If You Don’t Ask, You Don’t Count: Elements to Consider in Understanding Global Sexual and Gender Minority Data on Noncommunicable Diseases

Abstract

AbstractEvaluation and comparison of incidence and prevalence of noncommunicable diseases (NCDs) among sexual and gender minorities (SGMs) to cisgender and/or heterosexual populations rest on the belief that SGM populations have unique characteristics that influence the rates. Several theoretical concepts, briefly discussed in this chapter, have been postulated regarding this disparity. These include minority stress theory, fundamental cause theory, compression of morbidity theory, and cumulative disadvantage hypothesis. In each case, and most clearly articulated by the fundamental cause theory, structural stigma, discrimination, and power structures among disadvantaged populations drive these health disparities. In the analyses evaluating health disparities, numerous methodological issues reduce the generalizability of results. Probabilistic-based sampling design is rarely used because the data do not exist. Among the few examples that use this study design, the SGM sample is small or covers multiple years. Another methodological issue is the consistently younger mean age of the SGM participants compared to cisgender and/or heterosexual groups. Across the globe, country-specific cultural norms determine the visibility and value of SGM populations. Moving forward, a hope is that, in the near future, the SGM population will be described as one important group, among others, in assessing the health of each nation.