Healthcare satisfaction at the intersections of sexual orientation and race/ethnicity.

OBJECTIVES: Existing scholarship has consistently demonstrated disparities in healthcare experience based on sexual identity. However, relatively little research has considered intersections with race/ethnicity, despite that intersection with other characteristics may complicate healthcare experiences and satisfaction among sexual minorities. This study aims to address such a gap by examining healthcare satisfaction across the intersections of sexual and racial/ethnic identity. DESIGN: Utilizing data on U.S. adults included in the 2013-2018 Behavioral Risk Factor Surveillance System (BRFSS) (n = 372,766), we investigate levels of satisfaction with care among a range of groups simultaneously embodying two identities. RESULTS: Findings from ordered logistic regression models show that among adults who identify as heterosexual, the odds of reporting high satisfaction with care are lower among Blacks, Asians, and Native Americans. Among sexual minority adults, the likelihood of reporting high satisfaction with care is consistently lower among Native American gay and lesbian adults compared to gays and lesbians of other race/ethnicity or Native American and White heterosexuals, indicating heightened vulnerability to poorer healthcare experience among this multiple minority group. CONCLUSION: While levels of satisfaction with care tend to be generally high across groups, future research should endeavor to investigate the driving factors that lower the odds of high healthcare satisfaction among those with intersecting minority identities.

Intersectional Immunity? Examining How Race/Ethnicity and Sexual Orientation Combine to Shape Influenza Vaccination Among US Adults.

Influenza vaccination is a critical preventive healthcare behavior designed to prevent spread of seasonal flu. This paper contributes to existing scholarship by applying an intersectional perspective to examine how influenza vaccination differs across specific intersections of racial/ethnic and sexual identity. Drawing on aggregated state-level data from Behavioral Risk Factor Surveillance System (BRFSS) from 2011 to 2020, I examine how flu vaccination differs across 18 racial/ethnic-by-sexual orientation groups (N = 1,986,432). Findings from descriptive analyses and logistic regression modeling demonstrate three key findings. First, it corroborates previous studies of vaccination, finding lower rates of flu vaccination among black adults relative to whites; gays/lesbians vaccinate at higher rates than heterosexuals and bisexuals, with bisexuals reporting lower vaccination relative to both heterosexuals and gays/lesbians. Second, it demonstrates how sexual orientation complicates established patterns between race/ethnicity and vaccination (e.g., influenza vaccination is more racially stratified among heterosexuals, with patterns more variable among gays/lesbians) and how race/ethnicity complicates previous patterns of vaccination by sexual orientation (e.g., Asian bisexuals vaccinate more than both heterosexuals). Third, findings pinpoint identities (e.g., black heterosexuals relative to their white peers and white bisexuals relative to their gay/lesbian peers) most in need of influenza vaccination outreach efforts. Implications for findings suggest that heterosexuals, especially black, may be less likely to vaccinate against influenza thus may need more encouragement from clinicians to vaccinate. Additionally, influenza vaccination should be free for all persons to lessen the barrier of access for this preventative healthcare.

Parenthood, Stress, and Well-Being among Cisgender and Transgender Gay and Lesbian Adults.

OBJECTIVE: This study examines whether and how parenthood status is associated with two key aspects of health- mental well-being and smoking- among sexual minority adults across three gender identity groups: cisgender gay men, cisgender lesbian women, and transgender gay/lesbian adults. BACKGROUND: Parents tend to report worse health than non-parents due to elevated stress associated with parenting. However, most existing scholarship de facto examines parental status and health among cisgender heterosexual adults. Little research has employed an intersectional approach to focus on parenthood and health differences within sexual minority adults across varying gender identities. METHOD: OLS and logistic regression models were used to analyze data from the 2010 Social Justice Sexuality Project (N = 2,803), a survey of racially diverse sexual and gender minority adults residing in all 50 US states and Puerto Rico. RESULTS: In a sample composed predominantly of people of color, parenthood status is related to both mental well-being and smoking status among gay and lesbian adults, but this relationship is inconsistent across cisgender and transgender groups. OLS regression models show that parenthood is positively related to mental well-being among gay and lesbian transgender people, whereas logistic regression results find that parenthood is associated with higher odds of smoking among cisgender gay men. CONCLUSION: These findings suggest that among a sample of sexual and gender minorities composed mostly of people of color, parenthood status is connected with the health and well-being of gay and lesbian adults in ways that depend on gender identity.