Health disparities among LGBTQ+ adults aged 33-35 in northern Finland: findings from the NFBC1986 cohort

BACKGROUND: Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals experience elevated health-related risks and a higher prevalence of physical diseases, often attributed to minority stress resulting from discrimination and victimization related to their minority status. AIM: This cross-sectional study examined health-related risk factors (socioeconomic status, obesity, substance abuse, and physical inactivity), self-rated health, functional limitations, and physical morbidity among LGBTQ+ participants aged 33-35 in the population-based Northern Finland Birth Cohort 1986 (NFBC1986). METHODS: Data were drawn from NFBC1986 and were entirely self-reported. Assessed health parameters included sociodemographic and behavioral factors considered as health-related risk factors (current marital status, socioeconomic status, body mass index (BMI), smoking, alcohol use, physical activity), current self-rated health, functional limitations due to medical conditions in the past 6 months, and lifetime physical morbidity. Independent samples' t-tests, Mann-Whitney U-tests for non-normal distributions, and binary logistic regression were used to compare outcomes between LGBTQ+ and cisgender heterosexual participants. The study population comprised 2841 participants: 2721 (95.8%) cisgender heterosexual and 120 LGBTQ+ participants. Among the cisgender heterosexual participants, 1720 (63.2%) were women and 1001 men. Of the LGBTQ+ group, 103 (85.8%) belonged to cisgender sexual minority group, and 17 belonged to gender minority group. OUTCOMES: LGBTQ+ participants experience poorer health outcomes than cisgender heterosexual participants, which may be linked to minority stress related to stigma, discrimination, and victimization. RESULTS: LGBTQ+ participants reported significantly poorer self-rated health than cisgender heterosexual participants in both assigned female at birth (AFAB; P < .001), and assigned male at birth (AMAB; P = .030) groups, and were more often unpartnered (AFAB: P = .003; AMAB P < .001). AFAB LGBTQ+ participants also had lower socioeconomic status (P = .012), higher BMI (P = .006), and greater functional limitations (P = .022). AMAB LGBTQ+ participants were more likely non-smokers compared to cisgender heterosexual participants (P = .026). No significant differences were observed in physical morbidity between the groups. CLINICAL IMPLICATIONS: This study highlights the need for further consideration of the health of LGBTQ+ population and the implementation of healthcare interventions aimed at improving the health of this specific group. STRENGTHS AND LIMITATIONS: This study's main strength is the rich lifelong health data from the NFBC1986 cohort, while its limitation lies in the moderate sub-sample sizes. CONCLUSION: At ages 33-35, LGBTQ+ participants faced lower socioeconomic status, higher likelihood of being unpartnered, higher BMI, poorer self-rated health, and greater functional limitations, though no difference in physical morbidity was found compared to cisgender heterosexual participants.