Abstract
Objectives. We used nuanced measures of sexual minority status to examine disparities in victimization and their variations by gender, age, and race/ethnicity.
Methods. We conducted multivariate analyses of pooled data from the 2005 and 2007 Youth Risk Behavior Surveys.
Results. Although all sexual minorities reported more fighting, skipping school because they felt unsafe, and having property stolen or damaged at school than did heterosexuals, rates were highest among youths who identified as bisexual or who reported both male and female sexual partners. Gender differences among sexual minorities appeared to be concentrated among bisexuals and respondents who reported sexual partners of both genders. Sexual minority youths reported more fighting than heterosexual youths, especially at younger ages, and more nonphysical school victimization that persisted through adolescence. White and Hispanic sexual minority youths reported more indicators of victimization than did heterosexuals; we found few sexual minority differences among African American and Asian American youths.
Conclusions. Victimization carries health consequences, and sexual minorities are at increased risk. Surveys should include measures that allow tracking of disparities in victimization by sexual minority status.
Public attention to and scholarship on sexual minority youths grew significantly during the past decade1; victimization has been the subject of a great deal of this interest. Numerous studies have documented higher rates of victimization of sexual minority, or lesbian, gay, bisexual, and transgender (LGBT), youths than of their heterosexual peers. Most previous studies relied on community samples or on samples of sexual minority youths recruited through LGBT organizations or online. Most notable among those is the biannual National School Climate Survey, conducted by the Gay, Lesbian, and Straight Education Network, which has documented school-based victimization of LGBT youths for more than a decade. The 2011 survey of more than 7000 students, aged 13 to 21 years, showed that nearly 9 out of 10 LGBT students experience harassment at school.2
Although a few population-based studies have examined victimization of sexual minority youths, these studies typically have several limitations. Some are limited to single-item measures of sexual minority status.3 Experts argue that studies should measure multiple dimensions of sexual orientation (i.e., identity as well as behavior),1 but studies that incorporate multiple measures are rare. Even in fairly large population-based samples, the prevalence of sexual minorities is low enough that LGB youths are combined into a single category for statistical analyses.4,5
Multiple studies have documented strong gender differences in victimization among sexual minority youths: sexual minority adolescent boys report more victimization than do sexual minority adolescent girls.5 Few studies have been able to disaggregate victimization experiences of sexual minority youths by age and race. A recent school-based population survey in Wisconsin found that homophobic attitudes decline from 7th to 12th grades.6 Furthermore, analyses of the National School Climate Survey 2007 data showed that younger LGBT youths reported significantly more school victimization than did their older peers.7 Data from the 2005 wave of the same survey showed that White, Native American, and multiracial LGBT students reported having property stolen or damaged at school more often than did other LGBT students.8 Data from the 2007 wave of the survey showed that African American LGBT students were more likely than Whites to report anti-LGBT victimization at school.7 This research from Gay, Lesbian, and Straight Education Network was the first to show racial/ethnic group differences among LGBT students; we know of no published studies that make use of population-based data to examine racial/ethnic group differences in victimization.
We used pooled Youth Risk Behavior Survey (YRBS) data to examine differences in indicators of victimization by sexual identity and sexual behavior, as well as variability among sexual minorities by gender, age, and race/ethnicity.
METHODS
We analyzed a data set that pooled 2005 and 2007 Youth Risk Behavior Surveys9 (respondents were in grades 9–12) from several jurisdictions that included 1 or more measures of sexual orientation. Our approach to pooling the data and analyzing the pooled data set, along with the sexual orientation items and characteristics of the sample by jurisdiction, are described in detail elsewhere in this issue.9 We analyzed data from the 13 jurisdictions (Boston, MA; Chicago, IL; Connecticut; Delaware; Maine; Massachusetts; New York City, NY; San Diego and San Francisco, CA; Vermont; Rhode Island; Wisconsin; and Milwaukee, WI) that measured either sexual orientation identification or gender of sexual partners.
Measures
We assessed all measures, including demographic characteristics and sexual orientation, via self-report. The measurement and pooling of sexual orientation and race/ethnicity items are described elsewhere in this issue.9 We excluded respondents who were missing data on any sexual orientation measures, race/ethnicity, age, or gender. To maintain the largest sample size possible, we allowed our sample sizes to vary slightly by sexual minority status indicator. For all analyses of sexual orientation identity, our total analytic sample comprised 55 016 respondents; for the analysis of sexual behavior, our analytic sample totaled 58 699 persons; and for the analysis that incorporated both identity and behavior, our final analytic sample totaled 48 879 persons.
We measured sexual minority status with multiple strategies. We first employed a dichotomous omnibus measure that captured simply whether respondents reported any same-sex orientation in their identity or behavior. We coded respondents who reported any same-sex orientation as sexual minority and those who did not as sexual majority (referent). We also used a measure of sexual orientation identity, which ascertained whether respondents identified as heterosexual (referent), bisexual, or gay or were unsure of their sexual orientation identity. A measure of sexual behaviors indicated whether respondents had had no sexual partners, only other-sex partners (referent), both-sex partners, or only same-sex partners. Finally, we created a composite measure of sexual minority status from both identity and behavior that captured, by identity, whether respondents reported only opposite-sex partners; same- or both-sex partners, or no partners, resulting in 12 variables (referent was heterosexual–opposite-sex partners).
