Discrimination is bad for anyone’s health.
In the LGBT community, this stigmatization can lead to varying types of chronic health issues.
A lot of LGBT health research funding and public attention still goes to AIDS.
But the LGBT community also experiences higher rates of other less visible health issues, like high blood pressure and earlier onset of disabilities, according to a recent Kaiser Family Foundation Research report.
On top of that, LGBT adults face more challenges in getting healthcare.
Stress and anxiety that’s fueled by discrimination are the likely culprits, say many experts.
These stresses can occur on many fronts, such as hearing about constant LGBT legal battles, workplace discrimination, or being denied healthcare.
“There is minority stress,” Gilbert Gonzales, assistant professor in the Department of Health Policy at Vanderbilt University School of Medicine, told Healthline. “And it’s above the everyday stress. There’s also a lot of variation within the LGBT community.”
Another study of over 68,000 American adults found that lesbian, gay, and bisexual adults drank and smoked more heavily than heterosexual adults.
Gonzales, who co-authored the study, describes smoking and drinking as a “coping mechanism” for dealing with discrimination. “It could be drowning feelings by self-medicating,” he said.
Stress and anxiety are indeed linked to poor health outcomes, Carrie Henning-Smith, a research associate at the University of Minnesota School of Public Health and who also co-authored the report, told Healthline.
“And we need to be concerned about it,” she said. “Homophobia is alive and well.”
As the federal government begins collecting more health data on sexual orientation, these disparities are finally coming to light, experts noted.
Bisexual people face the most health issues
Peeling away the health differences within the LGBT community is revealing, too.
For example, lesbian — and especially bisexual — women are more likely to be overweight than heterosexual women.
“And being overweight is a big risk factor for chronic diseases,” said Gonzalez.
Lesbian and bisexual women are also more likely to receive diagnoses with some cancers as well as higher rates of cardiovascular disease, according to the Kaiser Foundation report.
But bisexual people reported the poorest overall health.
They’re less likely to describe their health as excellent and had higher levels of distress. This group was also the least likely to be insured and also avoided getting medical care in the past year due to cost.
“Bisexuals do have the highest health risks,” said Henning-Smith, who passionately believes that all people should have a chance to have a healthy life. “One theory is that they’re a minority within a minority.”
Gay men can suffer from little-discussed health issues too, such as eating disorders fueled by body image.
According to studies, gay men were seven times more likely to report binging and 12 times more likely to report purging than heterosexual men.
Transgender college students are five times more likely to have an eating disorder than their peers.
And binge eating has serious side effects, such as cardiovascular disease, high blood pressure, and diabetes.
“Binging can also lead to social isolation,” Dr. Stephanie Setliff, medical director at the Eating Recovery Center in Dallas, told Healthline, as feelings of shame and guilt arise.
Finally, older members of the LGBT community face mounting health issues as they age.
According to a University of Washington study that examined health conditions among LGB adults over 50, lesbian and bisexual women are more likely to have chronic health conditions than heterosexual women.
These health conditions include strokes, heart attacks, and asthma.
“This is a population that isn’t getting the attention it deserves,” said Karen Fredriksen-Goldsen, director of the Health Generations Hartford Center of Excellence at the University of Washington, in a press release about the study. “Lesbian and bisexual women tend to be more invisible.”
Aging gay men, lesbians, and bisexual people also usually lack family support and end up living alone.
They report higher rates of mental distress and isolation, according to a policy brief by the UCLA Center for Health Policy Research.
However, when moving into nursing homes, elder abuse is rampant, too.
According to surveys, 43 percent of LGBTQ seniors have either been abused by caretakers or witnessed abuse, such as being evicted from long-term care facilities.
“This abuse is a hard one,” said Gonzales. “When health deteriorates, some will enter nursing homes. Often, that process leads them to go back into the closet.”
Government agencies are starting to collect more data on sexual orientation in health surveys.
And so, light is finally being shed on LGBT health issues.
“Before that, there wasn’t any data,” said Henning-Smith. “However, the Census report still doesn’t include sexual orientation. And we still need to fill in lots of gaps.”
The Affordable Care Act (ACA) has helped as well. It’s cut the uninsured rate among lesbian, gay, and bisexual adults in half.
More employers are also offering same-sex health insurance for couples, say experts.
It’s especially important for the well-being of the LGBT community, experts add, to keep the ACA intact.
Yet, there’s still work to be done.
“The healthcare profession is behind the curve,” Dr. Benjamin Laniakea, a family medicine physician at Stanford Health Center who specializes in LGBT health, told Healthline. “There isn’t training for providers.”
Laniakea said that health providers should stay updated about LGBT health concerns.
“That means that they feel welcome at the front desk when handing in an intake sheet,” he said. “It’s the responsibility of the healthcare community to create care for the LGBT community, so they don’t have to find special providers.”