On March 31, the Institute of Medicine released a report on LGBT (lesbian, gay, bisexual, transgender) health. It’s a fairly important document, but it is almost three hundred pages long… So I’m going to cover it in several posts. There’s a lot of material in it, and I’m not going to cover it all. The bulk of the material I am covering is broken up by age group: childhood/adolescence, early/middle adulthood, and later adulthood.
As a note: when I say LGB in these articles, I really do mean just lesbian, gay and bisexual people. Some of the studies referenced only include sexual orientation, not gender identity.
Health of LGBT Children and Adolescents
In general, studies on LGBT youth health are scarce. Most of the studies that do exist focus on mental health (because chronic disease generally doesn’t affect young people). Most LGB youth are well-adjusted and happy.
What is known? Compared with heterosexual/cisgender youth:
- LGB youth definitely have a higher rate of suicidal ideation (thinking about committing suicide) and suicide attempts. This is true regardless of age, substance use, sex/gender, and race/ethnicity. Transgender youth may also be at a higher suicide risk.
- LGB youth seem to have higher rates of binge eating. In addition, young gay and bisexual men seem to have a higher rate of purging.
- What few studies have looked at LGB youth and pregnancy found that they either had similar or higher rates of teen pregnancy.
- LGB youth may be heavier than their heterosexual peers
Health risk factors:
- Harassment, victimization, and violence: LGBT youth report higher levels of these than heterosexual/cisgender youth. The harassment can occur at school or at home. Harassment at school is associated with lower grades, less school involvement and health problems. LGBT youth are also at a higher risk of punishment from school officials, police, or courts than heterosexual youth.
- Substance use: LGB youth use more drugs (including alcohol and tobacco) younger than heterosexual youth.
- Homelessness: LGBT youth are at a much higher risk for becoming homeless, and this risk appears to increase with age. 22-35% of all homeless youth are LGB. LGB youth are at a higher risk than heterosexual youth for being victimized or discriminated against while homeless. They are also at significant risk for “risky sexual behavior” (like prostitution).
- Childhood abuse: LGBT youth are at a higher risk for being sexually or physically abused.
As for protective factors…there aren’t any data yet. They’re working on it, though!
Other findings? It’s pretty well known that young people (adolescents) are uncomfortable talking about sex with their doctors. However, some small preliminary studies have found that doctors generally don’t ask about sexual orientation (or gender identity)! Some doctors feared upsetting their patients. Others weren’t sure how to handle a sexual minority patient. Others had negative impressions of LGBT people. All this makes me rather sad. 🙁
…and that’s it for what’s in the literature. There is, of course, lots more to young LGBT health…but it hasn’t hit the medical and psychiatric literature yet (meaning that there aren’t any studies).
Next time!: Health of LGBT adults