Abstract
INTRODUCTION: Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction that negatively impacts quality of life. Given the significant health disparities faced by the sexual and gender minority (SGM) communities, it is essential to explore IBS within the context of sexual orientation and gender identity (SOGI). This study aimed to compare the severity of gastrointestinal and psychological symptoms between cisgender heterosexual and SGM individuals with IBS. METHODS: This cross-sectional study recruited 718 participants, with 60.7% being women and a median age of 22. Of these, 542 (75.5%) identified as cisgender heterosexuals, and 176 (24.5%) identified as SGM. Participants, including both patients with IBS and healthy controls (HCs), completed a 60-item electronic survey addressing SOGI, the Rome IV IBS criteria, the Hospital Anxiety and Depression Scale, and the Irritable Bowel Syndrome Severity Scale (IBS-SSS). Statistical analyses included the Student t test, Wilcoxon rank-sum test, Kruskal-Wallis test, and Pearson or Spearman correlations. RESULTS: SGM individuals with IBS reported significantly higher IBS-SSS scores ( P = 0.032) and anxiety levels ( P = 0.032) than their cisgender heterosexual counterparts. In addition, the prevalence of lesbian women was higher in the IBS group compared with healthy controls ( P = 0.041). Cisgender heterosexual participants were more likely to report mild IBS symptoms compared with LGBTQIA+ participants ( P = 0.025). DISCUSSION: SGM individuals with IBS experience more severe symptoms and greater psychological distress compared with cisgender heterosexuals. These findings underscore the need to consider SOGI in health care to ensure that management strategies for IBS are inclusive and effectively address the unique needs of all individuals.