The Road to LGBTI+ Inclusion in Germany

Progress at the Federal and Länder Levels

Report

15 February 2023

2. The life situation of LGBTI+ individuals in Germany

Abstract

This chapter sheds light on the life situation of LGBTI+ individuals in Germany. It presents the most up-to-date data on the share of Germans who self-identify as LGBTI+, and evaluates the extent to which sexual and gender minorities are on a level playing field with other groups, including at the subnational level. It concludes by investigating how LGBTI+ Germans fare in terms of well-being. The results call for further action to improve the lives of LGBTI+ individuals. The share of LGBTI+ Germans may be as high as 14% (11.6 million people), and this population is still exposed to significant discrimination and violence, with detrimental effects on their life satisfaction and health.

Who are LGBTI+ individuals?

LGBTI+ is the acronym for “lesbian, gay, bisexual, transgender and intersex”. LGBTI people are defined with respect to three distinct features: sexual orientation; gender identity; and sex characteristics. The “plus” (+) leaves the demographic category open ended to acknowledge additional sexual orientations and gender identities that are not explicitly present in the acronym.

Sexual orientation

Sexual orientation allows for differentiating between heterosexuals, lesbians, gay men and bisexuals. It is indicative of a person’s capacity for emotional and/or sexual attraction to different-sex, same‑sex individuals, or both different- and same‑sex individuals. In this context, the “plus” refers to additional sexual orientations, such as “asexual” (lacking emotional and/or sexual attraction to anyone), “pansexual” (considering gender as irrelevant in determining whether one will be emotionally or sexually attracted to someone), among others.

Gender identity

Gender identity refers to a person’s internal sense of being masculine, feminine, androgynous or neither, regardless of sexual orientation. For individuals for whom gender identity corresponds to their biological sex, the Latin prefix cis (“on this side of”) is used to define them as “cisgender”. For those where this is not the case, the Latin prefix trans (“on the other side of”) is used to define them as “transgender”. A transgender person can be: (i) a transgender man (a person who was assigned female at birth but whose gender identity is male); (ii) a transgender woman (a person who was assigned male at birth but whose gender identity is female); (iii) a non-binary (or gender queer) person (a person who identifies with neither, both, or a combination of male and female genders). In this context, the “plus” refers to additional gender identities, such as “gender fluid” (not identifying oneself as having a fixed gender).

Sex characteristics

Sex characteristics refer to chromosomal patterns, hormonal structures, reproductive organs and sexual anatomy that determine an individual’s biological sex. Sex characteristics are sometimes ambiguous in comparison to medical standards rooted in binary concepts of “male” and “female”. An individual whose sex characteristics are neither wholly female, nor wholly male is called “intersex”. Due to this non-binary pattern, and although being intersex is distinct from a person’s sexual orientation or gender identity, intersex individuals are over-represented among the LGBT population (Jones et al., 2016[1]) – this explains why the letter “I” is typically added to the LGBT acronym to include intersex people. Importantly, being intersex is not a pathological condition, and rarely is life‑threatening (Fundamental Rights Agency, 2015[2]).

Source: (OECD, 2020[3]; Kasprowski et al., 2021[4]).

2.1. Introduction and main findings

Social acceptance of sexual and gender minorities − commonly referred to as “LGBTI+” individuals – dramatically improved across the OECD, as did their legal recognition (OECD, 2019[5]; OECD, 2020[3]). Yet, LGBTI+ equality is still far from being achieved. OECD countries are only halfway to full legal acceptance of LGBTI+ individuals and backsliding is being witnessed.1 Even in the most LGBTI+ inclusive OECD countries, sexual and gender minorities are not sheltered from discrimination and violence, as was revealed by the rise in abuse against LGBTI+ individuals due to forced proximity with unaccepting family members during COVID‑19 lockdowns (OECD, 2021[6]).

Chapter 2 provides a detailed overview of the life situation of LGBTI+ individuals in Germany to identify achievements and remaining challenges. After presenting the most recent data on the share of Germans who self-identify as LGBTI+, Chapter 2 evaluates the extent to which they are exposed to discrimination and violence, including at the subnational (state) level. It concludes by investigating how LGBTI+ Germans fare in terms of well-being.

Main findings

LGBTI+ individuals in Germany stand for a sizeable minority.
- Germany is among the very few OECD countries which collect information on sexual orientation (since 2016) and on gender identity (since 2021) in one of their nationally representative surveys, the Socio-Economic Panel (SOEP). While an estimate of the share of non-cisgender individuals based on SOEP 2021 is not yet available, it was estimated to amount to 0.6% by the German Health Update (GEDA 2019/2020‑EHIS). As for the share of Germans who self-identify as lesbians, gays or bisexuals, it is equal to 1.9% according to SOEP. Assuming no overlap between LGB and non-cisgender people, these findings suggest that LGBTI+ Germans represent 2.5% of the population, hence 2.1 million people or the equivalent of the population of Slovenia.
- Yet, these estimates likely understate the reality given the high rate not only of non-response but also of presumably false response.
- In a context where respondents may feel more secure in disclosing sensitive information to non-governmental polling companies than to national statistical offices, attempts of these companies to measure the share of LGBTI+ individuals merit attention, although caution is warranted: in this field, polling companies typically rely on opt-in panels rather than probability sampling, meaning that findings may overstate the size of the LGBTI+ population. According to the LGBT+ Pride 2021 Global Survey conducted by IPSOS, 11% of Germans self-identify as non-heterosexual: 2% as lesbian or gay, 6% as bisexual and 3% as “other”, i.e. “asexual”, “pansexual”, etc. Moreover 3% of Germans self-identify as non-cisgender. Assuming no overlap between non-heterosexual and non-cisgender people, the share of LGBTI+ individuals in the German population may be as high as 14% or 11.6 million people (the equivalent of the population of Belgium).
Despite strong improvements in social acceptance of LGBTI+ individuals in Germany, sexual and gender minorities are still exposed to significant discrimination and violence.
- There has been a shift towards greater acceptance of sexual and gender minorities in Germany (as in most other OECD countries). However, social acceptance remains limited and uneven across the national territory.
  - While the overall rate of social acceptance of LGBTI+ people in Germany was 10 percentage points lower than the EU-OECD average in 2015 (36% vs 46%), it had risen to 4 percentage points above this average by 2019 (57% vs 53%).
  - Yet, levels of social acceptance remain limited in 2019. This pattern is particularly observed when the hypothetical LGBTI+ individual referred to in social acceptance questions is depicted as a family member. While 66% of Germans would feel comfortable with an LGBTI+ work colleague, only 50% report comfort with the idea of their child being in “a love relationship” with an LGBTI+ person. Transgender and intersex individuals face lower social acceptance than do LGB individuals: 59% of Germans are comfortable with having an LGB son- or daughter-in-law while this share falls to 45% when the son- or daughter-in-law is transgender or intersex.
  - Survey data collected at the subnational level reveal strong regional disparities. Overall, levels of social acceptance of LGBTI+ individuals are higher in states of former West than former East Germany: while the rate of social acceptance of LGBTI+ individuals is equal to 74% in Bremen, it is 50% in Saxony.
- LGBTI+ Germans report strong feelings of being discriminated against together with high levels of violence, noting that the situation hasn’t improved over the past decade.
  - In 2019, more than half (58%) of LGBTI+ Germans reported having personally felt discriminated against during the 12 months prior to the survey in at least one of 8 hypothetical situations, including in education, labour market or health care settings: 41% among LGBs and 66% among transgender and intersex respondents, which is slightly more than the EU-OECD average. Feelings of discrimination have generally increased since 2012, a trend mainly driven by transgender respondents. Germany is no exception: the share of LGBTI+ Germans reporting discrimination was nearly 10 percentage points higher in 2019 than in 2012.
  - In 2019, a little more than one‑third (36%) of LGBTI+ respondents report having been physically or sexually attacked or threatened with violence in the five years prior to the survey (as compared to 33% on average across EU-OECD countries): 26% among LGBs and 41% among transgender and intersex respondents. Germany is among the few OECD countries where self-reported experience of violence by sexual and gender minorities has increased rather than decreased since 2012, a trend that concerns both non-heterosexual and non-cisgender individuals.
- Objective measures confirm substantial levels of anti-LGBTI+ discrimination at work and of violence in Germany.
  - Analyses based on SOEP 2016‑19 reveal significant unexplained gaps in labour market outcomes between LGBTI+ and non-LGBTI+ Germans. Although these groups show similar employment rates, LGBTI+ Germans have a 30% higher risk to be engaged in precarious work than their non-LGBTI+ counterparts. LGB Germans are also characterised by lower hourly wages, a result driven by men: the hourly wage of homosexual and bisexual men is 15% lower than that of heterosexual men. As for homosexual and bisexual women, they earn as much as heterosexual women, despite facing fewer family responsibilities. Although field experiments are scarce, they confirm suspicions of anti-LGBTI+ discrimination. In Munich for instance, a correspondence study conducted in 2012 unveiled that straight female candidates were between 20% and 30% more likely to be invited to a job interview than lesbian candidates with similar CVs and letters of application.
  - In 2020, violent hate crimes motivated by the presumed sexual orientation of the victim accounted for more than 10% of all violent politically motivated crimes. This figure is over ten times higher than it was two decades ago, when their share constituted less than 1%, presumably due to massive underreporting. When the gender identity of the victim is taken into account (an information introduced in 2020), this share rises above 15%.
LGBTI+ Germans show lower levels of well-being than their non-LGBTI+ counterparts.
- In the late 2010s, life satisfaction of LGBTI+ Germans was 10% lower than among the general population: when asked to report on a scale from 0 to 10 how satisfied they are with their life, LGBTI+ individuals responded 6.7, as compared to 7.4 across the German population at large.
- Consistent with stigma impairing health, LGBTI+ Germans are characterised by worse mental and physical health outcomes than the rest of the German population, based on SOEP 2016‑19.
  - LGBTI+ Germans are 2.6 times more likely to have ever been diagnosed with a depressive disorder compared to heterosexual cisgender Germans (26% vs 10%).
  - LGBTI+ Germans are 30% more likely to have ever been diagnosed with any physical health condition. In particular, they are 2.5, 1.7 and 1.3 times more likely to have been diagnosed with a heart disease, with migraines and with chronic back pain respectively.
- The coronavirus pandemic contributed to worsen these health disparities.

