sex with men (n = 2,605) derived from the Urban Men’s Health Study, found that as income and level of education decreased, the men who have sex with men were less likely to identify as gay, more likely to have sex with women, and less likely to be involved in the gay community (Barrett and Pollack, 2005). As mentioned in Chapter 2, evidence also suggests that there are income differences based on sexual orientation.

Cultural context based on one’s country of origin can influence the health of LGBT populations as well. Cultural norms of the home country and the ways in which they are modified by migration/immigration have been shown to affect the sexual health of Asian/Pacific Islander men who have sex with men (Chng and Geliga-Vargas, 2000). Other research suggests less tolerance toward LGB individuals in some Latin American countries than in the United States (Bianchi et al., 2007; Nierman et al., 2007). It should be noted, however, that laws in both Argentina and Mexico City allow marriage between same-sex couples. Research on the sexuality of Asian and Latino people in the United States has been sparse, and many of the studies that have been conducted suffer from sampling problems and other methodological limitations. However, some data are available from probability samples and are discussed elsewhere in this report (e.g., Chae and Ayala, 2010; Cochran et al., 2007c; Diaz et al., 2001).

Familial Factors

Some research, discussed below, examines gay men and lesbians in terms of families, and a very small amount of research looks at transgender family life. However, the committee could find no research on the family lives of bisexual people. Studies of partnering relationships typically refer to same-sex or different-sex couples. The experiences of bisexual people in these relationships do not appear to be reflected in research.

As noted in Chapter 2, gay men and lesbians are less likely to become parents than their heterosexual peers (Gates et al., 2007; Patterson, 2004; Patterson and Riskind, 2010). Results from the 2002 National Survey of Family Growth (NSFG) revealed that 35 percent of self-identified lesbians (aged 15–44) reported having given birth to at least one child, compared with 65 percent of same-aged heterosexual women. In the 2002 NSFG, only 16 percent of self-identified gay men reported having a biological or adoptive child, compared with 48 percent of same-aged heterosexual men (Gates et al., 2007; Patterson and Riskind, 2010). Thus, available data suggest that while fewer lesbian and gay than heterosexual adults become parents, many lesbian and gay adults do become parents.

Why are there fewer lesbian and gay than heterosexual parents? Lesbian and gay adults may be less likely to become parents in part because they have fewer unplanned pregnancies. However, data from the 2002



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