Lesbian, gay and bisexual men and women in England are more likely to report having long-standing mental health problems than their heterosexual counterparts, which could in part be down to the stigma they experience, researchers have claimed.
Sexual minorities were 2-3 times more likely to report having a longstanding psychological or emotional problem than their heterosexual counterparts, according to researchers from the RAND Corporation, University of Cambridge, and Harvard Medical School. Nearly 11% of gay men and 15% of bisexual men reported such a problem, compared with 5% of heterosexual men. Similarly, just over 12% of lesbian women and almost 19% of bisexual women reported problems compared with 6% of heterosexual women.
In the study, published in the Journal of General Internal Medicine, data from more than two million respondents to the 2009/2010 English General Practice Patient Survey was analysed. Respondents included more than 27,000 people who described themselves as gay, lesbian, or bisexual, making it one of the largest surveys of the healthcare of sexual minorities carried out anywhere.
Sexual minorities were also more likely to report fair or poor general health: 22% of gay men and 26% of bisexual men compared with 20% of heterosexual men; and 25% of lesbians and 31% of bisexual women compared with 21% of heterosexual women. Lesbian, gay and bisexual men and women were also up to 50% more likely than heterosexuals to report negative experiences with primary care services, including trust and confidence with their GP, communication with doctors and nurses, and overall satisfaction.
The researchers speculated that the poorer health reported by sexual minorities may in part be due to potentially hostile and stressful social environments created by the stigma, prejudice and discrimination that they face. The hostile environment could also carry over into the medical practice, leading to poor healthcare experiences. Fears of discriminatory treatment by a provider may also lead to patients postponing healthcare, which can further impair health.
Professor Martin Roland, director of the Cambridge Centre for Health Services Research, said: “The survey shows that sexual minorities suffer both poorer health and have worse experiences when they see their GP. We need to ensure both that doctors recognise the needs of sexual minorities, and also that sexual minorities have the same experience of care as other patients.”
Dr Marc Elliott, a principle researcher at the RAND Corporation, added: “We know that sexual minorities in the United States have health problems similar to those we see in England and also face stigma, prejudice, and discrimination. It is important to find out whether the US’s health care system also tends to produce worse experiences of care for sexual minorities.”
James Taylor, head of policy at lesbian, gay and bisexual charity Stonewall, said: “This research demonstrates how lesbian, gay and bisexual people continue to experience poorer mental health and poorer experiences when accessing primary care than their heterosexual counterparts. It is vital that lesbian, gay and bisexual people are able to access high quality healthcare free from discrimination and action is taken to improve their health.”
Elliott, MN et al. (2014) Sexual Minorities in England Have Poorer Health and Worse Health Care Experiences: A National Survey. Journal of General and Internal Medicine.