Are the differences in acceptance of LGBT individuals across Europe a public health concern?
By Richard Bränström
Although there has been much progress in many European countries regarding social acceptance of LGBT individuals in recent decades, much discrimination, social injustice, and intolerance still exists with adverse consequences for both physical and mental health in these populations.
Awareness of health disparities in specific populations, in particular based on ethnical background, gender, age, socioeconomic status, geography, and disability has increased during the past decades. And lately, public health policy and research have begun to address the issues of lesbian, gay, bisexual, and transgender (LGBT) populations, and many official public health agencies call for programs addressing the specific needs of LGBT individuals.
An increasing number of studies, although still limited, points to a higher prevalence of certain conditions among LGBT people that call for the attention of public health researchers and professionals. The most significant area of concern is the increased prevalence of mental health disorders. Recent studies show that LGBT youth are at greater risk for suicide attempts than non-LGBT youths and have higher prevalence of depression and anxiety diagnoses. Studies also show that transgender individuals are regularly stigmatized and discriminated against both in the health care sector and in the society as a whole.
Traditionally LGBT public health research has almost exclusively focused on sexually transmitted diseases. In particular, the start of the HIV/AIDS epidemic in the 1980s brought visibility to the LGBT population as a group with specific health needs. However, the public health consequences of discrimination of LGBT individuals have only recently been focus of greater attention.
The level of acceptance for minority sexual orientations differs greatly between countries. In the European Social Survey 2010, a question was used to assess level of acceptance of gay men and lesbians. The proportion of respondents that agreed to a statement that ‘Gay men and lesbians should be free to live their own life as they wish’ varied greatly between countries, from around 90% in the Netherlands, Sweden, and Norway to about one third of the respondents in Russia and Ukraine.
These results indicate that in many countries LGBT people still live in communities where a majority of the population supports discrimination and inequality for sexual minorities. In many countries, LGBT people are also subject to legal discrimination concerning basic civil rights, e.g. regarding recognition of same-sex unions.
But are these large differences in acceptance and legal discrimination influencing the health of LGBT individuals, and what needs to be done to overcome inequality in Europe’s health based on sexual orientation and gender identities? These questions are difficult to answer in the absence of sufficient data.
In a recent commentary in the European Journal of Public Health, we argue for greater awareness of these issues, and the need for more knowledge about the public health situation of LGBT populations through improved data quality and well-designed studies. Systematic data collection regarding sexual orientation and gender identity is required to better understand factors that can help us reduce and better understand disparities, as well as increase quality of health care provision for LGBT individuals. In addition to working towards greater acceptance to end discrimination and social injustice, greater efforts from public health researchers and policy makers are needed to reduce health disparities among LGBT populations.
Richard Bränström is a health psychologist and researcher. He is currently associate professor at the Karolinska Institute, Sweden, and he works with public health analyses at the Swedish National Institute of Public Health. His main research interest concern health inequalities, predictors of physical and mental health, and health related behaviors. He is the author of the commentary ‘All inclusive Public Health—what about LGBT populations?’, which is published in the European Journal of Public Health.
The European Journal of Public Health is a multidisciplinary journal in the field of public health, publishing contributions from social medicine, epidemiology, health services research, management, ethics and law, health economics, social sciences and environmental health.