When Australians complete the census on August 11 , they’ll face a new question that’s been a long time coming.
Author
- Karinna Saxby
Senior Research Fellow, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne
For the first time, people aged 16 and over will be asked about their sexual orientation – whether they identify as straight, lesbian, gay, bisexual, pansexual, asexual or use another term.
The information the census collects shapes billions of dollars in public spending , influences how health services are provided, and determines which populations governments can see – and which they cannot.
My new research , which has been peer-reviewed and accepted for publication in the American Journal of Public Health, is a reminder of what’s at stake when parts of the population go uncounted.
I found Australians in same-sex relationships are more likely to die prematurely, including by suicide.
But the change to this year’s census means for the first time, researchers will be able to examine how people’s health differs by sexual orientation across the whole population, not just in those living with a same-sex partner.
What is the new question?
The new census question will ask:
How does the person describe their sexual orientation?
You can answer straight, gay or lesbian, bisexual+, use your own term, or select “don’t know” or “prefer not to answer”. The question is optional and only for people aged 16 and over.
The wording was developed through extensive public consultation and testing, including with an LGBTIQ+ expert advisory committee. It reflects many years of work by community organisations, researchers and advocates – and its inclusion was far from inevitable.
In 2024, after reports the government would abandon this question and another about gender identity, widespread criticism from researchers, health organisations and the public saw the decision reversed in weeks .
Why is this so important?
In Australia, people who identify as lesbian, gay, bisexual, pansexual, asexual or another diverse sexuality represent an estimated 3.6% of the population .
Until now, we have only been able to learn about this population’s health via incomplete or limited data. Typically, sample sizes have been too small to study rare but important outcomes, such as premature death, or to see how outcomes differ across regions and smaller population groups.
But the new census question will allow us to see how people’s health differs by sexual orientation across the whole population. This means governments can allocate resources where they’re most needed.
What did I find?
My new study looked at 2011 census data and, using linked death records, tracked survival over the following 12 years.
It showed Australians in same-sex relationships are at significantly higher risk of dying prematurely compared with Australians in different-sex relationships.
For every 1,000 women in different-sex relationships, 983 were still alive after 12 years. But for women in same-sex relationships, that figure was only 979.
For men, the picture was similar but starker. For every 1,000 men in different-sex relationships, 971 were alive after 12 years. But only 963 in same-sex relationships were alive.
Taken together, we can say about one in five premature deaths among people in same-sex relationships were “excess” – that is, over and above what you’d expect from those in different-sex relationships.
Why is this happening?
The biggest driver was deaths from causes such as suicide. Such “external causes” made up nearly 12% of deaths among women in same-sex relationships, but just 2% among women in different-sex relationships. The pattern for men was similar: 13% versus about 3%.
These inequalities showed no sign of narrowing – even six years after marriage equality, the risk of dying prematurely had not declined.
These findings do not mean diverse sexual orientation causes poor health. Rather, the findings reflect the cumulative effects of stigma , discrimination and unequal access to health care , all of which can be prevented.
True inequality is likely greater
Due to the lack of census information on sexual orientation at the time, I could only identify a specific subset of Australians – people who were in same-sex relationships and living together at census time.
That limitation is precisely why the 2026 census matters. Instead of relying only on couples living together, researchers will be able to understand the health of people with diverse sexual orientations much more comprehensively.
Focusing just on people in same-sex relationships is also likely to undercount subgroups who have poorer mental health – including people without partners, young people, and people who identify as bisexual or pansexual.
In other words, my study measured the risk of dying prematurely among what is a healthier subset of people with diverse sexual orientations and still found they were more likely to die early. The true scale of the problem is likely larger.
What next?
Australia has a national action plan to address the health and wellbeing of LGBTIQA+ people. This says reducing health inequalities is a national priority. The new census question provides one of the key tools to measure whether those ambitions are being realised.
This action plan earmarks funding for initiatives such as training GP practices to be inclusive, to reduce barriers to care. But without population-level data on sexual orientation and health, we have no way of knowing whether investments like these are saving lives. Answers to the new census question can help us find out.
Finally, researchers will be able to track how health differs by sexual orientation across the whole population, not just cohabiting couples, and identify where inequalities are largest and for whom.
That is precisely the information governments need to direct suicide prevention efforts, health services, and funding to where they will save the most lives.
LGBTIQ+ Health Australia has information about the census , including privacy, participation and support.
Anonymous and free LGBTIQ+ peer support is available through QLife (1800 184 527). A list of services and supports is also available via LGBTIQ+ Health Australia . If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.
