The mental and physical health struggles among individuals belonging to gender and sexual minorities are well documented. In both adult and teenage groups, queer individuals are reported to face greater risks in terms of mental and physical health than their cisgender, heterosexual peers. However, most documentation on queer lives has involved a majority of white people. Indeed, globally, discourse on queer lives and queer issues is driven by Eurocentric and Amcentric approaches and vocabularies, leaving little scope or space for queer expression from the margins. In such a scenario, the health risks that queer individuals face in already marginalized communities face often go overlooked and neglected.

Keeping these factors in mind, Dr. Amal Khanolkar, a public health researcher at King’s College, London, sought to examine the health risks faced by people belonging to multiple minorities. Dr. Khanolkar conducted two separate sociological studies in the UK and Sweden, assisted by sociology researchers from each country in either of his studies. These are now published in the journals LGBT Health and eClinical Medicine.

The studies are significant as they are the first to explore the conditions of queer individuals belonging to ethnic minorities and identify the health risks that they face. The studies highlight intersectionality as an essential framework to understand how those who may belong to multiple minorities face oppression and risks to their well-being.

The researchersin the U.K. assessed the general and mental health conditions of a heterogeneous sample of over 9,000 17-year-old adolescents using questionnaires on their general health, mental health, and health-related behaviors such as smoking and drinking. Their sample included both white and non-white, queer, and straight individuals, and the researchers in their questionnaire added specific questions on the health of queer individuals within ethnic minorities.

In Sweden, the researchers looked at the health and health-related behaviors among both heterosexual and non-heterosexual individuals based on responses to the Swedish National Public Health Survey between 2018 and 2020. The sample, consisting of over 1,50,000 individuals, also included responses from refugee and migrant communities. The researchers inspected the responses of both heterosexual and non-heterosexual individuals among refugee and migrant communities.

The study in the UK revealed that non-heterosexual, non-cisgender individuals reported greater health risks in both white and non-white communities, although queer individuals belonging to both sexual and ethnic minorities did not report worse health outcomes than their white counterparts. In Sweden too, queer individuals were reported to face greater health risks than their heterosexual counterparts in both the majority communities and ethnic minorities. Transgender people in Sweden, including those from ethnic minorities, particularly faced higher physical violence than all other population sub-groups.

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The outcomes of these studies indicate that queer individuals from minority communities face as many health risks as queer individuals from white communities, and therefore public healthcare and policy should include people from all races while framing guidelines for better healthcare for queer individuals.

However, people from marginalized communities may be excluded from healthcare systems at a greater rate than their privileged counterparts. Previous research has noted that populations in the margins rarely make it to clinical trials, there is little policy formation around public health that centers them, thus pushing them on a cycle of constant negligence and disadvantage. As The Atlantic noted in a report from 2015, “Neglected by research, African American children have died from asthma at 10 times the rate of non-Hispanic white children.”

The Department of Public Health, Purdue, moreover, described how racism is a public health issue. “Social determinants of health, including racism-propelled adverse socioeconomic conditions, are key drivers of health disparities. The disproportionate burden of COVID-19 on Black and Latinx communities is just the latest example of how structural and systemic racism leads to devastating health outcomes,” the department noted.

There is also a deep mistrust among marginalized populations towards healthcare itself. Smithsonian Magazine notes in their report how pharmaceutical firms carry out questionable clinical trials in the developing world where “ethical oversight is minimal and desperate patients abound“.

Even though ethnically marginalized queer people have as many health risks as their white counterparts, when research them and their needs, their health risks have a chance of getting neglected or being overlooked. This has serious implications.

Last week, The Swaddle reported on a study on Digital Self Harm in teenagers, where the researchers noted that non-heterosexual individuals across races were twice as likely to report having engaged in self-cyberbullying. Queer individuals may also face more instances of bullying and are reported to be at greater risk of physical and sexual assault.

The researchers stress while reporting their findings from Sweden that “public health policy should emphasize preventive measures to reduce exposure to violence and discrimination in sexual- and gender minority individuals, increase access and use of mental healthcare services and sensitize healthcare professionals about higher rates of health and related issues faced by sexual- and gender minority individuals including those with multiple minority identities.” The need for a vocabulary and approach built around non-white populations and their sensibilities is urgent to address these issues.

Thus, public health research needs to be conscious of populations that exist in the margins, and also to minorities that may exist within minorities. Only an intersectional approach to healthcare and medical research can mitigate health risks among queer individuals in minority communities.

Science and scientific research remain colonial in the way research is conducted and policy is formulated, which leads to a deep distrust of scientific institutions and approaches in non-white communities. Without devising an intersectional framework, science and its benefits will only reach a few.