LGBTQ+ identity and its association with inflammation and cellular immune function

Ethan Morgan; Claire M. Kamp Dush; Thomas W. McDade; Juan Peng; Rebecca R. Andridge; Steve W. Cole; Wendy Manning; Lisa M. Christian

doi:10.1016/j.bbi.2025.02.032

LGBTQ+ identity and its association with inflammation and cellular immune function

Ethan Morgan^*, Claire M. Kamp Dush, Thomas W. McDade, Juan Peng, Rebecca R. Andridge, Steve W. Cole, Wendy Manning, Lisa M. Christian

^*Corresponding author for this work

Anthropology

Research output: Contribution to journal › Article › peer-review

Abstract

Self-identification among lesbian, gay, transgender, queer, and other sexual minorities (LGBTQ+) is complex and multifaceted, yet few studies have examined its impact on immune parameters. The National Couples’ Health and Time Study (NCHAT) is a nationally-representative cohort of 3,642 adult main respondents, ages 20 to 60 years, who are married or cohabiting, among whom 45 % self-identify as a non-heterosexual identity. Biological data were collected from a subset in the NCHAT Stress Biology study (NCHAT-BIO). The current analyses focus on data from 289 participants in NCHAT-BIO who identified as a non-heterosexual identity. Participants self-reported demographic, mental health, and LGBTQ+ identity items. Finger stick dried blood spot (DBS) sampling was self-administered by participants and assayed for C-reactive protein (CRP), interleukin-6 (IL-6), and antibodies against Epstein-Barr virus (EBV). Multivariable regression analyses were used to assess the relationship between each of the biomarkers and: 1) individual LGBTQ+ identity items and 2) latent profiles of LGBTQ+ identity items. Models were adjusted for demographic factors and other confounders. Among those assigned female at birth, a greater sense of pride in one's LGBTQ+ identity was associated with lower EBV antibody levels. Among those assigned male at birth, greater desire to keep one's identity private was associated with elevated CRP while those who would choose to be straight or wish they were heterosexual had elevated levels of IL-6. Meanwhile, being proud of one's LGBTQ+ identity predicted lower IL-6. These results provide novel evidence from a large sample that internalized stigma related to one's LGBTQ+ identity is associated with elevated inflammation and poorer cellular immune function while identity affirmation is associated with reduced inflammation. Future research should aim to develop and target both behavioral and biomedical interventions aimed at reducing health disparities among sexual minority populations.

Original language	English (US)
Pages (from-to)	333-341
Number of pages	9
Journal	Brain, Behavior, and Immunity
Volume	126
DOIs	https://doi.org/10.1016/j.bbi.2025.02.032
State	Published - May 2025

Funding

NCHAT is funded by the Eunice Kennedy Shriver National Institute of Child Health & Human Development, The Office of the Director, and the National Institute on Minority Health and Health Disparities (5R01HD094081-04, 1U01HD108779-01, & 1R03HD107126-01). NCHAT also benefited from support provided by the University of Minnesota's Minnesota Population Center (P2CHD041023) and the Bowling Green State University's Center for Family and Demographic Research (P2CHD050959). NCHAT-BIO is funded by the National Institute on Minority Health and Health Disparities (R21 MD018158 Christian/Morgan Multi-PI), the Eunice Kennedy Shriver National Institute for Child Health and Human Development through the Ohio State University Institute for Population Research (IPR) grant (P2CHD058484; Christian/Kamp Dush Multi-PI), and pilot funding from the OSU Department of Psychiatry & Behavioral Health Norman Browning Jr. MD. Family Research Fund (Christian/Kamp Dush Multi-PI). TM acknowledges support as a Fellow in the CIFAR Child and Brain Development Program. NCHAT is funded by the Eunice Kennedy Shriver National Institute of Child Health & Human Development, The Office of the Director, and the National Institute on Minority Health and Health Disparities (5R01HD094081-04, 1U01HD108779-01, & 1R03HD107126-01). NCHAT also benefited from support provided by the University of Minnesota\u2019s Minnesota Population Center (P2CHD041023) and the Bowling Green State University\u2019s Center for Family and Demographic Research (P2CHD050959). NCHAT-BIO is funded by the National Institute on Minority Health and Health Disparities (R21 MD018158 Christian/Morgan Multi-PI), the Eunice Kennedy Shriver National Institute for Child Health and Human Development through the Ohio State University Institute for Population Research (IPR) grant (P2CHD058484; Christian/Kamp Dush Multi-PI), and pilot funding from the OSU Department of Psychiatry & Behavioral Health Norman Browning Jr., MD., Family Research Fund (Christian/Kamp Dush Multi-PI). TM acknowledges support as a Fellow in the CIFAR Child and Brain Development Program.

Keywords

EBV latency
Identity
Immune function
Inflammation
LGBTQ+
Psychosocial stress
Sexual minority psychoneuroimmunology

ASJC Scopus subject areas

Immunology
Endocrine and Autonomic Systems
Behavioral Neuroscience

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.bbi.2025.02.032

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title = "LGBTQ+ identity and its association with inflammation and cellular immune function",