2.2. How many Germans self-identify as LGBTI+?

Identifying who is LGBTI+ is a critical prerequisite not only to assess whether, on average, a LGBTI+ person faces greater hurdles relative to a non-LGBTI+ person, but also to estimate the size of the LGBTI+ population and compute its overall disadvantage (if any). Yet, only two OECD countries have included a question on sexual orientation and/or gender identity in their census as of 2022: Canada in 2021 regarding gender identity; and the United Kingdom, also in 2021, regarding both sexual orientation (Great Britain and Northern Ireland) and gender identity (Great Britain only). In other OECD countries, data collection on these characteristics is limited. As of 2018, 15 OECD countries have regularly or sporadically deployed self-identification questions through representative surveys conducted by their national statistical offices (or equivalent) to collect data on sexual orientation, and only three countries have done so to collect data on gender identity – information on sex characteristics/intersex status has thus far been absent from official statistics (OECD, 2019[5]).

An alternative to data collected by national statistical offices are data flowing from surveys conducted by polling firms, in a context where interest in LGBTI+-related insights keeps increasing. For instance, the LGBT+ Pride 2021 Global Survey undertaken by IPSOS is the first attempt to measure the share of LGBTI+ individuals on a cross-national basis (Ipsos, 2021[7]).

2.2.1. National statistical data

In Germany, steps are being taken to actively bridge the data gap which has thus far hindered estimates of the size of the LGBTI+ population (Box 2.1). In 2016, a self-identification question on sexual orientation was added to the largest household panel survey in Germany, the Socio-Economic Panel (SOEP). Prior to this addition, data on sexual orientation was inferred indirectly, based on the kinship and relationship status of cohabitating adults. This method overlooked single non-heterosexual individuals as well as bisexual individuals living in a different-sex partnership; it also failed to capture data on the sexual orientation of other household members, such as adult children living with their parents. In 2021, a self-identification question on gender identity was also introduced in the SOEP. The results have not been published yet, but they will shed light on the share of Germans who self-identify not only as LGB (an information available since 2016), but also as non-cisgender.

Box 2.1. Who does the Socio-Economic Panel count, and how?

The Socio-Economic Panel (SOEP) is a representative panel survey of over 20 000 private households in Germany conducted annually since 1984; it currently includes over 30 000 interviews with household members aged 12 and older, though data on sexual orientation and gender identity are only collected among adults aged 18 and older.

SOEP 2016

In 2016, the following self-identification question on sexual orientation was added: “In the context of relationships, the question of sexual orientation arises. Would you describe yourself as..?” Response options include: (i) “Heterosexual or straight (that is, attracted to the opposite sex)”; (ii) “Homosexual (gay or lesbian, that is, attracted to the same sex)”; (iii) “Bisexual (attracted to both sexes)”; (iv) “Other”; (v) “Prefer not to say”; (vi) No answer. This approach allowed to identify 405 non-heterosexual households within the existing SOEP sample, i.e. households with at least one adult LGB member.

SOEP-LGB 2019

LGB people were too scarcely represented in the SOEP to allow for meaningful analysis. In order to glean more reliable conclusions from the survey, the German Federal Ministry of Education and Research funded in 2019 an initiative to create an additional sample of a hard-to-survey population that would include not only individuals who self-identify as lesbians, gays or bisexuals, but also who define themselves as transgender (including non-binary). In computer assisted telephone interviews (CATI), households were screened based on the following two questions:

A question on sexual orientation: the same as that introduced in 2016, except for the response option “Other” where respondents could this time specify their identifier (e.g.: “asexual”, “pansexual”, “demisexual”, etc.)
A question on gender identity that relied on the two‑step method. With this approach, respondents were first asked to indicate whether they were assigned female or male in their birth certificate – noting that at the time of birth of people who are now 18 years and older, there was no option to have anything but female or male entered into birth certificates in Germany (“Which sex was assigned to you on your birth certificate?” Possible responses are: “Female”; “Male”; No answer). Respondents were then asked to indicate their current gender identity, which may be female, male, transgender, or none of these (“How would you yourself describe your gender?” Possible responses are: “Female”; “Male”; “Transgender”; “None of these, …”; No answer). People who identified as transgender or none of these genders were recorded as non-cisgender, as well as people whose current gender identity did not align with the sex they were assigned at birth.

The initiative added 477 households into the SOEP sample, bringing the total to 882 households with 1 237 respondents aged 18 and older who identify as LGBTI+. Yet, given that these additional households were reached out through oversampling, they cannot be used to estimate the share of Germans who self-identify as LGBTI+.

SOEP 2021

In 2021, a two‑stage question on gender identity similar to the one used in SOEP-LGB 2019 was introduced. Results have not yet been published.

Source: (De Vries et al., 2021[8]; Kasprowski et al., 2021[4]; Socio-Economic Panel (SOEP), 2021[9]; De Vries et al., 2020[10]; Kühne, Kroh and Richter, 2019[11]; Kroh et al., 2017[12]; University of Bielefeld, n.d.[13]; Fischer et al., 2021[14]).

According to the 2016 SOEP, 1.9% of Germans self-identify as lesbians, gays or bisexuals. Though the proportion appears small, this nonetheless corresponds to 1.6 million Germans, hence more than the estimated population of Estonia.2 Moreover, although results from SOEP 2021 have not been released yet, estimates of the share of non-cisgender individuals have recently been inferred from the German Health Update (GEDA 2019/2020‑EHIS), a survey representative of the German resident population aged 15 or above that was conducted between 2019 and 2022 among 23 000 respondents (Allen et al., 2021[15]). This survey includes a two‑stage question similar to the one reported in Box 2.1 to measure sex assigned at birth and current gender identity. Based on this question, the share of non-cisgender Germans is equal to 0.6%: 0.5% concerning transgender individuals and 0.1% concerning gender-diverse individuals (Pöge et al., 2022[16]). Assuming no overlap between LGB and non-cisgender people, these findings suggest that LGBTI+ Germans represent 2.5% of the population, hence 2.1 million people or the equivalent of the population of Slovenia.3

Even so, these estimates likely understate the reality. For instance, SOEP data show 5.6% of Germans unwilling to answer the self-identification question on sexual orientation, either by outright non-response or by indicating “prefer not to say”. In addition, a further 7.1% of Germans responded to the question using the option “other”, which SOEP statisticians interpret predominantly as a form of non-response. Like with other sensitive subjects, a significant percentage of these non-responses may flow from non-heterosexual individuals who do not live openly as such, or do not feel comfortable disclosing this personal information in a survey conducted by public authorities (Kühne, Kroh and Richter, 2019[11]).

