Sexual Minorities, Gender Minorities, and Double Disadvantages in Health

A handful of large health surveys have included questions about sexual orientation for several years, such that a sizable literature shows that sexual minority people suffer health disadvantages relative to heterosexual people. Far less is known about gender minorities, however, because only a couple of surveys have asked questions about transgender status. This is limiting in part because in the handful of surveys where people indicate both their sexual orientation and their gender identity, there is a significant correlation between the two. That is, while sexual orientation and gender identity are two distinct concepts, there is clearly overlap between them. Transgender people are much more likely than non-transgender people to be sexual minorities, for example.

Do gender minorities also experience health disadvantages compared to cisgender people? And are any such disadvantages worse for LGB transgender people compared to heterosexual transgender people? It is certainly possible that gender minorities who are also sexual minorities may face a 'double disadvantage' with respect to health status, but existing research has not credibly addressed this question.

Vanderbilt's Approach:

Lawrence Stacey, assistant professor of Sociology and core faculty in the Vanderbilt LGBTQ+ Policy Lab, is a demographer of LGBTQ populations. He has published widely on 'chosen families' of sexual minorities in the United States as well as on health profiles of sexual minorities. In his recent work on double disadvantage, he has used multiple large datasets to show that people who are both sexual minorities and gender minorities experience significantly worse health than people who are only sexual minorities (e.g., gay or lesbian cisgender people) or only gender minorities (e.g., straight transgender people).

This is important because we know much more about sexual minorities than we do about gender minorities due to historical differences in what questions large surveys have included. One implication of Dr. Stacey's study is that it is important that surveys collect both sexual orientation and gender identity to fully capture the extent of health-related disadvantage facing LGBTQI people.