This study examines the role of social integration and social support, a significant yet under-investigated factor in mental health disparities by sexual orientation. By analyzing National Health and Nutrition Examination Survey data from a representative sample of the middle-aged U.S. population, the study shows that bisexual-identified individuals have the lowest levels of social resources and the poorest mental health status of all sexual orientation groups. Lesbian/gay-identified individuals and heterosexual-identified individuals with same-sex sexual experience are less socially integrated or perceive less emotional support than the sexual majority but do not report poorer mental health. Moreover, social integration and social support jointly mediate the link between sexual orientation and mental distress: sexual minorities are less socially integrated, which is related to a lower level of social support and, in turn, a higher level of mental distress. Additionally, minority-identified individuals reap more health benefits from confidants and emotional support. These findings suggest that sexual minorities are among those who most need and most benefit from supportive social relationships. The study therefore reveals the importance of social resource interventions in narrowing the mental health gap by sexual orientation.

Introduction Although population studies have documented the poorer health outcomes of sexual minorities, few have taken an intersectionality approach to examine how sexual orientation, gender, and race jointly affect these outcomes. Moreover, little is known about how behavioral risks and healthcare access contribute to health disparities by sexual, gender, and racial identities. Methods Using ordered and binary logistic regression models in 2015, data from the 2013 and 2014 National Health Interview Surveys (N=62,302) were analyzed to study disparities in self-rated health and functional limitation. This study examined how gender and race interact with sexual identity to create health disparities, and how these disparities are attributable to differential exposure to behavioral risks and access to care. Results Conditional on sociodemographic factors, all sexual–gender–racial minority groups except straight white women, gay white men, and bisexual non-white men reported worse self-rated health than straight white men (p<0.05). Some of these gaps were attributable to differences in behaviors and healthcare access. All female groups, as well as gay non-white men, were more likely to report a functional limitation than straight white men (p<0.05), and these gaps largely remained when behavioral risks and access to care were accounted for. The study also discusses health disparities within sexual–gender–racial minority groups. Conclusions Sexual, gender, and racial identities interact with one another in a complex way to affect health experiences. Efforts to improve sexual minority health should consider heterogeneity in health risks and health outcomes among sexual minorities.

ObjectiveThis is the first national study to examine disparities in loneliness and social relationships by sexual orientation in late adulthood in the United States.BackgroundPrior studies have shown that lesbian, gay, and bisexual (LGB) individuals often struggle with social relationships across the life course, likely because of stigma related to sexual orientation. However, little is known about whether loneliness is more prevalent among LGB people than among other groups in late adulthood, and if so, which relationships contribute to the loneliness gap.MethodWe analyzed data from a nationally representative sample of older adults from the 2015–2016 National Social Life, Health, and Aging Project (N = 3,567) to examine the disparity in loneliness by sexual orientation and identify links between this disparity and multiple dimensions of social relationships, including partner, family, friend, and community relationships.ResultsOlder LGB adults were significantly lonelier than their heterosexual counterparts, primarily due to a lower likelihood of having a partner and, to a lesser extent, lower levels of family support and greater friend strain. While they were also disadvantaged in the size of close family and frequency of community participation, these factors were less relevant to their loneliness. Overall, the conventionally defined inner layers of relationships (partnership and family) contributed more to the loneliness disparity than the outer layers of relationships (friends and community).ConclusionThese findings suggest that strengthening the partnerships and family relationships of sexual minorities is essential to reducing the loneliness gap.

Research on the social dimensions of health and health care among sexual and gender minorities (SGMs) has grown rapidly in the last two decades. However, a comprehensive review of the extant interdisciplinary scholarship on SGM health has yet to be written. In response, we offer a synthesis of recent scholarship. We discuss major empirical findings and theoretical implications of health care utilization, barriers to care, health behaviors, and health outcomes, which demonstrate how SGMs continue to experience structural- and interactional-level inequalities across health and medicine. Within this synthesis, we also consider the conceptual and methodological limitations that continue to beleaguer the field and offer suggestions for several promising directions for future research and theory building. SGM health bridges the scholarly interests in social and health sciences and contributes to broader sociological concerns regarding the persistence of sexuality- and gender-based inequalities.

It has long been documented that married individuals have better health outcomes than unmarried individuals. However, this marital advantage paradigm has been developed primarily based on heterosexual populations. No studies to date have examined the health effects of marriage among bisexuals, one of the most disadvantaged but understudied sexual minority groups, although a few have shown mixed results for gays and lesbians. Similarly, no research has examined how the gender composition of a couple may shape bisexuals’ health outcomes above and beyond the effects of sexual orientation. We analyzed pooled data from the 2013–2017 National Health Interview Survey (n = 154,485) and found that the health advantage of marriage applied only to heterosexuals and, to a lesser extent, gays and lesbians. Married bisexuals, however, exhibited poorer health than unmarried bisexuals when socioeconomic status and health behaviors were adjusted for. Moreover, bisexuals in same-gender unions were healthier than bisexuals in different-gender unions primarily because of their socioeconomic advantages and healthier behaviors. Together, our findings suggest that bisexuals, particularly those in different-gender unions, face unique challenges in their relationships that may reduce the health advantage associated with marriage.