Sexual orientation differences in functional limitations, disability, and mental health services use: results from the 2013-2014 National Health Interview Survey
Open accessAbstract
OBJECTIVES: The authors investigated sexual orientation differences in risk for mental health morbidity, functional limitations/disability, and mental health services use among adults interviewed in the nationally representative 2013-2014 National Health Interview Survey. METHOD: Respondents were 68,816 adults (67,152 heterosexual and 1,664 lesbian, gay, and bisexual [LGB] individuals), age 18 and older. Fully structured interviews assessed sexual orientation identity, health status, and services use. Using sex-stratified analyses while adjusting for demographic confounding, the authors compared LGB and heterosexual individuals for evidence of mental health-related impairments and use of mental health services. RESULTS: LGB adults, as compared to heterosexual adults, demonstrated higher prevalence of mental health morbidity and functional limitations. However, this varied by gender with LGB women evidencing elevated risk for both mental health and substance abuse (MHSA) and non-MHSA limitations. Among men, sexual orientation differences clustered among MHSA-related limitations. Overall, LGB adults were more likely than heterosexual adults to use services, with the source of functional limitations moderating these effects among men. CONCLUSION: MHSA-related morbidity is a significant concern among LGB individuals and is associated with higher levels of functional limitations/disability. The findings highlight that LGB persons use MHSA-related treatment at higher rates than heterosexuals do, and, among men, are more likely to do so absent MHSA or non-MHSA-related functional limitations. This presents a unique set of concerns within the integrated care setting, including the need to deliver culturally competent care sensitive to the context of probable sex differences among LGB individuals. (PsycINFO Database Record
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
LGBTQ+ persons are more likely to seek mental health services compared to the general population.
“Although LGBTQ+ persons are more likely to seek mental health services compared to the general population [10,11], this group consistently demonstrates unmet mental health treatment needs [12].”
From A randomized trial of acceptance-based behavioral therapy to improve mental health outcomes for LGBTQ+ persons: Study protocol (2023) · cites this paper as [10]
The Conclusion reports higher rates of mental health and substance-use treatment among LGB people than heterosexual people, and the Discussion reports a greater propensity to use mental health services. The study addresses sexual orientation, not the full LGBTQ+ population; it does not establish the claim for transgender people as a group. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Meyer, I. H. (2003) · Psychological Bulletin · doi:10.1037/0033-2909.129.5.674 · Cited by 14,736 · see citing works
Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., AlMazroa, M. A., Amann, M., Anderson, H. R., Andrews, K. G., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61766-8 · Cited by 11,805 · see citing works
KESSLER, R. C., ANDREWS, G., COLPE, L. J., HIRIPI, E., MROCZEK, D. K., NORMAND, S.-L. T., WALTERS, E. E., & ZASLAVSKY, A. M. (2002) · Psychological Medicine · doi:10.1017/s0033291702006074 · Cited by 10,327 · see citing works
Verbrugge, L. M., & Jette, A. M. (1994) · Social Science & Medicine · doi:10.1016/0277-9536(94)90294-1 · Cited by 3,310 · see citing works
How does sexual minority stigma “get under the skin”? A psychological mediation framework
Hatzenbuehler, M. L. (2009) · Psychological Bulletin · doi:10.1037/a0016441 · Cited by 2,695 · see citing works
Dannefer, D. (2003) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/58.6.s327 · Cited by 2,091 · see citing works
DiPrete, T. A., & Eirich, G. M. (2006) · Annual Review of Sociology · doi:10.1146/annurev.soc.32.061604.123127 · Cited by 2,069 · see citing works
Mays, V. M., & Cochran, S. D. (2001) · American Journal of Public Health · doi:10.2105/ajph.91.11.1869 · Cited by 1,452 · see citing works
Self-citationResilience in the study of minority stress and health of sexual and gender minorities.
Meyer, I. H. (2015) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000132 · Cited by 1,152 · see citing works
Cochran, S. D., Sullivan, J. G., & Mays, V. M. (2003) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.71.1.53 · Cited by 1,109 · see citing works
Fredriksen-Goldsen, K. I., Kim, H.-J., Barkan, S. E., Muraco, A., & Hoy-Ellis, C. P. (2013) · American Journal of Public Health · doi:10.2105/ajph.2012.301110 · Cited by 965 · see citing works
Meyer, I. H. (2013) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/2329-0382.1.s.3 · Cited by 900 · see citing works
Bostwick, W. B., Boyd, C. J., Hughes, T. L., & McCabe, S. E. (2010) · American Journal of Public Health · doi:10.2105/ajph.2008.152942 · Cited by 829 · see citing works
Meyer, I. H., Schwartz, S., & Frost, D. M. (2008) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.03.012 · Cited by 693 · see citing works
The impact of minority stress on mental health and substance use among sexual minority women.
