摘要：Objectives . This study determined to what extent lesbian, gay, bisexual, and transgender (LGBT) populations have been studied over the past 20 years of public health research. Methods . From MEDLINE English-language articles on human subjects published between 1980 and 1999, I identified articles that included LGBT individuals. The abstracts were analyzed with a coding procedure that categorized the content by topic, sexual orientation, and race/ethnicity. Results . LGBT issues were addressed by 3777 articles, or 0.1% of all Medline articles; 61% of the articles were disease-specific, and 85% omitted reference to race/ethnicity. Research unrelated to sexually transmitted diseases addressed lesbians and gay men with similar frequency, whereas bisexual persons were less frequently considered, and the least amount of research focused on transgender individuals. Conclusions . Findings supported that LGBT issues have been neglected by public health research and that research unrelated to sexually transmitted diseases is lacking. Despite increased interest in lesbian, gay, bisexual, and transgender (LGBT) populations' health as a legitimate focus of scientific study, public health research has not been systematically reviewed to identify the extent to which LGBT issues have been addressed. Historically, public health researchers have not recognized LGBT persons as a population with distinct health issues outside a framework of sexual deviance or sexually transmitted diseases (STDs). Before the 1980s, most studies that addressed LGBT populations focused on the etiology of homosexuality 1 or on mental disorders because homosexuality was classified as such until 1973. 2– 4 In the 1980s, a new virus, later known as HIV, was initially recognized to occur among gay men. 5, 6 Research on HIV and AIDS incorporated measures of same-sex behaviors to assess “risk behaviors.” 7, 8 In the 1990s, influenced by social movement advocacy, debate arose over whether lesbians' risk factors for developing breast cancer might be higher compared with those of heterosexual women. 1, 9 This focus on diseases that are of relevance to LGBT individuals developed into the recognition that LGBT populations are diverse communities with disparate health concerns. Hence, a systematic review of LGBT research also must identify gaps in knowledge regarding diverse sectors of LGBT populations in relation to behaviors, race/ethnicity, and socioeconomic position. This review is crucial to inform adequately the goals set for LGBT health in documents such as Healthy People 2010: Understanding and Improving Health 10 and its companion document on LGBT health, which addresses these populations more fully. 11 Documents that strive to identify solutions to LGBT populations' health concerns, such as Healthy People 2010 and the 1999 Institute of Medicine report on lesbian health, 1 regularly point to the lack of representative, population-based data on LGBT individuals. In the absence of adequate data, LGBT research is frequently hindered by methodological issues, such as defining, measuring, and sampling of LGBT populations. 1, 2 The lack of uniform definitions and measures for LGBT persons, such as behavior, identity, and desire, 12, 13 and of different sampling strategies severely limits the generalizability of study results. 14 Recognizing that existing LGBT studies may suffer from these limitations, one might wonder how often researchers have actually been able to collect data on LGBT populations and publish the results. Accordingly, the objective of this study was to determine the extent to which LGBT issues have been addressed in public health research and the contexts in which LGBT populations have been studied over the last 20 years.
