Higher Risk of Many Physical Health Conditions in Sexual Minority Men: Comprehensive Systematic Review and Meta-Analysis in Gay- and Bisexual-Identified Compared with Heterosexual-Identified Men.

Purpose: The purpose of this study was to provide a systematic review and, where possible, meta-analysis on the prevalence of physical health conditions in sexual minority men (SMM, i.e., gay- and bisexual-identified men) compared with heterosexual-identified men. Methods: A systematic literature search in the databases MEDLINE, Embase, CENTRAL, CINAHL, and Web of Science was conducted on epidemiological studies on physical health conditions, classified in the Global Burden of Disease project and published between 2000 and 2021. Meta-analyses comparing odds ratios were calculated. Results: In total, 23,649 abstracts were screened, and 32 studies were included in the systematic review. Main findings were that (1) Largest differences in prevalence by sexual identity were found for chronic respiratory diseases, particularly asthma: overall, SMM were significantly almost 50% more likely to suffer from asthma than heterosexual men. (2) Evidence of higher prevalence was also found for chronic kidney diseases and headache disorders in gay men and for hepatitis B/C in both gay and bisexual men. (3) We found an overall trend that bisexual men were more affected by some of the physical health conditions compared with gay men (e.g., cardiovascular diseases, asthma). However, regarding cancer, headache disorders, and hepatitis, gay men were more affected. Conclusion: We found evidence of physical health disparities by sexual identity, suggesting more health issues in SMM. Since some of these findings rely on few comparisons or small samples of SMM only, this review is intended to be a vehement plea for routinely including sexual identity assessment in health research and clinical practice.

[1]  Sarah A. Job,et al.  Interactions of Sexual Orientation and Gender Identity with Race/Ethnicity in Prevalence of Lifetime and Current Asthma Diagnosis. , 2023, LGBT health.

[2]  D. Frost,et al.  Cigarette Smoking and Minority Stress Across Age Cohorts in a National Sample of Sexual Minorities: Results From the Generations Study. , 2020, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[3]  J. Palamar,et al.  Co-occurring mental illness, drug use, and medical multimorbidity among lesbian, gay, and bisexual middle-aged and older adults in the United States: a nationally representative study , 2020, BMC Public Health.

[4]  N. Gupta,et al.  Disparities in the hospital cost of cardiometabolic diseases among lesbian, gay, and bisexual Canadians: a population-based cohort study using linked data , 2020, Canadian Journal of Public Health.

[5]  A. Mostaghimi,et al.  Association Between Sexual Orientation and Lifetime Prevalence of Skin Cancer in the United States. , 2020, JAMA dermatology.

[6]  R. Lipton,et al.  Migraine: Epidemiology, Burden, and Comorbidity. , 2019, Neurologic clinics.

[7]  A. Stinchcombe,et al.  Health Behaviors and Social Determinants of Migraine in a Canadian Population‐Based Sample of Adults Aged 45‐85 Years: Findings From the CLSA , 2019, Headache.

[8]  Nanor Minoyan,et al.  Sexual behaviour as a risk factor for hepatitis C virus infection among people who inject drugs in Montreal, Canada , 2019, Journal of viral hepatitis.

[9]  Jianqiang Hao,et al.  Sleep Deprivation and Chronic Health Conditions Among Sexual Minority Adults , 2019, Behavioral sleep medicine.

[10]  M. Eliason,et al.  Differential Influence of Weight Status on Chronic Diseases by Reported Sexual Orientation Identity in Men. , 2019, LGBT health.

[11]  G. Gonzales,et al.  Cancer diagnoses among lesbian, gay, and bisexual adults: results from the 2013–2016 National Health Interview Survey , 2018, Cancer Causes & Control.

[12]  D. Chyun,et al.  Sexual Orientation Differences in Modifiable Risk Factors for Cardiovascular Disease and Cardiovascular Disease Diagnoses in Men. , 2018, LGBT health.

[13]  J. Varney,et al.  Systematic review and meta-analysis of diabetes mellitus, cardiovascular and respiratory condition epidemiology in sexual minority women , 2018, BMJ Open.

[14]  T. Elasy,et al.  Prevalence of Self-Reported Diabetes by Sexual Orientation: Results from the 2014 Behavioral Risk Factor Surveillance System. , 2018, LGBT health.

[15]  Thomas Long,et al.  Prevalence of Obesity, Prediabetes, and Diabetes in Sexual Minority Men: Results From the 2014 Behavioral Risk Factor Surveillance System , 2018, The Diabetes educator.

[16]  S. Austin,et al.  Health and healthcare disparities among U.S. women and men at the intersection of sexual orientation and race/ethnicity: a nationally representative cross-sectional study , 2017, BMC Public Health.

[17]  J. Gallant,et al.  Comorbidities Among US Patients With Prevalent HIV Infection—A Trend Analysis , 2017, The Journal of infectious diseases.

[18]  J. Jabson,et al.  Sexual orientation measurement and chronic disease disparities: National Health and Nutrition Examination Survey, 2009-2014. , 2017, Annals of epidemiology.

