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. Author manuscript; available in PMC: 2026 Feb 28.
Published in final edited form as: Soc Sci Res. 2024 Jun 15;122:103049. doi: 10.1016/j.ssresearch.2024.103049

The role of romantic relationships for sexual minority young adults’ depressive symptoms: Does relationship type matter?

Jaime Hsu 1,*, Sara Mernitz 2
PMCID: PMC12947718  NIHMSID: NIHMS2150171  PMID: 39216913

Abstract

Sexual minority young adults consistently report higher rates of depression than heterosexual young adults. Drawing on the National Longitudinal Study of Adolescent to Adult Health, this study examines if types of romantic relationships provide mental health benefits for lesbian, gay, and bisexual young adults. Further, analyses distinguish between same- and different-sex unions to help determine which relationship types offer the most mental health benefits. The results show that marriage is linked to fewer depressive symptoms for gay and lesbian young adults, compared to being unpartnered or in a dating relationship. Further, same-sex unions are associated with fewer depressive symptoms, but not different-sex unions. Yet, bisexual respondents’ depressive symptoms are not associated with romantic relationships, regardless of relationship type. The results suggest that it is important to address the stigma surrounding sexual minority status and same-sex relationships to improve the burden of depressive symptoms on sexual minority young adults.

Introduction

Sexual minority people often report higher rates of depression than their heterosexual counterparts (Bostwick et al., 2014; Gattis et al., 2012; Krueger et al., 2018; Lee et al., 2016). Social isolation, bullying from peers, and the lack of family or other social support can perpetuate this disparity between sexual minority and heterosexual young adults (Hsieh & Liu, 2021; Mereish & Poteat, 2015), yet the role of romantic relationships is often neglected. Romantic relationships, such as dating relationships and romantic unions (cohabitation or marriage), serve as the most salient social relationships for health across the life course (Umberson et al., 2010), and even more so during the transition to adulthood (Joyner & Udry, 2000; Simon et al., 2010; Soller, 2014). Extant literature on social relationships and depressive symptoms generally suggests that certain romantic relationships are associated with fewer depressive symptoms for heterosexual young adults. Specifically, studies demonstrate this mental health benefit is dependent on the developmental timing of relationship formation for individuals and the type of the relationship (Davila et al., 2004; Donnelly et al., 2019; Kornblith et al., 2016; Mernitz & Kamp Dush, 2014; Whitton et al., 2020, 2021).

Yet, the link between young adult’s romantic relationships and depressive symptoms, or other mental health outcomes, focuses almost exclusively on heterosexual young adults (Simon et al., 2010; Soller, 2014; Still, 2021; Umberson et al., 2010; Whitton et al., 2013). A few studies on sexual minority young adults suggest that romantic involvement (i.e., dating relationships) can buffer minority stressors (Baams et al., 2014) and psychological distress, but only for lesbian/gay young adults, not bisexual young adults (Whitton et al., 2018b, 2018a); sexual minority people’s dating relationships were also linked to higher self-esteem, but only with same-sex partners (Baams et al., 2014; Bauermeister et al., 2010; Russell & Fish, 2016).

Although these existing studies suggest that romantic relationships could provide mental health benefits, they do not rely on nationally representative data, nor do they consider that health benefits might differ due to the type of romantic relationship considered. Indeed, studies on heterosexual young adults find robust mental health benefits from marriage and cohabitation (Mernitz & Kamp Dush, 2016; Musick & Bumpass, 2012; Uecker, 2012), but not always from dating relationships (Soller, 2014). Thus, certain types of relationships may be more beneficial for an individual’s mental health among sexual minority young adults.

Using the National Longitudinal Study of Adolescent to Adult Health (Add Health), we examine the role of dating, cohabiting, and marital relationships for depressive symptoms among gay, lesbian, and bisexual and heterosexual young adults. We classify sexual minority young adults by their reported same-sex attraction (Waves 1–4) and sexual minority identity (Waves 3–4) across the transition to adulthood to best account for developmental changes unique to this period of the life course. We examine the associations between relationship types and depressive symptoms for sexual minority young adults. Further, we compare these associations for sexual minority young adults in same-sex unions (marriage and cohabitation) and those in different-sex unions.

Background

Romantic relationships and sexual minority mental health across relationship types

The health benefits of romantic relationships, such as dating relationships, cohabitation, and marriage, are well-established for heterosexual adults, with marriage typically offering the most mental and physical health benefits (Liu & Umberson, 2008; Umberson et al., 2010). These relationships promote health by providing increased emotional support, social control of risky health behaviors, and shared socioeconomic resources (Liu & Umberson, 2008; Umberson et al., 2010). For contemporary heterosexual young adults, these mental health benefits often extend to cohabiting unions as well as marriage (Mernitz, 2018; Mernitz & Kamp Dush, 2016). Yet, evidence on dating relationships’ ability to reduce depressive symptoms is less clear. Some studies have found that dating and committed relationships are beneficial for mental health compared to being unpartnered (Davila et al., 2004; Simon et al., 2010; Whitton et al., 2013). However, compared to unions, dating relationships might offer less benefits against depressive symptoms and can even be detrimental, especially when dating relationships occur at young ages (Davila et al., 2004; Joyner & Udry, 2000; Mernitz & Kamp Dush, 2014).

