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.