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Health and Wellbeing in Sexual Orientation and Gender Identity

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 October 2019) | Viewed by 72529

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Special Issue Editor

Prof. Catherine Meads

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Guest Editor

School of Nursing & Midwifery, Faculty of Health, Education, Medicine & Social Care, Anglia Ruskin University, Cambridge CB1 1PT, UK
Interests: Sexual orientation and health, LGBT health and wellbeing, systematic reviews in complex interventions

Special Issue Information

Dear Colleagues,

We are organising a Special Issue on sexual orientation, gender identity, and health in the International Journal of Environmental Research and Public Health. This is a peer-reviewed scientific journal (Impact factor 2.145) that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health (broadly defined). For detailed information on the journal, we refer you to https://0-www-mdpi-com.brum.beds.ac.uk/journal/ijerph.

Improving the health of specific populations is an important objective for service planners, policy-makers, public health officials, and care delivery staff. Enhancing public health means preventing disease, prolonging life, and promoting physical, mental, and social well-being. This is especially important for disadvantaged minority groups such as people of minority sexual orientation and gender identity populations, for which there is robust evidence of considerable health inequities. Improving health and wellbeing is an important objective for all who aspire to reducing health inequities (inequalities that are considered preventable). It is important to understand various factors that contribute to lesbian, gay, bisexual, trans, and similar (LGBT+) groups’ mental and physical health and the mediators and moderators of these factors. This Special Issue is open to any subject area regarding sexual orientation, gender identity, and related physical or mental health and wellbeing. We are particularly interested in areas where little previous research has been published, such as interventions for LGBT+ populations to improve mental and physical health and health behaviours, evidence-based approaches to inclusive services, and longitudinal studies on the long-term health impact of exogenous hormones in trans people. The listed keywords suggest just a few of many other possibilities. We will consider systematic reviews and primary qualitative or quantitative researches.

Prof. Catherine Meads
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Sexual orientation
Gender identity
LGBT
Intersectionality issues
Wellbeing
Physical health
Mental health
Trauma, grief, and loss
Behaviours and risks
Social determinants
Health behaviour and health seeking
Quality of life
Resilience
Empowerment
Social justice
Self-efficacy
Holistic approaches
Health knowledge, attitudes, practice
Health literacy
Human and civil rights
Social inclusion and sense of community
Social participation
Community participation

Published Papers (13 papers)

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Research

Jump to: Review

15 pages, 300 KiB

Open AccessArticle

Education First: Promoting LGBT+ Friendly Healthcare with a Competency-Based Course and Game-Based Teaching

by Hsing-Chen Yang

Int. J. Environ. Res. Public Health 2020, 17(1), 107; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17010107 - 22 Dec 2019

Cited by 9 | Viewed by 3062

Abstract

How, apart from by conveying professional knowledge, can university medical education nurture and improve the gender competency of medical students and thereby create an LGBT+ friendly healthcare environment? This study explored the use of game-based teaching activities in competency-based teaching from the perspective of competency-based medical education (CBME) and employed a qualitative case-study methodology. We designed an LGBT+ Health and Medical Care course in a medical school. Feedback was collected from two teachers and 19 medical students using in-depth interviews and thematic analysis was used to analyze the collected data. The findings of this study were as follows: (1) Games encouraged student participation and benefited gender knowledge transmission and transformation through competency learning, and (2) games embodied the idea of assessment as learning. The enjoyable feeling of pressure from playing games motivated students to learn. Using games as both a teaching activity and an assessment tool provided the assessment and instant feedback required in the CBME learning process. Game-based teaching successfully guided medical students to learn about gender and achieve the learning goals of integrating knowledge, attitudes, and skills. To fully implement CBME using games as teaching methods, teaching activities, learning tasks, and assessment tools, teachers must improve their teaching competency. This study revealed that leading discussions and designing curricula are key in the implementation of gender competency-based education; in particular, the ability to lead discussions is the core factor. Game-based gender competency education for medical students can be facilitated with discussions that reinforce learning outcomes to achieve the objectives of gender equality education and LGBT+ friendly healthcare. The results of this study indicated that game-based CBME with specific teaching strategies was an effective method of nurturing the gender competency of medical students. The consequent integration of gender competency into medical education could achieve the goal of LGBT+ friendly healthcare. Full article