Because marriage was not accessible for many sexual minority populations until 2015, when the U.S. Supreme Court legalized marriage for same-sex couples (Hatzenbuehler et al., 2012; Wight et al., 2013), less is known about associations between sexual minority marriage and depressive symptoms. Emergent studies show that sexual minority adults likely receive mental health benefits from marriage and cohabitation in comparable ways to heterosexual adults, namely through combined economic resources and increased emotional and social support (Donnelly et al., 2019; Hsieh & Liu, 2021; Reczek et al., 2017; Rostosky & Riggle, 2017). However, unlike heterosexual young adults, lesbian, gay, and bisexual young adults often experience stigma and discrimination surrounding these relationships, which are frequently linked with depressive symptoms (Hatzenbuehler, 2009; Stuber et al., 2008). Indeed, mental health disparities between sexual minority and heterosexual populations can be partially explained by lesbian, gay, and bisexual people experiencing more interpersonal and institutional discrimination and stigmatization (Hatzenbuehler, 2009; Meyer, 1995; Ross et al., 2016; Stuber et al., 2008).

Forming same-sex relationships might be a way to foster emotional and social support for sexual minority adults and alleviate these psychological stressors from stigma against sexual minorities (Rostosky & Riggle, 2017). Yet, same-sex relationships render sexual orientations visible to others and introduce new stress that could negatively impact one’s mental health. Indeed, lack of social support or recognition for same-sex couples (Neilands et al., 2020), greater relationship stigma (Rosenthal & Starks, 2015) and discrimination surrounding same-sex relationships at the societal level (Frost, 2011; LeBlanc et al., 2015; LeBlanc & Frost, 2020) could be linked with more depressive symptoms across all relationship types.

Prior studies on sexual minority older adults suggest that committed relationships are associated with fewer depressive symptoms for lesbian women and gay men (Donnelly et al., 2019; Feinstein et al., 2016; Kornblith et al., 2016; Parsons et al., 2013). Gay and lesbian young adults might also receive these mental health benefits when in committed relationships, but these findings might not universally apply to all sexual minority groups (Baams et al., 2014; Bauermeister et al., 2010; Whitton et al., 2018b, 2018a, 2020, 2021). Dating relationships are associated with lower psychological distress for lesbian and gay young adults, but not for bisexual young adults in studies on a convenience sample of sexual minority adolescents (Whitton et al., 2018b). Romantic involvement in general is linked to lower depressive symptoms among gender and sexual minority people who were assigned female at birth (Whitton et al., 2020, 2021). However, other studies found that romantic involvement is less likely to offer similar health benefits for bisexual adults (Hsieh & Liu, 2021; Reczek et al., 2017), and is even associated with worse psychological distress and other mental health indicators for bisexual young adults (Whitton et al., 2018a, 2018b).

Taken together, these prior studies on both heterosexual and gay, lesbian, and bisexual populations might suggest that lesbian and gay young adults in any relationship have fewer depressive symptoms, but more so if they are married or cohabiting. Bisexual young adults might not receive similar mental health benefits, regardless of relationship type.

Hypothesis 1:

Romantic unions, or cohabitation and marriage, are associated with fewer depressive symptoms than dating relationships or being unpartnered for lesbian and gay young adults. Yet, these health benefits are less pronounced than they would be for heterosexual young adults.

Hypothesis 2:

Romantic relationships across all relationship types provide negligible benefits against depressive symptoms for bisexual young adults, unlike for heterosexual or lesbian/gay young adults.

Different-sex vs. same-sex union status

Sexuality is a fluid and dynamic process across an individual’s life course, but particularly in the adolescent and young adult years (Bishop et al., 2020; Russell & Fish, 2019). Not all sexual minorities exclusively form same-sex relationships and many enter different-sex relationships for a variety of motivations, such as partner availability (Diamond, 1998; Russell & Fish, 2016) or due to societal pressures or individual political ideologies (Budnick, 2016; Silva, 2019). Additionally, different-sex partnerships may be more common among those who identify as bisexual (Hsieh, 2014; Thomeer & Reczek, 2016). Although there is not much evidence on health outcomes for sexual minorities forming different-sex unions (cohabitation or marriage), many studies demonstrated that sexuality discordance, or the misalignment of sexual identity and behaviors, predicts worse mental health outcomes (Caplan, 2017; Gattis et al., 2012; Talley et al., 2015). Therefore, among gay and lesbian populations, the psychological stressors from sexuality discordance in a different-sex union could offset the potential benefits of being in a union. However, because bisexual young adults would not experience sexuality discordance from partnering with different-sex partners, their unions might not contribute to increased depressive symptoms.

