Journal of Urban Health

, Volume 93, Issue 6, pp 997–1009 | Cite as

Mental and Physical Health among Homeless Sexual and Gender Minorities in a Major Urban US City

  • Annesa FlentjeEmail author
  • Armando Leon
  • Adam Carrico
  • Debbie Zheng
  • James Dilley


Sexual and gender minorities have been shown to have greater rates of mental health, substance use disorders, and specific types of health problems compared to heterosexuals. Among the homeless population in several US urban areas, sexual and gender minorities are overrepresented but few studies have examined the mental and physical health status of homeless sexual and gender minorities, with studies on homeless gender minorities being particularly hard to find. Using survey data obtained from the city and county of San Francisco (2015 Homeless Survey), this study examined differences in causes of homelessness, physical and mental health problems, and domestic violence among homeless sexual and gender minorities and their heterosexual and cisgender (i.e., non-transgender) counterparts, respectively. Lesbians and bisexual women, and gay and bisexual men did not differ from their cisgender heterosexual counterparts. Cisgender men who identified as queer or “other” in response to sexual orientation questions had higher rates of psychiatric problems and posttraumatic stress disorder, while cisgender women who identified as queer or “other” had higher rates of psychiatric problems and drug and alcohol use. Transgender men who were homeless were found to be particularly at risk for physical health problems, mental health problems, and domestic violence or abuse. Transgender women were more likely to report posttraumatic stress disorder. This study suggests that transgender men and cisgender sexual minority men and women who identify as queer or “other” are groups among the homeless that may benefit from increased outreach and services.


Sexual minority Gender minority Homelessness Mental health Physical health Substance use 



The authors wish to acknowledge that Dr. Flentje’s work on the development of this manuscript was supported by the National Institute on Drug Abuse under award number K23DA039800. The authors would also like to acknowledge the City of San Francisco, for providing these data for analysis, and Applied Survey Research, for their work in collecting these data. The reporting of these data are solely the responsibility of the authors and the views expressed herein do not necessarily reflect the official policies or views of the City and County of San Francisco, Applied Survey Research, nor the National Institutes of Health, nor does mention of the City of San Francisco or the National Institutes of Health imply its endorsement.


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Copyright information

© The New York Academy of Medicine 2016

Authors and Affiliations

  1. 1.Department of Community Health SystemsUniversity of California, San Francisco, School of NursingSan FranciscoUSA
  2. 2.San Mateo County Psychiatry Residency Training ProgramSan MateoUSA
  3. 3.University of San FranciscoSan FranciscoUSA
  4. 4.Department of PsychiatryUniversity of California, San Francisco, School of MedicineSan FranciscoUSA

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