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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Understanding the Well-Being of LGBTQI+ Populations. Washington, DC: The National Academies Press. doi: 10.17226/25877.
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Understanding the Well-Being of

LGBTQI+ Populations

Committee on Understanding the Well-Being of Sexual and
Gender Diverse Populations

Charlotte J. Patterson, Martín-José Sepúlveda, and Jordyn White,
Editors

Committee on Population

Division of Behavioral and Social Sciences and Education

A Consensus Study Report of

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THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Understanding the Well-Being of LGBTQI+ Populations. Washington, DC: The National Academies Press. doi: 10.17226/25877.
×

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by contracts between the National Academy of Sciences and Gilead Sciences (award no. 05352), the Sexual and Gender Minority Research Office of the National Institutes of Health (award no. 75N98019F00850), the Robert Wood Johnson Foundation (award no. 75874), the TAWANI Foundation (unnumbered), and the Tegan and Sara Foundation (unnumbered). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-68081-3
International Standard Book Number-10: 0-309-68081-6
Digital Object Identifier: https://doi.org/10.17226/25877
Library of Congress Control Number: 2020949996

Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

Copyright 2020 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

Suggested citation: National Academies of Sciences, Engineering, and Medicine. (2020). Understanding the Well-Being of LGBTQI+ Populations. Washington, DC: The National Academies Press. https://doi.org/10.17226/25877.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Understanding the Well-Being of LGBTQI+ Populations. Washington, DC: The National Academies Press. doi: 10.17226/25877.
×

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The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

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Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Understanding the Well-Being of LGBTQI+ Populations. Washington, DC: The National Academies Press. doi: 10.17226/25877.
×

Image

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Understanding the Well-Being of LGBTQI+ Populations. Washington, DC: The National Academies Press. doi: 10.17226/25877.
×

COMMITTEE ON UNDERSTANDING THE STATUS AND WELL-BEING OF SEXUAL AND GENDER DIVERSE POPULATIONS

CHARLOTTE J. PATTERSON (Cochair), Department of Psychology, University of Virginia

MARTÍN-JOSÉ SEPÚLVEDA (Cochair), Health Systems and Policy Research, IBM Corporation (retired); CLARALUZ Consulting LLC

M.V. LEE BADGETT, Department of Economics, University of Massachusetts Amherst

MARLON M. BAILEY, Department of Women and Gender Studies, School of Social Transformation, Arizona State University

KATHARINE B. DALKE, Department of Psychiatry and Behavioral Health and Humanities, Pennsylvania State University College of Medicine

ANDREW R. FLORES, Department of Government, School of Public Affairs, American University

GARY J. GATES, retired

ANGELIQUE C. HARRIS, Department of Medicine, Boston University Medical Campus, Boston University

MARK L. HATZENBUEHLER, Department of Psychology, Harvard University

NAN D. HUNTER, Georgetown University Law Center

TONIA C. POTEAT, Department of Social Medicine, University of North Carolina Chapel Hill

SARI L. REISNER, Brigham and Women’s Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, and Fenway Health

STEPHEN T. RUSSELL, Department of Human Development and Family Sciences, University of Texas at Austin

DEBRA J. UMBERSON, Population Research Center, University of Texas at Austin

JORDYN WHITE, Study Director

KELLAN BAKER, Consultant, Bloomberg School of Public Health, Johns Hopkins University

KENNE DIBNER, Senior Program Officer

TARA BECKER, Program Officer

MARY GHITELMAN, Senior Program Assistant

MALAY K. MAJMUNDAR, Director, Committee on Population

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Understanding the Well-Being of LGBTQI+ Populations. Washington, DC: The National Academies Press. doi: 10.17226/25877.
×

COMMITTEE ON POPULATION

KATHLEEN MULLAN HARRIS (Chair), Department of Sociology, Carolina Population Center, and National Longitudinal Study of Adolescent to Adult Health, University of North Carolina at Chapel Hill

DEBORAH BALK, Marxe School of Public and International Affairs, and CUNY Institute for Demographic Research, Baruch College of the City University of New York

NANCY BIRDSALL, Center for Global Development, Washington, DC

ANN K. BLANC, Population Council, New York, NY

COURTNEY C. COILE, Department of Economics, Wellesley College

VICKI A. FREEDMAN, Institute for Social Research, University of Michigan

DANA A. GLEI, Georgetown University

ROBERT A. HUMMER, Department of Sociology, and Carolina Population Center, University of North Carolina at Chapel Hill

HEDWIG (HEDY) LEE, Department of Sociology, Washington University in St. Louis

JENNIFER J. MANLY, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University

EMILIO A. PARRADO, Department of Sociology and Population Studies Center, University of Pennsylvania

ANNE R. PEBLEY, Department of Community Health Sciences, Department of Sociology, California Center for Population Research, Bixby Center on Population and Reproductive Health, University of California, Los Angeles

ISABEL V. SAWHILL, The Brookings Institution, Washington, DC

REBECA WONG, University of Texas Medical Branch at Galveston

MALAY K. MAJMUNDAR, Director

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Understanding the Well-Being of LGBTQI+ Populations. Washington, DC: The National Academies Press. doi: 10.17226/25877.
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Acknowledgments

In 2011 the Institute of Medicine of the U.S. National Academies of Sciences, Engineering, and Medicine (National Academies) published The Health of Lesbian, Gay, Bisexual, and Transgender People, a landmark report about the health of this population. The report discussed the existing body of research about the health of lesbian, gay, bisexual, and transgender (LGBT) people, identified opportunities for further research, and made recommendations for actions to improve the health of LGBT people. By mid-2020 the report had been downloaded more than 15,000 times, and it had been used by researchers, educators, attorneys, health care professionals, government workers, journalists, community groups, and many others. It has influenced the work of the National Institutes of Health, the Centers for Disease Control and Prevention, and other governmental and nongovernmental organizations.