This discomfort appears highly dependent on age (Kühne, Kroh and Richter, 2019[11]; Kroh et al., 2017[12]). SOEP data demonstrate that respondents over 60 are less likely to provide a response to the self-identification question on sexual orientation compared to younger cohorts, which constitutes a commonly observed pattern (OECD, 2019[5]). Older generations may take a more conservative approach to sharing information that was once considered taboo. In addition, false responses may occur among older respondents who have historically experienced marginalisation and stigmatisation, and thus feel a social pressure to align with heteronormative standards.

The survey mode has also been found to have a significant impact on response rates, especially where sensitive or personal questions are concerned. The 2016 SOEP was predominantly carried out through computer-assisted personal interviews (CAPI): 72% of the more than 24 000 respondents who were asked for their sexual orientation were interviewed by an interviewer face‑to-face, with 90% of those interviews conducted via CAPI. The remaining 28% of respondents used a printed or digital self-administered questionnaire (SAQ) without an interviewer present. The rate of non-response to the direct question on sexual orientation was lower with CAPIs (4.4%) than with SAQs (8.7%), but the proportion of self-identified non-heterosexual respondents decreased by nearly half when an interviewer was present (Kühne, Kroh and Richter, 2019[11]). This result suggests that participants are more likely to provide false responses in face‑to-face scenarios where there is a felt pressure, not only to provide a definitive answer, but one that may be perceived as socially desirable.4 For some SOEP participants, this pressure may have been exacerbated by the presence of other household members or intimate partners.

2.2.2. Polling data

In a context where respondents may feel more secure in disclosing sensitive information to non-governmental polling companies than to national statistical offices, attempts of these companies to measure the share of LGBTI+ individuals merit attention. Yet, contrary to national statistical offices, these companies rarely rely on probability sampling, e.g. contacting respondents following a random draw from the phone directories. Rather, polling companies typically base their surveys on opt-in panels. This approach consists in exploiting pre‑existing samples held by the survey provider where members have signed up to take online surveys, in exchange of small rewards. Polling companies employ a variety of statistical techniques to adjust opt-in panels to ensure they match the national population on a chosen set of dimensions. That said, the fact that respondents are self-selected raises a risk that those who answer surveys related to LGBTI+ issues are the most open to those issues (Lehdonvirta et al., 2020[17]). Against this backdrop, while data collected by national statistical offices likely understate the share of LGBTI+ individuals, polling data likely overstate the size of sexual and gender minorities.

Consistent with this surmise, the share of Germans who self-identify as LGB in the LGBT+ Pride 2021 Global Survey conducted by IPSOS is markedly higher than the estimate deduced from the SOEP (8% vs 1.9%), noting that an additional 3% self-identify as “other”, i.e. “asexual”, “pansexual”, etc (Figure 2.1). Overall, an estimated 11% of Germans thus self-identify as non-heterosexual, with the highest share (6%) identifying as bisexual. The share of individuals who self-identify as non-heterosexual is estimated to be the same (11%) in Australia, Canada, Chile, Mexico and the United States, and is higher in Spain by just 1 percentage point. Considering countries for which data is available, non-heterosexuals comprise 9.1% of the OECD population on average. This average reflects the German pattern in that bisexuals make up the highest proportion (3.8%), followed by individuals who self-identify as “lesbian, gay or homosexual” (2.7%). In addition, an estimated 3% of Germans self-identify as non-cisgender, which is equalled only in Sweden, and is three times higher than the estimated OECD average of 1.6% (Figure 2.2). Overall, assuming no overlap between non-heterosexual and non-cisgender people, IPSOS findings suggest that LGBTI+ Germans represent 14% of the population, hence 11.6 million people or the equivalent of the population of Belgium.

Figure 2.1. More than 10% of Germans self-identify as non-heterosexual

Figure 2.2. 3% of Germans self-identify as non-cisgender

It is worthwhile noting that, similar to the SOEP (and other surveys), the probability to self-identify as non‑heterosexual and non-cisgender in the IPSOS survey strongly decreases with age. This finding is typically interpreted as reflecting a greater willingness of younger cohorts to disclose who they are in a context of increasing acceptance of sexual and gender minorities,5 rather than a true shift in sexual orientation and gender identity (OECD, 2019[5]). Regardless of their cause, these generational disparities at least suggest that the share of LGBTI+ individuals is on the rise and will continue rising in the future, as older cohorts give way to younger ones.

2.3. Are LGBTI+ Germans exposed to discrimination and violence?

LGBTI+ individuals account for a significant share of the German population. It is however unclear whether they are treated on an equal footing. After providing an overview of social acceptance of LGBTI+ people at both the federal and state levels (Section 2.3.1), this section investigates the extent to which LGBTI+ people self-report experiences of discrimination and violence (Section 2.3.2). It concludes by exploring LGBTI+ people’s exposure to discrimination and violence based on objective measures (Section 2.3.3).

2.3.1. Social acceptance of LGBTI+ individuals in Germany

The level of social acceptance of sexual and gender minorities within the population at large may influence the perceived risk – and lived experience – of discrimination and violence by LGBTI+ individuals (Flores, 2019[18]). This section provides an overview of attitudes towards LGBTI+ individuals at the federal and state levels.

Attitudes towards LGBTI+ individuals at the national level

Regular, representative cross-continent data on attitudes towards homosexuals have been collected as early as 1981, beginning with the World Values Survey (WVS). Similar inquiries have since been conducted by the European Values Survey, AmericasBarometer, LatinoBarometer, AsiaBarometer, AfroBarometer and by Gallup. While they can provide a helpful understanding of attitudes towards some members of the LGBTI+ population and their evolution, such measures are not without limitations (Box 2.2).

Box 2.2. Questions measuring social acceptance of homosexuality in cross-continent surveys present limitations

Three questions have been repeatedly used in cross-continent surveys to measure social acceptance of homosexuality.

Justifiability of homosexuality

“Please tell me whether you think [homosexuality] can always be justified, never be justified, or something in between using this card (the card being a scale from 1 to 10, where 1 means that homosexuality is never justifiable and 10 means that it is always justifiable)”

This question has been included in the World Values Survey since its first wave in 1981, and has since been deployed in such cross-national questionnaires as the AsiaBarometer, the European Values Survey and the Latinobarometer. It presents a number of controversial behaviours or polarising issues which places homosexuality alongside such items as euthanasia, abortion, divorce, prostitution, theft and fraud. The question is framed in such a way as to lead respondents to use morality as a criterion for determining the justifiability of homosexuality. Yet, perception of immorality and lack of acceptance do not necessarily coincide. For example, respondents in more liberal democracies may feel moral discomfort with homosexuality while also acknowledging that homosexuals deserve openness and benevolence from their fellow citizens.

Level of comfort with homosexual neighbours

In the second wave of the World Values Survey (1990), a question was added to measure respondents’ level of comfort with having homosexual neighbours, among other hypothetical groups. Since then, variations on this question have been adopted by such surveys as the AmericasBarometer, the AfroBarometer, the LatinoBarometer and the European Values Survey. The World Values Survey presents a list of various groups of people, asking “Could you please mention any that you would not like to have as neighbours?” Homosexuals are featured on the list alongside other demographic minorities such as “people of a different race” or “people of a different religion”, but also among such people as “drug addicts” and “heavy drinkers”. Yet, the exact wording of this question varies significantly from a survey to the next (and sometimes across rounds within the same survey), which precludes from running thorough cross-national comparisons of levels and trends regarding social acceptance of homosexuality.

