Sexual Minority Identity and Physical Illnesses: Role of Life-Course Victimization and Gender Differences

Abstract

Introduction: Sexual minority individuals experience higher rates of victimization and chronic physical health conditions. There are also known differences by gender in both victimization rates and victimization-linked chronic physical health conditions. However, few studies have examined gender differences regarding the association between sexual minority identity and chronic physical health conditions through cumulative life-course victimization, cumulative childhood victimization, and cumulative adult victimization.

Methods: This research uses a nationally representative dataset-the National Longitudinal Study of Adolescent to Adult Health (data collected from 1994 to 2018)-to examine (1) cumulative violence victimization across the life course and (2) the relative importance of violence victimization in childhood and adulthood as pathways between sexual minority identity and chronic physical health conditions while estimating differences by gender. Data processing and analysis were conducted between August 2021 and December 2024.

Results: Women who identified as mostly heterosexual and bisexual were more likely to experience chronic physical health disparities through indirect associations through victimization accumulation across the life course and violence victimization both in childhood and adulthood. Among lesbian women, there was an indirect association between sexual orientation and chronic physical health conditions through cumulative life-course victimization and childhood victimization.

Conclusions: Findings demonstrate that for women who identify as mostly heterosexual and bisexual, victimization-related chronic physical health vulnerabilities may manifest even before midlife, and both childhood and adult exposures are critical for physical health disparities in these groups. In contrast, childhood victimization maybe a more pervasive factor for chronic physical health conditions among lesbian women.