During young adulthood, entering same-sex romantic relationships, especially romantic unions, also presents an important developmental milestone for sexual minority young adults in affirming their identity (Bishop et al., 2020; Hall et al., 2021), and having support from a same-sex partner could alleviate the psychological stressors by improving self-perceptions and internalized homophobia (Bauermeister et al., 2010). Further, same-sex couples often mutually support one another’s health through care and regulations and the division of care labor is more equalitarian in romantic unions (Reczek et al., 2018; Reczek & Umberson, 2012). Thus, romantic involvement is associated with depressive symptoms of sexual and gender minority young adults, but this association depends on their sexual identities (i.e., bisexual and lesbian/gay) and partner characteristics (Whitton et al., 2018b, 2020). Current evidence might suggest that sexual minority young adults in same-sex unions have fewer depressive symptoms than their counterparts in different-sex unions. More recent findings on bisexual adults showed that being in a same-sex union is associated with better physical health compared to bisexual adults in different-sex unions because of their higher socioeconomic status and better health behaviors (Hsieh & Liu, 2019). These findings suggest that sexual minority young adults, including bisexual young adults, in same-sex unions might have fewer depressive symptoms than those in different-sex unions.

Hypothesis 3:

Lesbian, gay, and bisexual young adults report fewer depressive symptoms in a same-sex union, compared to those who are not in a union and those in a different-sex union.

Method

We use Waves 1 through 4 of the National Longitudinal Study of Adolescent and Adult Health (Add Health). Add Health is a nationally representative study that initially sampled 80 high schools and 52 middle schools in the US (Harris et al., 2019). Wave 1 data was collected during the 1994–1995 school year, Wave 2 in 1996, Wave 3 in 2000 and 2001 and Wave 4 in 2008 (n = 20,745). Students interviewed at Wave 1 were between 7th to 12th grades and were from 24 to 34 years old at Wave 4. The response rates remain relatively high across four waves, 79% for Wave 1, 88.6% for Wave 2, 77.4% for Wave 3, and 80% for Wave 4.

This study restricts the initial sample of 20,745 adolescents to those who completed Wave 4 (n = 15,701), when the dependent variable was measured, and to those who have valid cross-sectional weights at Wave 4 and are not missing data (n = 14,800). Afterward, we exclude 144 cases (1%) with missing values on one or more variables used in this study (n = 14,656). An attrition analysis (logistic regression) predicting missingness at Wave 4 from demographic and study variables at Wave 1 found that those missing at Wave 4 were more likely to be men, racial minorities, slightly older, and those with greater depressive symptoms at Wave 1. Those missing at Wave 4 were less likely to report exclusively different-sex attraction at Wave 1.

Variables

Depressive symptoms.

Depressive symptoms were measured at Wave 4 using an abridged 10-item assessment from the Center for Epidemiologic Studies Depression Scale (Radloff, 1977). Respondents are asked how often they had experienced negative and positive emotions within the past 7 days (e.g., “I felt sad”); values across all 10 items were summed to create a total indicator of symptoms. The frequency of emotions in the past 7 days was coded from 0 (never or rarely), 1 (sometimes), 2 (a lot of times) to 3 (most of the time and all the time). Items pertaining to positive affect (e.g., “I was happy”) are reversely coded. Thus, higher scores indicate worse depressive symptoms (α =.83).

Sexual orientation status.

Sexual orientation status was measured by two dimensions of sexuality because sexuality is complicated and subject to change over the life course (Bishop et al. 2020): romantic attraction from Waves 1 to 4 and sexual identity from Waves 3 and 4 (Harris et al., 2019). At all waves, participants were asked about their romantic attraction toward men, women, or both sexes; we used participant’s biological sex at Wave 1 and coded romantic attraction into same-sex, different-sex, and bisexual attraction at each wave. Sexual identity is measured by the question: “Please choose the description that best fits how you think about yourself” (asked at Waves 3 and 4 only). Participants answered with 100% heterosexual (straight), mostly heterosexual (straight) but sometimes attracted to people of your own sex, bisexual, mostly homosexual but sometimes attracted to people of the opposite sex, 100% homosexual (gay), not sexually attracted to either males or females, refused, or don’t know. The answers are collapsed to 1) 100% heterosexual and mostly heterosexual as heterosexual-identified young adults, 2) bisexual-identified as bisexual young adults, 3) mostly and 100% homosexual as lesbian- and gay-identified young adults. Those who answer “don’t know” or “refused” are coded as missing.