Lehavot, K., & Simoni, J. M. (2011) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0022839 · Cited by 652 · see citing works
Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States
BRESLAU, J., KENDLER, K. S., SU, M., GAXIOLA-AGUILAR, S., & KESSLER, R. C. (2005) · Psychological Medicine · doi:10.1017/s0033291704003514 · Cited by 642 · see citing works
Pachankis, J. E., Hatzenbuehler, M. L., Rendina, H. J., Safren, S. A., & Parsons, J. T. (2015) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000037 · Cited by 619 · see citing works
Herek, G. M., & McLemore, K. A. (2012) · Annual Review of Psychology · doi:10.1146/annurev-psych-113011-143826 · Cited by 556 · see citing works
McCabe, S. E., Bostwick, W. B., Hughes, T. L., West, B. T., & Boyd, C. J. (2010) · American Journal of Public Health · doi:10.2105/ajph.2009.163147 · Cited by 522 · see citing works
Cochran, S. D. (2001) · American Psychologist · doi:10.1037/0003-066x.56.11.931 · Cited by 447 · see citing works
Self-citationDiscrimination and mental health among lesbian, gay, and bisexual adults in the United States.
Bostwick, W. B., Boyd, C. J., Hughes, T. L., West, B. T., & McCabe, S. E. (2014) · American Journal of Orthopsychiatry · doi:10.1037/h0098851 · Cited by 444 · see citing works
Feinstein, B. A., Goldfried, M. R., & Davila, J. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0029425 · Cited by 412 · see citing works
Cochran, S. D., & Mays, V. M. (2007) · American Journal of Public Health · doi:10.2105/ajph.2006.087254 · Cited by 330 · see citing works
Self-citationMental Health and Suicidality Among Racially/Ethnically Diverse Sexual Minority Youths
Bostwick, W. B., Meyer, I. H., Aranda, F., Russell, S. T., Hughes, T. L., Birkett, M. A., & Mustanski, B. S. (2014) · American Journal of Public Health · doi:10.2105/ajph.2013.301749 · Cited by 303 · see citing works
Cochran, S. D., Mays, V. M., Alegria, M. M., Ortega, A. N., & Takeuchi, D. T. (2007) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.75.5.785 · Cited by 298 · see citing works
Self-citationCochran, S. D., Drescher, J., Kismödi, E., Giami, A., García‐Moreno, C., Atalla, E., Marais, A., Vieira, E. M., & Reed, G. M. (2014) · Bulletin of the World Health Organization · doi:10.2471/blt.14.135541 · Cited by 295 · see citing works
Self-citationCochran, S. D., & Mays, V. M. (2009) · Journal of Abnormal Psychology · doi:10.1037/a0016501 · Cited by 293 · see citing works
Calabrese, S. K., Meyer, I. H., Overstreet, N. M., Haile, R., & Hansen, N. B. (2014) · Psychology of Women Quarterly · doi:10.1177/0361684314560730 · Cited by 225 · see citing works
Gay and lesbian partnership: Evidence from California
Carpenter, C. S., & Gates, G. J. (2008) · Demography · doi:10.1353/dem.0.0014 · Cited by 198 · see citing works
The mental health of sexual minority adults in and out of the closet: A population-based study.