(This article belongs to the Special Issue Health and Wellbeing in Sexual Orientation and Gender Identity)

13 pages, 676 KiB

Open AccessArticle

A Systematic Review of UK Educational and Training Materials Aimed at Health and Social Care Staff about Providing Appropriate Services for LGBT+ People

by Ros Hunt, Christopher Bates, Susan Walker, Jeffrey Grierson, Sarah Redsell and Catherine Meads

Int. J. Environ. Res. Public Health 2019, 16(24), 4976; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16244976 - 07 Dec 2019

Cited by 16 | Viewed by 6271

Abstract

Background: There is greater dissatisfaction with health services by LGBT people compared to heterosexual and cisgender people and some of this is from lack of equality and diversity training for health professionals. Core training standards in sexual orientation for health professionals have been available since 2006. The purpose of this project is to systematically review educational materials for health and social care professionals in lesbian, gay, bisexual, and transgender (LGBT) issues. Methods: A protocol was developed and searches conducted in six databases. Selection criteria: any studies reporting delivery or evaluation of UK education of health and/or social care professionals in LGBT issues, with no language or setting restrictions. Inclusions and data extraction were conducted in duplicate. Narrative synthesis of educational evaluations was used. Educational materials were assessed using thematic synthesis. Results: From the searches, 165 full papers were evaluated and 19 studies were included in the narrative synthesis. Three were successful action-research projects in cancer services and in residential care. Sixteen sets of educational/training materials have been available since 2010. These varied in length, scope, target audience, and extent of development as classroom-ready materials. Conclusions: Despite the availability of appropriate training programmes for post-qualifying staff, recommendations to undertake training, best practice examples, and statements of good intent, LGBT people continue to report that they are experiencing discrimination or direct prejudice from health and/or social care services. Better training strategies using behaviour change techniques are needed. Full article

(This article belongs to the Special Issue Health and Wellbeing in Sexual Orientation and Gender Identity)

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14 pages, 701 KiB

Open AccessArticle

Victimization of Traditional and Cyber Bullying During Childhood and Their Correlates Among Adult Gay and Bisexual Men in Taiwan: A Retrospective Study

by Chien-Chuan Wang, Ray C. Hsiao and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2019, 16(23), 4634; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16234634 - 21 Nov 2019

Cited by 21 | Viewed by 3419

Abstract

This study examined the associations of timing of sexual orientation developmental milestones, gender role nonconformity, and family-related factors with victimization of traditional and cyber sexuality-related bullying during childhood among gay and bisexual men in Taiwan, in addition to the moderating effects of family-related factors on these associations. A total of 500 homosexual or bisexual men aged between 20 and 25 years were recruited into this study. The associations of early identification of sexual orientation, early coming out, level of masculinity, parental education levels, and perceived family support with victimization of traditional and cyber sexuality-related bullying were evaluated. Early identification of sexual orientation, low self-rated masculinity, and low family support were significantly associated with victimization of traditional bullying. Moreover, low family support, early coming out, and traditional bullying victimization were significantly associated with victimization of cyber bullying. Family support did not moderate the associations of early identification of sexual orientation and low masculinity with victimization of traditional bullying or cyberbullying. The factors associated with victimization of traditional and cyber sexuality-related bullying should be considered when mental health and educational professionals develop prevention and intervention strategies to reduce sexuality-related bullying. Full article

(This article belongs to the Special Issue Health and Wellbeing in Sexual Orientation and Gender Identity)

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18 pages, 328 KiB

Open AccessArticle

The Power of Recognition: A Qualitative Study of Social Connectedness and Wellbeing through LGBT Sporting, Creative and Social Groups in Ireland

by Nerilee Ceatha, Paula Mayock, Jim Campbell, Chris Noone and Kath Browne

Int. J. Environ. Res. Public Health 2019, 16(19), 3636; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16193636 - 27 Sep 2019

