Homophobia Is Bad For Public Health

Editor’s note (March 25, 2019): The study discussed in this article published in Social Sciences & Medicine has since been retracted. While the results of that particular study appear to have been due to a coding error and should no longer be considered valid, it is important to note that there is a large body of research supporting the idea that anti-gay prejudice appears to be harmful to the health of sexual minorities. See here, here, and here for examples of recent reviews and meta-analyses on this subject.

The targets of anti-gay prejudice and discrimination tend to experience worse health outcomes. Not only does the stress of victimization put wear and tear on the body, but victims of prejudice often turn to alcohol abuse, substance use, and a range of other unhealthy behaviors in order to cope or escape reality.

Anti-gay prejudice isn’t just unhealthy. In fact, it may actually translate to a dramatically shorter lifespan, according to a recent study published in the journal Social Sciences & Medicine. Anti-gay prejudice isn’t just harmful to the health of sexual minorities, though. Another recent study published in the American Journal of Public Health suggests that just holding anti-gay views may pose a health risk.

The Social Sciences & Medicine study examined how levels of anti-gay prejudice in communities across the United States are linked to mortality rates for sexual minorities using data from existing nationally representative surveys [1]. Specifically data from the General Social Survey collected between 1988-2002 was linked to data from the National Death Index through 2008.

For purposes of this study, a “sexual minority” was defined as anyone who had ever had same-sex sexual contact in the last year, the last 5 years, or since age 18. In other words, one did not necessarily have to self-identify as gay, lesbian, or bisexual to fall into this group. This resulted in a sample of 914 adults.

To determine the level of anti-gay prejudice in a given community, researchers looked at how people in that area responded to the following four survey items: (1) “If some people in your community suggested that a book in favor of homosexuality should be taken out of your public library, would you favor removing this book, or not?” (2) “Should a man who admits that he is a homosexual be allowed to teach in a college or university, or not?” (3) “Suppose a man who admits that he is a homosexual wanted to make a speech in your community. Should he be allowed to speak, or not?” (4) “Do you think that sexual relations between two adults of the same sex is always wrong, almost always wrong, wrong only sometimes, or not wrong at all?”

The researchers found that in communities with the highest levels of anti-gay prejudice, sexual minorities died at younger ages on average than those who lived in areas that were more gay-friendly. This difference wasn’t small either: in the most anti-gay communities, sexual minorities died 12 years earlier on average. Twelve years!

The other study I mentioned, published in the American Journal of Public Health, suggests that the negative health implications of homophobia aren’t limited to sexual minorities [2]. Using data from the same nationally representative U.S. datasets, researchers looked at how levels of anti-gay prejudice are linked to mortality rates for heterosexuals.

For purposes of this study “heterosexual” was defined as anyone who has only had partners of the other sex during the last year, the last 5 years, or since age 18. Again, participants did not necessarily have to self-identify as heterosexual. This resulted in a sample of 20,226 adults.

The results indicated that heterosexuals who lived in communities with more anti-gay prejudice died sooner than those who lived in gay-friendlier places. Although the difference wasn’t quite as large as it was for sexual minorities, it was still significant: in the most anti-gay communities, heterosexual adults died 2.5 years earlier on average.

Of course, in both of these studies, it is important to keep in mind that anti-gay prejudice probably isn’t the only thing that differs across geographic areas, which means that other factors could potentially explain the observed discrepancies in mortality rates. The researchers attempted to address this issue by controlling for several factors in the analyses, including socio-economic status, race, and age; however, there is always concern in studies of this nature about whether all possible confounding variables have been identified and taken into account.

Nonetheless, the results of these studies suggest that anti-gay environments may be harmful to the health of everyone—and not just LGBT folks. In light of this, we might be able to do a lot of good for public health to the extent that we can all learn to be more tolerant and accepting of those who are different from us.

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[1] Hatzenbuehler, M.L., Bellatorre, A., Lee, Y., Finch, B.K., Muennig, P., & Fiscella, K. (2014). Structural stigma and all-cause mortality in sexual minority populations. Social Sciences & Medicine, 103, 33-41.

[2] Hatzenbuehler, M.L., Bellatorre, A., & Muennig, P. (2014). Anti-gay prejudice and all-cause mortality among heterosexuals in the United States. American Journal of Public Health, 104, 332-337.

Image Source: Jenny Mealing via Wikimedia Commons

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