Compared with heterosexual women, those who identified as lesbian or bisexual had a 27 percent higher risk of developing type 2 diabetes.
What you sexually identify as may impact your risk of developing the most common type of diabetes, a study suggests. The findings, published in May 2018 in Diabetes Care, found that women who self-identify as lesbian or bisexual may have a higher risk of developing type 2 diabetes compared with those who identify as heterosexual.
Although previous research on the topic has been inconclusive, the researchers weren’t surprised by their results.
“It’s been known in the public health community that individuals with minority social statuses and individuals with stigma-based identities are at increased risk for having health disparities,” says one of the study’s authors, Heather L. Corliss, PhD, MPH, a professor at the Graduate School of Public Health at San Diego State University in California.
Minority Stress in Lesbian and Bisexual Women May Have Increased Their Risk for Diabetes
One of the many reasons for this may be due to stress. But it’s not the typical type of stress that likely comes to mind — rather, it’s a type often discussed in sociology and psychology literature, and it’s known as “minority stress.”
The concept refers to stressors, such as discrimination, that minorities, including but not limited to lesbian and bisexual women, are exposed to that are “above and beyond general everyday stressors,” Corliss explains.
Diabetes has been long known to disproportionately affect minority groups, such as Hispanics, African-Americans, and Asian Americans, according to the U.S. Food and Drug Administration (FDA). Research published in November 2014 in the American Journal of Public Health shows groups are believed to have an elevated risk for a number of reasons, including poverty and a lack of access to healthcare. And if an individual does have access to care, the disease prevention and management approaches available to them may not be culturally appropriate, say the authors of an article published in an April 2017 article in the International Journal of Environmental Research and Public Health.
But further research is needed to better understand how minority stress factors may contribute to lesbian and bisexual women’s higher risk of developing type 2 diabetes. In the current study, the authors specifically found that body mass index (BMI), which is a measure of body weight used to define obesity, plays a role in the sexual orientation and disease relationship.
How Researchers Drew a Link Between Sexuality and Diabetes Risk
Corliss and her colleagues analyzed health data from more than 94,000 women. The participants, all of whom were registered nurses and enrolled in the Nurses Health Study II, were ages 24 to 44 at the start of the study in 1989. Every other year until 2013, the women self-reported whether their doctor had or hadn’t diagnosed them with type 2 diabetes. There were 1,267 women who self-identified as lesbian or bisexual and 92,983 who identified as heterosexual.
Their results revealed that lesbian and bisexual women had a 27 percent higher risk of developing type 2 diabetes than heterosexual women over the course of the study follow-up. This difference was greatest when lesbian, bisexual, and heterosexual women were younger. Researchers noted BMI as the primary contributor to the disparity.
Corliss hopes healthcare providers will use this information to recognize that lesbian and bisexual women may be at a greater risk of obesity and obesity-related health conditions. But more important, she hopes the study findings will impact society as a whole.
“It’s less about what any lesbian or bisexual woman should or shouldn’t do from the results of this study,” Corliss says. “It’s more about what we should do as a society to address the social factors that contribute to health disparities in this country.”
Why More Studies on Minority Stress, Sexuality, and Risk of Diabetes Are Needed
Although the results add to a growing body of research specifically regarding sexual orientation, it’s important to point out that the findings might not be representative of all women in the United States. That’s because all of the participants in the study are professional nurses and a majority are non-Hispanic white, which the authors note in their published paper. Therefore, more research with a more nationally representative study group is needed.
The results also cannot be generalized to those who are “economically challenged, which is where we tend to see many impacted by this disease,” says Lisa Sumlin, PhD, an assistant professor at The University of Texas in Austin School of Nursing, who was not involved in the research. Sumlin is referring to people who are low income — a risk factor that is associated with the disease regardless of their race.
Additionally, the authors point out that participants self-reported their health measures, which could potentially led to errors or misclassification.
Despite these limitations, Sumlin describes the study as a “great start,” especially considering the inconclusiveness of previous research.
“To help reduce the impact of type 2 diabetes, especially among young lesbian, bisexual women, let’s address the psychological stress and stigma these women experience,” Sumlin suggests.