Cited by 28 | Viewed by 9453

Abstract

The broad research consensus suggesting substantial vulnerabilities among lesbian, gay, bisexual and transgender (LGBT) communities may fail to recognize the protective factors available to these populations. The sparse literature on mental health promotion highlights the importance of understanding strengths-based community approaches that promote LGBT wellbeing. Informed by the Ottawa Charter for Health Promotion, underpinned by Honneth’s Theory of Recognition, this paper outlines the findings of a qualitative Irish study on LGBT social connectedness through a diverse range of sporting, creative and social interests. Ten in-depth interviews were conducted with 11 people (including one couple) who self-identified as lesbian (5), gay (4), bisexual (1) and transgender (1) aged between 22 and 56 years. A university Research Ethics Committee granted approval. The data were transcribed and coded using thematic analysis, enhanced through a memo-writing approach to reflexivity. The theme of ‘connecting’ emphasized the shared nature of activities, with like-minded others through groups established by, and for, LGBT communities. Messages from the study reinforce the central role of LGBT communities in the promotion of mental health and social wellbeing, with important policy and practice implications. This requires the contextualization of the contribution of LGBT communities within understandings of social justice, identity and recognition. Full article

(This article belongs to the Special Issue Health and Wellbeing in Sexual Orientation and Gender Identity)

21 pages, 3267 KiB

Open AccessArticle

Inferring Opinions and Behavioral Characteristics of Gay Men with Large Scale Multilingual Text from Blued

by Ge Huang, Mengsi Cai and Xin Lu

Int. J. Environ. Res. Public Health 2019, 16(19), 3597; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16193597 - 26 Sep 2019

Cited by 12 | Viewed by 6745

Abstract

Gay men in many countries are increasingly using geosocial networking applications (GSN apps), thus offering new opportunities for understanding them. This paper provides a comprehensive content analysis of posts and opinions on Blued, the world’s largest gay social networking dating app, to infer and compare opinions and behavioral characteristics of gay men in different countries. Machine learning and linguistic programming approaches were used to extract themes and analyze sentiments of posts. The results show that the majority of posts are related to daily life activities, and less are related to sensitive topics. While most posts are positive or neutral, negative emotions, including anxiety, anger, and sadness, are mainly distributed in posts related to self-identification and sexual behaviors in China and to relationships in other countries. Voting items indicate that only 50.52% of the participants will take regular HIV tests while 50.2% would have casual sex when they are single. Additionally, 35.8% of the participants may try drugs when invited by friends. Our findings suggest an opportunity and necessity for researchers and public health practitioners to use open source data on GSN apps and other social medias to inform HIV interventions and to promote social inclusion for sexual minorities. Full article

(This article belongs to the Special Issue Health and Wellbeing in Sexual Orientation and Gender Identity)

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23 pages, 401 KiB

Open AccessArticle

The Needs of LGBTI People Regarding Health Care Structures, Prevention Measures and Diagnostic and Treatment Procedures: A Qualitative Study in a German Metropolis

by Ute Lampalzer, Pia Behrendt, Arne Dekker, Peer Briken and Timo O. Nieder

Int. J. Environ. Res. Public Health 2019, 16(19), 3547; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16193547 - 22 Sep 2019

Cited by 12 | Viewed by 4867

Abstract

(1) Background: Studies indicate that lesbian, gay, bisexual, transgender and intersex (LGBTI) people constantly face challenges and disadvantages in the health care system that prevent them from getting the best possible patient-centered care. However, the present study is the first to focus on LGBTI-related health in a major German metropolis. It aimed to investigate health care structures, prevention measures and diagnostic as well as treatment procedures that LGBTI individuals need in order to receive appropriate patient-centered health care and health promotion. (2) Methods: Following a participatory approach, five expert interviews with LGBTI people with multiplier function, i.e., people who have a key role in a certain social milieu which makes them able to acquire and spread information in and about this milieu, and three focus groups with LGBTI people and/or health professionals were conducted. Qualitative data were analyzed according to the principles of content analysis. (3) Results: The specific needs of LGBTI individuals must be recognized as a matter of course in terms of depathologization, sensitization, inclusion, and awareness. Such an attitude requires both basic knowledge about LGBTI-related health issues, and specific expertise about sufficient health care services for each of the minorities in the context of sex, sexual orientation and gender identity. (4) Conclusions: For an appropriate approach to LGBTI-centered health care and health promotion, health professionals will need to adopt a better understanding of specific soft and hard skills. Full article

(This article belongs to the Special Issue Health and Wellbeing in Sexual Orientation and Gender Identity)