Local social acceptance of homosexuality

In the late 2000s, Gallup included a question in their annual survey which asks respondents whether they consider their home city or neighbourhood to be “a good place or not a good place to live for gay or lesbian people”. However, the question risks measuring a respondent’s perception of local social acceptance of gay men and lesbians, rather than measuring the respondent’s own attitude towards homosexuality.

Source: (OECD, 2019[5]; Flores, 2019[18]; World Values Survey, 2017[19]; AfroBarometer, 2019[20]; Vanderbilt University, 2018[21]; Naurath, 2007[22])

The Special Eurobarometer on Discrimination provides a valuable alternative to these cross-continent data for the purpose of international comparison of attitudes, not only towards non-heterosexuals (including bisexuals), but also towards transgender individuals and, most recently, intersex individuals.6 Although data are limited to EU member countries and cover a shorter timeframe, it allows for a more comprehensive estimate of LGBTI+ acceptance.

Considering responses from the three questions detailed in Table 2.1, the average social acceptance for LGBTI+ individuals in Germany (proxied by the share of respondents who would feel totally comfortable7 with interacting in some way with an LGBTI+ person) was 57% in 2019, slightly higher than the EU-OECD average at the time (53%). However, a closer look at the data reveals strong in-group disparities (see Figure 2.3 for attitudes towards LGB individuals, Figure 2.4 for attitudes towards transgender individuals and Figure 2.5 for attitudes towards intersex individuals). In Germany, as across the EU-OECD, non-cisgender individuals face lower overall rates of social acceptance than do non-heterosexual individuals (OECD, 2019[5]). In 2019, non-heterosexual Germans (LGBs) experienced an average rate of social acceptance equal to 65% while this rate was equal to 54% for non-cisgender Germans (TIs), compared to 60% and 50%, respectively, in the EU-OECD. Even the Netherlands who show the highest social acceptance of LGBTI individuals in 2019 follows this pattern: the acceptance rate of Dutch respondents is equal to 92% concerning lesbians, gays and bisexuals, 81% concerning transgender individuals and 80% concerning intersex individuals.

Levels of acceptance also fluctuate noticeably depending on the hypothetical scenarios presented in each of the three survey questions. Across the EU-OECD, social acceptance is lowest in the scenario involving fictitious LGBTI+ daughter- or son-in-laws. This suggests that levels of acceptance among respondents decrease as their hypothetical ties with the LGBTI+ individual becomes more personal. In Germany, 59% of respondents are comfortable with the idea of their child being in “a love relationship” with a person of the same sex (as compared to 49% in the EU-OECD), noting that this rate drops to 45% when the hypothetical daughter- or son-in-law is transgender or intersex (39% in the EU-OECD).

QUESTION	LGBTI+ subgroup
	“gay, lesbian or bisexual person”	“transgender or transsexual person”	“intersex person”
Using a scale from 1 to 10, where ‘1’ means that you would feel “not at all comfortable” and ‘10’ that you would feel “totally comfortable”:
Please tell me how you would feel about having a person from each of the following groups in the highest elected political position in [your country]	2009 2 012 2015 2019	2012 2 015 2019	2019
Regardless of whether you are actually working or not, please tell me how comfortable you would feel, if a colleague at work with whom you are in daily contact, belonged to each of the following groups?	2015 2019	2015 2019	2019
Regardless of whether you have children or not, please tell me how comfortable you would feel if one of your children was in a love relationship with a person from one of the following groups.	2015 2019	2015 2019	2019

Source: (European Commission, 2012[23]; European Commission, 2015[24]; European Commission, 2019[25]).

Consistent with the well-documented shift towards greater acceptance of homosexuality in the OECD and beyond since the early 1980s (OECD, 2019[5]; Flores, 2019[18]),8 acceptance rates for LGBTI+ individuals have generally progressed across the EU-OECD. Between 2015 and 2019, average levels of acceptance in the EU-OECD rose by 9 percentage points (or 17%) for LGB people and by 8 percentage points (or 20%) for transgender people. In Germany, the rate of improvement is markedly better, increasing by 23 percentage points for both LGBs and transgender individuals, which corresponds to a growth in the rate of acceptance of 56% and 78% respectively. In fact, while attitudes towards LGBT individuals in Germany were 10 percentage points lower than the EU-OECD average in 2015, this gap was closed and surpassed by 4 percentage points in 2019. This result suggests that significant improvement in attitudes can occur even over a short period of time, regardless of baseline levels of acceptance.

Figure 2.3. Two-thirds of German respondents feel totally comfortable with interacting with a lesbian, gay or bisexual

Figure 2.4. Half of German respondents feel totally comfortable with interacting with a transgender person

Figure 2.5. Comfort with intersex individuals is as modest as comfort with transgender individuals across the EU-OECD

Attitudes towards LGBTI+ individuals at the subnational level

Germany provides a particularly interesting opportunity for analysis of LGBTI+ acceptance because representative data exist at the subnational level. More precisely, two surveys have been conducted thus far that help derive attitudes towards sexual and gender minorities across Germany’s 16 states:

In 2015, the Change Centre Foundation carried out the “Queer Germany” (Queeres Deutschland) survey via online interviews with over 2 000 respondents aged 18 and older about their views related to non-heterosexuals.9
In 2018, the Institute for Applied Social Science (Institut für angewandte Sozialwissenschaft) conducted the “Diversity Barometer” (Vielfaltsbarometer) survey with support from the Robert Bosch Foundation among over 3 000 respondents aged 16 and older.10

This subsection focuses on results from the German Diversity Barometer because, on top of relying on a larger and more recent sample, it measures opinions and behaviour towards a variety of socio-demographic groups, including both non-heterosexuals and non-cisgender individuals.

Regarding attitudes towards non-heterosexuals, the Diversity Barometer asked respondents to rate the following statements:

“It is disgusting when homosexuals kiss in public” (Es ist ekelhaft, wenn Homosexuelle sich in der Öffentlichkeit küssen);
“The fact that homosexuals could raise their own children is simply unthinkable” (Homosexuelle und eigene Kinder – das passt einfach nicht zusammen).

Regarding attitudes towards non-cisgender individuals, the Diversity Barometer asked respondents to react to the following statements:

“Changing one’s gender is against Nature” (Das Geschlecht zu ändern ist wider die Natur);
“Transsexual people should stay among themselves” (Transsexuelle Menschen sollten unter sich bleiben).

The level of social acceptance of these LGBTI+ subgroups is represented by the proportion of respondents who answered “strongly disagree” (stimmt gar nicht) to the aforementioned statements (Figure 2.6 and Figure 2.7). Rates of acceptance across Germany were slightly higher on average for non-cisgender individuals (64%) than they were for non-heterosexuals (60%), though this may be attributed to differences in language and style among questions for respective subgroups, and the sentiments they may evoke in turn.

Figure 2.6. Comfort with non-heterosexuals is the lowest in Saxony and the highest in Berlin

Figure 2.7. Comfort with non-cisgender individuals is the lowest in Saxony and the highest in Bremen

A closer look at the data sheds light on regional disparities with respect to social acceptance of LGBTI+ individuals. These disparities point to a west-east divide. Levels of acceptance towards non-heterosexuals across states of former West Germany are 7 percentage points higher than those across states of former East Germany. The trend persists for non-cisgender individuals who are shown to experience 5 percentage points more social acceptance across states of former West Germany (Table 2.2).

	Social acceptance of non-heterosexual people	Social acceptance of non-cisgender people
East German average	55%	61%
West German average	62%	66%

Note: This figure is based on the 2018 German Diversity Barometer that was conducted entirely online, with over 3 000 respondents aged 16 and older. The share of respondents who strongly disagree with negative statements on non-heterosexual individuals is computed as the average of the share of respondents who answered “strongly disagree” to the following two statements: “It is disgusting when homosexuals kiss in public”; “The fact that homosexuals could raise their own children is simply unthinkable”. The share of respondents who strongly disagree with negative statements on non-cisgender individuals is computed as the average of the share of respondents who answered “strongly disagree” to the following two statements: “Changing one’s gender is against nature”; “Transsexual people should stay among themselves”.

Source: (Robert Bosch Foundation, 2019[26]).

