A Comparative Analysis of Lifetime Medical Conditions and Infectious Diseases by Sexual Identity, Attraction, and Concordance among Women: Results from a National U.S. Survey

There have been limited studies assessing the differences in chronic health conditions between sexual minority (those who identify as lesbian or bisexual) and sexual majority (heterosexual) women. Research has primarily focused on overall physical and mental health or behavioral issues and not on specific health conditions. The addition of sexual orientation and attraction questions to the National Survey on Drug Use and Health (NSDUH) now allows for research regarding health conditions using a national survey that identifies participant sexual orientation and attraction. This study sought to compare the prevalence/odds of having 10 medical conditions/infectious diseases among women, assessing for differences associated with sexual identity, sexual attraction, and the degree of concordance between sexual identity and attraction. Data from 67,648 adult female participants in the 2015–2017 NSDUH survey were analyzed using bivariate and multivariable logistic regression models to assess for differences in prevalence/odds of seven medical conditions. Multivariable models adjusted for demographics, substance abuse/dependence, and mental illness. We found significant differences by sexual identity, but not sexual attraction or concordance. Compared with heterosexually identified women, women who identified as bisexual had significantly higher odds of having three medical conditions and two infectious diseases than heterosexual or lesbian women. The findings generally support those based on studies using more limited geographical samples. There are a number of potential associated and underlying factors that contribute to bisexual women reporting overall poorer health than heterosexual or lesbian women. The factors discussed include stigma, delays in seeking care, lack of insurance and access, and sexual minority women receiving poorer health care generally.