Lesbian, gay, bisexual, unsure/don’t know, or those using a different SOGIESC term had significantly higher rates of all mental health concerns.
This is according to a study – “Differences in Substance Use and Mental Health by Sexual Identity Among U.S. Adolescents and Young Adults” by Ty S. Schepis, Brady T. West, Sean Esteban McCabe, et al – that appeared in LGBT Health.
The researchers noted that there have been associations made between sexual identity and both substance use and mental health outcomes, but they wanted to delve into this even more.
For this study, data used were from 11,328 adolescents (12–17 years) and 13,131 young adults (18–25 years) completing the 2023 National Survey on Drug Use and Health. Sexual identity had six-response options: heterosexual, lesbian/gay, bisexual, using a different term, unsure/don’t know, and do not understand the question. Substance use variables included alcohol, cannabis, nicotine, prescription drug misuse, polysubstance use, and substance use disorder (SUD). Mental health variables included major depressive episodes, suicidal ideation, and serious psychological distress (measured only among young adults). Multivariable logistic regression models were fitted to examine whether substance use and mental health differed by sexual identity. Analyses adjusted for sociodemographics, occurred separately by age group and sex, and heterosexual individuals were the reference category.
The researchers found:
- Youth identifying as lesbian, gay, bisexual, unsure/don’t know, or using a different term had significantly higher rates of all mental health concerns than their heterosexual peers, with 80% of adjusted odds ratios above 3.0.
- Substance use-sexual identity links were less consistent, although lesbian and bisexual females were more likely than heterosexual females to have past-year SUD.
- Individuals not understanding the sexual identity question had lower rates than their heterosexual peers on 15 of 36 outcomes (41.7%).
“The results reiterate a need for screening, indicated prevention, and intervention for mental health concerns and substance use,” the researchers stated, adding the “importance of advocacy by healthcare professionals to improve the cultural and policy environment for adolescents and young adults who identify as lesbian, gay, bisexual, use another term, or are unsure about their sexual identity.”
They similarly noted that – although not assessed in this study – more negative state policy environments adversely impact the health of these individuals, so “we call on the healthcare community to replace such policies with ones that support the health and well-being of all adolescents and young adults.”