2.3.2. Perception of discrimination and experience of violence self-reported by LGBTI+ individuals in Germany

Acceptance of LGBTI+ people in Germany remains limited, which puts sexual and gender minorities at risk of discrimination and violence. Against this backdrop, this section investigates the perception of discrimination and experience of violence self-reported by LGBTI+ individuals based on two surveys conducted by the European Union Agency for Fundamental Rights (FRA):

The first survey was disseminated online in 2012, and collected anonymous data from over 93 000 respondents aged 18 and older who self-identified as LGBT across the EU.11
The second survey was conducted in 2019, again anonymously and online, among 140 000 respondents aged 15 and older across the EU. This second round also included respondents who self-identified as intersex.12

Perception of discrimination by LGBTI+ individuals in Germany

In both rounds of the FRA-LGBT(I) survey, respondents were asked whether they felt personally discriminated against over the last 12 months on the basis of their sexual orientation or gender identity in a variety of situations, such as “when looking for a job”: 11 situations were listed in 2012, against 8 in 2019.13 Compared to the 2012 round, the 2019 round does not cover experiences of discrimination in a bank or insurance company, or at a sport or fitness club. Moreover, in the 2019 data, experiences of discrimination when interacting with health care or social services personnel are grouped together, while they are singled out in the 2012 data.

Figure 2.8 presents the share of LGBTI+ respondents who reported having personally felt discriminated against during the 12 months prior to the survey in any (i.e. at least one) of the listed situations, in 2012 and in 2019. On average, more than half (58%) of LGBTI respondents reported feeling discriminated against in Germany in 2019, which is slightly more than the EU-OECD average (53%). Consistent with the fact that transgender and intersex people face lower social acceptance than LGB people, this group reports significantly higher levels of discrimination in all EU-OECD countries. In Germany for instance, 66% of transgender and intersex Germans feel discriminated against as compared to 41% among LGBs.

While the increase in social acceptance of LGBTI+ individuals documented in Section 2.3.1 portended a decrease in the perception of discrimination among this population, this perception stagnates among LGBs (Panel A of Figure 2.8) and strongly increases among transgender individuals (Panel B of Figure 2.8). In Germany, the share of LGBTI+ individuals reporting discrimination was nearly 10 percentage points lower in 2012 than in 2019. This pattern emerges despite the fact that the question measuring perception of discrimination covers fewer areas of life in 2019 (8) than in 2012 (11) − a methodological inconsistency that runs against finding a worsening in levels of perceived discrimination. Yet, rather than an increase in discriminatory acts against LGBTI+ individuals (that would be difficult to reconcile with greater acceptance of this population), this result suggests lower reluctance of sexual and gender minorities to report the unfair treatment they are subject to.

A closer look at the eight scenarios used in 2019 highlights that the perception of discrimination among LGBTI Germans is particularly high in health care, educational and labour market settings. The share of LGBTI Germans who report having felt discriminated against in the past 12 months is equal to 19% when interacting with school/university personnel, 17% when looking for a job or at work, and 18% when dealing with health care or social services personnel. Similarly, everyday discrimination in public is frequent, with for instance 21% of LGBTI Germans reporting discrimination at a cafe, restaurant, bar or nightclub. By contrast, sexual and gender minorities in Germany experience discrimination less often on the housing market (13%), or when dealing with the public administration or authorities, at least during check of ID or of any official document that identifies the holder’s sex (6%) (FRA, 2012[27]; FRA, 2020[28]).

Figure 2.8. A majority of LGBTI respondents reported feeling discriminated against in Germany as of 2019

Self-reported experience of violence by LGBTI+ individuals in Germany

The FRA-LGBT(I) surveys provide respondents with the opportunity to report experiences of violence, by asking them whether they were physically or sexually attacked or threatened with violence in the past five years (Figure 2.9).14 On average, a little more than one‑third (36%) of LGBTI respondents report experiences of violence in Germany in 2019, which, as it was already the case for the perception of discrimination, is slightly higher than the EU-OECD average (33%).

Again, consistent with the fact that transgender and intersex people face lower social acceptance than LGB people, this group reports greater exposure to violence in all EU-OECD countries. In Germany for instance, 41% of transgender and intersex Germans were physically or sexually attacked or threatened with violence in the past five years, as compared to 26% among LGBs.

Concerning trends, self-reported experience of violence by sexual and gender minorities has generally improved between 2012 and 2019, although not in Germany. Germany is among the few OECD countries where accounts of violence has increased rather than decreased.

Figure 2.9. A little more than one‑third of LGBTI respondents report experiences of violence in Germany as of 2019

2.3.3. Objective measures of anti-LGBTI+ discrimination and violence in Germany

Social acceptance of LGBTI+ people in Germany remains limited while perception of discrimination and self-reported experiences of violence among the LGBTI+ population is high. This section explores whether these attitudinal measures are corroborated through more objective data.

Anti-LGBTI+ discrimination

In Germany, like in other countries, objective measures of anti-LGBTI+ discrimination mainly derive from labour market data, based on nationally representative surveys and field experiments. Both types of evidence exist in Germany, and suggest that LGBTI+ Germans do face significant discrimination.

Nationally representative surveys

Since the introduction in 2016 of a self-identification question on sexual orientation in the German Socio-Economic Panel (SOEP) (Box 2.1), the German Institute for Economic Research (Deutsches Institut für Wirtschaftsforschung − DIW) has performed several comparisons of labour market outcomes of LGBTI+ and non-LGBTI+ individuals (De Vries et al., 2020[10]; Kroh et al., 2017[12]).15 These analyses reveal significant unexplained gaps, reflecting an OECD-wide trend (OECD, 2019[5]): LGBTI+ Germans suffer from a substantial disadvantage relative to non-LGBTI+ Germans in terms of labour market outcomes even when the effect of potential differences in observable characteristics across these two groups is neutralised, e.g. differences in age, education, occupation, type of work contract (full-time, part-time, etc.), sector, etc. More precisely:

Although LGBTI+ and non-LGBTI+ Germans show similar employment rates, LGBTI+ Germans have a 30% higher risk to be engaged in precarious work, e.g. “mini-jobs”, a term coined in Germany to describe a form of marginal employment that is generally characterised as part-time with a low wage (EUR 450 per month or less).
Even holding the type of work contract constant, LGBTI+ Germans are characterised by lower labour earnings: the average hourly wage is equal to 18.14 euros for heterosexual men, while it is nearly 15% lower for homosexual and bisexual men. Moreover, homosexual and bisexual women show the same hourly wage as heterosexual women while they would be expected to earn more all other things held constant due to an often lower unpaid work burden. Indeed, women in different-sex couples devote considerably more time to childcare than their partner, while family responsibilities are fewer for homosexual and bisexual women: the latter are not only less likely to live with a partner or have children, they are also more likely to share paid and unpaid work equally with their same‑sex partner when cohabiting, in a registered partnership, or married (Valfort, 2017[29]). As an illustration, the proportion of dual-income households in Germany is substantially higher among same‑sex couples (67%) than among different-sex couples (54%) (Kroh et al., 2017[12]).

Yet, these estimates may constitute a lower bound of the penalty sexual and gender minorities face. Evidence shows that better educated individuals are overrepresented among respondents ready to provide anonymous information about private characteristics, such as their sexual orientation, as part of a census or a survey conducted by the national statistics office, if that could help to combat discrimination in their country (European Commission, 2019[25]). Against this backdrop, LGBTI+ people who disclose their sexual orientation and/or gender identity in surveys are likely not representative of the LGBTI+ population as a whole). Consistent with this surmise, Germans who self-identify as LGBTI+ in the SOEP show higher educational attainment than their non-LGBTI counterparts: 47% of LGBs report having university entrance qualifications, compared to 36% of heterosexuals (Kroh et al., 2017[12]). Similar results are obtained when non-cisgender individuals are included in the sample (De Vries et al., 2020[10]): the share of LGBTI+ individuals with a technical or upper secondary degree (60%) is considerably higher than for the rest of the German population (42%), a result that has been repeatedly confirmed in other OECD countries (Valfort, 2017[29]). This education premium for sexual and gender minorities is at odds with extensive evidence showing that LGBTI+-phobic bullying at school is a widespread phenomenon that undermines the educational attainment of students perceived as LGBTI+ (OECD, 2020[3]). As such, it suggests that comparisons of labour market outcomes of LGBTI+ and non-LGBTI+ Germans flowing from supposedly nationally representative surveys suffer from a strong selection bias that understates the disadvantage suffered by LGBTI+ individuals.16

Field experiments

The fact that survey-based evidence points to a labour market penalty for LGBTI+ people is not sufficient to conclude that sexual and gender minorities are discriminated against. This penalty can indeed flow from mechanisms that have nothing to do with discrimination. Such would be differences in unobserved characteristics between LGBTI+ individuals and the rest of the population, for instance as regards mental health (an issue addressed in Section 2.4).

