The increase in prevalence and visibility of sexually gender diverse (SGD) populations illuminates the need for greater understanding of the ways in which current laws, systems, and programs affect their well-being. Individuals who identify as lesbian, gay, bisexual, asexual, transgender, non-binary, queer, or intersex, as well as those who express same-sex or -gender attractions or behaviors, will have experiences across their life course that differ from those of cisgender and heterosexual individuals. Characteristics such as age, race and ethnicity, and geographic location intersect to play a distinct role in the challenges and opportunities SGD people face. Understanding the Well-Being of LGBTQI+ Populations reviews the available evidence and identifies future research needs related to the well-being of SDG populations across the life course. This report focuses on eight domains of well-being; the effects of various laws and the legal system on SGD populations; the effects of various public policies and structural stigma; community and civic engagement; families and social relationships; education, including school climate and level of attainment; economic experiences (e.g., employment, compensation, and housing); physical and mental health; and health care access and gender-affirming interventions. The recommendations of Understanding the Well-Being of LGBTQI+ Populations aim to identify opportunities to advance understanding of how individuals experience sexuality and gender and how sexual orientation, gender identity, and intersex status affect SGD people over the life course.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMMITTEE ON UNDERSTANDING THE STATUS AND WELL-BEING OF SEXUAL AND GENDER DIVERSE POPULATIONS
• COMMITTEE ON POPULATION
• Acknowledgments
• Summary
  • A GROWING NEED FOR ENHANCED DATA COLLECTION
  • CHANGES TO THE LEGAL LANDSCAPE
  • EFFECTS OF PUBLIC POLICY AND STIGMA
  • COMMUNITY AND CIVIC ENGAGEMENT
  • FAMILIES AND SOCIAL RELATIONSHIPS
  • EDUCATIONAL ENVIRONMENTS
  • ECONOMIC STABILITY
  • PHYSICAL AND MENTAL HEALTH
  • COVERAGE, ACCESS, AND UTILIZATION OF HEALTH CARE
  • RESEARCH RECOMMENDATIONS
  • POPULATION DATA
  • MEASUREMENT CHALLENGES
  • CRITICAL DATA GAPS
  • DATA USE
  • EVIDENCE-BASED PROGRAMMING AND INTERVENTIONS
  • CONCLUSION
• I. BACKGROUND AND CONTEXT
• Prologue
  • REFERENCES
• 1. Introduction
  • BACKGROUND
  • CHARGE TO THE COMMITTEE
  • KEY TERMS AND DEFINITIONS
  • ADDRESSING THE CHARGE
  • COMMITTEE’S APPROACH TO THE STUDY
  • METHODS AND APPROACH TO THE EVALUATION OF EVIDENCE
  • REFERENCES
• 2. Health and Well-Being in Diverse Populations: Frameworks and Concepts
  • SOCIAL ECOLOGY
  • SOCIAL CONSTRUCTIONISM
  • STIGMA
  • INTERSECTIONALITY
  • IDENTITY AFFIRMATION
  • LIFE COURSE
  • SUMMARY
  • REFERENCES
• II. UNDERSTANDING SEXUAL AND GENDER DIVERSE POPULATIONS
• 3. Demography and Public Attitudes of Sexual and Gender Diverse Populations
  • PREVALENCE
  • THE ROLE OF PUBLIC ATTITUDES
  • GEOGRAPHIC VARIATION
  • GENDER AND SEXUAL ORIENTATION
  • AGE
  • RACE AND ETHNICITY
  • CHILD REARING
  • SUMMARY AND CONCLUSIONS
  • REFERENCES
• 4. Current State of Data Collection
  • TYPES OF DATA COLLECTION
  • METRICS AND MEASUREMENT
  • SUMMARY AND CONCLUSIONS
  • REFERENCES
• III. DOMAINS OF WELL-BEING
• 5. Law and Legal Systems
  • THE NEW BASELINE
  • CONTINUING GAPS IN LEGAL PROTECTION
  • AREAS OF LAW THAT LACK PROTECTIONS AGAINST DISCRIMINATION
  • RELIGIOUS LIBERTY EXCEPTIONS TO ANTI-DISCRIMINATION LAWS
  • SUMMARY AND CONCLUSIONS
  • REFERENCES
• 6. Public Policy and Structural Stigma
  • PUBLIC POLICY, SOCIAL MOVEMENTS, AND PUBLIC OPINION
  • STRUCTURAL STIGMA
  • SUMMARY AND CONCLUSIONS
  • REFERENCES
• 7. Community and Civic Engagement
  • THE NATURE OF SEXUAL AND GENDER DIVERSE COMMUNITIES
  • THE IMPORTANCE OF SPACE TO SEXUAL AND GENDER DIVERSE COMMUNITIES
  • CIVIC AND POLITICAL INVOLVEMENT
  • SUMMARY AND CONCLUSIONS
  • REFERENCES
• 8. Families and Social Relationships
  • SOCIAL AND FAMILY RELATIONSHIPS IN CHILDHOOD AND ADOLESCENCE
  • PARENTING AND OTHER FAMILY RELATIONSHIPS
  • CLOSE RELATIONSHIPS IN ADULTHOOD
  • SUMMARY AND CONCLUSIONS
  • REFERENCES
• 9. Educational Environments
  • DISCRIMINATORY EXPERIENCES AT SCHOOL
  • EDUCATIONAL ATTAINMENT
  • EDUCATION LAWS AND SCHOOL POLICIES
  • SCHOOL CLIMATE
  • SEXUAL AND GENDER DIVERSE PARENTS AND THEIR CHILDREN
  • SUMMARY AND CONCLUSIONS
  • REFERENCES
• 10. Economic Well-Being
  • SOCIOECONOMIC STATUS
  • WORKFORCE ISSUES
  • HOUSING
  • SUMMARY AND CONCLUSIONS
  • REFERENCES
• 11. Physical and Mental Health
  • PHYSICAL HEALTH
  • SEXUAL AND REPRODUCTIVE HEALTH
  • VIOLENCE AND VICTIMIZATION
  • MENTAL AND BEHAVIORAL HEALTH
  • SUMMARY AND CONCLUSIONS
  • REFERENCES
• 12. Coverage, Access, and Utilization of Evidence-Based Health Care
  • COVERAGE, ACCESS, AND UTILIZATION
  • GENDER-AFFIRMING CARE FOR TRANSGENDER PEOPLE
  • CONVERSION THERAPY
  • INTERSEX GENITAL SURGERY
  • SUMMARY AND CONCLUSIONS
  • REFERENCES
• IV. Research Needs
• 13. Recommendations
  • POPULATION DATA
  • MEASUREMENT CHALLENGES
  • CRITICAL DATA GAPS
  • DATA USE
  • EVIDENCE-BASED PROGRAMMING AND INTERVENTIONS
  • CONCLUSION
  • REFERENCES
• Appendix A. Summary of Prior Related National Academies Reports and Activities
• Appendix B. Agenda: Public Seminar on Amplifying Visibility and Increasing Capacity for Sexual and Gender Diverse Populations
• Appendix C. Biographical Sketches of Committee Members and Staff

Suggested citation:

Suggested citation: National Academies of Sciences, Engineering, and Medicine. (2020). Understanding the Well-Being of LGBTQI+ Populations. Washington, DC: The National Academies Press. https://doi.org/10.17226/25877.

Digital Object Identifier: https://doi.org/10.17226/25877

Library of Congress Control Number: 2020949996

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