Through the dimensions of sexual attraction and sexual identity, the respondents are categorized into 1) heterosexual (n = 13,989), 2) lesbian/gay (n = 344), and 3) bisexual (n = 323) young adults. To be classified as a sexual minority, individuals must report at least one sexual minority attraction (same-sex or bisexual) at Waves 1–4 and a sexual minority identity (bisexual, mostly homosexual, 100% homosexual) at Waves 3 or 4. The heterosexual category includes respondents if they report exclusive different-sex attraction across Waves 1–4 and a 100% heterosexual or mostly heterosexual identity at Waves 3 or 4. Respondents are categorized as lesbian or gay if they reported same-sex attraction at least once between Waves 1–4 and report a mostly/exclusively homosexual identity at least once at Waves 3 or 4. The bisexual category includes those who report both-sex attraction at least once between Waves 1–4 and endorse a bisexual identity at least once at Waves 3 or 4 (Savin-Williams & Vrangalova, 2013).

Respondents who report both bisexual attraction and lesbian/gay identities are categorized as gay and lesbian, whereas those who report both same-sex attraction and bisexual identities are categorized as bisexual. For example, an individual who reported both same- and different-sex attraction at Waves 1–4 and a bisexual identity at Wave 3–4 is considered bisexual; an individual who reports different-sex attraction in Waves 1–2, bisexual attraction in Waves 3–4, and a gay/lesbian identity in Waves 3–4 is considered gay and lesbian. For cases where their sexual attraction and sexual identity do not align (e.g. if someone reports consistently different-sex attraction across all 4 waves but a gay/lesbian identity at Wave 3 and/or 4), their sexual identities at Wave 3 or 4 are prioritized (0.5% of the sample, n = 75). If respondents report no attraction or are missing data on sexual identity at Wave 3 and 4, their predominant sexual attractions averaged across the 4 waves are prioritized (0.2% of the sample, n = 36). Those who are consistently missing or who reported asexual sexuality across attraction and identity are excluded (<0.1%).

To ensure our results are robust and not due to our sexual orientation status measurement, we conduct two sensitivity analyses: 1) we consider only sexual identity and no longer include sexual attraction, and 2) we prioritize sexual attraction over sexual identity (all analyses available upon request). Results remain identical in both sensitivity analyses, except the statistical significance disappears between married gay/lesbian people and dating lesbian/gay people when sexual attraction is no longer included in the measurement of sexual orientation (sensitivity analysis #1). However, this change is likely due to the reduction in sample size as the general pattern of results does not change.

Relationship types.

At Wave 4, Add Health asked about respondents’ romantic relationship history (Harris et al., 2019). For each partner, they ask “type of relationship with partner” and whether it is current. Answers include marriage, cohabitation, pregnancy, current dating, and most recent. We coded each relationship type reported from the Wave 4 history (Joyner et al., 2017). We include all current marital relationships, cohabiting relationships, and dating relationships. Participants are considered unpartnered if they are not in a current romantic relationship. Although prior studies separate those who never married and those who were previously married (Hsieh & Liu, 2019; Reczek et al., 2017), very few lesbian, gay, and bisexual people are previously married (n = 16) in the current data due primarily to the nationwide legalization of marriage for same-sex couples occurring after data collection in 2015. Pregnancy-only relationships, and those who never married or previously married are collapsed into “unpartnered” status. Notably, there are lesbian/gay respondents who are married (n = 27) and a larger sample of bisexual respondents who are married (n = 102).

Same-sex and different-sex unions were identified through the respondent’s biological sex at Wave 1 and the reported sex of their partner at Wave 4. Those who are in dating relationships are collapsed with those who are unpartnered as “not in a union;” small cell sizes for same-sex dating relationships prohibit distinguishing between unpartnered and dating relationships. Table 1 shows the breakdown of young adults belonging to each of these categories. No substantial evidence suggests that gay, lesbian, and bisexual people report their partner’s sex incorrectly (Joyner et al., 2017). Sensitivity analyses (available upon request) suggest that excluding a single case where a participant reported a same-sex union while reporting no same-sex attraction or sexual minority identity does not change the results.

Table 1.

Sexual Orientation Status and Relationship Types (N = 14,656)

Heterosexual Young Adults
(n = 13,989)		 Lesbian and Gay Young Adults
(n = 344)		 Bisexual Young Adults
(n = 323)
Relationship Types
 Unpartnered 3,040 (22%) 128 (37%) 85 (26%)
 Dating 2,2204 (16%) 74 (22%) 51 (16%)
 Cohabiting 2,619 (19%) 114 (33%) 85 (27%)
 Married 6,126 (44%) 27 (8%) 102 (32%)
Union Status
 Not in a Union 5,244 (37.5%) 203 (59%) 136 (42%)
 Same-Sex Union 32 (<1%) 115 (33.4%) 16 (5%)
 Different-Sex Union 8,713 (62.3%) 26 (7.6%) 171 (53%)
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Data from Add Health Waves 1–4

Table 1 shows the relationship types by partner’s sex and sexual orientation status. We combine same-sex cohabitation and marriage to test Hypothesis 3, that same-sex unions are associated with fewer depressive symptoms. In total, young adults reported 163 current same-sex unions. For gay and lesbian young adults, many also formed different-sex unions (8% of the sample). Bisexual young adults were more likely to form different-sex unions than same-sex unions. As noted earlier, this study conceptualizes sexuality as a complex and dynamic process that is subject to change over a person’s life course. Thus, which partner they are romantically involved with does not determine their sexual minority status.

