Birth Cohort Trends in Health Disparities by Sexual Orientation

Lesbian, gay, and bisexual-identified (LGB) people experience worse mental and physical health than their straight-identified counterparts. Given remarkable social and legal changes regarding LGB status in recent decades, we theorize that this profound health disadvantage may be changing across cohorts. Using data from the 2013–2018 National Health and Interview Surveys, we analyze five mental and physical health outcomes—psychological distress, depression, anxiety, self-rated physical health, and activity limitation—across three birth cohorts colloquially known as (1) Millennials, (2) Generation Xers, and (3) Baby Boomers and pre-Boomers. We find no evidence of reduced health disparities by sexual orientation across cohorts. Instead, relative to straight-identified respondents, the health disadvantages of gay, lesbian, and—most strikingly—bisexual-identified people have increased across cohorts. Findings highlight the importance of identifying the causes of increased health disparities as well as designing and implementing more direct public policies and programs to eliminate health disparities among more recent LGB cohorts.