Embodiment of minority stress: Differences in allostatic load by sexual orientation identity

Introduction: The Minority Stress Theory posits that sexual minorities experience more stress due to stigma, discrimination, and prejudice. Frequent exposure to social stressors can manifest in prolonged physiological dysregulation, leading to increased risk for disease and premature mortality. We examine differences in allostatic load (AL), a measure of the cumulative physiological wear and tear on the body's regulatory systems, by sexual orientation.

Methods: Pooled 2005-2010 nationally-representative National Health and Nutrition Examination Survey data for adults aged 20-59 self-identified as either heterosexual, lesbian, gay or bisexual (LGB) with AL measures (n=8,069) were analyzed using adjustments for complex survey design and sample weighting. The AL index comprised of 9 biomarkers and anthropometric measures based on the scientific literature, with a high AL (>3) classified as the highest quartile in the population distribution.

Results: LGB adults represented 3.9% (95% CI: 3.27%-4.57%) of the total US population. Heterosexuals had a similar mean AL score (AL mean=2.19; 2.12-2.25) to LGB adults (2.16 [1.85-2.47]). However, after adjusting for sociodemographic characteristics in a logistic regression analysis, LGB adults had 1.35 times higher likelihood (0.85-1.96) of having a high AL compared to heterosexuals.

Conclusion: US LGB adults may have a greater likelihood of having a high AL, although this difference was not statistically significant, in part due to small sample size This presentation will pool additional years of data to increase sample size. Future research should examine specific social stressors in this population and their relationship with elevated AL.