Health Disparities Among Women by Sexual Orientation Identity and Same-Sex or Different-Sex Cohabiting Partnership Status

  • Maya N.L. Taylor
    Department of Medicine, Health & Society, Vanderbilt University, Nashville, Tennessee
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  • Gilbert Gonzales
    Correspondence to: Gilbert Gonzales, PhD, MHA, Department of Medicine, Health & Society, 2301 Vanderbilt Place PMB #351665, Nashville, TN 37235–1665. Phone: 1–615–343–6958; fax: 1-615-343-8889.
    Department of Medicine, Health & Society, Program for Public Policy Studies, Vanderbilt University, Nashville, Tennessee

    Department of Health Policy, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee
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Published:August 07, 2021DOI:



      The objective of this study was to compare health outcomes by sexual orientation identity and cohabiting partnership status (defined as whether heterosexual, lesbian, and bisexual women were non-partnered, partnered in a cohabiting same-sex relationship, or partnered in a cohabiting different-sex relationship).


      We used data on heterosexual (n = 95,289) and sexual minority (n = 2,600) women aged 18 years and older from the 2013–2018 National Health Interview Survey. We estimated adjusted odds ratios (AORs) with 95% confidence intervals (CIs) from multivariable logistic regression models comparing health outcomes by sexual orientation identity and cohabiting partnership status while controlling for sociodemographic characteristics.


      Compared with heterosexual women in a different-sex relationship, nonpartnered women generally reported worse health outcomes regardless of sexual orientation. Lesbian women with a same-sex partner were more likely to report poor/fair health (AOR, 1.61; 95% CI, 1.09–2.37), current cigarette smoking (AOR, 1.48; 95% CI, 1.14–1.94), and binge drinking (AOR, 1.63; 95% CI, 1.19–2.23) compared with heterosexual women with a different-sex partner. Bisexual women with a different-sex partner were more likely to report poor/fair health (AOR, 1.91; 95% CI, 1.23–2.97), severe psychological distress (AOR, 2.86; 95% CI, 1.78–4.59), current cigarette smoking (AOR, 1.38; 95% CI, 1.01–1.88), and binge drinking (AOR, 1.66; 95% CI, 1.18–2.32) compared with heterosexual women with a different-sex partner.


      More research is needed to identify the processes in which heterosexual and sexual minority women partner and cohabitate with members of the same or different sex—and whether or how this influences their health. Meanwhile, health care providers should be mindful that families are diverse, and acknowledging this diversity could be a first step toward achieving health equity for all women regardless of sexual orientation.
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      Maya N. L. Taylor is a recent graduate of the Department of Medicine, Health & Society at Vanderbilt University. Her research and policy interests are in gender, sexuality, and health.


      Gilbert Gonzales, PhD, MHA, is an Assistant Professor in the Department of Medicine, Health & Society at Vanderbilt University. His research examines impacts of public policy on health, access to care, and health services utilization for lesbian, gay, bisexual, and transgender (LGBT) populations.