Pachankis, J. E., Cochran, S. D., & Mays, V. M. (2015) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000047 · Cited by 198 · see citing works
Self-citationPachankis, J. E., Rendina, H. J., Restar, A., Ventuneac, A., Grov, C., & Parsons, J. T. (2015) · Health Psychology · doi:10.1037/hea0000180 · Cited by 185 · see citing works
Austin, A. E., Herrick, H., & Proescholdbell, S. (2015) · American Journal of Public Health · doi:10.2105/ajph.2015.302904 · Cited by 184 · see citing works
McCabe, S. E., West, B. T., Hughes, T. L., & Boyd, C. J. (2012) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2012.01.007 · Cited by 176 · see citing works
Sexual Minority Health and Health Risk Factors
Hsieh, N., & Ruther, M. (2016) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2015.11.016 · Cited by 152 · see citing works
Sexual-Orientation Disparities in Cigarette Smoking in a Longitudinal Cohort Study of Adolescents
Corliss, H. L., Wadler, B. M., Jun, H.-J., Rosario, M., Wypij, D., Frazier, A. L., & Austin, S. B. (2012) · Nicotine & Tobacco Research · doi:10.1093/ntr/nts114 · Cited by 138 · see citing works
Grella, C. E., Greenwell, L., Mays, V. M., & Cochran, S. D. (2009) · BMC Psychiatry · doi:10.1186/1471-244x-9-52 · Cited by 137 · see citing works
Self-citationAnxiety and related disorders and concealment in sexual minority young adults
Cohen, J. M., Blasey, C., Barr Taylor, C., Weiss, B. J., & Newman, M. G. (2016) · Behavior Therapy · doi:10.1016/j.beth.2015.09.006 · Cited by 115 · see citing works
Gevonden, M. J., Selten, J., Myin‐Germeys, I., de Graaf, R., ten Have, M., van Dorsselaer, S., van Os, J., & Veling, W. (2013) · Psychological Medicine · doi:10.1017/s0033291713000718 · Cited by 103 · see citing works
Xu, F., Sternberg, M., & Markowitz, L. (2010) · Sexually Transmitted Diseases · doi:10.1097/olq.0b013e3181ce122b · Cited by 102 · see citing works
Gender Differences in Functional Status in Middle and Older Age: Are There Any Age Variations?
Liang, J., Bennett, J. M., Shaw, B. A., Quiñones, A. R., Ye, W., Xu, X. J., & Ofstedal, M. B. (2008) · The Journals of Gerontology Series B · doi:10.1093/geronb/63.5.s282 · Cited by 102 · see citing works
Sexual Orientation and All-Cause Mortality Among US Adults Aged 18 to 59 Years, 2001–2011
Cochran, S. D., Björkenstam, C., & Mays, V. M. (2016) · American Journal of Public Health · doi:10.2105/ajph.2016.303052 · Cited by 100 · see citing works
Self-citationFrisch, M., & Simonsen, J. (2013) · International Journal of Epidemiology · doi:10.1093/ije/dyt024 · Cited by 87 · see citing works
Daily minority stress and affect among gay and bisexual men: A 30-day diary study
Eldahan, A. I., Pachankis, J. E., Rendina, H. J., Ventuneac, A., Grov, C., & Parsons, J. T. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.10.066 · Cited by 86 · see citing works
Cochran, S., Bandiera, F., & Mays, V. (2013) · American Journal of Public Health · doi:10.2105/ajph.2013.301423 · Cited by 83 · see citing works
Self-citationPhysical Limitation and Emotional Well-Being
Caputo, J., & Simon, R. W. (2013) · Journal of Health and Social Behavior · doi:10.1177/0022146513484766 · Cited by 66 · see citing works
An Age–Period–Cohort Analysis of Political Tolerance in the United States
Schwadel, P., & Garneau, C. R. H. (2014) · Sociological Quarterly · doi:10.1111/tsq.12058 · Cited by 60 · see citing works
Disparities in Health and Disability Among Older Adults in Same-Sex Cohabiting Relationships
Gonzales, G., & Henning‐Smith, C. (2014) · Journal of Aging and Health · doi:10.1177/0898264314551332 · Cited by 60 · see citing works
Mental Health Differences between Young Adults with and without Same-Sex Contact
Ueno, K. (2010) · Journal of Health and Social Behavior · doi:10.1177/0022146510386793 · Cited by 59 · see citing works
Brandt, D. E., Ho, P., Chan, L. E., et al. (2014) · Quality of Life Research · doi:10.1007/s11136-014-0740-6 · Cited by 45 · see citing works
Lyons, H. Z., Bieschke, K. J., Dendy, A. K., Worthington, R. L., & Georgemiller, R. J. (2010) · Professional Psychology Research and Practice · doi:10.1037/a0021121 · Cited by 43 · see citing works
Health Conditions in Younger, Middle, and Older Ages: Are There Differences by Sexual Orientation?