Demographic and Socioeconomic Controls.

Utilizing the longitudinal design, we control for depressive symptoms (Radloff, 1977) at Wave 1 (10 items, α =.81) as they are likely to be associated with selection into young adulthood romantic relationships (Mernitz & Kamp Dush, 2014). Demographic controls include the respondent’s biological sex, racial/ethnic category constructed at Wave 1 (Udry et al., 2003), region of residence at Wave 4, and age at Wave 4. We control for dichotomous indicators of respondents’ family structure at Wave 1 (Harris, 1999) and educational attainment at Wave 4 (ref: college education). We also control for employment status at Wave 4 (employed, employed but not in work, unemployed, not in the labor force; employed is the reference) and welfare status at Wave 4 (ref: not receiving welfare).

Analytic Strategy

We use hierarchical ordinary least-squares regression models to predict depressive symptoms in young adulthood from our relationship type categories and sexual orientation statuses, controlling for adolescent depressive symptoms and other demographic covariates (Hypotheses 1 and 2). In Stata 17, we first test an unconditional model with sexual orientation and relationship types to establish the associations between depressive symptoms with sexual orientation and relationship types (Model 1). We then create interaction terms by each sexual orientation status and relationship types to test between-group differences (Model 2) and examine how these change after controlling for covariates (Model 3). We alter the reference group in Model 3 to fully test between-group differences for all relationship types.

To explore how the relationship types matter within each sexual orientation group, we visualize the predicted depressive symptoms based on Model 3 in Table 3 for each group based on the interactions between each sexual orientation status (lesbian/gay, bisexual, or heterosexual) and each relationship type (unpartnered, dating, cohabiting, or married) in Figure 1. We conducted pairwise comparisons of relationship types and sexual orientation status by rotating the reference category of sexual orientation group, and annotate the significant differences. These comparisons allow us to explore within-sexual orientation differences by relationship types (Reczek et al., 2017).

Table 3.

Estimated Coefficients For Depressive Symptoms, Sexual Orientation Status and Relationship Types

Model 1
(N = 14,656)		 Model 2
(N = 14,656)		 Model 3
(N = 14,656)
Variables b SE b SE b SE
Sexual Orientation Status (Ref: Lesbian/Gay)
 Heterosexual −0.22 0.38 −0.63 0.69 −0.46 0.62
 Bisexual 2.15*** 0.59 1.41 1.09 0.88 0.94
Relationship Types (Ref: Unpartnered)
 Married −1.34*** 0.14 −1.59 1.62 −2.66* 1.14
 Cohabiting −0.67*** 0.17 −1.92* 0.81 −1.26 0.71
 Dating −0.80*** 0.18 −0.69 0.88 −0.31 0.79
Interaction Term a (Ref: Lesbian/Gay × Unpartnered)
 Heterosexual × Married 0.27 1.62 1.56 1.14
 Heterosexual × Cohabiting 1.28 0.83 0.51 0.73
 Heterosexual × Dating −0.13 0.90 −0.20 0.81
 Bisexual × Married 0.35 1.88 1.19 1.44
 Bisexual × Cohabiting 1.77 1.39 0.49 1.20
 Bisexual × Dating 1.29 1.72 0.62 1.64
Women 0.42*** 0.11
Age at Wave 4 −0.00 0.03
Depressive Symptoms at Wave 1 0.27*** 0.01
Race (Ref: non-Hispanic White)
 Non-Hispanic black 0.50** 0.17
 Latino/a 0.26 0.21
 Asian 0.52* 0.20
 Other/Mixed-Race 0.31 0.30
Region of Residence at Wave 4 (Ref: Northeast)
 Midwest −0.14 0.17
 South −0.44** 0.15
 West −0.19 0.16
Educational at Wave 4 (Ref: Less than College)
 College −0.82*** 0.10
Family structure at Wave 1 (Ref: Other)
 Two Biological Parents Present −0.21 0.11
Public Welfare at Wave 4 (Ref: Not Receiving)
 Receiving Welfare 1.06*** 0.12
Employment Status at Wave 4 (Ref: Employed)
 Employed but Not Working 1.64*** 0.36
 Unemployed 1.77*** 0.30
 Not in Labor Force 1.04*** 0.20
Constant 7.08*** 0.04 7.49*** 0.68 5.32*** 1.11
R-squared 0.01 0.02 0.16
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Note.

a

Interaction terms are between relationship status and sexual orientation.

Based on Model 3, Figure 1 visualizes all possible pair-wise comparisons within each sexual orientation group by rotating the reference category.

*

p < .05.

**

p < .01.

***

p < .001.

