Many of the sources of minority stress and discrimination experienced by sexual minorities unfortunately begin at home, with the families of origin of sexual minorities, thus after reviewing the issues concerning discrimination and minority stress, the review will move on to examine the family experiences of lesbians and sexual minorities as they relate to issues of mental and physical health. Social support from friends and family plays an important role in determining mental and physical health, and a lack of social support has been linked to health deficits (Blair, 2008)
This issue can be especially problematic when looking at the needs of lesbians entering long-term care facilities, where if their sexual identity is not disclosed, accepted or understood, their relationships may become invisible and neglected. Furthermore, researchers have suggested that sexual minority elders may be especially vulnerable to the stressful experiences of having to come out in environments, which are perceived to be hostile, and as a result they may avoid doing so, or may suffer more severe consequences when they do come out (Brotman, Ryan, & Cormier, 2003)
Within these three studies it is entirely possible that some of the samples overlap with each other based on the variations in individual definitions of sexual identity, let alone the definitions used by various researchers. The consensus that has been growing among sexual minority researchers is that it is important to measure various dimensions of sexual identity (Brown & Alderson, 2010)
Within these three studies it is entirely possible that some of the samples overlap with each other based on the variations in individual definitions of sexual identity, let alone the definitions used by various researchers. The consensus that has been growing among sexual minority researchers is that it is important to measure various dimensions of sexual identity (Brown & Alderson, 2010)
Social exclusion and health outcomes. Social exclusion has been directly linked to negative mental and physical health outcomes in a variety of populations (Campbell & Jovehelovitch, 2000; Culley, 2010; Fish, 2010; Marmot, 2005; Weik, Maroof, Zoller & Dinzer, 2010; Zoller, Maroof, Weik & Deinzer, 2010)
A great deal of research has established the various risk factors that are unique to lesbians with respect to health care concerns, such as being at an increased risk for various forms of cancer, substance use, tobacco use and obesity (Roberts, 2006). Very few of the differences found between lesbian women and heterosexual women in health status and health risks are not related to sexual identity itself, but rather to the consequences of sexual identity, such as minority stress and the consequences of persistent discrimination (Cochran, 2001; Meyer, 2003)
A great deal of research has established the various risk factors that are unique to lesbians with respect to health care concerns, such as being at an increased risk for various forms of cancer, substance use, tobacco use and obesity (Roberts, 2006). Very few of the differences found between lesbian women and heterosexual women in health status and health risks are not related to sexual identity itself, but rather to the consequences of sexual identity, such as minority stress and the consequences of persistent discrimination (Cochran, 2001; Meyer, 2003)
A great deal of research has established the various risk factors that are unique to lesbians with respect to health care concerns, such as being at an increased risk for various forms of cancer, substance use, tobacco use and obesity (Roberts, 2006). Very few of the differences found between lesbian women and heterosexual women in health status and health risks are not related to sexual identity itself, but rather to the consequences of sexual identity, such as minority stress and the consequences of persistent discrimination (Cochran, 2001; Meyer, 2003)
The links between diminished social support and mental health are well established (Dew & Bromet, 1991; Reisen & Poppen, 1999; Ross, Lutz & Lakey, 1999), especially among the elderly (Dean, Kolody & Wood, 1990). Furthermore, social support has been shown to be an important causal contributor to physical health (Cohen & Syme, 1985; Wallston, Alagna, Devellis & Devellis, 1983), which underscores the importance of finding ways of incorporating existing social networks into the lives of sexual minority seniors
Specifically, lesbians are more likely to be overweight or obese (Struble, Lindley, Montgomery, Hardin & Burcin, 2010), to smoke (American Lung Association, 2010; Coker, Austin & Schuster, 2010; Lee, Griffin & Melvin, 2009; Steele, Ross, Dobinson, Veldhuizen & Tinmouth, 2009; Tang et al., 2004), use alcohol excessively (Dilley, Simmons, Boysun, Pizacani & Stark, 2010; Mayer, Bradford, Makadon, Stall, Goldhammer & Landers, 2008) and to have substance use issues (Coker et al
