Young people who make up the lesbian, gay and bisexual (LGB)* population are diverse. But they have health needs and risks that are LGB specific. Some LGB youths experience health disparities, or inequalities, because of the discrimination and stigma they face.
People who identify as LGB have specific health needs. They may have a harder time getting health care. They need health care professionals who understand and respect who they are. People who are LGB may not feel comfortable revealing their status, so they don’t get the care they need. Health care professionals aren’t always trained in addressing LGB-specific health care needs; some have even refused to treat LGB patients. Some LGB people turn to unhealthy behaviors (like substance abuse) to cope with misunderstanding or rejection from loved ones and society.
Gay-related stressors exist in all parts of LGB people’s lives. People who are LGB may face discrimination in the home, within their religion, at school, work and in the language that people use. In some states, LGB couples aren’t permitted to be married legally. So, they face barriers at the institutional level in being accepted for who they are. Many researchers explain these disparities using the minority stress theory. This theory says that the biggest reasons for disparities are the experiences with discrimination and victimization people have because they identify as LGB.
Michael P. Marshal, PhD, associate professor of psychiatry and of pediatrics at the University of Pittsburgh and psychologist with Children’s Hospital of Pittsburgh of UPMC’s Division of Adolescent Medicine, and colleagues, have studied LGB health disparities, particularly among youths. They’ve found that LGB youths are more likely to experience bullying, physical abuse from parents and sexual abuse than heterosexual youths. Because of this abuse, they are more likely to suffer from mental health problems, behavioral and substance abuse problems.
Researchers have found that LGB youths are at an increased risk for suicide, homelessness (some LGB youths get kicked out of the house when their parents find out the youths are gay) and use fewer preventive health services than heterosexual youths. LGB youths don’t even have the same access to participating in research. People under the age of 18 require parental consent to be involved in a study. Because some LGB youths haven’t yet told (or “come out”) their parents of their LGB status, getting parental consent may be problematic or unsafe.
It’s important to note that, despite difficult gay-related stressors and discrimination, most LGB youths report being healthy and happy. Another hopeful sign is how LGB health disparities affect different populations. It’s well-known that there are health disparities in the African American community. It’s also known that there are health disparities in the LGB community.
One question is whether individuals who are members of both communities, such that they have two “intersecting” minority identities, have even more disparities than people who are members of only one or the other. In his research, Dr. Marshal tested this question. He found evidence that African American LGB girls and young women have no greater disparities than Caucasian LGB girls and young women. In fact, he found that African American young women who identified as LGB had smaller disparities than did White young women. Researchers like Dr. Marshal are now looking for the reasons behind this resiliency.
“It’s possible that African American girls and young women who have been experiencing and coping with racial discrimination for a long time, are able to use those coping skills when they experience gay-related discrimination.” says Dr. Marshal. “Perhaps they have been able to go to family members for skills to cope with racism, and the skills they’ve developed help them cope with discrimination in general, which decreases their risk for disparities.”
Dr. Marshal adds, “As researchers, we can learn from this resiliency. We need to understand how they learn their coping skills so we can help others who are in need.”
*For the purposes of this article, we’re focusing on people who identify as lesbian, gay or bisexual. The transgender population has similar stressors as people who are LGB, but transgender struggles are unique and different from the LGB population’s. We hope to address health disparities in the transgender population in a separate issue.
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