health: Reducing disparities through a contextual approach. Annu Rev Public Health 2018;39(1):273–289;.
44. Dekker MC, Ferdinand RF, Lang NDJV, et al. Developmental trajectories of depressive symptoms from early childhood to late adolescence: Gender differences and adult outcome. J Child Psychol Psychiatry 2007;48(7):657–666;.
45. Gilbey D, Mahfouda S, Ohan J, et al. Trajectories of mental health difficulties in young people who are attracted to the same gender: A systematic review. Adolesc Res Rev 2020;5(3):281–293;.

Information & Authors

Information

Published In

cover image LGBT Health
LGBT Health
Volume 9Issue Number 8November/December 2022
Pages: 564 - 570
PubMed: 35856801

History

Published in print: November/December 2022
Published online: 30 November 2022
Published ahead of print: 19 July 2022

Permissions

Request permissions for this article.

Topics

Authors

Affiliations

Department of Human Development and Family Sciences, Population Research Center, University of Texas at Austin, Austin, Texas, USA.
Allen B. Mallory
Department of Human Sciences, The Ohio State University, Columbus, Ohio, USA.
Department of Family Science, Prevention Research Center, University of Maryland, College Park, Maryland, USA.
David M. Frost
Social Research Institute, University College London, London, United Kingdom.
Phillip L. Hammack
Department of Psychology, University of California, Santa Cruz, Santa Cruz, California, USA.
Marguerita Lightfoot*
School of Medicine, University of California, San Francisco, San Francisco, California, USA.
Andy Lin
Office of Advanced Research Computing, University of California, Los Angeles, Los Angeles, California, USA.
Bianca D.M. Wilson
The Williams Institute, School of Law, University of California, Los Angeles, Los Angeles, California, USA.
The Williams Institute, School of Law, University of California, Los Angeles, Los Angeles, California, USA.

Notes

*
Current affiliation: School of Public Health, Portland State University, Portland, Oregon, USA.
Address correspondence to: Stephen T. Russell, PhD, Department of Human Development and Family Sciences, Population Research Center, University of Texas at Austin, 108 E. Dean Keeton Street, Stop A2702, Austin, TX 78712-1248, USA [email protected]
An earlier version of this article was presented at the 2019 Interdisciplinary Association for Population Health Science Annual Conference in Seattle, Washington, October 1–4, 2019.

Authors' Contributions

I.H.M., D.M.F, P.L.H., M.L., S.T.R., and B.D.M.W. designed and acquired the data; all authors conceptualized the study; and S.T.R., A.B.M., and J.N.F. operationalized the analyses and wrote the first draft of the article. A.L. and A.B.M. conducted analyses. All authors contributed to subsequent drafts of the final article and all co-authors reviewed and approved the article before submission.

Author Disclosure Statement

No competing financial interests exist.

Funding Information

The Generations Study was funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD grant 1R01HD078526) and through supplemental grants from the National Institutes of Health, Office of Behavioral and Social Sciences Research, and the Office of Research on Women's Health. This work was also supported by grant, P2CHD042849, Population Research Center, and by grant, T32HD007081, Training Program in Population Studies, both awarded to the Population Research Center at The University of Texas at Austin by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and by grant F31MH115608 awarded by the National Institute of Mental Health to A.B.M.
The authors acknowledge support for this research from the Priscilla Pond Flawn Endowment at the University of Texas at Austin. J.N.F. acknowledges support from P2CHD041041, awarded to the Maryland Population Research Center, by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and from the University of Maryland Prevention Research Center cooperative agreement no. U48DP006382 from the Centers for Disease Control and Prevention.

Metrics & Citations

Metrics

Citations

Export citation

Select the format you want to export the citations of this publication.

View Options

Get Access

Access content

To read the fulltext, please use one of the options below to sign in or purchase access.

Society Access

If you are a member of a society that has access to this content please log in via your society website and then return to this publication.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF/EPUB

View PDF/ePub

Full Text

View Full Text

Media

Figures

Other

Tables

Share

Share

Copy the content Link

Share on social media

Back to Top