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Overview

Data from the 2000 Census gives us some insight into NJ’s LGBT population. Census questionnaires ask for “unmarried partner,” and then match partners as same-sex or not. 16,604 (9.4% of NJ total) of coupled households were same sex, and over 5,000 households included an average of 2 children.¹ New Jersey ranked 10th in the nation with the number of same sex couples. These figures are likely to be underreported due to confidentiality concerns and the perceived non-applicability of census descriptive terms. 35% of lesbian couples were raising children, compared to 26% of gay male couples. The municipalities with the largest number of gay couples were Jersey City, Newark and Paterson.²

Unfortunately, the 2000 census does not measure how many LGBT individuals there are in the country. National survey data on the number of LGBT people in the country is scarce. A 1994 report that compiled two surveys estimated that 2.8% of men and 1.4% of women self-reported as gay or lesbian, while 7.7% of men and 7.5% of women reported homosexual desire.³

New Jersey had a population estimate of 8.7 million people in 2005, 75.2% of which is 18 years old or older, and 51.3% is female.⁴ Thus, a reasonable estimate of the number of gay male adults in New Jersey is 89,000 and lesbian adults in New Jersey is 47,000.

Surveillance data for HIV and AIDS in homosexual and bisexual men have been reported for many years. As of December 31,2005,over 15,000 cases of AIDS were reported in men who have sex with men, and over 7,000 men who have sex with men (MSM) are living in New Jersey with HIV or AIDS.⁵

There are four factors that influence health and well-being: genetics, environment, health services, and habits or lifestyle. Perceptions about sexual orientation and gender identity are clearly affected by attitudes regarding these factors. People (including health professionals) who believe that sexual orientation and gender identity are due primarily to genetic influences are more likely to be accepting of differences, than those who believe that differences are due to environment or the result of choice. Discrimination within the health care system, whether overt or subtle, also exists. Lifestyle practices such as drug and alcohol consumption have long been important health determinants in LGBT communities.

Key Health Concerns for LGBT Communities

The Gay & Lesbian Medical Association, along with Columbia University’s Center for LGBT Health, identified the following key health concerns for LGBT communities: cancer, HIV/AIDS, mental health, suicide among youths, substance abuse, and access to quality care.⁶ In recent years, outbreaks of syphilis among gay men have added sexually transmitted diseases (STDs) to the list as well.

Cancer

LGBT people may be disproportionately affected by some types of cancers, including breast cancer, cancers related to acquired immunodeficiency syndrome (AIDS), lung cancer, and cancers caused by human papillomavirus (HPV).

Lesbians may be at increased risk for ovarian cancer. In addition to traditional risk factors such as family history of ovarian, breast or colon cancer, not bearing children, not using oral contraceptives and lack of gynecologic care may contribute to such an increased risk. Lesbians may also be at higher risk for breast cancer than heterosexual women due to higher rates of obesity, alcohol consumption, lack of bearing children, and lower rates of breast cancer screening.

A study of the New York and California cancer registries and the National Death Index found gay and bisexual men to be at excess risk for anal cancer, non-Hodgkin’s lymphoma, and Hodgkin’s disease. Although the authors determined that the increase in risk for both non-Hodgkin’s lymphoma and Hodgkin’s disease was related to increased incidence of HIV/AIDS among gay men, they found the increased risk for anal cancer to be unrelated to HIV/AIDS.⁷

The increased risk of anal cancer in gay men is clearly due to infection with HPV and HIV, although HIV-negative men have increased rates of anal cancer as well. A history of receptive anal intercourse and a high lifetime history of sexual partners, along with a history of smoking (which is increased already among gay men) are also risk factors.⁸ The important issue here is that early detection and prevention is possible. Precancerous dysplastic lesions can be detected with cytopathologic tests (“anal PAP smears”).

It is also likely that lesbians and gay men are at higher risk for lung cancer, as smoking rates and alcohol consumption, two important risk factors, are higher in LGBT populations than in the general community. There are no data on incidence of cancer in transgender persons. Long-term exposure to hormones could increase risk of certain cancers. For example, breast cancer has been reported in male-to-female transsexuals, and ovarian cancer in female-to male transsexuals.

Although data is needed on the national incidence of cancers in the LGBT population in the United States, no national cancer registries collect data on sexual orientation or gender identity.

Obesity

There is general concern about the rate of obesity in the United States. While there is no definitive data on LGBT populations, there is concern that some segments of the LGBT community experience high rates of obesity. In such people, long-term adverse health consequences are likely. Persons who are overweight or obese are at increased risk for high blood pressure, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, and some types of cancer.

There are studies that suggest that lesbians are more likely to be obese than heterosexual women or their heterosexual sisters. In addition, lesbians tend to be less preoccupied with weight and body image than heterosexual women.⁹ One population of gay and bisexual men, known as “bears,” may be at significant risk for adverse health outcomes associated with poor nutrition and being overweight. “Bears” typically celebrate large bodies as more masculine and generally identify a sexual attraction to other large men.¹⁰

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