Research on lesbian, gay, bisexual, and other sexual-minority (two-spirit) American Indians/Alaska Natives is sparse. Existing epidemiologic data, however, indicate that the general American Indian/Alaska Native (AIAN) population is at disproportionately greater risk for poorer general health and physical pain and impairment. According to the National Center for Health Statistics, in 2004 American Indians/Alaska Natives had the highest prevalence of respondent-rated fair or poor health (16.5%) of the racial/ethnic groups surveyed. According to the National Center for Health Statistics, in 2004 American Indians/Alaska Natives had the highest prevalence of respondent-rated fair or poor health (16.5%) of the racial/ethnic groups surveyed. Moreover, American Indians/Alaska Natives had the highest prevalence of past-month severe headache or migraine (19.1%), low back pain (35.3%), neck pain (18.8%), and joint pain (39.6%). American Indians/Alaska Natives were most likely to experience limitations in daily activities caused by chronic conditions than were other racial/ethnic groups (17.1%). Two-spirit American Indians/Alaska Natives may also face serious public health problems. For example, research focused on two-spirit AIAN communities suggests a high prevalence of HIV infection and substance use. Moreover, studies on two-spirit American Indians/Alaska Natives indicate high levels of exposure to social hazards, including experiences of homophobia in mainstream and AIAN heteronormative contexts as well as racism within gay communities.
Racial Discrimination and Racial Identity Attitudes in Relation to Self-Rated Health and Physical Pain and Impairment Among Two-Spirit American Indians/Alaska Natives
By David H. Chae, ScD, and Karina L. Walters, PhD, 2009