[19]  T. Collins,et al.  Environmental injustice and sexual minority health disparities: A national study of inequitable health risks from air pollution among same-sex partners. , 2017, Social science & medicine.

[20]  C. Henning‐Smith,et al.  Health Disparities by Sexual Orientation: Results and Implications from the Behavioral Risk Factor Surveillance System , 2017, Journal of Community Health.

[21]  Brian A. Feinstein,et al.  Bisexuality, Minority Stress, and Health , 2017, Current Sexual Health Reports.

[22]  J. Simoni,et al.  Disparities in Physical Health Conditions Among Lesbian and Bisexual Women: A Systematic Review of Population-Based Studies , 2017, Journal of homosexuality.

[23]  M. Mansh,et al.  Sexual orientation disparities in the prevalence of asthma and allergic rhinitis among US adults. , 2016, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[24]  Grant W. Farmer,et al.  Gay Acres: Sexual Orientation Differences in Health Indicators Among Rural and Nonrural Individuals. , 2016, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[25]  Paul R Martin.  Stress and Primary Headache: Review of the Research and Clinical Management , 2016, Current Pain and Headache Reports.

[26]  M. King,et al.  Sexual orientation and symptoms of common mental disorder or low wellbeing: combined meta-analysis of 12 UK population health surveys , 2016, BMC Psychiatry.

[27]  M. Chren,et al.  Association of Skin Cancer and Indoor Tanning in Sexual Minority Men and Women. , 2015, JAMA dermatology.

[28]  K. Divaris,et al.  Sexual orientation‐related oral health disparities in the United States , 2018, Journal of public health dentistry.

[29]  Lynette M. Renner,et al.  Disparities in long-term cardiovascular disease risk by sexual identity: The National Longitudinal Study of Adolescent to Adult Health. , 2015, Preventive medicine.

[30]  D. Frost,et al.  Minority stress and physical health among sexual minority individuals , 2015, Journal of Behavioral Medicine.

[31]  M. Eliason.  Chronic Physical Health Problems in Sexual Minority Women: Review of the Literature. , 2014, LGBT health.

[32]  Steven C. Fiala,et al.  Sexual Orientation and Sex Differences in Adult Chronic Conditions, Health Risk Factors, and Protective Health Practices, Oregon, 2005–2008 , 2014, Preventing chronic disease.

[33]  M. Clark,et al.  Health Conditions in Younger, Middle, and Older Ages: Are There Differences by Sexual Orientation? , 2014, LGBT health.

[34]  Grant W. Farmer,et al.  Health inequalities among sexual minority adults: evidence from ten U.S. states, 2010. , 2014, American journal of preventive medicine.

[35]  Kerri L. Johnson,et al.  Minority Stress and Physical Health Among Sexual Minorities , 2013, Perspectives on psychological science : a journal of the Association for Psychological Science.

[36]  J. Moorman,et al.  Age at asthma onset and subsequent asthma outcomes among adults with active asthma. , 2013, Respiratory medicine.

[37]  E. Erosheva,et al.  The physical and mental health of lesbian, gay male, and bisexual (LGB) older adults: the role of key health indicators and risk and protective factors. , 2012, The Gerontologist.

[38]  Joseph G. L. Lee,et al.  A systematic review of the aetiology of tobacco disparities for sexual minorities , 2011, Tobacco Control.

[39]  U. Boehmer,et al.  Cancer survivorship and sexual orientation , 2011, Cancer.

[40]  M. Kivimäki,et al.  Stressful life events and the onset of asthma , 2010, European Respiratory Journal.

[41]  G. Miller,et al.  Harsh Family Climate in Early Life Presages the Emergence of a Proinflammatory Phenotype in Adolescence , 2010, Psychological science.

[42]  Laura Smart Richman,et al.  Perceived discrimination and health: a meta-analytic review. , 2009, Psychological bulletin.

[43]  Sheldon Cohen,et al.  Psychological stress and disease. , 2007, JAMA.

[44]  R. Lipton,et al.  The epidemiology of migraine. , 2005, The American journal of medicine.

[45]  G. Conway,et al.  Prevalence of polycystic ovaries and polycystic ovary syndrome in lesbian women compared with heterosexual women. , 2004, Fertility and sterility.

[46]  S. Segerstrom,et al.  Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. , 2004, Psychological bulletin.

[47]  H. Christensen,et al.  Sexual orientation and mental health: results from a community survey of young and middle-aged adults. , 2002, The British journal of psychiatry : the journal of mental science.

[48]  S. Austin,et al.  Sexual orientation identity disparities in health behaviors, outcomes, and services use among men and women in the United States: a cross-sectional study , 2016, BMC Public Health.

[49]  A. Herring,et al.  Health disparities among young adult sexual minorities in the U.S. , 2015, American journal of preventive medicine.

[50]  D. Bowen,et al.  Disparities in Health Risk Behavior and Psychological Distress Among Gay Versus Heterosexual Male Cancer Survivors. , 2014, LGBT health.

[51]  T. Hughes,et al.  Health status, health service use, and satisfaction according to sexual identity of young Australian women. , 2011, Women's health issues : official publication of the Jacobs Institute of Women's Health.