11 pages, 328 KiB

Open AccessArticle

Effect of Same-Sex Marriage Referendums on the Suicidal Ideation Rate among Nonheterosexual People in Taiwan

by I-Hsuan Lin, Nai-Ying Ko, Yu-Te Huang, Mu-Hong Chen, Wei-Hsin Lu and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2019, 16(18), 3456; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16183456 - 17 Sep 2019

Cited by 11 | Viewed by 3801

Abstract

Taiwan held voter-initiated referendums to determine same-sex marriage legalization on 24 November 2018. This study aims to compare suicidal ideation rates in heterosexual and nonheterosexual participants of a first-wave survey (Wave 1, 23 months before the same-sex marriage referendums) and a second-wave survey (Wave 2, one week after the same-sex marriage referendums) in Taiwan and to examine the influence of gender, age, and sexual orientation on the change in suicidal ideation rates in nonheterosexual participants. In total, 3286 participants in Wave 1 and 1370 participants in Wave 2 were recruited through a Facebook advertisement. Each participant completed an online questionnaire assessing suicidal ideation. The proportions of heterosexual and nonheterosexual participants with suicidal ideation were compared between the Wave 1 and Wave 2 surveys. Suicidal ideation rates between participants in the Wave 1 and Wave 2 surveys were further compared by stratifying nonheterosexual participants according to gender, age, and sexual orientation. Nonheterosexual participants in the Wave 2 survey had a higher suicidal ideation rate than those in the Wave 1 survey, whereas no difference was observed in suicidal ideation rates between heterosexual participants in Wave 2 and Wave 1. Nonheterosexual participants who were female, younger, gay, lesbian, and bisexual in Wave 2 had a higher suicidal ideation rate than those in Wave 1. The suicidal ideation rate significantly increased in nonheterosexual participants experiencing the same-sex marriage referendums in Taiwan. Whether civil rights of sexual minority individuals can be determined through referendums should be evaluated. Full article

(This article belongs to the Special Issue Health and Wellbeing in Sexual Orientation and Gender Identity)

21 pages, 419 KiB

Open AccessArticle

Romantic Attraction and Substance Use in 15-Year-Old Adolescents from Eight European Countries

by András Költő, Alina Cosma, Honor Young, Nathalie Moreau, Daryna Pavlova, Riki Tesler, Einar B. Thorsteinsson, Alessio Vieno, Elizabeth M. Saewyc and Saoirse Nic Gabhainn

Int. J. Environ. Res. Public Health 2019, 16(17), 3063; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16173063 - 23 Aug 2019

Cited by 11 | Viewed by 6326

Abstract

Sexual minority youth are at higher risk of substance use than heterosexual youth. However, most evidence in this area is from North America, and it is unclear whether the findings can be generalized to other cultures and countries. In this investigation, we used data from the 2014 Health Behaviour in School-aged Children (HBSC) study to compare substance use in same- and both-gender attracted 15-year-old adolescents from eight European countries (n = 14,545) to that of their peers who reported opposite-gender attraction or have not been romantically attracted to anyone. Both-gender attracted, and to a lesser extent, same-gender attracted adolescents were significantly more likely to smoke cigarettes, consume alcohol, get drunk and use cannabis, or be involved in multiple substance use in the last 30 days compared to their opposite-gender attracted peers. Those adolescents who have not been in love had significantly lower odds for substance use than all other youth. The pattern of results remained the same after adjusting for country, gender and family affluence. These findings are compatible with the minority stress and romantic stress theories. They suggest that sexual minority stigma (and love on its own) may contribute to higher substance use among adolescents in European countries. Full article

(This article belongs to the Special Issue Health and Wellbeing in Sexual Orientation and Gender Identity)

12 pages, 695 KiB

Open AccessArticle

Sexually Transmitted Infections and Associated Factors in Homosexuals and Bisexuals in Granada (Spain) during the Period 2000–2015

by Isabel Llavero-Molino, María Teresa Sánchez-Ocón, María Ángeles Pérez-Morente, Beatriz Espadafor-López, Adelina Martín-Salvador, Encarnación Martínez-García and César Hueso-Montoro

Int. J. Environ. Res. Public Health 2019, 16(16), 2958; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16162958 - 16 Aug 2019

