Sexual orientation, gender expression and socioeconomic status in the National Longitudinal Study of Adolescent to Adult Health

J Epidemiol Community Health. 2023 Nov 28;78(2):121-128. doi: 10.1136/jech-2022-220164. Online ahead of print.

Abstract

Background: Socioeconomic status (SES) is a fundamental contributor to health, yet it is rarely examined relative to gender expression, particularly gender non-conformity and sexual orientation.

Methods: We use data from 11 242 Wave V respondents (aged 33-44) in the National Longitudinal Study of Adolescent to Adult Health (2016-2018) to examine associations between socially assigned gender expression, sexual orientation and SES, in logistic and multinomial regression models stratified by sex assigned at birth.

Results: Among both women and men a general pattern of heightened risk for lower SES among gender non-conforming sexual minorities relative to gender conforming heterosexuals was observed. Gender non-conforming heterosexuals were also at elevated risk of lower SES compared with their conforming heterosexual peers.

Conclusion: Socioeconomic differences by sexual orientation and gender expression have important implications for understanding health disparities among gender non-conforming sexual minorities and their gender conforming heterosexual counterparts.

Keywords: COHORT STUDIES; ECONOMICS; EDUCATION; GENDER IDENTITY; HEALTH.