Physical Health Disparities Across Dimensions of Sexual Orientation, Race/Ethnicity, and Sex: Evidence for Increased Risk Among Bisexual Adults

Abstract

Accumulating evidence suggests that sexual minority individuals are at increased risk for physical health conditions compared to heterosexual individuals. However, we know little about physical health disparities affecting bisexual individuals, a population at increased risk for psychiatric and substance use conditions compared to both heterosexual and lesbian/gay populations. Using a large, nationally representative sample, we examined physical health disparities for bisexual individuals. To advance research on sexual minority health disparities, we further: (1) compared prevalence rates of physical health conditions across three dimensions of sexual orientation (i.e., identity, attractions, behavior) and (2) examined whether disparities differed by sex and race/ethnicity. Results indicated that sexual minority individuals were at increased risk for many physical health conditions. Notably, individuals with bisexual identity, attractions, and/or behavior were at increased risk for more physical health conditions than other sexual minority groups. The number and types of physical health disparities affecting bisexually identified individuals and individuals with same- and opposite-sex attractions and/or sexual partners varied across sex and race/ethnicity, with the most consistent disparities emerging for individuals who reported same- and opposite-sex sexual partners. Our findings highlight the substantial physical health disparities affecting sexual minorities and the heightened risk conferred by all facets of bisexuality.

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Notes

  1. 1.

    Lifetime physical health was not assessed at Wave 2 and, therefore, is not examined in the current manuscript.

  2. 2.

    Sexual orientation differences in risk for HIV/AIDS and other STIs using the NESARC dataset have been presented elsewhere (Oldenburg, Perez-Brumer, & Reisner, 2014; Sweet & Welles, 2012), so we do not examine them here. In the current analyses, we use these variables as covariates in a set of sensitivity analyses (see footnote 3).

  3. 3.

    Given known disparities in HIV/AIDS and other STIs (CDC, 2015; Logie, Navia, & Loutfy, 2015), we conducted analyses with and without controlling for HIV, AIDS, and STI diagnoses. Both sets of results yielded similar results. Thus, for brevity and because sexual orientation differences in risk for HIV/AIDS using the NESARC dataset have been presented elsewhere (Oldenburg et al., 2014; Sweet & Welles, 2012), we present analyses unadjusted for HIV/AIDS and STIs.

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Dyar, C., Taggart, T.C., Rodriguez-Seijas, C. et al. Physical Health Disparities Across Dimensions of Sexual Orientation, Race/Ethnicity, and Sex: Evidence for Increased Risk Among Bisexual Adults. Arch Sex Behav 48, 225–242 (2019). https://doi.org/10.1007/s10508-018-1169-8

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Keywords

  • Physical health
  • Health disparities
  • Sexual orientation
  • Bisexual