COMMENTARY

Health Risks Faced by Lesbian, Gay, and Bisexual Youth

Jonathan Mermin, MD, MPH

Disclosures

May 22, 2017

Editorial Collaboration

Medscape &

New Data on LGB Youth

In 2016, the Centers for Disease Control and Prevention (CDC) released the first US nationally representative data on the health risks faced by lesbian, gay, and bisexual (LGB) high school students. These data show that the approximately 1.3 million LGB youth in the United States experience more physical and sexual violence and bullying than their heterosexual peers. LGB youth also are at risk for unhealthy drug use and suicide.

Findings from Sexual Identity, Sex of Sexual Contacts, and Health-Related Behaviors Among Students in Grades 9-12—United States and Selected Sites, 2015, published in CDC's Morbidity and Mortality Weekly Report, show that LGB students experience physical and sexual violence and bullying at levels two to three times higher than that of their heterosexual peers. LGB students are significantly more likely to report:

  • Being forced to have sex (18% LGB vs 5% heterosexual);

  • Sexual dating violence (23% LGB vs 9% heterosexual);

  • Physical dating violence (18% LGB vs 8% heterosexual); and

  • Being bullied at school or online (at school: 34% LGB vs 19% heterosexual; online: 28% LGB vs 14% heterosexual)

The data show that these experiences can place LGB students at substantial risk for poor health outcomes:

  • 29% of LGB youth reported attempting suicide in the past year.

  • LGB students were two to five times more likely than other students to report using several illegal drugs, including injection drugs.

  • More than 1 in 10 LGB students have missed school during the past 30 days because of safety concerns.

The report examines the prevalence of more than 100 health behaviors among LGB students compared with other students. The analyses are possible owing to the inclusion of two new questions about the sex of sexual contacts and sexual identity on the 2015 National Youth Risk Behavior Survey (YRBS), the principal source of data for tracking health risk behaviors among the nation's high school students.

More information can be found at CDC Study of Lesbian, Gay, and Bisexual Students' Health Supplemental Data.

Does the YRBS Identify Transgender Students?

There is a need for current national, state, and local health data on the transgender population. CDC will be piloting a gender identity question in 2017 on selected state and local YRBS, and will continue to evaluate whether the number of transgender respondents in these samples is large enough to produce reliable estimates of their behavior or whether other data sources are needed. Other CDC data systems, such as the National Violent Death Reporting System, have been adapted to better capture gender identity and share information on experiences of violence among transgender individuals.

Why Are LGB Youth Experiencing Poor Outcomes?

Although survey data do not reveal the causes of the disparities in behaviors between LGB and heterosexual students, other research[1,2,3] suggests a number of factors that may put LGB youth at risk for sexual and physical abuse and other types of violence. These include social isolation, lack of parental or caregiver support, lack of safety or support at school, or harmful norms about masculinity and femininity (eg, violence against those not seen as being masculine or feminine enough).

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