Survey finds excess health problems in lesbians, gays, bisexuals

Gay, lesbian and bisexual individuals reported more health problems than straight men and women, in a large U.S. survey.

For the first time since its launch in 1957, the National Health Interview Survey in 2013 and 2014 included a question about sexual orientation.

With nearly 69,000 participants, the survey revealed that lesbian, gay and bisexual adults "were more likely to report impaired physical and mental health, heavy alcohol consumption, and heavy cigarette use, potentially due to the stressors that (they) experience as a result of interpersonal and structural discrimination," researchers wrote online June 28 in JAMA Internal Medicine.

Overall, 67,150 survey respondents were heterosexual, 525 lesbian, 624 gay and 515 bisexual. The average age was about 47.

Gilbert Gonzales of the Vanderbilt University School of Medicine in Nashville and colleagues found that compared to heterosexual women, lesbians were 91 percent more likely to report poor or fair health. Lesbians were 51 percent more likely, and bisexual women were more than twice as likely, to report multiple chronic conditions, compared to straight women.

Gay, lesbian and bisexual people were also more likely than heterosexuals to report heavy drinking and smoking. While gays and lesbians reported worse psychological distress than heterosexuals, bisexual people suffered the most, the survey showed.

For example, about 17 percent of heterosexual men had at least moderate psychological distress, compared to about 26 percent of gay men and about 40 percent of bisexual men.

Similarly, about 22 percent of heterosexual women had at least moderate psychological distress, compared to about 28 percent of lesbian women and about 46 percent of bisexual women.

"While there aren't that many studies focusing on bisexual adults, previous studies have indicated they're probably at greater risk," he said.

Other factors too, along with so-called minority stress, may account for health differences between heterosexuals and lesbian, gay and bisexual people, Gonzales said.

"It will be interesting to see how legal same-sex marriage will affect these health disparities, or if the lifestyle itself is to blame." Gonzales said.

Katz advised that doctors should proactively create "environments that are inclusive and supportive of sexual minority patients."

"This environmental support explanation is a very common one, and to be sure it does indeed matter," Dr. Mark Regnerus, a sociology professor at the University of Texas at Austin. 

"The odds that ‘stigma’ explains all of the variance in troubled outcomes, however, are low."

Regnerus explained that scientifically, a different study of the data would have to be set up in order to determine whether external discrimination or the homosexual lifestyle itself is what causes the striking health problems in gays. 

"It's difficult to know unless they had and employed a measure of social stigma or lack of support in their study."