Boehmer, U., Miao, X., Linkletter, C. D., & Clark, M. A. (2014) · LGBT Health · doi:10.1089/lgbt.2013.0033 · Cited by 42 · see citing works
The Effect of Lifetime Cumulative Adversity and Depressive Symptoms on Functional Status
Shrira, A., & Litwin, H. (2014) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbu056 · Cited by 42 · see citing works
Grella, C. E., Cochran, S. D., Greenwell, L., & Mays, V. M. (2011) · Psychiatric Services · doi:10.1176/appi.ps.62.4.404 · Cited by 34 · see citing works
Self-citationLesbian, Gay, And Bisexual Adults Making Gains In Health Insurance And Access To Care
Skopec, L., & Long, S. K. (2015) · Health Affairs · doi:10.1377/hlthaff.2015.0826 · Cited by 32 · see citing works
Hope, D. A., & Chappell, C. L. (2015) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12099 · Cited by 30 · see citing works
Grella, C. E., Cochran, S. D., Greenwell, L., et al. (2011) · Psychiatric Services · doi:10.1176/ps.62.4.pss6204_0404 · Cited by 28 · see citing works
Self-citationMcGeorge, C. R., & Carlson, T. S. (2014) · Journal of Marital and Family Therapy · doi:10.1111/jmft.12106 · Cited by 22 · see citing works
Mental and Physical Health Needs of Lesbian, Gay, and Bisexual Clients in Substance Abuse Treatment
Flentje, A., Livingston, N. A., Roley, J., & Sorensen, J. L. (2015) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2015.06.022 · Cited by 20 · see citing works
García, J., Muñoz‐Laboy, M., Parker, R. G., & Wilson, P. A. (2013) · Archives of Sexual Behavior · doi:10.1007/s10508-013-0072-6 · Cited by 16 · see citing works
Siordia, C. (2014) · Sexuality and Disability · doi:10.1007/s11195-014-9364-6 · Cited by 12 · see citing works
Is Work Disability More Common among Same-sex than Different-sex Married People?
Björkenstam, C., & Tinghög, P. (2016) · Epidemiology Open Access · doi:10.4172/2161-1165.1000242 · Cited by 2 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 2
- Cochran SD Mays VM 2013 A systematic review of sexual orientation and the prevalence of mental health disorders: Implications for research and mental health services Patterson C D’Augelli A Handbook of Psychology and Sexual Orientation 204 222 New York Oxford University Press
- Stata Corporation 2013 Stata 13 User's Guide College Station, TX Stata Press
Cited by
Sorted by citations
Pachankis, J. E., McConocha, E. M., Clark, K. A., Wang, K., Behari, K., Fetzner, B. K., Brisbin, C. D., Scheer, J. R., & Lehavot, K. (2020) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000508 · Cited by 227 · see citing works
Pachankis, J. E., Harkness, A., Maciejewski, K. R., Behari, K., Clark, K. A., McConocha, E., Winston, R., Adeyinka, O., Reynolds, J., Bränström, R., et al. (2022) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000724 · Cited by 112 · see citing works
Moitra, E., Brick, L. A., Cancilliere, M. K., Elwy, A. R., Erbe, A. M., Fenn, N., Nunn, A. S., Salhaney, P., & Chan, P. A. (2023) · Contemporary Clinical Trials · doi:10.1016/j.cct.2023.107211 · Cited by 2 · see citing works
- Authors
- Cochran, S. D., Björkenstam, C., & Mays, V. M.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Cochran, Susan D.
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2017-12
- Volume
- 85
- Issue
- 12
- Pages
- 1111-1121
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC5709145
- OpenAlex
- W2751472904
- Cited by
- 70
- References
- 61
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 13 · 2023: 10 · 2022: 11 · 2021: 13 · 2020: 4 · 2019: 7 · 2018: 3 · 2017: 1
- FWCI
- 5.87
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Center for Minority Health and Health Disparities (MD0006923)
- Wenner-Gren Foundation
- Swedish Research Council (340-2013-5164)
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- sexual orientation, lesbian, gay, and bisexual adults, mental health service utilization, functional limitations, disability, substance abuse, sex differences, gender differences, culturally competent care, integrated care, sexual minority health
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Mental Disorders, Female, Health Status, Health Surveys, Humans, Male, Mental Health, Mental Health Services, Middle Aged, Sexuality, Substance-Related Disorders, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
