Stigma, Discrimination & the Specter of Violence Is Taking A Toll On Our Hearts

Ever-increasing research illuminates a bleak reality. LGBTQ+ adults, it turns out, fare much worse in terms of heart health compared to their heterosexual peers. In 2018, the American Heart Association grimly reported that lesbian, gay, and bisexual adults were 36% less likely to have ideal cardiovascular health. This figure was based on a risk-factor survey that included elements such as smoking and blood glucose levels.

By 2021, the association had released a statement highlighting the high prevalence of heart disease among transgender and gender diverse individuals. They connected these alarming rates to the stress spawned by discrimination and transphobia.

This data merely echoes what clinicians and LGBTQ+ health researchers have noted for decades. The community is battling unique, pervasive hurdles, and it's costing them both mental and physical wellbeing.

Take Raymond, for instance, a middle-aged gay man living in Chicago. "I always knew that being gay would come with its own set of challenges," he said. "But nobody warned me that those challenges could potentially lead to a heart attack."

It's Not Just Heart Disease That's Killing Gay Men

Before we get to the meat of this article we do want to point out one thing.  Gay men? We're in the deep end of an unhealthy pool, facing stats that should have us all on high alert. We are 300% more likely to experience depression and 113% more likely to suffer from anxiety disorders.

The shadow of mental health struggles extends to physical health.  For example, gay men have a 16% higher likelihood of adverse cardiovascular conditions and a 24% increase in high blood pressure. Every beat of a stressed heart is a reminder of the link between our mental battles and their physical toll.

The impact on lifestyle choices is equally alarming. The mental pressure cooker of living with untreated depression or anxiety can lead to a 38% higher likelihood of smoking, a desperate attempt to find solace in harmful habits.

Moreover, the stark 300%+ higher likelihood of contracting STIs is a sobering testament to how mental health struggles can lead to risky behaviors, as individuals search for connection or escapism from their internal turmoil.

The impact extends to addiction, with rates of alcoholism and substance abuse 178% and 122% higher, respectively. Moreover, gay men face a staggering 200% higher risk of homelessness and a heartbreaking 316% increase in the likelihood of suicide.

You know what can help?  Queer Theory.  It can help you get rid of homonegativity and improve your health.



Okay, let's get back to the main point of this article.

Heart Disease: The Silent Stalker

Cardiovascular disease is, tragically, the number one cause of death in the United States. As per the Centers for Disease Control and Prevention, about 80% of premature heart disease and strokes could be prevented. However, this burden isn't shared equally across the population.

In a chat with the New York Times, health experts detailed why these inequities persist and shed light on the steps that LGBTQ+ adults can take to safeguard their heart health.

When the Heart is Under Stress

Unique stressors plague LGBTQ+ adults. Stigma, discrimination, the ever-present specter of violence—all these can lead to disease both directly and indirectly.

Billy Caceres, an assistant professor at the School of Nursing and the Center for Sexual and Gender Minority Health Research at Columbia University, put it succinctly. "Stress can tinker with hormones that regulate your blood pressure and heart rate," he told the New York Times.

Dr. Carl Streed, an assistant professor at Boston University School of Medicine, pointed out another silent killer—hypervigilance. This persistent feeling of being on the edge, of perpetually scanning for potential threats, can lead to a surge in cortisol levels and subsequent long-term cardiovascular problems.

Further, chronic inflammation—a potential fallout of persistent stress—can increase your blood pressure and heart rate, warns Dr. Erin Michos, associate director of preventive cardiology at Johns Hopkins University School of Medicine.

Scott Bertani, the director of advocacy at HealthHIV, speaks of 'allostatic load,' the total toll chronic stress exacts on both brain and body. "Our bodies are responding to complex and challenging life events and demands. It's not surprising that this takes a toll," he informed the New York Times.

The severity of this toll is captured in the lived experience of Edward, a trans man from New York City. "Coming out was one of the most stressful periods of my life," he confessed. "It was like standing on a ledge, my heart constantly racing. And it wasn't just a one-time thing. Every new person, every new environment brings back that stress."

Self-Medicating and Its Consequences

To manage the incessant threat of discrimination or harassment, a significant portion of the LGBTQ+ community turns to self-medication with substances like tobacco and alcohol. Dr. Streed, also a researcher at the Center for Transgender Medicine and Surgery at Boston Medical Center, indicated that these industries have targeted the LGBTQ+ community via advertising, particularly during Pride month.

