The health of lesbian, gay, bisexual, transgender and intersex people

Abstract

Sex, gender and sexual orientation are diverse, as are the ways of living associated with them. The extent to which people can live a free and self-determined life according to their own body, gender, sexuality and way of life influences their social resources, opportunities for participation and discrimination and has an influence on their life situation and health. A narrative review of lesbian, gay, bisexual, transgender and intersex (LGBTI) health was conducted including international and German reviews, meta-analyses and population-based studies. The focus of this article is the legal, social and medical recognition as well as health status of LGBTI people in Germany. While the legal framework in Germany for homosexual and bisexual people has gradually improved, many civil society stakeholders have pointed to major deficits in the medical and legal recognition of transgender and intersex people. In addition, scientific findings frequently have not yet found its way into medical practice to an adequate extent. Available data on LGBTI health indicate a need for action in the areas of mental health and health care provision. However, due to a lack of comprehensive data, conclusions cannot be drawn on the general health situation and health resources of LGBTI people. For the concrete planning and implementation of measures as well as the differentiated portrayal of the situation in Germany, the databases must be expanded, not least via population-representative surveys.

Similarities and Differences of Mental Health in Women and Men: A Systematic Review of Findings in Three Large German Cohorts

“…Mental health of the LHBTI community has been expected to differ from the overall population [e.g., depression and suicidal behavior (108,109)] due to the heteronormative orientation of society (110,111)". Increasing social acceptance could lead to more possibilities to express one's gender identity and sexual orientation which could improve the health status of sexual minorities (11). A further limitation in this study is that mental health was measured by self-report questionnaires.…”

“…Only very recently, the binary assessment of sex has been supplemented by the third category, diverse sex. Therefore, this paper does not discuss gender diversity, although it is known that the mental health of the German LHBTI community (lesbian, gay, bisexual, transgender and intersex individuals) should be further examined (11). Mental health of the LHBTI community has been expected to differ from the overall population [e.g., depression and suicidal behavior (108,109)] due to the heteronormative orientation of society (110,111)".…”

“…Sex differences in mental health can be explained by sex hormones (7,8) and dysregulations in the hypothalamic-pituitary-adrenal (HPA) axis (7, 9), especially for stress-related psychiatric disorders. Gender differences in mental health can be explained by e.g., gender-based violence (10), low self-esteem (7) and belonging to a gender minority (11). The interplay between sex and gender is an important factor in mental health.…”

Validation of the Personal Attributes Questionnaire-8: Gender Expression and Mental Distress in the German Population in 2006 and 2018

“…As gender is both an important part of the individual self-concept and a reflection of societal trends of gender roles, we reapplied the scale in two representative national samples at two different time points, in 2006 and 2018. The shift towards a more individualistic society [25], in which values such as autonomy, self-expression and an ethos of individual rights are emphasized, expressions of diversity are more common [26,27]. We therefore expected stronger expressions of masculinity and femininity in 2018 compared to 2006.…”

A new way to measure partner burden in depression: Construction, validation, and sensitivity to change of the partner burden in depression questionnaire

“…The PBD is short enough to be administered in couple therapy if a depressive disorder is a primary diagnosis. Participants in the online sample (sample 1) were diverse with regard to their sexual orientation reflecting approximately the general German population (Pöge et al, 2020). We used both a cross-sectional (online) and a longitudinal intervention design, studying prognostic validity with rigor.…”