Study: Health care use among gay, lesbian and bisexual Canadians

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A new study published today in Health Reports provides the first national picture of health care use by sexual orientation. It shows that the use of health care services differs depending on self-identified sexual preference.

The study examined whether self-identified sexual preference was a factor in the use of various aspects of health care, such as consulting health care providers, having a regular doctor, and using preventive procedures, such as Pap tests.

The study was based on combined 2003 and 2005 data from the Canadian Community Health Survey for adults aged 18 to 59.

It found that gay men were much more likely than heterosexual men to have consulted a medical specialist or mental health service providers, such as social workers or counselors, in the year prior to the survey.

Among women, lesbians were less likely than heterosexual women to have seen a family doctor in the year prior to the survey or to have undergone a Pap test in the three previous years.

An estimated 346,000 adults identified themselves as gay, lesbian or bisexual in the survey. These people represented 1.9% of the total population aged 18 to 59. Of this group, 130,000 were gay men, 59,000 bisexual men, 71,000 lesbians, and 85,000 bisexual women.

Use of health care services differs by sexual preference

The study suggests that the use of health care services differs by self-identified sexual preference, independent of other factors such as age, income, education and health status that are known to influence health care use.

About 29% of gay men consulted a medical specialist in the 12 months before the survey, compared with 19% of heterosexual men.

Similarly, 8% of gay men consulted a psychologist, nearly triple the proportion of 3% among their heterosexual counterparts. About 7% of gay men consulted social workers or counsellors, compared with 4% of heterosexual men.

There were no differences between bisexual and heterosexual men in consultations with doctors. However, bisexual men had more frequent contact with social workers or counsellors.

Among women, 77% of lesbians had seen a family doctor in the 12 months before the survey, compared with 83% of heterosexual women.

On the other hand, 10% of lesbians consulted a psychologist, as did 11% of bisexual women, well above the proportion of only 4% among heterosexual women.

Similarly, 7% of lesbians and 9% of bisexual women attended a self-help group, while only 3% of their heterosexual counterparts did so.

About 17% of bisexual women had contact with social workers or counsellors, nearly three times the proportion of 6% among heterosexual women.

Lesbians, bisexuals less likely to have a regular doctor

Statistically similar proportions of gay, bisexual and heterosexual men reported that they did not have a regular doctor.

Among women, 19% of lesbians and 24% of bisexuals did not have a regular doctor, as opposed to only 12% of heterosexuals.

Bisexual men and women were more likely than heterosexuals to report having had an unmet health care need in the year prior to the survey.

Preventive screening

Less than two-thirds of lesbians reported having had a Pap test within three years of the survey, well below the more than three-quarters of heterosexual and bisexual women who had done so.

The proportions of lesbian and heterosexual women aged 50 to 59 who had had a mammogram in the two years prior to the survey did not differ significantly. However, bisexual women were less likely to have had a mammogram in that period.

More self-reported health problems

An estimated 65% of gay men and 63% of lesbians reported their health as excellent or very good, virtually identical to rates among the heterosexual population.

However, 12% of bisexual men and 16% of bisexual women reported fair or poor health. These levels were significantly higher than the roughly 8% of men and women in the heterosexual population who reported the same health status.

The study found that gay men and bisexual women tended to report more chronic conditions than did the heterosexual population. They were also more likely to have had at least one disability day due to physical illness in the two weeks prior to the survey.

Bisexual men and women were more likely than heterosexual men and women to perceive their mental health as fair or poor.

All sexual minority groups reported levels of mood or anxiety disorders above those for the heterosexual population.

Definitions, data sources and methods: survey number 3226.

The article "Health care use among gay, lesbian and bisexual Canadians," is now available in the complete version of the latest issue of Health Reports, Vol. 19, no. 1 (82-003-XWE, free) from the Publications module of our website. A printed version (82-003-XPE, $24/$68) is also now available.

For more information about Health Reports, contact Christine Wright (613-951-1765; christine.wright@statcan.gc.ca), Health Information and Research Division.

For more information, or to enquire about the concepts, methods or data quality of this release, contact Michael Tjepkema (416-952-4620; michael.tjepkema@statcan.gc.ca), Health Information and Research Division.