Do LGBT youth have a higher prevalence of cancer than their non-LGBT brothers and sisters? To be honest, we don’t actually know. National cancer registries, which record all tumors, do not include information about sexual orientation or gender identity, leaving LGBT youth cancers hidden in the data. But, through some state health surveys, we do know that LGBT adults have higher cancer rates and higher prevalence of cancer risk factors. Many of these risk factors are behaviors which began in adolescence, like smoking.
In one recent study of LGBT individuals the investigator commented “Sexual minorities are at risk for cancer later in life, I suggest, from a host of behaviors that begin relatively early in life,” (1) And, recently, the head of the U.S. Food and Drug Administration defined smoking as a pediatric disease, because the vast majority of adult smokers started in adolescence (2).
I believe that many LGBT health disparities, including cancer, can be traced to minority stress. Minority stress is a public health theory that explains that stress resulting from discrimination and stigmatization of minority groups affects the individuals’ health in a number of ways throughout their lives. Many studies of minority stress show that lesbian, gay, bisexual and transgender people experience this. The behaviors linked to this form of stress, like smoking cigarettes, can be then seen as coping mechanisms, even if they cause later health problems.
The discrimination that LGBT youth face may be further compounded if they are people of color, disabled or poor. The relationship between discrimination and health was confirmed earlier this year in a study that found that LGB people who live in communities with high levels of homophobic prejudice had a 12-year reduction in life expectancy than their heterosexual peers in the same community (3). Last year, another study found that LGB people who experienced “prejudice-related major life events” were 3x more likely to suffer a serious physical health problem over the next year than people who had not experienced such events regardless of other factors such as age, gender, employment and health history (4).
So how does this play out for LGBT youth specifically? Their lives begin to diverge from their heterosexual brothers and sisters early on. One study found that, when asked about their greatest concerns, heterosexual high school students stated that grades were their primary worry. They listed college, careers, and financial pressures next on their lists. LGBT students, by contrast, reported more immediate, tangible issues such as non-accepting families, school bullying and fear of being out as their top 3 worries (5). They were more afraid about the present, limiting their ability to plan as well for their futures.
Since we know that stigma and discrimination often lead to negative health outcomes, it is not surprising that we see higher levels of smoking, alcohol consumption, substance abuse and riskier sexual behavior in LGBT youth, all of which increase their later cancer risks. One study found that of “the 12 cancer-risk behaviors including tobacco use, drinking alcohol, early sex, multiple sexual partners, higher body mass index (BMI) and lack of exercise, LGBT youth were more likely than heterosexuals to engage in the risky behavior.” (1)
So, while there is limited data on cancer among LGBT youth, it is clear that lifetime stressors related to LGBT status, beginning early in adolescence, coupled with unhealthy coping mechanisms set in motion the increased cancer incidence among LGBT adults. The roots of these cancers are in homophobia as a pediatric disease.
Related: LGBT Medical Care Concerns
1. Rosario, M., Corliss, H. L., Everett, B. G., Reisner, S. L., Austin, S. B., Buchting, F. O., & Birkett, M. (2014). Sexual orientation disparities in cancer-related risk behaviors of tobacco, alcohol, sexual behaviors, and diet and physical activity: pooled Youth Risk Behavior Surveys. American journal of public health, 104(2), 245-254.
2. New York Times: http://www.nytimes.com/1995/03/09/us/fda-head-calls-smoking-a-pediatric-disease.html
3. Garcia, M. (2014). Study: Antigay communities lead to early LGB death. Advocate.com. Retrieved from http://www.advocate.com/health/2014/02/16/study-antigay-communities-lead-early-lgb-death
4. Durso, L. E., & Meyer, I. H. (2013). Patterns and predictors of disclosure of sexual orientation to healthcare providers among lesbians, gay men, and bisexuals. Sexuality Research and Social Policy, 10(1), 35-42.
5. GROWING UP LGBT IN AMERICA (HRC). (2012) http://www.hrc.org/youth