Cited by 3 | Viewed by 3248

Abstract

Sexually transmitted infections (STIs) are a major public health issue. Previous research shows the vulnerability of the homosexual and bisexual population, as well as the influence of economic, political, and cultural determinants. The aim of this study was to describe the socio-demographic healthcare profile and the main risk factors associated with STIs in homosexuals and bisexuals seen at the STI clinic in Granada (Spain) during the years 2000–2015. Infection prevalences were compared between the economic crisis period (2008–2014) and the rest of the years analysed. A cross-sectional observational and analytical study was conducted by reviewing 261 clinical records of individuals with suspected or present infection. Univariate, bivariate, and multivariate analyses were performed. 91.2% of the individuals were men, and 8.8% were women, with the mean age being 28.61 (SD = 9.35, Range = 17–74) years old. The prevailing sexual orientation identity was homosexual. 94.2% were single. The main reason for consultation was HIV. Differences in prevalence were found between crisis and non-crisis years (OR = 3.91; 95% CI = 1.73–9.19). In conclusion, their profile was that of a young, single man suspecting possible HIV infection. STI prevalence was significantly higher in the years of economic recession in comparison to the rest of the years. Full article

(This article belongs to the Special Issue Health and Wellbeing in Sexual Orientation and Gender Identity)

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9 pages, 291 KiB

Open AccessArticle

LGBT+ Health Teaching within the Undergraduate Medical Curriculum

by Jessica Salkind, Faye Gishen, Ginger Drage, Jayne Kavanagh and Henry W. W. Potts

Int. J. Environ. Res. Public Health 2019, 16(13), 2305; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16132305 - 28 Jun 2019

Cited by 34 | Viewed by 5547

Abstract

Introduction: The lesbian, gay, bisexual, and transgender (LGBT+) population experience health and social inequalities, including discrimination within healthcare services. There is a growing international awareness of the importance of providing healthcare professionals and students with dedicated training on LGBT+ health. Methods: We introduced a compulsory teaching programme in a large London-based medical school, including a visit from a transgender patient. Feedback was collected across four years, before (n = 433) and after (n = 541) the session. Student confidence in using appropriate terminology and performing a clinical assessment on LGBT+ people was assessed with five-point Likert scales. Fisher exact tests were used to compare the proportion responding “agree” or “strongly agree”. Results: Of the students, 95% (CI 93–97%) found the teaching useful with 97% (96–99%) finding the visitor’s input helpful. Confidence using appropriate terminology to describe sexual orientation increased from 62% (58–67%) to 93% (91–95%) (Fisher p < 0.001) and gender identity from 41% (36–46%) to 91% (88–93%) (p < 0.001). Confidence in the clinical assessment of a lesbian, gay or bisexual patient increased from 75% (71–79%) to 93% (90–95%) (p < 0.001), and of a transgender patient from 35% (31–40%) to 84% (80–87%) (p < 0.001). Discussion: This teaching programme, written and delivered in collaboration with the LGBT+ community, increases students’ confidence in using appropriate language related to sexual orientation and gender identity, and in the clinical assessment of LGBT+ patients. Full article

(This article belongs to the Special Issue Health and Wellbeing in Sexual Orientation and Gender Identity)

14 pages, 587 KiB

Open AccessArticle

Interpersonal Sensitivity and Loneliness among Chinese Gay Men: A Cross-Sectional Survey

by Dongdong Jiang, Yitan Hou, Xiangfan Chen, Rui Wang, Chang Fu, Baojing Li, Lei Jin, Thomas Lee and Xiaojun Liu

Int. J. Environ. Res. Public Health 2019, 16(11), 2039; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16112039 - 08 Jun 2019

