Physical and sexual violence are known public health hazards, imposing physical and emotional burdens on those who experienced such violence; and adolescent members of the LGBTQIA community are believed to be at higher risk than their heterosexual peers for violence.
This was stressed in “Physical and Sexual Violence Among Gay, Lesbian, Bisexual, and Questioning Adolescents”, a study by Theodore L. Caputi, MPH, Chelsea L. Shover, PhD and Ryan J. Watson, PhD that appeared in JAMA Pediatrics.
For this cross-sectional study, the researchers used pooled data from USA’s 2015 and 2017 YRBS public use files to broaden the sample size and scope of the analysis. The survey in each of these years had a response rate of 60%.
The YRBS uses a three-stage cluster sample of US counties within all states, schools within counties, and classrooms within schools to achieve a nationally representative sample of American adolescents. Participants in the YRBS in each year were asked to indicate their sex (female or male) and sexual orientation (heterosexual, gay or lesbian, bisexual, or not sure) and whether they had experienced any of three types of physical violence (past-year physical violence committed by a romantic partner, past-year physical fights anywhere, or past-year physical fights at school) and two types of sexual violence (lifetime forced intercourse, past-year sexual assault by a romantic partner). In 2017, participants were asked an additional question: whether they had experienced past-year sexual assault committed by anyone.
Of the 28 ,811 participants in the 2015 and 2017 YRBS, 87.1% reported their sexual orientation as heterosexual, 2.2% as gay or lesbian, 7.0% as bisexual, and 3.7% as not sure.
Twelve percent of sexual minority adolescents reported physical violence committed by a romantic partner, 27.6% engaged in a physical fight, and 11.1% engaged in a physical fight on school property. Furthermore, 20.6% of sexual minority adolescents reported experiencing sexual assault, 18.0% reported experiencing forced intercourse, and 12.5% reported experiencing sexual assault by a romantic partner.
After adjusting for confounders, sexual minority adolescents were consistently more likely than their heterosexual counterparts to report physical and sexual violence, including physical violence committed by a romantic partner (adjusted risk ratio [aRR], 1.97; 95% CI, 1.65-2.34) and sexual assault committed by anyone (aRR, 2.10; 95% CI, 1.68-2.58) in the preceding 12 months. Bisexual sexual minority adolescents were at a particularly elevated risk for violence, including physical violence committed by a romantic partner (aRR, 2.22; 95% CI, 1.82-2.67) and sexual assault committed by anyone (aRR, 2.36; 95% CI, 1.76-3.10).
Sexual minority female adolescents were at an elevated risk of physical violence relative to the risk to heterosexual female adolescents, including engaging in a physical fight anywhere (aRR, 1.74; 95% CI, 1.53-1.96) and engaging in a fight on school property (aRR, 1.91; 95% CI, 1.49-2.43). Sexual minority male adolescents had elevated risks of sexual violence relative to the risks to heterosexual male adolescents, including the risk of sexual assault (aRR, 4.64; 95% CI, 2.97-6.84) and the risk of forced intercourse (aRR, 4.70; 95% CI, 3.40-6.32).
The researchers noted that “sexual minority adolescents—particularly bisexual youth—are at an elevated risk for both physical and sexual violence. Given the substantial physical and emotional consequences of violence for those subjected to it and the large existing health disparities among sexual minority adolescents, addressing both physical and sexual violence against sexual minority adolescents should become a public health priority.”
And since the results suggest the existence of a crisis of violence against sexual minority adolescents, the researchers recommend working with policy makers and clinicians to design, implement, and assess interventions to reduce the risks and mitigate the harms of violence committed against sexual minority adolescents.