Sexual Minorities Have Greater COVID-19 Risk Factors

Gay, lesbian, or bisexual adults have higher rates than heterosexual people of health conditions that increase the risk of developing severe COVID-19, according to national survey data. Currently, US COVID-19 surveillance systems don’t collect data on patients’ sexual orientation or gender identity—a concern that advocacy groups and health care organizations raised during a meeting with the CDC in November 2020. To help fill the information gap, the CDC analyzed Behavioral Risk Factor Surveillance System data from 2017 to 2019 to determine the prevalence in this population of conditions that raise the risk of severe COVID-19. About 5% of the survey’s respondents identified as gay, lesbian, or bisexual. Too few respondents identified as transgender or nonbinary to reliably estimate their COVID-19 risk factors, the authors noted. Overall, people who identified as gay, lesbian, or bisexual had higher self-reported rates of asthma, cancer, heart disease, chronic obstructive pulmonary disease, hypertension, kidney disease, obesity, smoking, and stroke than heterosexual individuals. Some of these conditions were more prevalent among individuals who are in both sexual and racial or ethnic minority groups. The authors suggested that gay, lesbian, or bisexual people may encounter discrimination or stigmatization that increases their vulnerability to illness and limits their ability to have economic security, access to health care, and supportive relationships. They also noted that these biases may be greater toward people in both sexual and racial or ethnic minority groups, exacerbating their risk of developing severe COVID-19. “Collecting data on sexual orientation in COVID-19 surveillance and other studies would improve knowledge about disparities in infection and adverse outcomes by sexual orientation, thereby informing more equitable responses to the pandemic,” the authors wrote.