Landmark census analysis reveals scale of LGBT+ health inequalities in Scotland
A major new report from the Glasgow Centre for Population Health (GCPH) in collaboration with LGBT Health and Wellbeing (LGBTHW) has, for the first time, used national census data to provide a comprehensive picture of the health and wellbeing of LGBT+ people in Scotland, revealing stark and systemic inequalities, particularly for transgender communities.
Drawing on Scotland’s Census 2022 – the first to include questions on sexual orientation and trans status – the report analyses data from more than 5.4 million people, offering an unprecedented population-level insight into LGBT+ lives.
The findings show that LGBT+ people represent a significant and growing part of Scotland’s population. According to the census, 4.4% of adults identify as lesbian, gay or bisexual (approximately one in 23 people), while 0.47% report a trans status or history. Among young adults aged 16–24, more than one in eight identify as LGB+, highlighting a major demographic shift that has important implications for future public health planning.
However, the report also reveals substantial inequalities in health and wellbeing.
Mental health disparities are among the most pronounced. Bisexual and “other” sexual orientation groups report mental health conditions at rates over three times higher than heterosexual people, while gay and lesbian individuals report more than double the rate. Among trans populations, the inequalities are even more striking, with between 46% (trans women) and nearly 56% (non-binary) reporting a mental health condition, compared with around 13% of the cisgender population.
The study also identifies higher rates of disability, developmental disorders and learning difficulties across many LGBT+ groups, with the most severe and overlapping disadvantages experienced by trans and non-binary people. Alongside health inequalities, the analysis highlights socioeconomic disparities. LGBT+ people are less likely to own their homes, more likely to rent privately, and experience higher rates of unemployment – despite also having higher levels of degree-level education compared with the heterosexual population.
The authors stress that these inequalities are not inevitable, but reflect the cumulative impact of stigma, discrimination and structural barriers, including, often unintentionally, within healthcare systems that have not always been designed with LGBT+ lives in mind.
The report calls for urgent, coordinated action, including the development of a national LGBT+ Equality Action Plan, recognition of LGBT+ status as a social determinant of health, and targeted investment in mental health support for LGBT+ communities.
Chris Harkins, GCPH Programme Manager and lead author, said:
“This analysis marks a turning point for public health in Scotland. For the first time, we can see clearly – at a national level – the scale and pattern of health inequalities affecting LGBT+ communities. These findings are not incidental; they are systemic, measurable and therefore actionable. With the right commitment, Scotland now has a real opportunity to turn this evidence into meaningful change and build a more inclusive and equitable public health system for all.”
Rebecca Hoffman, LGBTHW Policy and Research Manager and co-author added:
“As Scotland’s national LGBTQ+ organisation committed to achieving health equity for all LGBTQ+ people in Scotland, we were not shocked our census analysis found striking health inequality within our communities. Our findings unfortunately support what we see on the ground, every day. Given the rise in younger cohorts identifying as LGBT+, public health systems must incorporate LGBT+ populations within their frameworks otherwise they risk becoming increasingly disconnected with the realities of the communities they serve, limiting their effectiveness and relevance for future generations.”
Mohasin Ahmed, GCPH Public Health Practitioner Specialist and co-author, also added:
“The findings of this report reinforce that advancing LGBT+ health is not a peripheral issue, but central to delivering on Scotland’s vision for a fairer, healthier nation, one where the values of inclusion and dignity are fully realised.”
The report emphasises that improving LGBT+ health is not only an issue of fairness, but essential to ensuring that public health systems remain relevant and responsive to a changing population. As younger generations are increasingly likely to identify as LGBT+, the authors highlight that addressing these inequalities is critical to the future effectiveness, sustainability and integrity of Scotland’s public health landscape.
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