Cited by 12 | Viewed by 8349

Abstract

To understand the current status of, and factors related to interpersonal sensitivity (IS) and loneliness among Chinese gay men. The Chinese version SCL-90-R was used to evaluate the status of IS, and the short-form UCLA Loneliness scale (ULS-8) was used for assessing loneliness level. Associations between demographics and IS were examined by chi-square tests and multivariable logistic regress analysis. Linear regression was used to assess the correlations between demographic factors and IS and loneliness. Dating practices and venues were summarized by multiple responses. Gay men who screened positive IS was identified in 36%. Age (OR_25–29 = 8.731, 95% CI 2.296 to 33.139), education level (OR_college = 0.037, 95% CI 0.046 to 0.911), being the only-child at home (OR_yes = 4.733, 95% CI 2.293 to 9.733), monthly income (OR_>7000 = 0.228, 95% CI 0.055 to 0.944), numbers of current sexual partners (OR₁ = 0.285, 95% CI 0.129 to 0.629; OR₂ = 0.109 95% CI 0.027 to 0.431) were related to IS. IS was also associated with a higher score of ULS-8 (β = 6.903, p < 0.001). Other variables associated with the score of ULS-8 included: living in a non-nuclear family (β = 0.998, p = 0.020), being a college student (β = −1.556, p = 0.044), having a higher monthly income (β for 3000–5000 yuan = −1.177, p = 0.045; β for over 7000 yuan = −2.207, p = 0.002), having sexual partners (all β < 1, p < 0.001), being the only-child (β = 1.393, p = 0.005). Nearly half of the sample (46.78%) reported that they looked for dating partners on the Internet or dating apps. IS and loneliness are positively correlated. Our study suggests that more humanistic care and social support should be given to Chinese gay men. Full article

(This article belongs to the Special Issue Health and Wellbeing in Sexual Orientation and Gender Identity)

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14 pages, 305 KiB

Open AccessArticle

A Comparative Analysis of Lifetime Medical Conditions and Infectious Diseases by Sexual Identity, Attraction, and Concordance among Women: Results from a National U.S. Survey

by Kelly Horn and James A. Swartz

Int. J. Environ. Res. Public Health 2019, 16(8), 1399; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16081399 - 18 Apr 2019

Cited by 5 | Viewed by 2453

Abstract

There have been limited studies assessing the differences in chronic health conditions between sexual minority (those who identify as lesbian or bisexual) and sexual majority (heterosexual) women. Research has primarily focused on overall physical and mental health or behavioral issues and not on specific health conditions. The addition of sexual orientation and attraction questions to the National Survey on Drug Use and Health (NSDUH) now allows for research regarding health conditions using a national survey that identifies participant sexual orientation and attraction. This study sought to compare the prevalence/odds of having 10 medical conditions/infectious diseases among women, assessing for differences associated with sexual identity, sexual attraction, and the degree of concordance between sexual identity and attraction. Data from 67,648 adult female participants in the 2015–2017 NSDUH survey were analyzed using bivariate and multivariable logistic regression models to assess for differences in prevalence/odds of seven medical conditions. Multivariable models adjusted for demographics, substance abuse/dependence, and mental illness. We found significant differences by sexual identity, but not sexual attraction or concordance. Compared with heterosexually identified women, women who identified as bisexual had significantly higher odds of having three medical conditions and two infectious diseases than heterosexual or lesbian women. The findings generally support those based on studies using more limited geographical samples. There are a number of potential associated and underlying factors that contribute to bisexual women reporting overall poorer health than heterosexual or lesbian women. The factors discussed include stigma, delays in seeking care, lack of insurance and access, and sexual minority women receiving poorer health care generally. Full article

(This article belongs to the Special Issue Health and Wellbeing in Sexual Orientation and Gender Identity)

Review

Jump to: Research

24 pages, 635 KiB

Open AccessReview

A Systematic Review of Sexual Minority Women’s Experiences of Health Care in the UK

by Catherine Meads, Ros Hunt, Adam Martin and Justin Varney

Int. J. Environ. Res. Public Health 2019, 16(17), 3032; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16173032 - 21 Aug 2019

Cited by 22 | Viewed by 8029

Abstract

Sexual minority women (SMW) experience worse health and disproportionate behavioural risks to health than heterosexual women. This mixed-methods systematic review evaluated recent studies on health experiences of UK SMW, published 2010–2018. Analysis was through narrative thematic description and synthesis. Identified were 23,103 citations, 26 studies included, of which 22 provided qualitative and nine quantitative results. SMW had worse health experiences that might impact negatively on access, service uptake and health outcomes. Findings highlighted significant barriers facing SMW, including heteronormative assumptions, perceptions and experiences of negative responses to coming out, ignorance and prejudice from healthcare professionals, and barriers to raising concerns or complaints. Little information was available about bisexual and trans women’s issues. Findings highlighted the need for explicit and consistent education for healthcare professionals on SMW issues, and stronger application of non-discrimination policies in clinical settings. Full article

(This article belongs to the Special Issue Health and Wellbeing in Sexual Orientation and Gender Identity)

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