How well do you sleep? For LGBTQ+ teens and adults, the answer is likely “Not well.” This has serious implications for overall health and well-being, including mental health.
Disparities in sleep
While adults in the United States are generally sleep-deprived, the rate is even higher for LGBTQ+ individuals. One study released last year found that more than half of the gender-minority adults regularly got less than seven hours’ sleep, which is the minimum recommended amount. Other studies have found similar sleep deficiencies for LGBTQ+ individuals overall.
These sleep disparities have also been found in teens and tweens. The results of a study published in March in LGBT Health showed that 10- to 14-year-olds who identified as sexual minorities were more than twice as likely to have trouble falling or staying asleep as those who did not. The kids who answered “maybe” to the question, “Are you gay or bisexual?” were almost as likely to have sleep issues, noted Dr. Jason Nagata, an assistant professor of pediatrics at the University of California, San Francisco, and the study’s lead author.
Sleep data for older teens shows similar disparities, with the 2019 Youth Risk Behavior Survey by the Centers for Disease Control and Prevention (CDC) finding that only 16% of gay, lesbian, or bisexual teens clocked at least eight hours of nightly sleep (the minimum recommended amount), compared to 23% of heterosexual teens.
Why LGBTQ+ individuals sleep worse
Factors contributing to poor sleep in minority populations fall into two broad categories: distal (further away or external), and proximal (closer or internal), noted Billy Caceres, Ph.D., an assistant professor at the Columbia University School of Nursing.
In a study published last year examining the sleep of gender-minority adults, Caceres found that both categories contributed to poor sleep. However, the adults with higher levels of internal stressors — in this case, a high expectation of “being stereotyped or rejected by others” — had the most trouble with their sleep. Participants who’d experienced discrimination also had worse sleep.
Notably, the study was conducted in New York City, San Francisco, and Atlanta, all “generally very progressive cities,” said Caceres, who noted that the results would likely be even more pronounced elsewhere.
Even so, “you don’t actually have to experience discrimination yourself to be aware of discrimination against people like you and have that impact your sleep,” he says.
The impact of this awareness and internalization is particularly relevant in the current climate, given the record number of U.S. laws and bills targeting LGBTQ+ rights. According to the American Civil Liberties Union, as of June 2, 2023, 491 such bills had been introduced in the 2023 state legislative sessions across the country.
“Discriminatory laws toward the LGBT community in general can lead to more feelings of isolation, anxiety, and depression, which can then worsen sleep,” Nagata explained.
Mental health impact
While research on various subsets of the LGBTQ+ community is ongoing, findings to date suggest that bisexual, nonbinary, and transgender individuals often have more issues with their sleep. Similar results have been found for mental health.
There are also age-related differences: Studies show that mental health issues are more pronounced in younger adults and in adolescents who identify as LGBTQ+. One study published last year found that Gen Z respondents were more likely than older adults to report “psychological distress,” ranging from “feeling nervous” to feeling “so depressed that nothing could cheer you up.”
The implications are even greater for teens and tweens, who are already facing a mental health crisis. Earlier this year, the CDC released data from 2021 showing that 35% of high schoolers who identify as heterosexual had experienced “persistent feelings of sadness or hopelessness” in the past year. But the percentage was nearly double — 69% — for LGBQ+ students (the terminology used in the survey). In the same survey, 22% of students who identified as heterosexual reported poor mental health during the past 30 days, but the percentage more than doubled to 52% for students who identified as LGBQ+.
Additionally, it’s important to note that the relationship between sleep and mental health goes both ways: Lack of sleep exacerbates conditions including anxiety, depression, and suicidality, and mental health conditions in turn affect sleep.
A growing portion of the population
Gallup poll results released earlier this year show that 7% of U.S. adults identify as “lesbian, gay, bisexual, transgender, or other,” — double what the organization found just 10 years ago when it first added the question to its survey.
Notably, younger adults were far more likely to identify as LGBTQ+ than older generations. Nearly 20% of Gen Z adults (those ages 18-23) identified as LGBTQ+, as did 11% of Millennials and 3% of Gen Xers, Gallup found.
The numbers are even higher for the under-18 Gen Z population: High school data shared by the CDC earlier this year shows that about one in four students identify as LGBTQ+.
For LGBTQ+ kids and teens, who have greater sleep needs than their adult counterparts, it’s particularly important to establish a regular sleep routine and create a sleep-conducive environment, Nagata said. He also recommends seeking mental health support if needed, “to address any underlying stressors that may be contributing to sleep disruptions.”