The authors evaluated emotional distress among 9th-12th grade students, and examined whether the association between LGBT status and emotional distress was mediated by perceptions of having been treated badly or discriminated against because others thought they were gay or lesbian. Data come from a school-based survey in Boston, MA (n=1,032); 10% were LGBT, 58% were female, and age ranged from 13-19 years. About 45% were Black, 31% were Hispanic, and 14% were White. LGBT youth scored significantly higher on the scale of depressive symptomatology. They were also more likely than heterosexual, non-transgendered youth to report suicidal ideation (30% vs. 6%, p<0.0001) and self-harm (5% vs. 3%, p<0.0001). Mediation analyses showed that perceived discrimination accounted for increased depressive symptomatology among LGBT males and females, and accounted for an elevated risk of self-harm and suicidal ideation among LGBT males. Perceived discrimination is a likely contributor to emotional distress among LGBT youth.

Objectives We assessed sexual orientation disparities in exposure to violence and other potentially traumatic events and onset of posttraumatic stress disorder (PTSD) in a representative US sample. Methods We used data from 34653 noninstitutionalized adult US residents from the 2004 to 2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions. Results Lesbians and gay men, bisexuals, and heterosexuals who reported any same-sex sexual partners over their lifetime had greater risk of childhood maltreatment, interpersonal violence, trauma to a close friend or relative, and unexpected death of someone close than did heterosexuals with no same-sex attractions or partners. Risk of onset of PTSD was higher among lesbians and gays (adjusted odds ratio [AOR]=2.03; 95% confidence interval [CI]=1.34, 3.06), bisexuals (AOR=2.13; 95% CI=1.38, 3.29), and heterosexuals with any same-sex partners (AOR=2.06; 95% CI=1.54, 2.74) than it was among the heterosexual reference group. This higher risk was largely accounted for by sexual orientation minorities’ greater exposure to violence, exposure to more potentially traumatic events, and earlier age of trauma exposure. Conclusions Profound sexual orientation disparities exist in risk of PTSD and in violence exposure, beginning in childhood. Our findings suggest there is an urgent need for public health interventions aimed at preventing violence against individuals with minority sexual orientations and providing follow-up care to cope with the sequelae of violent victimization.

Purpose-To examine the relationship between sexual orientation and past-year reports of bullying victimization and perpetration in a large sample of American youth.Methods-Survey data from 7,559 adolescents aged 14 to 22 who responded to the 2001 wave questionnaire of the Growing Up Today Study were examined cross-sectionally. Multivariable generalized estimating equations regression was performed using the modified Poisson method. We examined associations between sexual orientation and past-year bully victimization and perpetration with heterosexuals as the referent group, stratifying by gender and controlling for age, race/ethnicity, and weight status.Results-Compared to heterosexual males, mostly heterosexual males (risk ratio (RR): 1.45; 95% confidence interval (CI): 1.13, 1.86) and gay males (RR 1.98; CI 1.39, 2.82) were more likely to report being bullied. Similarly, mostly heterosexual females (RR 1.72, 95% CI 1.45, 2.03), bisexual females (RR 1.63, 95% CI 1.14, 2.31), and lesbians (RR 3.36, 95% CI 1.76, 6.41) were more likely to report being bullied than were heterosexual females. Gay males (RR 0.34, 95% CI 0.14, 0.84) were much less likely to report bullying others than were heterosexual males. Mostly heterosexual females (RR 1.70, 95% CI 1.42, 2.04) and bisexual females (RR 2.41, 95% CI 1.80, 3.24) were more likely to report bullying others than heterosexual females. No lesbian participants reported bullying others.Conclusions-There are significant differences in reports of bullying victimization and perpetration between heterosexual and sexual minority youth. Clinicians should inquire about sexual orientation and bullying, and coordinate care for youth who may need additional support.

This study investigated stability and change in self-reported sexual orientation identity over time in youth. We describe gender-and age-related changes in sexual orientation identity from early adolescence through emerging adulthood in 13,840 youth ages 12-25 employing mobility measure M, a measure we modified from its original application for econometrics. Using prospective data from a large, ongoing cohort of U.S. adolescents, we examined mobility in sexual orientation identity in youth with up to four waves of data. Ten percent of males and 20% of females at some point described themselves as a sexual minority, while 2% of both males and females reported ever being "unsure" of their orientation. Two novel findings emerged regarding gender and mobility: (1) Although mobility scores were quite low for the full cohort, females reported significantly higher mobility than did males. (2) As expected, for sexual minorities, mobility scores were appreciably higher than for the full cohort; however, the gender difference appeared to be eliminated, indicating that changing reported sexual orientation identity throughout adolescence occurred at a similar rate in female and male sexual minorities. In addition, we found that, of those who described themselves as "unsure" of their orientation identity at any point, 66% identified as completely heterosexual at other reports and never went on to describe themselves as a sexual minority. Age was positively associated with endorsing a sexual-minority orientation identity. We discuss substantive and methodological implications of our findings for understanding development of sexual orientation identity in young people.

