Sexual and Gender Identity Properties and Associations With Physical and Mental Health Among SGM Midlife and Older Adults: Findings From Aging With Pride: National Health, Aging, and Sexuality/Gender Study

Objectives: Unidimensional measures of sexual and gender identity are most often used in research. Yet, sexuality and gender are defined by complex characteristics. Guided by the Health Equity Promotion Model, we assess multidimensional properties of sexual and gender identity. Methods: This study utilizes 2016 survey data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS) to investigate properties of identity (affirmation, visibility, centrality, integration, congruence, continua, transformation) and their association with multimorbidity, disability, general health, depression, quality of life among SGM adults ( N = 2233), 50 and older. Results: Higher affirmation, centrality, congruence, and transformation were associated with better health, while identity integration and continua were associated with some adverse health outcomes. Bisexual men, sexually diverse and transgender individuals had the lowest identity centrality and visibility. Discussion: The findings necessitate a multidimensional approach to identity and the use of measures that are comprehensive and responsive to sexual and gender diversity.