Same-sex couples living in Australian regions with high levels of stigma are less likely to visit the GP, more likely to use anti-depressants and more likely to have poorer health than heterosexual couples, a new study by Monash University has revealed.

The study exposes the gaps in health care access among lesbian, gay and bisexual couples in same sex relationships. It points to an association between structural stigma against LGBTQI persons and the health of sexual minorities. The research further supports the view that gay men who experience stigma may be less aware of, or adhere to HIV medication.

PhD researcher Karinna Saxby along with Dr Sonja de New and Associate Professor Dennis Petrie from the Centre for Health Economics in the Monash Business School conducted the study, which was published on May 17, 2020 to coincide with the International Day against Homophobia, Biphobia, Interphobia and Transphobia.

The study looked at 83, 519 adults who were in same-sex relationships (41,265 in same-sex female relationships and 42,254  in male same-sex relationships) across Australia. Of these couples, 6550 (8%) women and 5411 (6%) men lived in regions with high structural stigma.

The study classified regions with stigma based on how they had voted in the 2017 national vote for recognising same-sex marriages.  The regions that had voted against legalising same-sex marriages were considered as ones with high stigma (56% No Vote had highest stigma) and conversely those that had supported same sex marriages were regions with low stigma.

The three major findings in the study was that as structural stigma increases, compared to heterosexual couples, Australian same-sex couples:

were less likely to visit the doctor and use fewer GP and pathology services if they do;
use more scripts for mental health disorders (such as anti-depressants and anti-anxiety medication); and
were more likely to report having a disability or to have received disability support payment.

“The lesbian, gay and bisexual (LGB) community have worse health outcomes than their heterosexual counterparts. Sociocultural factors that disadvantage minority groups can contribute to these health inequalities by inducing pathophysiological stress responses, risky health behaviours and apprehension to seek appropriate healthcare,” said Saxby in a press release.

“Our results suggest that individuals in same-sex relationships in stigmatised regions are in poorer health and have an increased use of medications for mental health disorders, such as anti-depressants, but are less likely to seek proper help,”said Saxby.

  The research revealed that the effects of stigma were higher for same-sex couples with lower income, less education and those living in areas with limited access to GPs and other health care services.

The figures for women in same-sex relationships were worse. In low stigma areas, women in same-sex relationships were less likely to visit a GP and used more scripts for mental health disorders than their heterosexual counterparts. In regions with high stigma, women in same-sex relationships acessed even fewer primary health care services and filled more scripts for mental health disorders.

“Our findings suggest that there may be a need to embed more LGBTQI inclusive practices in the primary care setting, particularly in regions with higher levels of structural stigma. This is especially important in areas with low income and poor access to healthcare. More broadly, ongoing efforts to reduce stigmatisation of sexual minorities, such as bolstering protections through anti-discrimination laws, are likely to play important roles in bridging the persisting sexual minority health gap,” the study recommended.

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