have seldom been examined. In addition, many of the available studies have relied on small convenience samples. There are many opportunities for additional research. Both cross-sectional and longitudinal research is needed on the intersection of contextual factors (e.g., race, geography, socioeconomic status), attending to multiple levels of consideration (e.g., community, structural, biomedical), with respect to sexual- and gender-minority status. Similarly, research is needed to address the risk and protective factors associated with, as well as interventions to promote, health and well-being in LGBT populations. The following topics in LGBT health research would benefit from additional study:

  • Demographic and descriptive information, including the percentage of adults who are LGBT and how that percentage varies by demographic characteristics such as race, ethnicity, socioeconomic status, geography, and religion; also, the percentage of LGBT adults who are parents, as well as the general experiences and health status of LGBT adults and how these vary by demographic characteristics.

  • Family and interpersonal relations, including the effect of the greater likelihood of childlessness in LGBT populations and their experience of parenting (with a particular focus on the experience of gay, bisexual, and transgender parents, which is largely absent from the research literature); the experience and prevalence of “chosen families”; and the experience of intrafamily and domestic violence (such as intimate partner violence), as well as anti-LGBT victimization.

  • Health services, including barriers to access (particularly related to identity disclosure and interactions with providers), utilization rates, and quality of care received.

  • Mental health, including eating disorders, the prevalence of depression and suicidality (particularly unknown among transgender adults), and the effects of stigma and discrimination (particularly unknown among bisexual adults).

  • Physical health, including substance use (particularly among transgender individuals); cancer rates, risks, and treatment (e.g., breast cancer among lesbians and bisexual women; anal cancer rates and evaluations of the effectiveness of screening among men who have sex with men; cancer among transgender adults in general, about which very little is known); cardiovascular disease among all LGBT adults; and obesity (particularly among lesbian and bisexual women).

  • Sexual and reproductive health, including HIV rates and interventions (particularly addressing racial disparities); fertility, infertility, and reproductive health issues; and reproductive technology and its use.



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