The statistics reflect this grim reality. The Centers for Disease Control and Prevention reported that around 25% of lesbian, gay or bisexual adults used a commercial tobacco product in 2020. This figure starkly contrasts with the 18.8% among heterosexual adults. A disparity attributed, in part, to the tobacco industry's history of aggressive marketing campaigns.

Dennis, a 45-year-old gay man from Atlanta, acknowledges this truth. "When stress gets too much, it's easy to reach for a smoke or a drink," he confessed. "And during Pride month, it feels like those ads are everywhere."

A Link Between Sleep and Heart Health

The mounting evidence reveals that LGBTQ+ adults experience more sleep disruptions than the general population, possibly due to chronic stress. Dr. Caceres conveyed to the New York Times, "There's a link between sleep and heart health. Many in our community don't have the luxury of undisturbed sleep."

Fear: A Barrier to Care

A 2017 survey conducted by researchers at Harvard T.H. Chan School of Public Health and the Robert Wood Johnson Foundation found that more than one in six LGBTQ+ adults avoided seeking health care due to discrimination fears.

This hesitation hinders LGBTQ+ adults from accessing potentially lifesaving preventive health care, warns Dr. Michos. "An annual physical, which typically screens for cardiovascular risk factors, is essential for all adults," she emphasized.

Lucas, a bisexual man from Seattle, mirrors these concerns. "I once had a doctor who made me feel like my sexuality was a disease," he told us. "Now, every time I need to visit a clinic, I can't help but feel anxious."

More Than Just 'Happy Pride'

While discussing heart health, it's essential to consider the effects of gender-affirming hormones. Although they positively impact mental health, there is some evidence that high doses of testosterone and estrogen can carry cardiovascular risks. Dr. Michos stresses, "Individuals on these hormones should consult their doctors about maintaining heart health."

She also emphasized the American Heart Association's seven steps for optimal heart health: managing blood pressure, keeping cholesterol levels low, reducing blood sugar, daily exercise, nutritious diet, healthy body weight, and avoiding smoking. But it's not as simple as preaching a healthy lifestyle, especially when individuals are under significant psychological distress and discrimination.

"Social support can help buffer the physical and psychological strain of stress," said Dr. Michos. And for those in the LGBTQ+ community, finding such support can dramatically improve health outcomes.

Organizations like SAGE, which helps older adults, The Trevor Project, offering crisis intervention and suicide prevention for young people, and the Bisexual Resource Center, focusing on bisexual issues, can help people connect and find the support they need.

"LGBTQ+ health isn't just about HIV prevention," stressed Dr. Caceres. "A lot of the time, it ends up being focused on that. But sexual health is just one dimension of the health we, as queer people, should be considering."

Echoing these sentiments, 30-year-old trans woman Jessica, from San Francisco, shared, "In the beginning, all I cared about was getting my hormones. But I've realized that there's so much more to my health. I just wish more people understood that."

You Are More Than a Statistic

Framed in the harsh glare of statistical reality, it's easy to forget that each percentage point, each data set, represents real people, with real struggles, and real courage. The growing recognition of LGBTQ+ heart health is not merely an academic conversation—it's a matter of life and death.

Heart health for gay folks is entangled with the realities of discrimination, stress, and fear. And while rainbow flags wave cheerfully in the summer breeze, we must not forget the pressing health issues that still plague our resilient community.

Dr. Streed's words from his conversation with the New York Times should serve as a wake-up call to us all. "As we champion diversity and equality," he said, "it's essential that we don't forget the very real and very harmful health disparities that persist within the LGBTQ+ community."

For Andrew, a 56-year-old gay man living with heart disease in Austin, Texas, it's not just a wake-up call—it's his everyday life. "Every day, I fight to keep my heart healthy, to manage my stress, to find safe spaces," he told us. "We, as an LGBTQ+ community, need more than parades—we need awareness, understanding, and action when it comes to our health."

Every member of the community, every Andrew, Jessica, Lucas, Dennis, and Edward, deserves not only to be seen and celebrated but also to live a healthy, vibrant life, free from the shadow of hidden health disparities.

As Dr. Michos so eloquently said to the New York Times, "Living a healthy lifestyle is critical for preventing heart disease, but we can't preach health without acknowledging the significant psychological distress and discrimination faced by individuals in the LGBTQ+ community."