Sexual minorities: health issues

The following summary provides a short overview of Scottish or UK research on the health of the LGB population. Little research has been carried out examining general health issues of the LGB population. Most has focussed on sexual health, though some studies have also examined mental health, screening uptake, smoking and alcohol use. 

Recruiting a representative sample of people from the LGB population is a problem common to many of the studies in this area. Many use convenience sampling, which makes it more difficult to generalise any findings on incidence and prevalence to the wider LGB population.

Stonewall has also published a number of reports it has commissioned from YouGov, using polling methodology with large samples.  These are all available as Stonewall research.

Sexual Health

Sexually transmitted infections are a concern for men who have sex with men (MSM).  Health Protection Scotland (now Public Health Scotland) produced a report in 2017 identifying HIV, syphilis, and gonorrhoea as highly prevalent.  HIV in particular is concerning for MSM, who account for around half of all cases, making HIV more prevalent in this small population group than the public in general.  In their December 2019 update on HIV, Health Protection Scotland (now Public Health Scotland) reported that there were 326 reports of HIV diagnoses in Scotland in 2019. Of these, 139 were from MSM. Data was available for 5,617 people diagnosed and living with HIV in Scotland at the time, with 2,662 being MSM. However, the actual number of people living with HIV in Scotland was estimated to be 6,122. Of the 5,617 people diagnosed and living with HIV in Scotland, 5,074 were attending specialist care, 4,970 were receiving antiretroviral therapy, and 4,714 had achieved an undetectable viral load. The number of reports of new HIV diagnosis was lower than any in the time series, starting in 2010. Anal intercourse between MSM is associated with a risk of developing anal cancer and individuals with HIV are at particular risk (Frisch et al, 1997, see key references). Research has not fully established the natural history of this cancer but it is thought to be associated with human papilloma virus infection. 

Discrimination experience of LGB people in Scotland

The LGBT in Scotland - Hate Crime and Discrimination (2017) report of more than 1260 LGBT people in Scotland, found that one in five had experienced hate crime or incident due to their sexual orientation and/or gender identity in the last 12 months. 

For children and adolescents, The School Report 2017 by Stonewall presents findings on the experiences of 3,713 young people aged 11-19 in Britain's schools: almost half (45%) reported they had experienced homophobic bullying in 2017, though there is evidence this figure has fallen since 2007.  The 2008 Prescription for Change Scotland report describes the responses of the 514 lesbian and bisexual participants in the Prescription for Change survey in relation to health needs and experiences.  At that time, half of respondents reported having negative experiences in the health sector in the previous year. 

The Stonewall 2015 Unhealthy Attitudes report covers Health and Social Care staff: a quarter have seen negative language used by staff whilst at work in the past 5 years, with a higher figure reported for staff in the Scottish report.  In 2018, Stonewall Scotland published LGBT in Scotland: Work report based on a survey of LGBT employees experiences in the workplace. It found that one in six LGBT employees have been subjected to negative comments or conduct from colleagues in the last year.

Mental Health

The Scottish Surveys Core Questions 2016 (SSCQ) found wellbeing, measured by the Shortened Warwick and Edinburgh Mental Wellbeing Scale (SWEMWB), to be lower among those who self-identify as LGB & other compared to those who self-identify as heterosexual (23.8 vs. 24.4, age-standardised).

Smoking

The Scottish Surveys Core Questions 2018 (SSCQ) found smoking rates were higher among adults in Scotland who identified as LGB & other compared to those who self-identify as heterosexual (21.4% vs. 17.6%), but the 2019 SSCQ found 17.7% of LGB people and 17.5% of heterosexual people smoked.

Alcohol

The 2008 Prescription for Change Scotland report reported that lesbian and bisexual women in Scotland had a higher frequency of drinking alcohol: 13% reported drinking on 5 or more days a week, compared with 7% of the general female population.

The 2011 Stonewall report on Lesbian, Gay & Bisexual People in Later Life also found that older LGB people drink alcohol more often than the heterosexual population with 45% drinking on at least 3 or 4 days a week compared to 31% of heterosexual people

End of life care

In 2016, Marie Curie published a report (1.26Mb), Hiding Who I Am: The reality of end of life care for LGBT people, which highlighted a number of key issues experienced by LGBT people at the end of life. These included: anticipating discrimination; complexities of religion and LGBT end of life care; assumptions about identity and family structure; varied support networks; unsupported grief and bereavement; and increased pressure on LGBT carers.