Julie Fish (2010) argues that examining health from a social exclusion standpoint is an important step in fully understanding the social determinants of health and states that it is important to incorporate an understanding of how living and working conditions contribute to health outcomes. Researchers in this area are consistently calling for the examination of social exclusion as a predicting factor in health outcomes, as opposed to solely focusing in specific healthcare interventions (Culley, 2010; Fish, 2010; Marmot, 2005)
Being over the age of 65 in 2010 indicates that an individual has been alive since at least 1945, and has therefore lived through an historical era that has seen significant changes in the lives of sexual minorities. As an example, a 75-year-old lesbian today has lived during a time when rounded up, sterilized, imprisoned and even murdered, not only by extremists such as the Nazis, but also closer to home (Daley, 1998; Peterson & Bricker-Jenkins, 1996)
The importance of social attitudes is highlighted in the links that have been well established in the literature between social support and health (Cassel, 1976; Cobb, 1976; House, Umberson & Lnadis, 1988; Uchino, Cacioppo & Kiecolt-Glasser, 1996). Social support has been shown to have a variety of health implications, ranging from improved mental health (Dean, Kolody & Wood, 1990; Dew & Bromet, 1991; Reisen & Poppen, 1999; Ross, Lutz & Lakey, 1999) to better immune system functioning (Uchino et al
What is particularly concerning is the continued neglect of incorporating the existing social networks of sexual minority elders into their daily lives, a concept that is repeatedly strapped with the hurdle of overcoming existing institutional barriers based on heterosexist policies and a discriminatory legal system. The links between diminished social support and mental health are well established (Dew & Bromet, 1991; Reisen & Poppen, 1999; Ross, Lutz & Lakey, 1999), especially among the elderly (Dean, Kolody & Wood, 1990)
Some researchers have attempted to get around this issue by conducting population-based studies that are large enough to provide a decent sample size of sexual minorities. Given the size of a study required to generate a random sampling of sexual minorities large enough for analysis, these studies are quite large are therefore rarely designed with studying the health of sexual minorities, but rather the analyses are done post-hoc on data that happened to include information about sexual orientation and identity (Diamant, Wold, Spritzer & Gelberg, 2000)
The first challenge in this area is the ability of researchers (and sexual minorities themselves) to agree upon and utilize a shared definition of the term lesbian. Sexual identity itself is a fluid and complicated concept, and thus it can only be expected that the term would be defined differently between individuals and groups for whom the term holds relevancy (Diamond, 2000)
, 2008; Roberts, 2006; Steele et al., 2009), with only a few studies reporting no significant differences in smoking between lesbians and heterosexual women (Zarisky & Dibble, 2010) or reverse effects with heterosexual women smoking more than lesbians (Dibble, Roberts, Robertson & Paul, 2002)
, 2008; Roberts, 2006; Steele et al., 2009), with only a few studies reporting no significant differences in smoking between lesbians and heterosexual women (Zarisky & Dibble, 2010) or reverse effects with heterosexual women smoking more than lesbians (Dibble, Roberts, Robertson & Paul, 2002)
This is an erroneous assumption, especially given the advanced statistical methods available today to address issues of unequal sample sizes and missing data. In one review of a major public health study that did include sexual orientation in the demographics, researchers found that this inclusion provided a wealth of information concerning sexual minority health disparities, and the inclusion of the demographic variable added no cost to the conduction of the study (Dilley et al
Given the strong links between general social support and health, researchers have sought to investigate the impact of specific forms of social support and health outcomes. In a recent study of sexual minority youth, levels of support available from friends and family for dealing with minority stress were compared with levels of support from the same sources for dealing with other forms of stress (Doty, Willoghby, Lindahl & Malki, 2010)