To better measure anti-LGBTI+ discrimination, field experiments are key. In the labour market, these experiments mainly take the form of “correspondence studies”, or studies in which resumes for fictitious candidates identical in every respect save their sexual orientation or gender identity are submitted to real job postings. Any difference in the rate at which fictitious LGBTI+ and non-LGBTI+ candidates are invited to the job interview by employers (called « the callback ») is interpreted as evidence of discrimination based on sexual orientation or gender identity.

Thus far, two correspondence studies have been conducted in Germany to investigate hiring discrimination against LGBTI+ applicants. The first focuses on discrimination based on sexual orientation against female candidates who apply as secretaries, clerical assistants or accountants in a wide range of sectors in Munich and in Berlin, two German cities characterised by significantly different levels of acceptance of LGBTI+ individuals (Weichselbaumer, 2014[30]).17 This field experiment that took place in 2012 relied on the two main methodological approaches to imply the applicant’s sexual orientation through correspondence:

Approach 1 deployed resumes which differed in terms job history, without compromising levels of job experience. Lesbian candidates included volunteer engagement or work experience in an obviously LGBTI+ organisation, whereas heterosexual candidates stated neutral organisations that did not allude to sexual orientation. For example, where a lesbian resume indicated “bookkeeping at the Lesbian and Gay Association of Germany (Lesben- und Schwulenverband in Deutschland, LSVD)”, the heterosexual resume indicated “bookkeeping in a non-profit cultural centre”;
Approach 2 highlighted the gender of the candidate’s partner, a strategy feasible in countries like Germany where it is common to specify the partner’s first and last name on a CV. For example, under the “family status” section of her CV, the lesbian applicant mentions “in a registered partnership with Katharina Krause”, while the heterosexual applicant indicates “married to Andreas Krause”.

Consistent with social acceptance of LGBTI+ individuals being higher in Berlin than in Bavaria, Weichselbaumer’s field experiment reveals that lesbian applicants are significantly discriminated against in Munich, but not in Berlin. In Munich, straight female candidates are between 20% (approach 2) and 30% (approach 1) more likely to be invited to a job interview by prospective employers (Weichselbaumer, 2015[31]). This finding is similar to the average result found in other OECD countries when relying on the same methodological approaches (OECD, 2019[5]), noting that field experiments in these countries also point to high levels of hiring discrimination against gay men: on average, male homosexual applicants are 50% less likely than their heterosexual counterparts to be called back by the employer.

The second correspondence study in Germany concentrates on discrimination based on gender identity against male‑born candidates who apply for dramaturgical internships in German-speaking theatres across the country (Gerhards, Sawert and Tuppat, 2021[32]). This field experiment that took place in 2019 relied on three main methodological approaches to suggest the applicant’s non-cisgender identity through correspondence:

Approach 1 deployed resumes which indicated a typically female first name in quotation marks (i.e. “Gloria”) alongside the male first name assigned at birth, so as to signal a transgender applicant;
Approach 2 explicitly indicated “transgender”, as opposed to “male”, in the gender section of the resumé;
Approach 3 deployed resumes whose only difference was the name of the theatre company wherein the candidate gained previous experience. For example, the transgender applicant indicated an internship with a “queer youth theatre group”, whereas the cisgender applicant indicated an internship at a “youth theatre group”.

Contrary to the Weichselbaumer field experiment, this study revealed no hiring discrimination against the male‑to-female transgender applicant: the latter shows the same probability of being invited for an interview with the prospective theatre company as the male cisgender applicant (Gerhards, Sawert and Tuppat, 2021[32]). Yet, this study is limited by the fact that it focuses on a single sector, i.e. the field of art and entertainment. Not only is this field typically characterised by open-mindedness towards minorities, but it also is known to employ LGBTI+ individuals in large numbers (OECD, 2021[6]). By contrast, field experiments conducted in other OECD countries across a wider range of sectors point to significant hiring discrimination against transgender applicants – see (Bardales, 2013[33]) in the US and (Granberg, Andersson and Ahmed, 2020[34]) in Sweden.

Although these experimental results may be considered limited to LGBTI+ applicants who are open about their sexual and gender identities through the hiring process, they nonetheless convey valid findings that apply to LGBTI+ individuals who may be perceived as such despite being less forthcoming about their personal lives. Evidence exists to suggest that homosexual males are significantly more likely to be categorised as such by unknown, external observers (Rule and Ambady, 2008[35]). Similarly, a transgender identity may be detectable, even if it is not verbally disclosed. For instance, transgender Germans report expressing their gender through physical appearance in greater numbers compared to the EU-OECD average: 55% of trans women and 71% of trans men express their identities openly through their physical appearance in Germany, compared to 48% of trans women and 58% of trans men in the EU-OECD (FRA, 2020[28]).18 Even where gender expression is ambiguous, it can be revealed during the first job interview when recruiters consult identity documents or diplomas for transgender candidates who have not yet undertaken the legal process to change their gender marker.

It is worth stressing that correspondence studies likely understate the extent of hiring discrimination against LGBTI+ job candidates since they do not perform a follow-up analysis on job interview outcomes. For example, a significant number of field experiments related to racial and ethnic discrimination in the hiring process combine correspondence studies with audit studies, where actors who embody the fictitious applicants are sent to job interviews. Available evidence from all such studies reveals considerable second-stage discrimination: in addition to receiving 53% more callbacks, candidates who embody the racial or ethnic majority continue through the hiring process to receive 145% more job offers than comparable minority applicants (Quillian, Lee and Oliver, 2020[36]).

Anti-LGBTI+ Violence

Administrative data from German police reveal significant violence against LGBTI+ individuals (Box 2.3). In 2020, violent hate crimes motivated by the presumed sexual orientation of the victim accounted for more than 10% of all violent politically motivated crimes. This figure is over ten times higher than it was two decades ago, when their share constituted less than 1%, presumably due to massive underreporting (BMI, 2021[37]). When the gender identity of the victim is taken into account (an information introduced in 2020), this share rises above 15%.

Yet, it is well known that administrative police data underestimates actual violence against sexual and gender minorities due to widespread underreporting (Palmer and Kutateladze, 2021[38]; Pezzella and Fetzer, 2021[39]). Indeed, when thinking about the last incident of hate‑motivated physical or sexual attack they underwent, only 13% of LGBTI+ Germans said having reported it to the police, according to the 2019 FRA-LGBTI survey (FRA, 2020[40]).

Box 2.3. Data on violent politically motivated hate crimes in Germany

Violent politically motivated hate crimes are a subcategory of “politically motivated crimes”.

They are characterised by serious criminal offences – such as murder, dangerous and grievous bodily harm, rape and sexual assault – that, “in consideration of the circumstances of the offence and/or the attitude of the perpetrator”, are committed “on the basis of prejudices of the perpetrator with regard to nationality, ethnicity, skin colour, religious affiliation, social status, physical and/or mental disability or impairment, gender/sexual identity, sexual orientation or physical appearance” of the victim.

Once reported to police, statistics on violent politically motivated hate crimes are maintained by the Criminal Police Reporting Service (Kriminalpolizeilicher Meldedienst − KPMD). The KPMD compiles data on all politically motivated crimes that are recorded by the Criminal Police Offices at the state level (Landeskriminalamt − LKA) and at the federal level (Bundeskriminalamt − BKA).

Source: (BMI and BMJ, 2021[41])

2.4. How do LGBTI+ Germans fare in terms of well-being?

In comparison to heterosexual and cisgender individuals, LGBTI+ peoples’ disproportionately high exposure to discrimination and violence risks reducing their overall well-being (Flores, 2019[18]; OECD, 2019[5]). This section begins by analysing the overall life satisfaction of LGBTI+ individuals as compared to the general population in OECD countries for which data exist (Section 2.4.1). It then focuses on differences in health outcomes, both with respect to mental health and physical health (Section 2.4.2).