Figure 1:

Figure 1:

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Predicted Depressive Symptoms from Model 3

Note: All significance tests are based on comparisons within sexual orientation samples. The models include the whole sample (N = 14,656). Error bar shows the 95% confidence interval.

a Difference between the married and the cohabiting is statistically significant (p < 0.05).

b Difference between the married and the dating is statistically significant (p < 0.05).

c Difference between the married and the unpartnered is statistically significant (p < 0.05).

d Difference between the cohabiting and the dating is statistically significant (p < 0.05).

e Difference between the cohabiting and the unpartnered is statistically significant (p < 0.05).

f Difference between the dating and the unpartnered is statistically significant (p < 0.05).

To examine if effects differ by different- or same-sex union status (Hypothesis 3), we use ordinary least-squares regression models to predict depressive symptoms in young adulthood from different- or same-sex unions (marriage and cohabitation) compared to not being in a union among lesbian/gay or bisexual young adults. We again control for adolescent depressive symptoms and other demographic covariates. For Hypothesis 3, we also visualize the predicted depressive symptom scores by rotating the reference category of sexual orientation status to demonstrate the within-group comaprisons for lesbian/gay and bisexual populations. We annotate significant differences to aid in the interpretation for all results.

Results

Descriptive Results

Table 2 summarizes the descriptive analyses by sexual orientation statuses. Around 95.5% of young adults in the full sample are categorized as heterosexual, 2.5% are lesbian and gay, 2% are bisexual. Results suggested that lesbian, gay, and bisexual individuals reported more depressive symptoms than heterosexual individuals in young adulthood (Wave 4) and in adolescence (Wave 1); bisexual individuals reported more depressive symptoms on average than heterosexual young adults. 43% of heterosexual young adults are married, in comparison to around 7% for lesbian and gay young adults and 35% for bisexual young adults. By contrast, lesbian and gay young adults are the most likely to be in a cohabiting relationship (33%) than heterosexual (20%) and bisexual (28%) young adults; they are also more likely to be in a dating relationship (20%) or unpartnered (40%) in comparison to other groups.

Table 2.

Weighted Descriptive Statistics by Sexual Orientation Statuses (N = 14,656)

Heterosexual Young Adultsb
(n = 13,989)		 Lesbian and Gay Young Adultsc
(n = 344)		 Bisexual Young Adults d
(n = 323)
Variables % M
(SD)		 Range % M
(SD)		 Range % M
(SD)		 Range
Depressive Symptoms at W4 6.0d
(.83)		 0–30 6.6d
(.36)		 0–25 8.5bc
(.47)		 0–30
Relationship Types at W4
 Married 43cd 7bd 35bc
 Cohabiting 20cd 33bd 28bc
 Dating 16c 20bd 11c
 Unpartnered 21c 40bd 26c
Sex
 Female 49d 44d 82bc
 Male 51 56 18
Depressive Symptoms at W1 6.5cd
(.09)		 0–30 7.4bd
(.36)		 0–27 8.5bc
(.36)		 0–27
Age at Wave 4 28.3d
(.12)		 24–34 28.3d
(.17)		 24–32 27.8bc
(.16)		 25–33
Race
 Non-Hispanic White 68d 62d 74bc
 Non-Hispanic Black 16 15 12
 Latino 11c 16b 11
 Asian 3d 3 1b
 Other 2 4d 1c
Family Structure at W1
 Others 45d 53 54b
 Two Biological Parents Present 55 47 46
Region of Residence at W4
 Northeast 13 16 11
 Midwest 28 25 36
 South 42 42 34
 West 17 18 20
College Degree at W4
 No College Degree 69cd 66ab 80bc
 College Degree 31 34 20
Welfare Receipt at W4
 Not Receiving Welfare 76cd 86bd 54bc
 Receiving Welfare 24 14 46
Employment Status at W4
 Employed 81d 85d 73bc
 Employed but Not Workinga 3 2 4
 Unemployed 4 6 7
 Not in Labor Force 12cd 7bd 17bc
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Note. M = Mean. SD = Standard Deviation.

a

Represents people who are currently employed, but are not actively working (e.g., on temporary leave).

b

Significantly different from heterosexual sample.

c

Significantly different from lesbian and gay sample.

d

Significantly different from bisexual sample. (p<.05)

Overall, bisexual young adults are primarily women (82%) and have lower socioeconomic status compared to heterosexual, gay, and lesbian young adults. Indeed, bisexual young adults have the lowest rate of being employed (73%) in comparison to heterosexual (81%) and gay and lesbian (85%) young adults; they are also least likely to receive a college degree (20%) and more likely to receive welfare (46%). Lesbian and gay young adults are more likely to be college graduates than other groups (34%).

Relationship Benefits and Relationship Types

Table 3 shows the estimated regression coefficients for depressive symptoms at Wave 4 from relationship types (n = 14,656). For the full sample (Table 3), we present results from hierarchical regressions.