abstract = "Self-identification among lesbian, gay, transgender, queer, and other sexual minorities (LGBTQ+) is complex and multifaceted, yet few studies have examined its impact on immune parameters. The National Couples{\textquoteright} Health and Time Study (NCHAT) is a nationally-representative cohort of 3,642 adult main respondents, ages 20 to 60 years, who are married or cohabiting, among whom 45 \% self-identify as a non-heterosexual identity. Biological data were collected from a subset in the NCHAT Stress Biology study (NCHAT-BIO). The current analyses focus on data from 289 participants in NCHAT-BIO who identified as a non-heterosexual identity. Participants self-reported demographic, mental health, and LGBTQ+ identity items. Finger stick dried blood spot (DBS) sampling was self-administered by participants and assayed for C-reactive protein (CRP), interleukin-6 (IL-6), and antibodies against Epstein-Barr virus (EBV). Multivariable regression analyses were used to assess the relationship between each of the biomarkers and: 1) individual LGBTQ+ identity items and 2) latent profiles of LGBTQ+ identity items. Models were adjusted for demographic factors and other confounders. Among those assigned female at birth, a greater sense of pride in one's LGBTQ+ identity was associated with lower EBV antibody levels. Among those assigned male at birth, greater desire to keep one's identity private was associated with elevated CRP while those who would choose to be straight or wish they were heterosexual had elevated levels of IL-6. Meanwhile, being proud of one's LGBTQ+ identity predicted lower IL-6. These results provide novel evidence from a large sample that internalized stigma related to one's LGBTQ+ identity is associated with elevated inflammation and poorer cellular immune function while identity affirmation is associated with reduced inflammation. Future research should aim to develop and target both behavioral and biomedical interventions aimed at reducing health disparities among sexual minority populations.",

keywords = "EBV latency, Identity, Immune function, Inflammation, LGBTQ+, Psychosocial stress, Sexual minority psychoneuroimmunology",

author = "Ethan Morgan and \{Kamp Dush\}, \{Claire M.\} and McDade, \{Thomas W.\} and Juan Peng and Andridge, \{Rebecca R.\} and Cole, \{Steve W.\} and Wendy Manning and Christian, \{Lisa M.\}",

note = "Publisher Copyright: {\textcopyright} 2025 The Authors",

year = "2025",

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doi = "10.1016/j.bbi.2025.02.032",

language = "English (US)",

volume = "126",

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T1 - LGBTQ+ identity and its association with inflammation and cellular immune function

AU - Morgan, Ethan

AU - Kamp Dush, Claire M.

AU - McDade, Thomas W.

AU - Peng, Juan

AU - Andridge, Rebecca R.

AU - Cole, Steve W.

AU - Manning, Wendy

AU - Christian, Lisa M.

PY - 2025/5

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N2 - Self-identification among lesbian, gay, transgender, queer, and other sexual minorities (LGBTQ+) is complex and multifaceted, yet few studies have examined its impact on immune parameters. The National Couples’ Health and Time Study (NCHAT) is a nationally-representative cohort of 3,642 adult main respondents, ages 20 to 60 years, who are married or cohabiting, among whom 45 % self-identify as a non-heterosexual identity. Biological data were collected from a subset in the NCHAT Stress Biology study (NCHAT-BIO). The current analyses focus on data from 289 participants in NCHAT-BIO who identified as a non-heterosexual identity. Participants self-reported demographic, mental health, and LGBTQ+ identity items. Finger stick dried blood spot (DBS) sampling was self-administered by participants and assayed for C-reactive protein (CRP), interleukin-6 (IL-6), and antibodies against Epstein-Barr virus (EBV). Multivariable regression analyses were used to assess the relationship between each of the biomarkers and: 1) individual LGBTQ+ identity items and 2) latent profiles of LGBTQ+ identity items. Models were adjusted for demographic factors and other confounders. Among those assigned female at birth, a greater sense of pride in one's LGBTQ+ identity was associated with lower EBV antibody levels. Among those assigned male at birth, greater desire to keep one's identity private was associated with elevated CRP while those who would choose to be straight or wish they were heterosexual had elevated levels of IL-6. Meanwhile, being proud of one's LGBTQ+ identity predicted lower IL-6. These results provide novel evidence from a large sample that internalized stigma related to one's LGBTQ+ identity is associated with elevated inflammation and poorer cellular immune function while identity affirmation is associated with reduced inflammation. Future research should aim to develop and target both behavioral and biomedical interventions aimed at reducing health disparities among sexual minority populations.

AB - Self-identification among lesbian, gay, transgender, queer, and other sexual minorities (LGBTQ+) is complex and multifaceted, yet few studies have examined its impact on immune parameters. The National Couples’ Health and Time Study (NCHAT) is a nationally-representative cohort of 3,642 adult main respondents, ages 20 to 60 years, who are married or cohabiting, among whom 45 % self-identify as a non-heterosexual identity. Biological data were collected from a subset in the NCHAT Stress Biology study (NCHAT-BIO). The current analyses focus on data from 289 participants in NCHAT-BIO who identified as a non-heterosexual identity. Participants self-reported demographic, mental health, and LGBTQ+ identity items. Finger stick dried blood spot (DBS) sampling was self-administered by participants and assayed for C-reactive protein (CRP), interleukin-6 (IL-6), and antibodies against Epstein-Barr virus (EBV). Multivariable regression analyses were used to assess the relationship between each of the biomarkers and: 1) individual LGBTQ+ identity items and 2) latent profiles of LGBTQ+ identity items. Models were adjusted for demographic factors and other confounders. Among those assigned female at birth, a greater sense of pride in one's LGBTQ+ identity was associated with lower EBV antibody levels. Among those assigned male at birth, greater desire to keep one's identity private was associated with elevated CRP while those who would choose to be straight or wish they were heterosexual had elevated levels of IL-6. Meanwhile, being proud of one's LGBTQ+ identity predicted lower IL-6. These results provide novel evidence from a large sample that internalized stigma related to one's LGBTQ+ identity is associated with elevated inflammation and poorer cellular immune function while identity affirmation is associated with reduced inflammation. Future research should aim to develop and target both behavioral and biomedical interventions aimed at reducing health disparities among sexual minority populations.

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KW - LGBTQ+

KW - Psychosocial stress

KW - Sexual minority psychoneuroimmunology

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LGBTQ+ identity and its association with inflammation and cellular immune function

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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