Examining Food Insecurity Among LGBTQ+ Populations: A Scoping Review

• Background and Purpose:

Food insecurity within the LGBTQ+ community is not well understood. Much of the research in this area has either clustered all people with low incomes together or has focused on specific marginalized groups (e.g., racial/ethnic minorities, households with children.) This has made it difficult to develop practice and policy level interventions that address the specific needs of LGBTQ+ populations.

This study sought to inform future practice, policy, and research by describing food insecurity within LGBTQ+ populations by answering the following research question:

1) What is known about the prevalence, risk factors, coping strategies and consequences of food insecurity in LGBTQ+ populations?

• Methods:

This study applied the techniques of a scoping review to answer the research question. This methodology allowed a focus on broader questions in comparison to a systematic review due to its ability to explore the breadth of the literature, map and summarize the evidence, and inform future research.

Using the JBI methodology, several international electronic databases were searched (e.g., Pub-Med), followed by a search of Google Scholar to maximize the number of available articles. Examples of descriptors used included: “food insecurity,” OR “hunger” AND “LGBTQ+,” “gay,” “ lesbian,” “sexual minority” or “gender minority” respectively. Last, an ancestry search of identified articles was performed. All searches were limited to 2012-2022. Article titles and abstract were reviewed to eliminate irrelevant and duplicate papers. Next, a full text review was conducted of remaining articles to determine eligibility for the study. Last, data was extracted from articles selected for the study using Covidence software.

• Results:

Database and ancestry searches yielded 634 records. After removing duplicates, 439 articles were screened for eligibility; 83 advanced to full-text review. During this process, 21 articles were excluded, leaving a total of 62 articles. Two broad themes related to the research question include: 1) social intersections (e.g., discrimination, sex work, and HIV/AIDS) 2) structural intersections (e.g., policy and service delivery).

• Conclusions and Implications:

The results indicate that LGBTQ+ populations experience disparities in food insecurity compared to their non-LGBTQ peers across multiple demographic variables (e.g., age, race/ethnicity, student status) and disparities within the group associated with gender identity (e.g., higher prevalence among cis and transgender women). They also experience specific marginalization that make them vulnerable to experiencing food insecurity (e.g., family rejection, inadequate access to affordable healthcare, and un- and under-employment). Additionally, attempts to access services present a unique set of barriers including service denial, poor treatment by staff, and breach of confidentiality. While LGBTQ+ populations are more likely to utilize SNAP compared to non-LGBTQ+ peers, other coping strategies related to food insecurity (e.g., sex work) place them at risk for harm (e.g., exposure to violence and STIs). The results of this study support the need for interventions addressing food insecurity to be tailored not only to the unique experiences of the LGBTQ+ community but to also consider the needs of specific subgroups within the population (e.g., transgender people, and youth). More research within each subgroup is also warranted.