To directly test if romantic unions are associated with fewer depressive symptoms than dating relationships or being unpartnered for lesbian and gay young adults, but that these associations are weaker than they are for heterosexual young adults (Hypothesis 1), we look at the interaction terms by sexual orientation status and relationship types. We find that lesbian or gay young adults who were married reported fewer depressive symptoms compared to unpartnered lesbian or gay young adults (consistent with Hypothesis 1). Lesbian or gay young adults who were cohabiting did not differ from unpartnered lesbian or gay adults on their depressive symptoms (inconsistent with Hypothesis 1). We also visualize the results from pairwise comparisons to show within-group associations for lesbian/gay young adults (see Figure 1). Additional pairwise comparisons (see Figure 1) indicated that cohabiting lesbian and gay young adults did not differ from those in dating relationships or those who were married. We also found no significant differences between lesbian and gay young adults in dating relationships and those who are unpartnered in terms of their depressive symptoms. Moreover, in Model 3, the interaction term of relationship types and sexual orientation status are not statistically significant. Thus, there is no statistically significant difference in these associations between heterosexual and lesbian and gay young adults (inconsistent with Hypothesis 1).

For Hypothesis 2, that romantic relationships across all relationship types provide negligible mental health benefits for bisexual young adults (see Figure 1), we found minimal evidence of any benefits across all relationship types (consistent with Hypothesis 2). For bisexual young adults, those who were unpartnered did not differ in their depressive symptoms compared to bisexual young adults in any relationship type (see Figure 1). However, these results should be interpreted with caution due to smaller cell sizes for bisexual population. Although these estimates were not statistically significant, the estimates show similar patterns to those for lesbian/gay people and the large standard errors could suggest that the nonsignificance is due to greater variability in the sample.

Different-sex vs. Same-sex Union Status

The third hypothesis predicts that same-sex unions will be associated with fewer depressive symptoms for all sexual minority young adults than not being in a union or being in a different-sex union. To ease the interpretation, we present the visualized predicted values of depressive symptoms from the regression results in Figure 2 (full regression results are available upon request). We found that same-sex union status matters for lesbian and gay young adults, but not for bisexual young adults (partially supporting Hypothesis 3).

Figure 2:

Figure 2:

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Predicted Depressive Symptoms in Controlled Model

Note: All significance tests are based on group comparisons within sexual minority samples. Error bar shows the 95% confidence interval. The model includes the whole sample (N = 14,656).

a Difference between Lesbian/Gay young adults who are not in a union and Lesbian/Gay young adults in a Same-Sex Union in the controlled model is statistically significant (p < 0.05).

For lesbian and gay adults (Figure 2, Lesbian/Gay young adults), being in a same-sex union, but not a different-sex union, is associated with fewer depressive symptoms compared to not being in a union. However, pairwise comparison tests did not find a significant difference in depressive symptoms between lesbian or gay young adults in a same-sex union and those in a different-sex union (inconsistent with Hypothesis 3). For bisexual young adults (Figure 2, Bisexual young adults), union status was not significantly associated with depressive symptoms. Indeed, bisexual young adults in a same-sex union or a different-sex union did not report lower depressive symptoms compared to not being in a union; there was also no difference between those in a same-sex union and those in a different-sex union. Yet, given the small sample size and large standard errors for the same-sex union estimates, the nonsignificance of these results may be due more to sample variability and should be interpreted with caution.

Discussion

Despite the significance of romantic relationships for the mental health of heterosexual young adults (Simon & Barrett, 2010; Still, 2021; Whitton et al., 2013), prior research has yet to examine the role of these relationships on depressive symptoms among lesbian, gay, and bisexual young adults in a nationally representative U.S. sample. Consistent with the first hypothesis and existing research (Donnelly et al., 2019; Hsieh & Liu, 2019; Reczek et al., 2017; Whitton et al., 2018b, 2021), we found that marital relationships are associated with fewer depressive symptoms for gay and lesbian young adults than dating relationships. Yet, these benefits are not more pronounced for heterosexual young adults (inconsistent with Hypothesis 1). These findings suggest that factors theorized to promote mental health for married heterosexual young adults, such as increased emotional and social support and greater socioeconomic resources (Liu & Umberson, 2008; Umberson et al., 2010), likely apply to married lesbian and gay young adults in similar ways.

We found that romantic relationships of all types are not associated with bisexual young adults’ depressive symptoms (consistent with the second hypothesis), even when bisexual young adults were partnered in different-sex unions. The interaction term between sexual orientation and relationship types is also statistically insignificant for this population. This finding suggests that bisexual young adults might face unique stressors not experienced by other young adults that offset any potential benefits of romantic relationships, suggesting that bisexual young adults might benefit more from certain relationships than other groups in the absence of these stressors. Specifically, a qualitative study found that bisexual adults, primarily women, in different-sex relationships felt that their bisexual identity was often not acknowledged or respected by their partner (Mernitz et al., 2022).

