Sexual (Minority) Trajectories, Mental Health, and Alcohol Use: A Longitudinal Study of Youth as They Transition to Adulthood
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Lesbian, gay, bisexual, and queer/questioning youth health disparities are well documented; however, study limitations restrict our understanding of how the temporal interplay among domains of sexuality (attraction, behavior, and identity) situate individuals to be more or less at risk for poor mental health and alcohol use across the transition to adulthood. Four waves of data from the National Longitudinal Study of Adolescent to Adult Health (n = 12,679; 51.29 % female) were used with repeated measures latent class analysis to estimate sexual trajectory groups designated by prospective reports of romantic attraction, sexual/romantic behavior, and sexual identity from adolescence to adulthood. Five unique trajectories emerged: two heterosexual groups (heterosexual early daters [58.37 %] and heterosexual later daters [29.83 %]) and three sexual minority groups (heteroflexible [6.44 %], later bisexually identified [3.32 %], and LG[B] identified [2.03 %]). These sexual trajectories differentiate risk for depressive symptomology, suicidal thoughts and behaviors, and alcohol use during adolescence and early adulthood. Groups where individuals first reported same-sex attraction and sexual minority identities in adulthood (heteroflexible and later bisexually identified) had similar levels of depression, suicidality, and greater substance use than those who largely reported same-sex attraction and behavior during adolescence (the LG[B] identified group). These later recognition groups showed greater risk for poor outcomes in waves where they also first reported these changes in attraction, behaviors, and identities. The emergence of three sexual minority groups reveal within-group differences in sexuality and sexual trajectories and how these experiences relate to risk and timing of risk across the transition to adulthood.
KeywordsLGB youth Sexual development Mental health Depression Suicide Alcohol use
The authors would like to thank Drs. Ming Cui and John Taylor for their help in developing this project and to the reviewers for their insightful and helpful comments. This research was supported in part by the National Science Foundation under Grant No. SMA-1401836.
Conflict of interest
The authors report no conflict of interest.
The manuscript is based off the dissertation work of JF who drafted the manuscript and performed the statistical analyses. KP assisted JF in conceptualizing the project, research questions, and study design. KP also contributed revisions to the preliminary and final manuscripts. Both authors read and approved the final manuscript.
- Bell, J. G., & Perry, B. (2015). Outside looking in: The community impacts of anti-lesbian, gay, and bisexual hate crimes. Journal of Homosexuality, 62, 98–120. doi: 10.1080/00918369.2014.957133
- Chandra, A., Mosher, W. D., Copen, C., & Sionean, C. (2011). Sexual behavior, sexual attraction, and sexual identity in the United States: Data from the 2006-2008 National Survey of Family Growth. Atlanta, GA: US Department of Health and Human Services Centers for Disease Control and Prevention National Center for Health Statistics.Google Scholar
- Chantala, K. (2006). Guidelines for analyzing Add Health data. Carolina Population Center, University of North Carolina at Chapel Hill. http://www.cpc.unc.edu/projects/addhealth/data/guides/wt-guidelines.pdf
- Chantala, K. & Tabor, J. (1999). Strategies to perform a design-based analysis using the Add Health data. Carolina Population Center: University of Carolina at Chapel Hill.Google Scholar
- Collins, L., & Lanza, S. (2010). Latent class and latent transition analysis: With application in the social, behavioral, and health sciences. Hoboken, NJ: John Wiley & Sons, Inc.Google Scholar
- Dermody, S. S., Marshal, M. P., Cheong, J., Burton, C., Hughes, T., Aranda, F., & Friedman, M. S. (2014). Longitudinal disparities of hazardous drinking between sexual minority and heterosexual individuals from adolescence to young adulthood. Journal of Youth and Adolescence, 43, 30–39. doi: 10.1007/s10964-013-9905-9.PubMedCentralPubMedCrossRefGoogle Scholar
- Gates, G. J. (2010). Sexual minorities in the 2008 General Social Survey: Coming out and demographic characteristics. Los Angeles, CA: The Williams Institute on Sexual Orientation.Google Scholar
- Harris, K. M., Halpern, C. T., Whitsel, E., Hussey, J., Tabor, J., Entzel, P., & Udry, J. R. (2009). The National Longitudinal Study of Adolescent to Adult Health: Research design [WWW document]. http://www.cpc.unc.edu/projects/addhealth/design.
- Hatzenbuehler, M. L., Corbin, W. R., & Fromme, K. (2008). Trajectories and determinants of alcohol use among LGB young adults and their heterosexual peers: Results from a prospective study. Developmental Psychology, 44, 81–90. doi: 10.1037/0012-16184.108.40.206.Trajectories.PubMedCentralPubMedCrossRefGoogle Scholar
- Hatzenbuehler, M. L., McLaughlin, K. A., Keyes, K. M., & Hasin, D. S. (2010). The impact of institutional discrimination on psychiatric disorders in lesbian, gay, and bisexual populations: A prospective study. American Journal of Public Health, 100, 452–459. doi: 10.2105/AJPH.2009.168815.
- Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Washington, DC: The National Academies Press.Google Scholar
- Marshal, M. P., King, K. M., Stepp, S. D., Hipwell, A., Smith, H., Chung, T., et al. (2012). Trajectories of alcohol and cigarette use among sexual minority and heterosexual girls. Journal of Adolescent Health, 50, 97–99. doi: 10.1016/j.jadohealth.2011.05.008.PubMedCentralPubMedCrossRefGoogle Scholar
- McCabe, S. E., Bostwick, W. B., Hughes, T. L., West, B. T., & Boyd, C. J. (2010). The relationship between discrimination and substance use disorders among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health, 100, 1946–1952. doi: 10.2105/AJPH.2009.163147.PubMedCentralPubMedCrossRefGoogle Scholar
- McCabe, S. E., West, B. T., Hughes, T. L., & Boyd, C. J. (2013). Sexual orientation and substance abuse treatment utilization in the United States: Results from a national survey. Journal of Substance Abuse Treatment, 44, 4–12. doi: 10.1016/j.jsat.2012.01.007.PubMedCentralPubMedCrossRefGoogle Scholar
- Miller, S., Lansford, J. E., Costanzo, P., Malone, P. S., Golonka, M., & Killeya-Jones, L. A. (2009). Early adolescent romantic partner status, peer standing, and problem behaviors. The Journal of Early Adolescence, 29, 839–861. doi: 10.1177/0272431609332665.PubMedCentralPubMedCrossRefGoogle Scholar
- Mustanski, B., Van Wagenen, A., Birkett, M., Eyster, S., & Corliss, H. L. (2014). Identifying sexual orientation health disparities in adolescents: Analysis of pooled data from the Youth Risk Behavior Survey, 2005 and 2007. American Journal of Public Health, 104, 211–217.PubMedCentralPubMedCrossRefGoogle Scholar
- Muthén, L. K., & Muthén, B. O. (1998–2012). Mplus user’s guide, 7th ed. Los Angeles, CA: Muthén & Muthén.Google Scholar
- Reed, E., Prado, G., Matsumoto, A., & Amaro, H. (2010). Alcohol and drug use and related consequences among gay, lesbian and bisexual college students: Role of experiencing violence, feeling safe on campus, and perceived stress. Addictive Behaviors, 35, 168–171. doi: 10.1016/j.addbeh.2009.09.005.PubMedCentralPubMedCrossRefGoogle Scholar
- Riolo, S. A., Nguyen, T. A., Greden, J. F., & King, C. A. (2005). Prevalence of depression by race/ethnicity: Findings from the National Health and Nutrition Examination Survey III. American Journal of Public Health, 95, 998–1000. doi: 10.2105/AJPH.2004.047225.PubMedCentralPubMedCrossRefGoogle Scholar
- Rosario, M., Hunter, J., Maguen, S., Gwadz, M., & Smith, R. (2001). The coming-out process and its adaptational and health-related associations among gay, lesbian, and bisexual youths: Stipulation and exploration of a model. American Journal of Community Psychology, 29, 133–160.PubMedCrossRefGoogle Scholar
- Russell, S. T., Kosciw, J., Horn, S., & Saewyc, E. (2010). Safe schools policy for LGBTQ students. Social Policy Report, 24(4), 1–17. Retrieved from Society for Research in Child Development. http://www.srcd.org/sites/default/files/documents/spr_24_4_final.pdf
- Saewyc, E. M., Bauer, G. R., Skay, C. L., Bearinger, L. H., Resnick, M. D., Reis, E., & Murphy, A. (2004). Measuring sexual orientation in adolescent health surveys: Evaluation of eight school-based surveys. Journal of Adolescent Health, 35, 345.e1–345.e15. doi: 10.1016/j.jadohealth.2004.06.002
- Snapp, S., McGuire, J., Sinclair, K., Gabrion, K., & Russell, S. T. (in press). LGBTQ-inclusive curriculum: Why supportive curriculum matters. Sex Education. Google Scholar
- StataCorp. (2013). Stata statistical software: Release 13. College Station, TX: StataCorp LP.Google Scholar
- Talley, A. E., Hughes, T. L., Aranda, F., Birkett, M., & Marshal, M. P. (2014). Exploring alcohol-use behaviors among heterosexual and sexual minority adolescents: Intersections with age, sex, and race/ethnicity. American Journal of Public Health, 104, 295–303. doi: 10.2105/AJPH.2013.301627.PubMedCentralPubMedCrossRefGoogle Scholar