Heightened prevalence of chronic fatigue syndrome in U.S. sexual minorities, 2026, Balshi et al

[forestglip]

Heightened prevalence of chronic fatigue syndrome in U.S. sexual minorities

Spoiler: Authors

Balshi, Alexandra; Dempsey, John P.; Thompson, Hannah R.; Montgomery, Mary W.

Purpose
To assess the prevalence and odds of chronic fatigue syndrome (CFS) among lesbian, gay, bisexual, and other sexual minority individuals (LGB+) in the United States using a multi-year, nationally representative survey.

Methods
We performed multivariate logistic regression of 2021–2023 National Health Interview Surveys to determine any relationship between LGB+ identity and CFS.

Results
Of 86,440 Americans, CFS was present in 1,489 [1.7%]. A higher proportion of LGB+ adults (2.4% [95% confidence interval (CI): 2.21%–2.59%]) than non-LGB+ adults (1.7% [95% CI: 1.60%–1.80%] reported CFS (p = 0.002).

After adjusting for age, sex, race, ethnicity, income, education, employment, depression, and history of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia, LGB+ participants were more likely to report CFS than were heterosexuals (adjusted odds ratio, 1.47; 95% CI, 1.12–1.92).

Conclusion
LGB+ adults in the United States have a disproportionate prevalence and odds of CFS compared with heterosexual individuals.

Web | DOI | Journal of Psychiatric Research | Paywall

 

[Dolphin]

Highlights​

• •
  This nationally representative study revealed that sexual minority adults have a significantly higher prevalence of chronic fatigue syndrome compared to heterosexuals.
• •
  After adjusting for social drivers of health and comorbid conditions including depression, sexual minority individuals were at significantly higher odds of reporting chronic fatigue syndrome.
• •
  The higher prevalence of depression in the sexual minority population, as well as among those with chronic fatigue syndrome, suggests that mental illness may contribute to CFS development.

 

[Simon M]

It's great to have some data on this,but the NIHS survey is highly questionable because if you ask a general audience if they have an ME/CFS diagnosis, you get an implausibly high prevalence rate (1.7% here - probably <<0.5% is true with a diagnosis). Luis Nacul did a follow up study on a Canada BC study (Generations?) and found most declaring ME/CFS didn't meet IOM/CCC criteria [I may not have all the details right, but the gist is right]. So I'm not sure how much this tells us.

 

[Dolphin]

It's great to have some data on this,but the NIHS survey is highly questionable because if you ask a general audience if they have an ME/CFS diagnosis, you get an implausibly high prevalence rate (1.7% here - probably <<0.5% is true with a diagnosis). Luis Nacul did a follow up study on a Canada BC study (Generations?) and found most declaring ME/CFS didn't meet IOM/CCC criteria [I may not have all the details right, but the gist is right]. So I'm not sure how much this tells us.

Part of the reason such figures are implausible is because lots of people with ME/CFS haven’t been diagnosed with it (they may not have any diagnosis or may have one or more other ones), so a diagnosed rate of 1.7% is probably equivalent to a prevalence rate of 4%-10%.

 

[RedFox]

I'm gay so I guess this is about me. It's plausible LGBTQ people have a higher rate of ME/CFS because they tend to have higher rates of diseases in general. However, I doubt the results because 1.7% is too high a prevalence.

 

[Creekside]

I expect that variability in minority groups making claims of a disease is greater than the difference in people actually having the disease. Just the "tough manly men don't complain" would throw the numbers off.

 

[Yann04]

Also the ME/CFS community tends to be lot more open to non-dominant identities.

This is just personal experience but I know 2 people who described themselves as cisgender before ME/CFS and since then have changed pronouns. I think the fact ME/CFS community tends to be more welcoming (not everywhere ofc but as a general trend a bit better than the world at large) is helpful in this case.

Also I don’t know about others but I feel way less attached to my gender than I did before I had ME/CFS. I mean I’m just a person locked in bed I don’t really see myself as a “man” anymore.

 

[Yann04]

lesbian, gay, bisexual, and other sexual minority individuals (LGB+)

As a sidenote it’s really sad to see LGBTQ+ be shortened like this. If I recall correctly this is a direct consequence of the censoring US government grant funding bodies have had under the new government.

 

[SNT Gatchaman]

It's great to have some data on this,but the NIHS survey is highly questionable because if you ask a general audience if they have an ME/CFS diagnosis, you get an implausibly high prevalence rate

And "a health professional" could be anything.

2.1. Chronic fatigue syndrome definition

The NHIS asked participants whether they had “ever been told by a health professional that they had Chronic Fatigue Syndrome (CFS) or Myalgic Encephalomyelitis.”