Inclusion of sexual and gender minority health in NIH research projects

Background/Purpose: Lesbian, gay, bisexual, and transgender (LGBT) populations experience disproportionate behavioral risks and psychosocial health problems. We investigated research projects funded by the U.S. National Institutes of Health (NIH) to determine which subpopulations and health topics are prioritized for funding.

Methods: We utilized Research Portfolio Online Reporting Tools (RePORTER) to systematically review NIH-funded research projects, career research awards, fellowships, and training research awards to determine project titles or abstracts containing LGBT-related terms. We conducted a directed content analysis to classify the primary health foci for each project, guided by health topics outlined by American Journal of Public Health. We ran descriptive statistics of population subgroups and health foci.

Findings: Preliminary results show NIH has funded 541 research projects pertaining to LGBT health, or 0.4% of the total number of projects from 1988 through 2011. A large majority of LGBT-related projects serve the health of sexual minority males (86.2%), while substantially less focus on sexual minority females (15.1%) and transgender populations (7.0%). 8.8% of projects include youth under 18 years of age, and scant research (0.4%) explicitly examine adults 50+ years of age. Additionally, more than three-quarters of projects focus on HIV, 28.4% on illicit substance use, and 22.4% on mental health issues.

Conclusions: These findings highlight the paucity of research on sexual minority women and transgender populations. Further, important LGBT health issues, such as alcohol and tobacco use, obesity, violence, and cancer are also underexamined. This has implications for NIH and other funding agencies, health research scientists, and LGBT advocates.