2.4.1. LGBTI+ Germans’ life satisfaction

LGBTI+ individuals experience lower rates of subjective life satisfaction than their non-LGBTI+ counterparts across the EU (Figure 2.10). Germany is no exception. When asked to report on a scale from 0 “not at all satisfied” to 10 “completely satisfied” how satisfied they are with their life, LGBTI+ individuals respond 6.7 as compared to 7.4 in the general population. This gap is similar to that observed on average across EU-OECD countries. This observation is consistent with SOEP data from 2016 which indicate lower life satisfaction among non-heterosexual than among heterosexual respondents (7 vs 7.4), though data from that year exclude non-cisgender individuals (Kroh et al., 2017[12]).19

Figure 2.10. The life satisfaction of LGBTI+ Germans is 10% lower than among the general population

2.4.2. LGBTI+ Germans’ health

LGBTI+ people’s strong exposure to discrimination and violence should not only undermine their life satisfaction, but also their mental and physical health. Stigma (i.e. the fact that sexual and gender minorities live in social environments that largely view heterosexual and cisgender identity as the only way of being normal) is known to generate anxiety, depression, as well as suicide ideation and attempt (Meyer, 2003[44]; Perales and Todd, 2018[45]). Lower mental health in turn has the potential to impair LGBTI+ people’s physical health by providing a fertile ground to other pathologies, such as cardiovascular diseases.

Consistent with results obtained OECD-wide (OECD, 2019[5]; Pöge et al., 2020[46]), SOEP data confirm that LGBTI+ Germans are characterised by worse health outcomes than the rest of the German population, which translates into them being twice as likely as their non-LGBTI+ counterparts to have taken over six weeks of sick leave from work in 2019 (8% vs 4%) (Kasprowski et al., 2021[4]). More precisely, in terms of mental health (Figure 2.11):

LGBTI+ Germans are 2.6 times more likely to have ever been diagnosed with a depressive disorder compared to heterosexual cisgender Germans (26% vs 10%). This finding is consistent with results from SOEP data collected in 2016 which show that LGBs were 2.2 times more likely than their non-LGB counterparts to report diagnosis of a depressive disorder (Kroh et al., 2017[12]).
In addition to increased feelings of “diminished interest”, “feeling down”, “nervousness” and “incessant worrying” indicative of depressive disorders, German LGBTI+ individuals are also 1.9 times more likely to have ever been diagnosed with a sleeping disorder (15% vs 8%), and 2.3 times more likely to have ever been diagnosed with occupational burnout (9% vs 4%) compared to non-LGBTI+ Germans.

A closer look at the data reveals staggering in-group differences. For example, 39% of transgender respondents report having ever been diagnosed with an anxiety disorder compared to 9% of cisgender LGBs. Transgender Germans are also nearly three times more likely to have ever been diagnosed with an eating disorder than are LGBs (12% vs 4.5%) (Kasprowski et al., 2021[4]).

In terms of physical health, LGBTI+ individuals in Germany are twice less likely to have never been diagnosed with any physical health condition relative to non-LGBTI+ individuals (26% vs 42%). Notably (Figure 2.11):

LGBTI+ Germans are 2.5 times more likely to have been diagnosed with a heart disease, such as heart failure or cardiac insufficiency (10% vs 4%);
They are 1.3 times more likely to have been diagnosed with chronic back pain (16% vs 12%);
12% of LGBTI+ Germans have been diagnosed with migraines compared to 7% of non-LGBTI+ individuals.

Figure 2.11. LGBTI+ Germans suffer from mental and physical health issues in far greater numbers than non-LGBTI+ Germans

Complementary evidence confirms that rather than an innate predisposition to such medical conditions, disparities in mental and physical health endured by the LGBTI+ population is linked to their chronic exposure to stigmatisation, discrimination and violence. Notably, a rapidly growing literature is providing compelling evidence that stigma does cause LGBT people’s worse mental health. In the United States for instance, the reduction in the number of suicide attempts between LGB and heterosexual youth was substantially higher in states that had adopted same‑sex marriage before its legalisation by the Supreme Court in 2015, than in others – a trend that was not apparent before the implementation of this inclusive policy (Raifman et al., 2017[47]). Consistent with the fact that LGBTI people’s stigmatisation is at the root of their lower mental health, LGBTI+ Germans are twice as likely as their non-LGBTI+ counterparts to report having felt (very) often “socially isolated” (10% vs 5%). They are also three times as likely to report having felt (very) often “left out” (15% vs 5%) (Kasprowski et al., 2021[4]).

Importantly, the data presented in this section reflects the situation of Germans before the coronavirus pandemic. Several studies aimed at evaluating changes in the mental health status of the German population during the pandemic confirm a significant increase in depressive symptoms, citing that individuals with pre‑existing depressive disorders are particularly at risk of worsening symptoms (Moradian et al., 2021[48]; Armbruster and Klotzbücher, 2020[49]). Unsurprisingly, complementary findings show that LGBTI+ individuals are among groups that have been hit the hardest (Box 2.4). Contact regulation during the pandemic was often restricted to biological families while LGBTI+ individuals disproportionately rely on elective families. As such, social distance and lockdowns have led to isolation from friends and acquaintances or to forced proximity with unaccepting family members. Moreover, LGBTI+ individuals have been particularly affected by the loss of various meeting places such as associations or clubs, which represent an important infrastructure in which contacts are made and counselling is offered.

Box 2.4. The COVID‑19 pandemic has disproportionately impacted LGBTI+ people in Germany

In March 2020, Germany implemented its first series of infection containment measures, including home confinement across German federal states.

Community-based reports

Pandemic containment measures often restricted individuals to their biological families, failing to recognise that LGBTI+ individuals disproportionately rely on their friends as elective families. Social distancing measures and lockdowns have, in some cases, led to forced proximity with potentially unaccepting family members, exposing LGBTI+ individuals to increased discrimination and family violence, or to isolation in an effort to avoid these.

This has only been aggravated by intermittent or permanent closure of LGBTI+-friendly and LGBTI+-specific associations, clubs, grassroots organisations and NGOs. COVID‑19 has shrunk important infrastructure, not only in terms of networking, socializing, and advocacy, but also in terms of essential service provision, such as counselling, peer support groups, and other important resources in the form of housing, employment, health and legal services. Overall, initial studies indicate that LGBTI+ individuals are among groups that have been hit the hardest by the pandemic as a result of narrowing resource constellations. While many such services and supports are now available remotely, via telephone or internet, accessibility may be compromised by privacy concerns, especially in situations of co-habitation where individuals may not be living openly.

In terms of employment, LGBTI+ people working in sectors heavily impacted by the pandemic – such as tourism, hospitality, arts and entertainment – are faced with added anxiety about finding new employment. Their increased exposure to discrimination in the labour market can make it that much more difficult to find a new job. In addition, the fact that LGBTI+ people earn lower wages on average may lead to their having a smaller security net in times of economic precarity.

Non-cisgender individuals are especially at risk in terms of curbed service delivery and limited access to health care associated with recognition and expression of their gender identities. Legal services necessary to alter gender markers on official documents in Germany have been deemed non-essential and thus either ceased altogether or have been limited, creating delays and access issues for individuals seeking to legally affirm their gender identity. Lastly, limited access to health care professionals have compromised hormone therapies or gender-related surgeries that play a critical role in gender expression and self-affirmation.

Survey data

Currently, only one quantitative assessment of the differential impacts of the coronavirus pandemic on mental health between heterosexual, cisgender individuals and LGBTI+ people in Germany exists. The survey was disseminated online through adverts on social media platforms and anonymous data was collected between 20 April and 20 July 2020 among 2 332 respondents aged 18 and older. The study deployed the abridged, five‑item well-being index developed by the World Health Organization (WHO‑5) to assess mental health during the first wave of the pandemic.

In line with pre‑pandemic data, the survey revealed lower rates of subjective well-being and higher rates of clinically significant depression among LGBTI+ respondents compared to non-LGBTI+ respondents. Data also point to in-group disparities, where cisgender bisexual, cisgender asexual and non-cisgender individuals appear to be the most impacted.

