By Ryan Gierach, West Hollywood, California
Last week, the local rag reported – under a breathless headline – that “Survey Finds Only 1.6% of Americans Identify as Gay or Lesbian”
Sounds like a fun census, huh? But what was is this “Only?”
It turns out this headline served as a bit click-bait to get people to look at a health survey. The word “only” was likely a raspberry to the rest of the world – West Hollywood claims a 41 percent LGBT population.
Besides that, accurately defining and counting lesbian, gay, bisexual and straight people is well-nigh impossible given taboos and social strictures still ruling much of the nation. Every study that asks about orientation will have fuzzy figures for reasons spanning from self-loathing to hiding to denial and fear.
The study was historic, not because it tried to find out how many LGBs exist in America, but because it was the first time this national survey asked questions about lesbian, gay and bisexual health in the 57 years of its existence.
The survey’s inclusion of lesbians, gays and bisexuals follows on nearly 20 years of activism by gay and lesbian academics focused on convincing the federal government to objectively ascertain and provide for the health care of the nation’s LGBT community.
The elimination of health disparities has long driven the field of public health, the thinking being that class, race, ethnicity, etc. ought not determine your health outcomes. This forms the foundation of the decennial Health People campaigns run by the U.S. Government.
The George W. Bush administration’s Department of Health and Human Services’ Healthy People 2010 initiative failed to include sexual orientation, the Healthy People 2020 programs include the goal of improving the health, safety, and well-being of lesbian, gay, bisexual, and transgender (LGBT) persons.
The recently released survey from the Center for Disease Control’s (CDC) National Health Interview Study (NHIS) sought to quantify the percentage of Americans who identify as lesbian, gay or bisexual – the 2013 survey contained no gender identity questions – to provide national estimates for indicators of health-related behaviors, health status, health care service utilization, and health care access by sexual orientation.
While you have to begin with that question – how many – the survey was not at all a census, then. Not a set point by which any one city, county or state can lay claim to the “gayest” or the, well, would it be “lesbianist?” city in the country.
It was a study to identify risk behaviors (ex. smoking versus non-smoking) and overall healthiness of gays, lesbians and bisexuals.
Another aspect of the study sought to find out how accessible and how well utilized were health services by the LGB (gender identity was not asked in 2013’s survey) community.
In other words, they asked how healthy the LGB community was, what risks they faced and how well they got health care.
Why is that important? The survey’s findings echoed other studies’ results, confirming the need for special needs. “Many of the associations between sexual orientation and various health outcomes found in this analysis are similar to those found in past research,” said the paper.
One nugget inside the study demonstrates, “For example, a higher percentage of women aged 18–64 who identified as bisexual had experienced serious psychological distress compared with those who identified as straight,” explained the researchers, “which is similar to findings in previous studies examining differences in psychological distress by sexual orientation.”
What did the researchers find in this first ever survey?
Strikingly, only 66 percent of gay men have been tested for HIV while 36.7 percent of straight men have been tested.
They found that LGB Americans are just about as healthy as straight Americans, but more of them smoke and drink and fewer LGBs have immediate or regular access to health care.
They looked at a handful of behaviors as a key to risk.
LGB adults smoked straights in the tobacco contest by an approximately eight point margin (gay – 27.2 percent, bisexual men – 29.5 percent) Straight male smokers reported using tobacco at a 19.6 percent rate.
Apparently LGBs also out drink straight people. Gays and lesbians who reported having had five or more drinks in one day at least once in the past year numbered 35.1 percent, bisexual 41.5 percent – straights drank at a rate of 26.0 percent.
The survey also asked about aerobic exercise, and found not a jot of difference between straight and gays.
So far as general health, gay and bi men reported levels or Excellent and Good health in the same numbers as straight men. Lesbians, however, reported Excellent or good health at a 54 percent rate compared to straight women’s 63.3 percentile.
The scary bit of data is the differential in serious psychological distress. Bi-sexual men 18-64 experienced such episodes in the past 30 days at an 11.0 percent rate compared to only 3.9 percent of straight respondents.
While the report showed only a small disparity between straight (3.3) and gay men (4.5 percent), “Among women aged 18–64, a higher percentage of those who identified as bisexual (10.8 percent) experienced serious psychological distress compared with those who identified as straight (4.5 percent).”
Obesity hits the lesbian community harder than any other – except the bi-sexual female community. Female bisexuals show up as reporting 40.4 percent obese compared to 35.9 percent of lesbians.
Gay men are roughly on par with straight men – 28.9 to 29.7 percent, while bisexual men report obesity rates of 34.8 percent.
Strikingly, only 66 percent of gay men have been tested for HIV while 36.7 percent of straight men have been tested. Gay men also gat flu shots at a higher rate than straight men.
Bisexual and lesbian women reported difficulty in accessing health care due to finances.
In sum, the NHIS study can be used, “differently across surveys or research studies, says the survey.
“For example, much of the past research that has found poorer reported health among sexual minorities [looked at] fair or poor health compared with all other health statuses… whereas the present study [looked at] reporting very good or excellent health compared with all other health statuses.
In another caveat, the study noted that, “much of what is known about the health and well-being of sexual minorities has been gleaned from studies using state-level or more specialized samples that (unlike NHIS) do not allow for generalizations to be made to the vaster U.S. adult population (a distinct strength of NHIS).”
But even that strength cannot discern certainty from such a small data dump. The CDC will need many more years of data to track more accurately the health of the nation’s sexual minorities – including adding gender identity to the mix.
Returning to the numbers game, Gary J. Gates, PhD, the Williams Distinguished Scholar at the Williams Institute, UCLA School of Law, has been at work using nine major surveys and census reports to make estimates of the gay population of the country.
He lists reasons of why it is difficult it to get accuracy on sexual orientation as, “ differences in the definitions of who is included in the LGBT population, differences in survey methods, and a lack of consistent questions asked in a particular survey over time.”
After all, Gallup asked straight Americans what percentage of their neighbors are gay - America thought gays made up one-in-four Americans.
Look at : http://www.cdc.gov/nchs/nhis.htm for the complete report.