Physical Health Inequalities Among Single and Partnered Sexual Minorities

Background

Sexual minority populations are growing, and LGB-identified persons have diverse relationships with same- and different-sex partners. Yet little is known about whether the documented benefits of partnership for health extend to sexual minority individuals and, if so, whether those benefits counterbalance previously established sexual minority health disparities. We examine physical health disparities by sexual orientation and relationship status, attending to heterogeneities across genders, gay/lesbian and bisexual persons, and marriage and cohabitation.

Methods

To yield sufficiently large subsamples at the intersection of sexual identity, relationship status, and gender, we pooled repeated cross-sectional data from the nationally representative 2018-2022 Swedish National Public Health Surveys (N = 312,926 to 318,515). Focal physical health outcomes were self-rated health, physical symptoms, functional impairment, body mass index, and chronic conditions.

Results

In multivariate models, unpartnered Swedish sexual minorities, regardless of sexual identity or gender, were more likely to report poor physical health compared to heterosexuals (p<.05). As among heterosexuals, married and cohabiting gay or lesbian identified respondents reported better health than singles (p<.05). For bisexual women, partnership was not linked to better physical health, but the health of bisexual married and cohabiting men was similar to that of heterosexual married men.

Conclusions

Partnership status is an important factor linked to heterogeneity in physical health disparities experienced by Swedish sexual minorities. In the relatively supportive Swedish context, partnership can largely counterbalance sexual minority health disparities for gay/lesbian-identified persons and bisexual men. For bisexual women and unpartnered lesbian/gay and bisexual Swedes, expanded societal protections have not provided sufficient protection from health disparities. More supports are needed.

Key messages

• We know little about whether partnership protects health among sexual minorities. In relatively supportive Sweden, partnership counterbalances sexual minority health disparities for some subgroups.

• Unpartnered sexual minority Swedes, but not partnered gays/lesbians, report poorer physical health than heterosexuals. Partnership was protective for bisexual men but not bisexual women.