Source: (BMFSFJ, 2021[50]; OECD, 2021[6]; LSVD, 2021[51]; ILGA Europe, 2020[52]).

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Notes

← 1. The Constitutions of Latvia, Hungary and the Slovak Republic were amended in 2006, 2012 and 2014 respectively to define marriage as the union between a man and a woman and, hence, constitutionally ban same‑sex marriage. In Hungary, a bill was passed in 2020 that defines gender only based on sex assigned at birth, meaning that transgender individuals can no longer change their gender marker in the civil registry and on their identity documents. Moreover, in June 2021, Hungary passed a law prohibiting the showing of “any content portraying or promoting sex reassignment or homosexuality” to minors. In Poland, since 2019, more than 100 Polish municipal or local governments have proclaimed themselves to be “LGBT-free zones”, i.e. ‘‘free from LGBT ideology’’. While their enforcement is ambiguous, these declarations have fed an atmosphere of hatred and violence against the LGBT population. In Türkiye, while the Istanbul Pride had been held annually since 2003, it was banned in 2015 over “security concerns” and hasn’t resumed ever since.

← 2. This population estimate is based on 2020 or most recent data compiled by the OECD and available here: https://data.oecd.org/pop/population.htm.

← 3. Similar estimates of the share of LGBTI+ individuals can be derived from the GeSiD (Gesundheit und Sexualität) study, a nationally representative survey that was conducted between 2018 and 2019 among approximately 5 000 Germans aged 18 to 75 year (Briken et al., 2021[58]) (Muschalik et al., 2021[59]).

← 4. For additional evidence on the benefits of using self-administered questionnaires to avoid unreliable responses to sensitive survey questions, see, among others, (Robertson et al., 2018[53]; Burkill et al., 2016[55]; Gnambs and Kaspar, 2014[56]; Liu and Wang, 2016[57]).

← 5. For an enlightening case study on social acceptance and LGBTI+ self-identification, see (Miles-Johnson and Wang, 2018[54])

← 6. Data remain unavailable for additional categories of sexual orientation and gender identity denoted by the “+” in the LGBTI+ acronym.

← 7. Rates of social acceptance presented in this section consider the proportion of responses deemed “totally comfortable”. Respondents are considered “totally comfortable” when they indicated comfort levels of “7 or higher” on the ten‑point scale, for each of the hypothetical scenarios presented in the three questions in Table 2.1.

← 8. More precisely, the 2019 update of the LGBT Global Acceptance Index (LGBT-GAI) established by Andrew Flores shows that acceptance of LGBT people improved between 1981 and 2017 across the globe, with only limited polarisation: while 131 of 174 countries experienced increases in acceptance, only 16 are characterised by a decline (27 experienced no change). However, it is important to keep in mind that these results mainly capture levels and trends in social acceptance of homosexuality. Although the LGBT-GAI seeks to measure acceptance of lesbian, gay, bisexual and transgender people altogether, only 7 of the 71 questions used to compute the index focus on acceptance of transgender individuals. Moreover, these questions are measured at only one point in time, which means that the evolution of the LGBT-GAI over time fails to capture potential improvement in attitudes towards transgender individuals.

← 9. The Change Centre Foundation is an independent non-profit based in Meerbusch (North Rhine‑Westphalia) that aims to promote science and research in the field of social change. In the original German, the survey was entitled Queeres Deutschland. Zwischen Wertschätzung und Vorbehalten.

← 10. Data collection was carried out by INFAS (Institute for Applied Social Science – Institut für angewandte Sozialwissenschaft) in Bonn, and scientific support for the project was provided by Jacobs University Bremen. The results were published in 2019 by the Robert Bosch Foundation (Robert Bosch Stiftung), a charitable institution that conducts and finances social, cultural and scientific projects.

← 11. The sample composition was as follows: 62% of respondents were gay men, 16% were lesbian women, 8% were bisexual men, 7% were bisexual women, and 7% were transgender. The data explorer is available at the following url: https://fra.europa.eu/en/publications-and-resources/data-and-maps/survey-fundamental-rights-lesbian-gay-bisexual-and.

← 12. The sample composition was as follows: 42% gay males, 20% bisexual women, 16% lesbian women, 14% trans persons, 7% bisexual males and 1% intersex persons. The data explorer is available at the following url: https://fra.europa.eu/en/data-and-maps/2020/lgbti-survey-data-explorer.

← 13. In 2012, the share of LGBT individuals who report having personally felt discriminated against because of being LGBT during the last 12 months is equal to the percentage of LGBT individuals who respond “yes” to the following question: “During the last 12 months, have you personally felt discriminated against because of being L, G, B or T in any of the following 11 situations? (i) when looking for a job; (ii) at work; (iii) when looking for a house or apartment to rent or buy (by people working in a public or private housing agency, by a landlord); (iv) by health care personnel (e.g. a receptionist, nurse or doctor); (v) by social service personnel; (vi) by school/university personnel – this could have happened to you as a student or as a parent; (vii) at a cafe, restaurant, bar or nightclub; (viii) at a shop; (ix) in a bank or insurance company (by bank or company personnel); (x) at a sport or fitness club; (xi) when showing your ID or any official document that identifies your sex. In 2019, this share is equal to the percentage of LGBTI individuals who respond “yes” to the following question: “In the past 12 months have you personally felt discriminated against due to being LGBTI in any of the following 8 areas of life? (i) when looking for a job; (ii) at work; (iii) when looking for housing; (iv) by health care or social services personnel; (v) by school/university personnel; (vi) at a cafe, restaurant, bar or nightclub; (vii) at a shop; (viii) when showing your ID or any official document that identifies your sex.”

← 14. In 2012, the share of LGBT individuals who report experiences of violence during the last 5 years is equal to the percentage of LGBT individuals who respond “yes” to the following question: “In the last 5 years, have you been: physically/sexually attacked or threatened with violence at home or elsewhere (street, on public transport, at your workplace, etc) for any reason?”. The data explorer is available at the following url: https://fra.europa.eu/en/publications-and-resources/data-and-maps/survey-fundamental-rights-lesbian-gay-bisexual-and. In 2019, the share of LGBTI individuals who report experiences of violence during the last 5 years is equal to the percentage of LGBTI individuals who report at least one incident for the following question: “In the last 5 years, how many times have you been physically or sexually attacked at home or elsewhere (street, on public transport, at your workplace, etc.) for any reason?”. For 2019, a new question was added which asked about experiences of violence due to being LGBTI, though for consistency across reference periods, this question is not considered in this chapter. The data explorer is available at the following url: https://fra.europa.eu/en/data-and-maps/2020/lgbti-survey-data-explorer.

← 15. These analyses rely on SOEP 2016 and SOEP-LGB 2019 (Box 2.1), as well as on the LGBielefeld Project 2019. The latter initiative collects data on sexual orientation and gender identity through an online survey administered by the Faculty of Sociology at the Bielefeld University in Berlin, noting that the LGBielefeld questionnaire largely corresponds to SOEP questions, thereby allowing for data to be analysed in combination.

← 16. This selection bias seems less prevalent in the LGBT+ Pride 2021 Global Survey presented in Section 2.2, which is consistent with respondents being less reluctant to disclose who they are in surveys conducted by polling companies: LGBTI+ individuals are less, not more educated than non-LGBTI+ individuals in this survey.

← 17. According to the 2018 Diversity Barometer, the rate of social acceptance of non-heterosexuals is more than 10 percentage points lower in Bavaria (whose capital city is Munich) than in Berlin (60% vs 71%). A similar result emerges regarding the rate of social acceptance of non-cisgender individuals: this rate is equal to 63% in Bavaria, but to 70% in Berlin.

← 18. Both rounds of the FRA survey featured a number of transgender-specific questions. Data presented here stem from the 2019 round, for respondents who answered “never” when asked whether they avoided expression of their gender through physical appearance for fear of being assaulted, threatened or harassed”.

← 19. Among respondents 18 and older via personal interview, the SOEP asked “How satisfied are you with your life, all things considered?” The answers are ratings on a scale of zero (completely dissatisfied) to ten (completely satisfied)”.

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