The complex representation and contradicting results linking sexual orientation to allostatic load

This commentary discusses a publication by Katsuya Oi and Amanda M. Pollitt using the National Longitudinal Study of Adolescent to Adult Health to assess presumed sexual orientation effects on allostatic load, the ‘wear and tear’ of chronic stress. Their findings indicate that discordant heterosexual women—those whose sexual attractions or behaviors do not align with their heterosexual identity—experience notably higher allostatic load compared to other sub-groups. In contrast, women who identify as non-heterosexual did not exhibit significantly elevated allostatic load. Several theoretical problems, interpretative inadequacies, issues with terminology, and misrepresentation of the existing literature limit the full impact of this original work. In the spirit of collegial critique, the objective of this commentary is to offer potential resolutions and considerations for future research among sexually diverse as well as gender diverse populations.