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

Abstract 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.