Who Cares? Unpaid Caregiving by Sexual Identity, Gender, and Partnership Status Among U.S. Adults.

Recent scholarship indicates that sexual minority adults have higher caregiving rates than heterosexuals and that women are more likely to be caregivers than men. However, little research has addressed how gender and sexuality intersect in shaping caregiving status. This study uses data from the Behavioral Risk Factor Surveillance System and aggregates a probability-based sample of adults living in 36 U.S. states between 2015 and 2021. We examine who provides care among adult heterosexual, lesbian, gay, and bisexual men and women. Results reveal that women are more likely to be caregivers than men, but only among heterosexuals. We find little variation in caregiving by sexuality among women, but bisexual men are more likely than heterosexual men to be caregivers; the latter result appears to be driven by unpartnered, bisexual men. Lastly, we contextualize caregivers' experiences and reveal selected descriptive differences in patterns of care recipient-caregiver relationships across gender and sexual identity groups. Our findings advance understanding of caregiving and changing family ties in an era of population aging and increasing diversity in sexual identities.

Sexual Orientation and Age-Related Patterns of Suicidal Ideation Among U.S. Adults.

Purpose: We aimed to explore whether and how suicidal ideation differs according to specific sexual orientations (i.e., heterosexual, gay/lesbian, bisexual orientation) and age groups in gender-stratified analyses. Methods: We identified state health departments from nine U.S. states that collected Behavioral Risk Factor Surveillance System data on both sexual orientation and suicidal ideation from 2011 to 2018 for adults aged 18 and older (n = 113,337). Logistic regression and average marginal effects (AME) were used to examine the likelihood of suicidal ideation by sexual orientation, gender, and age. Results: We found that after important sociodemographic and socioeconomic controls, sexual minority adult men and women experienced significantly higher odds of suicidal ideation than their same-gender heterosexual counterparts. After all adjustments, lesbian women had more than three times higher odds and bisexual women had almost four times higher odds than heterosexual women. Compared with heterosexual men, gay men reported twice higher odds and bisexual men exhibited 3.67 times higher odds of suicidal ideation. Analysis of the AME revealed age-specific disparities. The likelihood of suicidal ideation for bisexual men aged 18-24 years was significantly higher than that for gay and heterosexual men of the same age. Among women, bisexual women closer to middle age (35-44 years) experienced a higher likelihood of suicidal ideation than heterosexual or lesbian women of the same age. Conclusion: The elevated risk of suicidal ideation among sexual minority people throughout different stages of adulthood has important implications for policies and support services.

Contextual Influences on Nonresponse to Health Survey Questions About Sexual Orientation and Gender Identity.

Purpose: We examined the relationship between state context and survey nonresponse to sexual orientation (SO) and gender identity (GI) questions. Methods: We obtained data from the 2014-2020 Behavioral Risk Factor Surveillance System (BRFSS) surveys. Item nonresponse was defined as selecting "don't know/not sure" or "refused" for each of two questions about SO and GI. Nonresponse patterns included responding to both SO and GI questions; responding only to the SO question (nonresponse to GI); responding only to the GI question (nonresponse to SO); and responding to neither question. State-level contextual measures included legal protections for lesbian, gay, bisexual, transgender, or other sexual or gender minority (LGBT+) people, LGBT+ social movement strength, and public opinion regarding LGBT+ issues. Results: The analysis included 1,459,525 respondents from 44 states (190 state-years). On weighted analysis, 96.5% of adults answered both SO/GI questions, 2.4% responded only to GI, 0.4% responded only to SO, and 0.7% responded to neither. The demographic profile of individuals with GI-only nonresponse differed markedly from the profile of adults with SO-only nonresponse. An increasingly favorable legal climate for LGBT+ people was associated with greater rates of response to SO and GI questions. However, a more LGBT+ friendly state climate measured by social movement strength or public opinion was not consistently associated with reduced SO and GI question nonresponse. Conclusion: Contextual factors have mixed association with nonresponse to SO and GI question on BRFSS surveys. Our results warrant continued development of health survey questionnaires to elicit accurate information on respondents' SO and GI.