Health Risks Among Sexual Minority Youth
Sexual Minority Students at Greater Risk for Unhealthy, Unsafe Behaviors
According to a new CDC report, sexual minority students* are more likely than heterosexual students to experience multiple health risks, such as tobacco, alcohol, and other drug use; sexual risk behaviors; and violence.
Although many sexual minority students cope with the transition from childhood to adulthood successfully and become healthy and productive adults, others face challenges such as stigma, discrimination, family disapproval, social rejection, and violence. Sexual minority students are also at increased risk for certain negative health outcomes. For example, young gay and bisexual males have disproportionately high rates of HIV, syphilis, and other sexually transmitted diseases (STDs)1,2 and adolescent lesbian and bisexual females are more likely to have ever been pregnant than their heterosexual peers.3
To understand more about behaviors that can contribute to negative health outcomes among sexual minority students, CDC analyzed data from the Youth Risk Behavior Surveillance System.† The findings of this analysis are described in the Morbidity and Mortality Weekly Report,"Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9–12 in Selected Sites—Youth Risk Behavior Surveillance, United States, 2001–2009."
What the Report Highlights
For this report, CDC analyzed data from Youth Risk Behavior Surveys conducted during 2001–2009 by seven states and six large urban school districts on high school students' sexual identity (heterosexual, gay, lesbian, bisexual, or unsure), sex of sexual contacts (sexual contact with the opposite sex only, with the same sex only, or with both sexes), or both. The findings from this report show the disproportionate rates at which sexual minority students experience many health risks, compared with heterosexual students.
Specifically, the report summarizes results by sexual minority status across 13 sites and 76 health risks in the following 10 categories:
- Behaviors that contribute to violence (e.g., did not go to school because of safety concerns)
- Behaviors related to attempted suicide (e.g., made a suicide plan)
- Behaviors that contribute to unintentional injuries (e.g., rarely or never wore a seat belt)
- Tobacco use (e.g., ever smoked cigarettes)
- Alcohol use (e.g., binge drinking)
- Other drug use (e.g., current marijuana use)
- Sexual behaviors (e.g., condom use)
- Dietary behaviors (e.g., ate vegetables 3 or more times per day)
- Physical activity and sedentary behaviors (e.g., physically active at least 60 minutes per day for 7 days)
- Weight management (e.g., did not eat for 24 or more hours to lose weight or to keep from gaining weight)
Risks by Sexual Identity. Nine states and large urban school districts asked a question about students' sexual identity (that is, whether students identified as heterosexual, gay or lesbian, bisexual, or unsure). Across these locations, gay and lesbian students had higher prevalence rates than heterosexual students for health risks in seven of the 10 health risk categories: behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, and weight management.
Bisexual students had higher prevalence rates than heterosexual students for health risks in eight of the 10 health risk categories: behaviors that contribute to unintentional injuries, behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, and weight management.
Risks by Sex of Sexual Contacts. Twelve states and large urban school districts asked about the sex of students' sexual contacts. Across these locations, students who had sexual contact with persons of both sexes had higher prevalence rates than those who only had sex with persons of the opposite sex for health risks in six of the 10 health risk categories: behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, and weight management.
By addressing the challenges sexual minority students face—such as stigma, discrimination, family disapproval, social rejection, and violence—schools, parents, and public health agencies can help to improve health outcomes and reduce the prevalence of health-risk behaviors among these young people.
- Public health and school health policies and practices are needed to support the establishment of safe and supportive environments for sexual minority students.
- Training should be provided for school staff and others who work with sexual minority youth to help professionals
- Understand the concerns and health needs of sexual minority students.
- Implement effective programs and services to reduce health risks among these young people.
- Surveys used to monitor health risks and health outcomes among high school students should include questions on sexual identity, sex of sexual contacts, or both.
What CDC Is Doing
CDC funds state, territorial, tribal, and local education and health agencies to help schools implement policies and practices to reduce health risks among sexual minority youth. The LGBTQ Youth Programs-At-A-Glance provides information about specific program activities.
CDC also funds health agencies and community organizations to promote the use of evidence-based HIV prevention programs, some of which are geared toward sexual minority students.
- Full MMWR Report
- MMWR Press Release
- MMWR Backgrounder
- Lesbian, Gay, Bisexual, and Transgender Health—Youth (includes resources for youth, parents, and educators)
- Youth Risk Behavior Surveillance System
- Health Risks Among Sexual Minority Youth
- CDC. HIV surveillance in adolescents and young adults. Atlanta: U.S. Department of Health and Human Services; 2010.
- CDC. Sexually Transmitted Disease Surveillance 2009. Atlanta: U.S. Department of Health and Human Services; 2010.
- Goodenow C, Szalacha LA, Robin LE, Westheimer K. Dimensions of sexual orientation and HIV-related risk among adolescent females: evidence from a statewide survey. American Journal of Public Health 2008;98(6):1051–1058.
*Sexual minority students were defined in this report as those who identify as gay, lesbian, or bisexual or who have sexual contact with persons of the same or both sexes.
† The Youth Risk Behavior Surveillance System monitors the prevalence of a wide range of health risk behaviors among population-based samples of high school students. Interested states and large urban school districts may add questions regarding sexual identity and the sex of sexual contacts.
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