Health Disparities Among Lesbian, Gay, Bisexual, Transgender, and Nonbinary Adults 50 Years Old and Older in the United States

Abstract

Purpose: The purpose of this study was to examine health disparities among LGBT and nonbinary adult subgroups of those 50 years old and older. Methods: This was a cross-sectional analysis of data from the 2019 Behavioral Risk Factor Surveillance System survey. Access to health care, disabilities, health risk and healthy behaviors, and general health and chronic diseases and conditions were compared between gay men, bisexual men, lesbian/gay women, bisexual women, transgender women, transgender men, and nonbinary adults 50 years old and older. Rao-Scott corrected chi-square tests were utilized to determine significant differences between subgroups using weighted data. Multiple comparisons adjusted p values (Bonferroni) analyses were conducted when chi-square tests were significant. Results: Health disparities were identified among subgroups of LGBT and nonbinary older adults, with those who identified as nonbinary or as transgender women being the most vulnerable. Older nonbinary adults, transgender women, and bisexual men were more likely to not have a personal doctor or to not have had a medical checkup in the past 2 years, and nonbinary older adults were more likely to report disabilities, poor mental and physical health, depression, and asthma. Conclusion: Public health professionals and health care providers can use this information to target interventions to specific groups. Subgroup analyses of LGBT and nonbinary adults who are 50 years old and older need to continue with a focus on the most vulnerable groups. In addition, more research is needed that disaggregates transgender and nonbinary older adults to identify the unique health concerns of each group.

Psychometric Evaluation of Three Versions of the UCLA Loneliness Scale (Full, Eight-Item, and Three-Item Versions) among Sexual Minority Men in Taiwan

“…Finally, most of the sample was made up of gay men (83.3%) and only a small proportion was bisexual (16.7%). Research has found that bisexual men may be at elevated risk for health disparities and shortage of social resources compared with gay men [87,88]. Although no differences were found in loneliness between the two samples, further study is needed to examine whether the role of loneliness in health differs between gay and bisexual men.…”

Disparities in health condition diagnoses among aging transgender and cisgender medicare beneficiaries, 2008-2017

“…Second, since our administrative data did not capture gender identity, we were forced to infer the gender identity of our sample and combine individuals who likely hold nonbinary and binary gender identities in the same category based on their shared use of certain gender-affirming hormones, procedures, or anatomy-specific care. Nonbinary transgender people have been shown to have differential healthcare utilization and risk of various health outcomes than binary transgender people ( 32 , 120 ), and so the necessary combining of these groups in the present study may have obscured key differences in the probability of being diagnosed with one or more health conditions. Third, transgender and cisgender beneficiaries were included in our study based on their observed care, whereas individuals who did not access relevant care through fee-for-service Medicare at any point during the study period were not included; thus, our sample is unlikely to represent all aging transgender and cisgender Medicare beneficiaries.…”

“…Extending prior research ( 3 , 5 , 12 , 13 , 30 , 31 , 33 ), we observed an elevated burden of health condition diagnoses among TFN or TMN people overall, with the greatest burden observed among TFN people relative to other groups. Our novel methods to identify a transgender sample using Medicare claims data and infer gender may be helpful for future researchers seeking to study the diagnosis of rare conditions, as well as identify transgender subgroups in need of preventive and treatment interventions aimed at reducing morbidity ( 26 , 29 , 30 , 32 ) and mortality ( 42 , 121 ) among aging transgender people in the U.S.…”

“…Aging transgender adults are expected to be at an even higher risk of developing physical and mental health conditions than their cisgender peers due to stigma-related stress experienced throughout their lives and barriers to accessing quality healthcare ( 9 , 21 – 25 ). Although researchers are increasingly studying the health of aging transgender adults ( 26 – 28 ), and some national studies have explored disparities among predominantly aging populations relative to cisgender groups ( 29 – 32 ), no national research, to our knowledge, has explored within- (e.g., trans feminine people vs. trans masculine people) and between- (e.g., transgender vs. cisgender) group gender differences among aging transgender adults and a general population of cisgender adults. Without comparative data on the health of aging transgender and cisgender subpopulations, it is difficult to know which subgroups are in greatest need of public health and policy interventions.…”

Moderating Effect of Community and Individual Resilience on Structural Stigma and Suicidal Ideation among Sexual and Gender Minority Adults in the United States

“…Lastly, the number of participants who identified as transgender or gender non-binary was small. We could not conduct analyses to determine differences in outcomes between cisgender and transgender/non-binary participants even though research has shown differences in mental health outcomes between subsets of the SGM community [ 68 ].…”