Bisexual identities are also found to be invalidated in same-sex relationships (Flanders et al., 2017), which may be why bisexual young adults in same-sex unions did not experience decreased depressive symptoms (inconsistent with Hypothesis 3). Therefore, having a partner, regardless of whether the partner is a same- or different-sex partner, may offer relationship benefits but may not counteract bi-specific stressors like the erasure of identity (Feinstein et al., 2016, 2019; Flanders et al., 2017). Consequently, bi-specific stressors continue to influence bisexual young adults in relationships (Hsieh & Liu, 2021; Zivony & Lobel, 2014). However, there were not many bisexual young adults in a same-sex union in our sample. Same-sex unions could emerge as a source of health-promoting factor against depressive symptoms for bisexual young adults in a larger sample, particularly as the patterns for bisexual young adults in same-sex unions mirrored those for lesbian/gay young adults.

Partially consistent with Hypothesis 3, we found that same-sex unions are associated with fewer depressive symptoms for lesbian and gay young adults. Yet, lesbian and gay young adults who are currently cohabiting or married with same-sex partners did not significantly differ in their depressive symptoms from those who are in different-sex unions (partially inconsistent with Hypothesis 3). Theoretically, while same-sex unions were associated with lower depressive symptoms when compared to not being in a union, same-sex couples do experience unique couple-level minority stressors, above and beyond individual minority stressors, such as greater relationship stigma and lack of social support for their relationship (LeBlanc et al., 2015; LeBlanc & Frost, 2020; Neilands et al., 2020). These stressors may repress the benefits of same-sex unions when compared to different-sex unions, but not completely offset the benefits received from romantic partners generally, such as increased emotional and social support (Baams et al., 2014; Rostosky & Riggle, 2017) or possibly more socioeconomic resources (Liu et al., 2013; Reczek et al., 2017). However, given the small cell sizes for lesbian and gay young adults in any union, the lack of difference between those in same- and different-sex unions may become more pronounced in other studies.

Several limitations qualify the findings in this study. First, the data were collected prior to the U.S. Supreme Court ruling that legalized marriage for same-sex couples in 2015. Thus, the same-sex married sample might be less representative of the national population of sexual minority people. Scholars should further explore how the legalization of same-sex marriage alters the association between same-sex marriage and depressive symptoms during young adulthood. Second, the sample sizes prohibit stratification by gender within the sexual minority sample, and it is likely that the mental health benefits of relationships differ for men and women. Future research might explore the possibility that gender matters for relationships and health, echoing emerging evidence suggesting that respondent’s and partner’s gender matter for sexual and gender minorities’ relationships and mental health (Whitton et al., 2020, 2021).

Moreover, relationship characteristics, such as the quality of these relationships, likely affect how beneficial a relationship is for a young adult’s mental health (Carr et al., 2016; Haas & Lannutti, 2021; Proulx et al., 2007; Still, 2021). Future research could include relationship quality as a possible mechanism through which certain relationships influence mental health. Lastly, romantic partners’ sexual orientation was not measured in the study. Bisexual young adults who partner with heterosexual partners may have different mental health outcomes than those who partner with other bisexual partners. Indeed, partnering with heterosexual partners may lead to more instances of a partner’s binegativity (Feinstein et al., 2019; Mernitz et al., 2022) that may not be apparent in relationships with other bisexual partners, contributing to worse mental health among these young adults.

Despite the limitations, this study contributes to the literature on social relationships and health by examining how relationship types, including if a union was a different-sex or same-sex union, are associated with depressive symptoms by various sexual orientations. Using a national probability sample, we found evidence that lesbian and gay young adults broadly reported fewer depressive symptoms when in romantic unions compared to those who are not in a union. However, bisexual young adults did not report any benefits against depressive symptoms from relationships. The findings emphasize that although relationships matter for young adult sexual minority mental health, consistent with studies on heterosexual young adults (e.g., Mernitz & Kamp Dush, 2016), these benefits vary by the relationship type. This study suggests that addressing the stigma associated with same-sex relationships and protecting same-sex marriage as a fundamental right for sexual minority people are crucial to improving the disparity in depressive symptoms between heterosexual and sexual minority young adults.

Acknowledgement:

This research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development grant number R03HD099417 (awarded to Mernitz) and P2CHD042849, Population Research Center, awarded to the Population Research Center at The University of Texas at Austin. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Add Health is directed by Robert A. Hummer and funded by the National Institute on Aging cooperative agreements U01AG071448 (Hummer) and U01AG071450 (Aiello and Hummer) at the University of North Carolina at Chapel Hill. Waves I-V data are from the Add Health Program Project, grant P01HD31921 (Harris) from Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), with cooperative funding from 23 other federal agencies and foundations. Add Health was designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill.

Contributor Information

Jaime Hsu, Department of Sociology, University of Texas at Austin.

Sara Mernitz, Population Research Center, University of Texas at Austin.

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