Sexual Orientation Identity and Its Implication in the Disparities in Psychological Health-Related Quality of Life

Abstract

Purpose:

To examine disparities in psychological health-related quality of life (HRQoL) among sexual minority women within racial/ethnic subgroups.

Design:

A secondary analysis of the 2018 Behavioral Risk Factor Surveillance Survey (BRFSS).

Setting:

United States.

Subjects:

Noninstitutionalized, cisgender, adult women in the U.S (unweighted n = 81,947).

Measures:

Socioeconomics, health behaviors, and healthcare access as risk factors, whereas 1 item measures psychological HRQoL as an outcome.

Analysis:

Weighted multivariable logistic regressions to estimate the odds of having adversely psychological HRQoL in relation to sexual orientation and other correlates within a racial/ethnic subgroup independently.

Results:

The prevalence of adverse psychological HRQoL was greater in bisexual and “other” sexual orientation women. Both bisexual (adjusted odds ratio [aOR] = 1.58; 95% confidence interval [CI] = 1.26-2.00) and “other” sexual orientation (Aor = 1.93; 95%CI = 1.26-2.96) had greater adjusted odds of adversely psychological HRQoLcompared to their heterosexual peers in non-Hispanic White women. Bisexual women (aOR = 3.42; 95%CI = 1.98-5.88) had greater adjusted odds of adversely psychological HRQoLcompared to their heterosexual peers in Latinas. No similar pattern was observed in non-Hispanic Black women.

Conclusion:

Disparities in psychological HRQoL varied by sexual orientation identities within different racial/ethnic subgroups. The magnitude of the association for Latina bisexual women was strong. Implications for bisexual health among people with intersecting identities are discussed.