It has been well-documented that lesbian, gay, and bisexual adolescents have an increased risk of being bullied. Studies have found that this can have a significant impact on their development and result in adverse health outcomes. Now, new research published in JAMA Internal Medicine found that adults who are members of the LGBT community were more likely to report impaired physical and mental health and heavy drinking and smoking, and this may be linked to the discrimination they face.

Researchers, led by Dr. Gilbert Gonzales of Vanderbilt University in Tennessee, analyzed data from the 2013 and 2014 National Health Interview Survey which, for the first time, included a question on sexual orientation. The study involved 525 lesbians, 624 gay people, 515 people who identified as bisexual, and 67,150 of their heterosexual peers. Their analysis suggests that sexual minorities experience greater health risks than heterosexuals.

“Findings from our study indicate that LGB adults experience significant health disparities - particularly in mental health and substance use - likely due to the minority stress that [lesbian, gay and bisexual] adults experience as a result of their exposure to both interpersonal and structural discrimination,” researchers wrote.

Specifically, they found that 16.9 percent of heterosexual men had moderate or severe psychological distress, while 25.9 percent of gay men and 40.1 percent of bisexual men reported those levels of distress. Bisexual men reported the highest prevalence of heavy drinking at 10.9 percent compared with heterosexual (5.7 percent) or gay (5.1 percent) men. Furthermore, gay and bisexual men were more likely to be current smokers compared to heterosexual men, but bisexual men were more likely to be heavy smokers.

Among women, 21.9 percent of heterosexuals showed symptoms of moderate and severe psychological distress compared with 28.4 percent of lesbians and 46.4 percent of bisexuals. Both lesbian and bisexual women (greater than 25 percent) were more likely to be current smokers compared with just 14.7 percent of heterosexual women, but lesbians were more likely to be heavy smokers than heterosexual and bisexual women. Researchers also found that lesbian women were more likely to report poor or fair health and multiple chronic conditions compared with heterosexual women. While bisexual women were more likely to report multiple chronic conditions than heterosexual women, they also had the heaviest alcohol consumption compared with lesbian and heterosexual women.

The findings not only show that members of the LGBT community have greater health risks than heterosexuals, but that bisexual adults in particular have the highest prevalence and risk of psychological distress. Researchers believe this may be due to them being marginalized by both the heterosexual population and by gay and lesbian adults. In fact, a 2013 study found that 15 percent of people surveyed consider bisexuality illegitimate. This study also found that gay and lesbian adults were significantly more negative towards bisexuality, with bisexual men facing the most stigma. Marginalization from the heterosexual and homosexual community leaves bisexuals with fewer people with whom to connect.

Dr. Mitchell H. Katz, deputy editor of JAMA Internal Medicine, said health care professionals could help lower the health risks lesbian, gay and bisexual people face by creating environments that are inclusive and supportive of sexual minority patients.

“As a first step toward eliminating sexual orientation-based health disparities, it is important for health care professionals to be aware and mindful of the increased risk of impaired health, alcohol consumption and tobacco use among their LGB adult patients," the article concludes.

Source: Gonzales G, Przedwirski J, Henning-Smith C. Comparison of Health and Health Risk Factors Between Lesbian, Gay, and Bisexual Adults and Heterosexual Adults in the United States. JAMA Internal Medicine. 2016.