Adult minority sexual orientation is a risk indicator for positive histories of experiencing parental maltreatment during childhood. While the reasons for this are beyond the scope of the current study, previous research suggests that childhood individual differences, including possibly gender atypicality, may be a causal factor.

WHAT'S KNOWN ON THIS SUBJECT: Childhood gender nonconformity has been associated with poorer relationships with parents, but it is unknown if childhood gender nonconformity is associated with childhood abuse or with posttraumatic stress disorder. WHAT THIS STUDY ADDS:We identify gender nonconformity before age 11 years as a risk indicator for physical, sexual, and psychological abuse in childhood and lifetime probable posttraumatic stress disorder in youth. abstract OBJECTIVES: Childhood gender nonconformity has been associated with poorer relationships with parents, but it is unknown if childhood gender nonconformity is associated with childhood abuse or risk of posttraumatic stress disorder (PTSD) in youth. METHODS:We examined whether gender nonconformity before age 11 years was associated with childhood sexual, physical, and psychological abuse and lifetime risk of probable PTSD by using self-report questionnaire data from the 2007 wave of the Growing Up Today Study (n = 9864, mean age = 22.7 years), a longitudinal cohort of US youth. We further examined whether higher exposure to childhood abuse mediated possible elevated prevalence of PTSD in nonconforming children. Finally, we examined whether association of childhood gender nonconformity with PTSD was independent of sexual orientation.RESULTS: Exposure to childhood physical, psychological, and sexual abuse, and probable PTSD were elevated in youth in the top decile of childhood gender nonconformity compared with youth below median nonconformity. Abuse victimization disparities partly mediated PTSD disparities by gender nonconformity. Gender nonconformity predicted increased risk of lifetime probable PTSD in youth after adjustment for sexual orientation. CONCLUSIONS:We identify gender nonconformity as an indicator of children at increased risk of abuse and probable PTSD. Pediatricians and school health providers should consider abuse screening for this vulnerable population. Further research to understand how gender nonconformity might increase risk of abuse and to develop family interventions to reduce abuse risk is needed.

Adolescents with a minority sexual orientation (e.g., lesbian, gay, bisexual) are more likely to use substances than their heterosexual peers. This study aimed to increase understanding of the development of drug use in this vulnerable population by: 1) comparing longitudinal patterns of pastyear illicit drug use (e.g., marijuana, cocaine, ecstasy) and misuse of prescription drugs among minority sexual orientation youth relative to heterosexual youth and, 2) examining how sexual orientation subgroup, gender, and age relate to variation in risk of drug use. Data come from the Growing Up Today Study, a community-based cohort of adolescents who were assessed three times between 1999-2005 with self-administered questionnaires when they ranged in age from 12 to 23 years (N=12,644; 74.9% of the original cohort). Multivariable repeated measures generalized estimating equations using modified Poisson regression was used to estimate relative risks. Participants indicating their sexual orientation was mostly heterosexual, bisexual, or lesbian/gay were more likely than completely heterosexual youth to report past-year illicit drug use and misuse of prescription drugs. Gender was an important modifier; bisexual females were most likely to report Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. ContributorsDrs. Corliss and Austin designed the study. Dr. Corliss and Ms. Wylie conducted data analysis. Dr. Wypij provided statistical consultation. All authors participated in data interpretation. Dr. Corliss wrote the first draft of the manuscript. All authors contributed to critical revisions of the manuscript for important intellectual content and have approved the final manuscript. Drs. Corliss, Austin, and Frazier obtained funding. Conflict of InterestAll authors declare that they have no conflicts of interest. NIH Public Access

Objectives To compare sexual orientation group differences in the longitudinal development of alcohol use behaviors during adolescence. Design Community-based prospective cohort study. Setting Self-reported questionnaires. Participants A total of 13450 Growing Up Today Study participants (79.7% of the original cohort) aged 9 to 14 years at baseline in 1996 were followed for over seven years. Main Exposure Self-reported sexual orientation classified as heterosexual, mostly heterosexual, bisexual, or lesbian/gay. Main Outcome Measures Age of alcohol use initiation, any past-month drinking, number of alcohol drinks usually consumed, and number of binge drinking episodes in the past year. Results Compared to heterosexuals, youth reporting any minority sexual orientation reported initiating alcohol use at younger ages. Greater risk of alcohol use was consistently observed for mostly heterosexual males and females and for bisexual females, whereas gay and bisexual males and lesbians reported elevated levels of alcohol use on only some indicators. Gender was an important modifier of alcohol use risk; mostly heterosexual and bisexual females exhibited the highest relative risk. Younger age of alcohol use initiation among minority sexual orientation participants significantly contributed to their elevated risk for binge drinking. Conclusions Our findings suggest that disparities in alcohol use among youth with a minority sexual orientation emerge in early adolescence and persist into young adulthood. Healthcare providers should be aware that adolescents with a minority sexual orientation are at greater risk for alcohol use.