Sexual Minority Status as a Social Determinant of Health: A Cross-National Analysis

Abstract

This thesis is predicated on the scholarly consensus that sexual minorities are more vulnerable to negative health outcomes than their heterosexual counterparts. I examine trust in medical institutions as a pivotal mechanism through which sexual minority status is a social determinant of health. Thorough analysis of a comprehensive, self-designed survey disseminated through Amazon Mechanical Turk confirms the existence of trust-in-physician differentials between LGB and heterosexual communities. Several demographic factors, internalized homophobia, salience of sexuality to identity, close community acceptance of sexual minorities, societal stigma, and patient-centered care are identified as significant predictors of LGB trust. Trust in physicians correlates with better self-rated physical and mental health status among the LGB community. The effect of trust appears higher in developing nations. While the evidence is speculative, I conjecture that information poverty in developing countries might amplify the importance of a trusting physician in explaining health outcomes compared to the US.