Progress has been made in the legal recognition of same-sex partnerships and in non-discrimination policies vis-à-vis the LGBTQIA+ community in many European countries. Despite this, write Francesco Berlingieri and Matija Kovacic, sexual minorities still experience poorer health outcomes, are more likely to feel lonely and report having lower-quality social relationships than heterosexual people. 

Greece has recently become the first Christian Orthodox nation to legalise same-sex marriage after the country’s parliament voted with a large majority on a bill drafted by the centre-right government. The Netherlands passed similar legislation in 2001 and 20 other European countries have since followed suit. Attitudes towards sexual minorities have also substantially improved over this period in Europe. Figure 1 shows, for instance, that individuals in the European Union (across various age groups) tend to be more comfortable with having a non-heterosexual head of government nowadays compared to 15 years ago.

However, there are still some EU countries with a very low degree of LGBTQIA+ legal equality. In several EU member states, only a minority of people think that there is nothing wrong with a sexual relationship between two persons of the same sex. More generally, despite advances in legal inclusion, a large share of LGBTQIA+ individuals in Europe report experiencing discrimination in various aspects of life, including at work and in accessing housing, healthcare and social services.

Figure 1: Attitudes toward non-heterosexual head of government in the EU, 2009-2023

Sizable disparities in health, wellbeing and social support networks

All of this makes it important to document the various disparities between sexual minorities and other people. While there is evidence of large disparities in earnings and other labour market outcomes, less is known about systematic differences in health outcomes and wellbeing, especially outside the US and the UK.

This is because, for most EU countries, there has been no large survey asking questions on sexual orientation and gender identity with extensive information on health and social connectedness – until now. The EU Loneliness Survey (EU-LS), a new large online survey covering all 27 EU countries, allows us to document the differences between non-heterosexual (i.e., lesbian, gay, bisexual people and those having another sexual orientation, henceforth LGB+) and heterosexual people in terms of physical and mental health conditions, risk behaviours, loneliness feelings, and extensive social media use.

Figure 2 shows that LGB+ individuals in Europe have a 7 percentage point higher probability of experiencing poor general health conditions compared to their heterosexual peers. Moreover, they are 5 percentage points more likely to experience depression and 3 percentage points more likely to be generally unhappy in their lives. LGB+ people have a 3 percentage point higher likelihood of undertaking risky behaviour in relation to the health domain. They also tend to have social relationships of lower quality compared to the rest of the population: the probability of feeling lonely most of the time is 4 percentage points higher among LGB+ individuals, while they are 8 percentage points less likely to have social support from family members and friends. These are considerable differences, given the incidence of the considered outcomes in the overall population (see the note below the figure).

Some of these findings significantly differ across gay, lesbian, and bisexual individuals. For instance, our research suggests that disparities in overall health and risk-taking behaviours in the health domain are mainly driven by lesbian women, while the lack of social support and severe loneliness mainly affect gay men. Disparities in the incidence of depression and unhappiness, on the other hand, are mainly driven by bisexual people.

Figure 2: Disparities in health, wellbeing and social support between sexual minorities and heterosexual people in the EU

In addition to the outcomes reported above, LGB+ individuals are also spending more time on social networking sites and instant messaging tools. This, in their opinion, brings them to neglect work, school, or family-related duties more frequently compared to their heterosexual peers.

We also find that the differences between non-heterosexual and heterosexual people tend to be more pronounced in countries where LGBTQIA+ rights are less enforced. In particular, sexual minorities are more at risk of adverse health conditions in these countries compared to countries with stronger protections of LGBTQIA+ rights. Moreover, we find that outcomes vary according to individuals’ relationship status and household income, with single and less wealthy non-heterosexual people suffering more than their heterosexual peers from depressive symptoms and reporting having poorer overall health.

More data is needed to monitor progress and better understand the causes of these disparities 

The EU-LS survey allows for the first important snapshot of how sexual minorities fare in terms of health and relationship quality in Europe. It is a great first step. However, a much more widespread inclusion of questions about sexual orientation and gender identity in large surveys is needed if we are to monitor progress when it comes to LGBTQIA+ equality issues – taking the lead, for instance, from the inclusion of a question on sexual orientation in Census data in Malta and the UK. We believe that including such questions in representative longitudinal studies would allow for a better understanding of the causes of existing disparities, including the potential role of stigmatisation, discrimination, and harassment of sexual and gender minorities.

Moreover, several questions remain open and call for the attention of researchers and policymakers alike. First, more research is needed to examine economic and non-economic outcomes for transgender people, possibly relying on administrative data linkages. Second, more effort should be made to understand the effects of public policies related to sexual minorities when it comes to a range of outcomes and behaviours (e.g., around individuals’ finances, employment, health, education and so on). Finally, very little is known about disparities between sexual minorities and their heterosexual peers in developing countries and so filling this gap would represent an important element from a comparative development perspective.

All articles posted on this blog give the views of the author(s). They do not represent the position of LSE Inequalities, nor of the London School of Economics and Political Science. They also do not imply a policy position of the European Commission. Neither the European Commission nor any person acting on behalf of the Commission is responsible for the use which might be made of this publication.

Image credits: karuka via Shutterstock.