Stability and Change in Self-Reported Sexual Orientation Identity in Young People: Application of Mobility Metrics

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

Repeated Changes in Reported Sexual Orientation Identity Linked to Substance Use Behaviors in Youth

Purpose—Previous studies have found that sexual minority (e.g., lesbian, gay, bisexual) adolescents are at higher risk of substance use than heterosexuals, but few have examined how changes in sexual orientation over time may relate to substance use. We examined the associations between change in sexual orientation identity and marijuana use, tobacco use, and binge drinking in U.S. youth. Methods—Prospective data from 10,515 U.S. youth ages 12-27 years in a longitudinal cohort study were analyzed using sexual orientation identity mobility measure M (frequency of change from 0 [no change] to 1 [change at every wave]) in up to five waves of data. Generalized estimating equations were used to estimate substance use risk ratios and 95% confidence intervals; interactions by sex and age group were assessed. Results—All substance use behaviors varied significantly by sexual orientation. Sexual minorities were at higher risk for all outcomes, excluding binge drinking in males, and mobility score was positively associated with substance use in most cases (p\u3c.05). The association between mobility and substance use remained significant after adjusting for current sexual orientation and varied by sex and age for selected substance use behaviors. This association had a higher positive magnitude in females than males and in adolescents than young adults. Conclusions—In both clinical and research settings it is important to assess history of sexual orientation changes. Changes in reported sexual orientation over time may be as important as current sexual orientation for understanding adolescent substance use risk

Sexual Orientation and Functional Pain in U.S. Young Adults: The Mediating Role of Childhood Abuse

Objective: Pain without known pathology, termed ‘‘functional pain,’’ causes much school absenteeism, medication usage, and medical visits. Yet which adolescents are at risk is not well understood. Functional pain has been linked to childhood abuse, and sexual orientation minority youth (gay, lesbian, bisexual, ‘‘mostly heterosexual,’’ and heterosexual with same-sex sexual contact) are more likely to be victims of childhood abuse than heterosexuals, thus may be at greater risk of functional pain. Methods: We examined sexual orientation differences in past-year prevalence of functional headache, pelvic, and abdominal pain and multiple sites of pain in 9,864 young adults (mean age = 23 years) from a large U.S. cohort. We examined whether childhood abuse accounted for possible increased risk of functional pain in sexual minority youth. Results: Sexual minority youth, except for gays and lesbians, were at higher risk of functional pelvic and abdominal pain and multiple sites of pain than heterosexuals. Gay and lesbian youth had elevated prevalence only of abdominal pain. Childhood abuse accounted for 14% to 33% of increased experience of multiple sites of pain in minority youth. Conclusions: Youth who identify as ‘‘mostly heterosexual’’ or bisexual or who identify as heterosexual and have had samesex partners comprised 18% of our sample. Clinicians should be aware that patients with these orientations are at elevated risk of functional pain and may be in need of treatment for sequelae of childhood abuse. Conventional categorization of sexual orientation as heterosexual or homosexual may fail to distinguish a large number of youth who do not wholly identify with either group and may be at elevated risk of health problems

Research, Curricula, and Resources Related to Lesbian, Gay, Bisexual, and Transgender Health in US Schools of Public Health

To assess the extent to which public health schools conduct research, offer planned curricula, and provide resources related to lesbian, gay, bisexual, and transgender health, we mailed a self-administered questionnaire to individual department chairpersons at each school. Survey results suggested that departmental lesbian, gay, bisexual, and transgender research and curricular activities extending beyond HIV and AIDS were uncommon in most public health school programs. Expanding lesbian, gay, bisexual, and transgender health research and curricula may help health professionals improve their response to lesbian, gay, bisexual, and transgender health disparities

Sexual Violence Victimization History and Sexual Risk Indicators in a Community-Based Urban Cohort of “Mostly Heterosexual” and Heterosexual Young Women

Objectives. We sought to examine sexual violence victimization in childhood and sexual risk indicators in young adulthood in a primarily Latina and Black cohort of “mostly heterosexual” and heterosexual women in the Project on Human Development in Chicago Neighborhoods (PHDCN)

Vaping Disparities at the Intersection of Gender Identity and Race/Ethnicity in a Population-Based Sample of Adolescents.

BackgroundTransgender adolescents use vape products (eg, e-cigarettes) at higher rates than cisgender adolescents. Little is known about how these disparities differ from the intersectional perspective of both gender identity and race/ethnicity.MethodsWe examined disparities in past 30-day vaping frequency at the intersection of gender identity and race/ethnicity among adolescents participating in two pooled waves of the population-based California Healthy Kids Survey (N = 953 445; 2017-2019). Generalized linear mixed models included gender identity-by-race/ethnicity interactions and adjusted for potential confounders. Stratified models quantified relationships between gender identity and vaping within race/ethnicity strata and between race/ethnicity and vaping within gender identity strata.ResultsTransgender adolescents of color were more likely to report a higher frequency of vaping than cisgender white adolescents. In models stratified by race/ethnicity, transgender adolescents evidenced greater odds of more frequent vaping than cisgender adolescents of the same race/ethnicity; disparities were greatest between transgender and cisgender Black adolescents (adjusted odds ratio [AOR]: 6.05, 95% CI: 4.76-7.68) and smallest between transgender and cisgender white adolescents (AOR: 1.20, 95% CI: 1.06-1.35). In models stratified by gender identity, disparities were greatest between transgender Black and transgender white adolescents (AOR: 2.85, 95% CI: 2.20-3.70) and smallest between transgender multiracial and transgender white adolescents (AOR: 1.28, 95% CI: 1.05-1.58). Similar, though less consistent, patterns emerged for adolescents of color unsure of their gender identity relative to cisgender white adolescents.ConclusionTransgender adolescents of color may be especially vulnerable to vaping disparities. Future research should identify and intervene on causal mechanisms undergirding disparities.ImplicationsResearch finds that transgender adolescents use vape products at higher rates than their cisgender peers, however, little is known about how patterns of adolescent vaping may differ by both gender identity and race/ethnicity, information needed to inform culturally tailored prevention and control initiatives to decrease adolescent vaping disparities. Our analysis of data from a population-based adolescent health survey finds evidence of magnified disparities in vaping frequency among transgender adolescents of color