Health risks higher for LGBT people, report finds

Members of the LGBT community are more likely to suffer health problems than heterosexuals in Hawaii, according to a new state Department of Health report.

The findings of the first-ever Hawaii Sexual and Gender Minority Health Report mirror the health experiences of lesbian, gay and bisexual folks on the mainland, officials say.

The report, unveiled at a recent conference about the needs of LGBT youth, found that lesbian, gay and bisexual youngsters face more risk factors than their heterosexual counterparts — a fact that leads to poorer health outcomes later in life.

“Clearly, there is more work to be done to address these issues,” said Ranjani Starr, an epidemiologist with the Health Department’s Chronic Disease Prevention and Health Promotion Division.

With data from surveys collected in 2011, 2013 and 2015, the report found that more than 1 in 10 Hawaii public high school students — or about 4,700 students — identify as lesbian, gay, bisexual or questioning. With limited data available on transgender individuals, the report offers only “preliminary information” on that group.

Much of the health disparities are explained by what the report describes as “minority stress theory,” or the additional stressors that sexual minorities experience, including internalizing homophobia, concealing identity and being subject to discrimination, bullying and family rejection.

“Not surprisingly, on all indicators of mental health, LGB youth perform worse than heterosexual youth,” the report says.

Every year, according to the report, 1 in 3 LGB youth attempt suicide, while nearly 1 in 5 identifying as questioning attempt suicide. Half of LGB youth say they have feelings of sadness or hopelessness, while 43.5 percent of LGB youth report purposely hurting themselves through behaviors such as cutting or burning.

LGB youth, according to surveys, are also more likely to engage in behaviors that lead to health problems later in life. Ten percent of LGB youth say they have injected illicit drugs, and nearly 50 percent drink alcohol, while 1 in 4 say they smoke cigarettes.

Rates of smoking, marijuana use, alcohol consumption and binge drinking among LGB youth in Hawaii are all comparable to LGB youth nationally and are all significantly higher than heterosexual youth, as are Hawaii rates of bullying and physical and sexual dating violence, Starr said.

LGB youngsters are less likely to have access to supportive adults at home, the data indicate, and less likely to be in relationships where they feel safe.

“More LGB youth have experienced emotional, physical and sexual violence or abuse in their relationships. Almost 1 in 5 LGB youth report having been forced to have sexual intercourse against their will,” the report says.

As for LGB adults, they report dealing with more health problems than heterosexual adults in Hawaii. Lesbian, gay and bisexual adults are twice as likely to suffer depression than heterosexual adults, while 40 percent report suffering from multiple chronic conditions.

“They suffer higher rates of cancer and asthma than the heterosexual population,” the report says. “Lesbian or bisexual women suffer disproportionately from obesity, prediabetes, stroke, asthma and arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia. They are more likely to be diagnosed with multiple chronic conditions than heterosexual women and more likely to report being in poor general health.”

Gay or bisexual men, meanwhile, are three times more likely to be a victim of rape or attempted rape and seven times more likely to experience abuse by a partner.

Heather Lusk, executive director of the CHOW Project, a statewide nonprofit that works with Hawaii communities affected by drug use, said the state data on this population are long overdue.

“It is a groundbreaking report,” Lusk said. “It’s great to see all the information put into one report that allows us to see the true health disparities that LGBT face in Hawaii.”

Lusk said she was surprised to see that so many LGB youth have injected drugs — about 10 percent compared with only 2 percent of heterosexual youth.

“That’s a really scary statistic,” she said. “I don’t know if I’ve ever seen such a high rate in any other community.”

Lusk added that the information will help her organization and others target that group better and work more diligently toward prevention.

Pediatrician Robert Bidwell said he wasn’t really surprised by anything in the report regarding youth.

“This is information I’ve already known from working with these kids,” said Bidwell, who runs a clinic for LGBT youth at Kapiolani Medical Center for Women &Children. “The risks stated there are the ones we see every day.”

Bidwell, also an associate clinical professor of pediatrics at the University of Hawaii at Manoa, said many here are under the impression that Hawaii is more accepting of LGBT people because of its status as a progressive blue state, its reputation for aloha and historical acceptance of homosexuality among Native Hawaiians.

But the reality for youth, he said, is that they experience the same discrimination and rejection their counterparts on the mainland feel.

“There are as many kids isolated and harassed in Hawaii as in any family I worked with from other parts of the country,” said Bidwell, who is originally from Minnesota.

At the same time, most Hawaii LGBT youth do not suffer from health issues, he said, and there is some optimism that attitudes and behaviors are changing for the better.

Still, he added, more community dialogue, youth programs and education are needed to improve health outcomes overall.