Since 2011 much has changed. Some of the challenges identified in the 2011 volume have been met, but others certainly remain. Research on LGBT health has burgeoned, but there is still much to learn. In 2019, the National Academies convened a committee to assess the current state of knowledge about the status and well-being of sexual and gender diverse people to identify important gaps in knowledge and to recommend research and research infrastructure actions to help fill these gaps. The committee’s work was supported by the Robert Wood Johnson Foundation, the Gilead Foundation, the Sexual and Gender Minority Research Office at the National Institutes of Health, the TAWANI Foundation, and the Tegan and Sara Foundation.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Understanding the Well-Being of LGBTQI+ Populations. Washington, DC: The National Academies Press. doi: 10.17226/25877.
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The task set for the committee was broader than the one addressed by the 2011 report. The committee was charged with reviewing data on people with differences of sex development (sometimes called “intersex”), as well as those who could, by virtue of their identities, behaviors, or attractions, either identify or be seen as LGBT. In undertaking its work, the committee was asked to address not only the mental and physical health of these populations, but also additional aspects of well-being in their lives as lived in families, communities, and in the context of cultural, legal, educational, economic, and religious institutions. The committee undertook to provide an overview of both existing evidence and of future research needs in these areas.

Thus, this report presents a considerable body of information across a wide array of topics and disciplines. The report was made possible by a year of discussion, information gathering, review, and deliberation among committee members, aided by a dedicated staff. We thank all of the committee members for their dedication and spirit as well as for their invaluable expertise.

In addition to the invited guests, reviewers, and members of the public who contributed to this report, and on behalf of the entire committee, we want to thank the National Academies staff members who made this report possible. In particular, we extend our sincere thanks to Jordyn White, study director; Kenne Dibner, senior program officer; Tara Becker, program officer; Kellan Baker, project consultant; Mary Ghitelman, senior program assistant; and Malay K. Majmundar, director of the Committee on Population. We would also like to thank Daniel Desautels for his contribution during his time at the National Academies as a Christine Mirzayan Science and Technology Policy Graduate Fellow. Without the constant support and guidance from these individuals, the report could not have been completed.

This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.

We thank the following individuals for their review of this report: Walter O. Bockting, Program for the Study of LGBT Health, Columbia University Irving Medical Center; Christopher (Kitt) S. Carpenter, Vanderbilt LGBT Policy Lab, Vanderbilt University; Laura E. Durso, executive director and chief learning officer, Whitman-Walker Institute; Heath Fogg Davis, Gender, Sexuality and Women’s Studies, Political Science, Temple University; Donald Haider-Markel, Kentucky University; Jennifer S. Hirsch,

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Understanding the Well-Being of LGBTQI+ Populations. Washington, DC: The National Academies Press. doi: 10.17226/25877.
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Department of Medicine, University of Chicago; Trevon D. Logan, Department of Economics, Ohio State University; Christy Mallory, School of Law, University of California, Los Angeles; Wendy D. Manning, Department of Sociology, Bowling Green State University; Jae M. Sevelius, Department of Medicine, Division of Prevention Science, University of California, San Francisco; and Russell Toomey, Family Studies and Human Development, University of Arizona.

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report, nor did they see the final draft before its release. The review of this report was overseen by Marshall H. Chin, Department of Medicine, University of Chicago, and Sara Rosenbaum, Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University. They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.

Charlotte J. Patterson and Martín-José Sepúlveda, Cochairs
Committee on Understanding the Status and Well-Being of
Sexual and Gender Diverse Populations

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Understanding the Well-Being of LGBTQI+ Populations. Washington, DC: The National Academies Press. doi: 10.17226/25877.
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The increase in prevalence and visibility of sexually gender diverse (SGD) populations illuminates the need for greater understanding of the ways in which current laws, systems, and programs affect their well-being. Individuals who identify as lesbian, gay, bisexual, asexual, transgender, non-binary, queer, or intersex, as well as those who express same-sex or -gender attractions or behaviors, will have experiences across their life course that differ from those of cisgender and heterosexual individuals. Characteristics such as age, race and ethnicity, and geographic location intersect to play a distinct role in the challenges and opportunities SGD people face.

Understanding the Well-Being of LGBTQI+ Populations reviews the available evidence and identifies future research needs related to the well-being of SDG populations across the life course. This report focuses on eight domains of well-being; the effects of various laws and the legal system on SGD populations; the effects of various public policies and structural stigma; community and civic engagement; families and social relationships; education, including school climate and level of attainment; economic experiences (e.g., employment, compensation, and housing); physical and mental health; and health care access and gender-affirming interventions.

The recommendations of Understanding the Well-Being of LGBTQI+ Populations aim to identify opportunities to advance understanding of how individuals experience sexuality and gender and how sexual orientation, gender identity, and intersex status affect SGD people over the life course.

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