Reassessing cardiometabolic health disparities among young adult sexual minority women: Evidence from a population-based cohort

Purpose We compared objective measures of cardiometabolic health (CMH) between women who identify as lesbian/gay or bisexual (LGB) and women who identify as heterosexual. In addition, we aimed to test whether group differences in stress reactivity partially explained disparities in CMH health. Methods Participants from a longitudinal study were identified for enrollment in 2017. The LGB group self-identified as LGB in 2017 (n = 239), and the heterosexual group identified as straight or heterosexual in each year that sexual identity was asked (study years 2010–2017) (n = 160). CMH was assessed via measurements and biomarkers, and stress reactivity via heart rate variability and cortisol levels during a social stress test. Participants also provided self-reports of stress and health. We tested group differences using sexual identity at Study Year 17, at the time of the visit, and as a proportion of years identifying as LGB. Results Group differences were tested using t-tests for continuous measures, logistic regression for dichotomous measures, and repeated-measures ANOVA for change over time. There were no significant differences in measures of CMH or stress reactivity by sexual identity group. LGB participants had worse self-reported health and higher levels of stress compared to heterosexual participants. Conclusion We discuss several frameworks for interpreting the present results of no differences in objective markers of health in the context of the existing literature, including developmental, socio-political, and methodological frameworks, and suggest directions for research to link the previous research with the results of the current study.