We developed a scale from 7 items related to fighting: “During the past 12 months, how many times were you in a physical fight on school property?” “During the past 12 months, how many times were you in a physical fight?” “During the past 12 months, how many times has someone threatened or injured you with a weapon such as a gun, knife, or club on school property?” Response options for these questions were zero times (coded as 1), 1 time (2), 2 or 3 times (3), 4 or 5 times (4), 6 or 7 times (5), 8 or 9 times (6), 10 or 11 times (7), and 12 or more times (8). “During the past 12 months, how many times were you in a physical fight in which you were injured and had to be treated by a doctor or nurse?” “During the past 30 days, on how many days did you carry a weapon such as a gun, knife, or club?” “During the past 30 days, on how many days did you carry a gun?” “During the past 30 days, on how many days did you carry a weapon such as a gun, knife, or club on school property?” Response options for these questions were zero times (coded as 1), 1 time (2), 2 or 3 times (3), 4 or 5 times (4), and 6 or more times (5). Preliminary factor analyses showed a single strong factor structure (α = 0.78; removal of questions related to weapons decreased the α score). We summed items for a total score (range = 0–44).
In addition to the scale for fighting, we included 2 single-item measures from the core section of the YRBS: “During the past 30 days, on how many days did you not go to school because you felt you would be unsafe at school or on your way to or from school?” Response options were zero days (coded as 1), 1 day (2), 2 or 3 days (3), 4 or 5 days (4), and 6 or more days (5). “During the past 12 months, how many times has someone stolen or deliberately damaged your property such as your car, clothing, or books on school property?" Response options were zero times (coded as 1), 1 time (2), 2 or 3 times (3), 4 or 5 times (4), , 6 or 7 times (5), 8 or 9 times (6), 10 or 11 times (7), and 12 or more times (8).
Statistical Analyses
We first calculated indicators of victimization across categories of the 3 measures of sexual minority status. For each measure of sexual minority status, we conducted the F test to examine whether means were statistically significantly different between sexual minority and majority groups. Next, we determined sexual minority group differences by gender, age, and race/ethnicity. We used ordinary least squares (for the fighting scale) and Poisson (for the measures of skipping school because of feeling unsafe and having property stolen or damaged) regression to examine the joint associations of sexual minority status, gender, age, and race/ethnicity with each indicator of victimization.
We conducted all analyses with the SVY commands in STATA version 12.0 (StataCorp LP, College Station, TX) to account for the complex design of the YRBS.
RESULTS
According to our omnibus measure of sexual minority status, sexual minority youths reported significantly more fighting, skipping school because they felt unsafe, and having property stolen or damaged at school (Table 1). Our results derived from the measure of sexual identity showed the same pattern: LBG and unsure youths reported higher scores on indicators of victimization. The results for the measure of sexual behavior showed that youths who had had no sexual experience reported the lowest scores on victimization indicators. We tallied higher scores for victimization indicators among youths who reported both-sex partners than those who reported other-sex partners.
TABLE 1—
Comparison of Indicators of Victimization By Sexual Minority Status, Sexual Identity, and Sexual Behavior: Pooled Youth Risk Behavior Surveys, United States, 2005–2007
| Fighting, μ (95% CI) | Skipping School Because of Feeling Unsafe, μ (95% CI) | Stolen Property, μ (95% CI) | |
| Omnibus measure | |||
| Sexual minority | 9.75 (9.39, 10.12) | 1.27 (1.23, 1.31) | 1.68 (1.60, 1.76) |
| Sexual majority | 8.48*** (8.41, 8.55) | 1.10*** (1.09, 1.11) | 1.37*** (1.35, 1.38) |
| Sexual identity | |||
| Gay/lesbian | 9.73** (8.76, 10.70) | 1.37*** (1.23, 1.49) | 1.88*** (1.60, 2.17) |
| Bisexual | 10.13*** (9.53, 10.73) | 1.29*** (1.20, 1.38) | 1.72*** (1.57, 1.88) |
| Heterosexual | 8.52 (8.45, 8.58) | 1.11 (1.10, 1.12) | 1.38 (1.36, 1.40) |
| Unsure | 9.66** (8.90, 10.43) | 1.32*** (1.23, 1.40) | 1.61*** (1.49, 1.74) |
| Sexual partners | |||
| Same-sex only | 9.69** (9.13, 10.25) | 1.23*** (1.11, 1.14) | 1.67*** (1.53, 1.80) |
| Both genders | 10.62*** (10.02, 11.21) | 1.32*** (1.24, 1.39) | 1.87*** (1.74, 2.00) |
| Other-sex only | 9.02 (8.92, 9.13) | 1.13 (1.12, 1.15) | 1.44 (1.42, 1.57) |
| None | 7.75*** (7.71, 7.80) | 1.07*** (1.06, 1.08) | 1.33*** (1.31, 1.35) |
Note. CI = confidence interval.
**P < .01; ***P < .001.
Table 2 presents gender, age, and race/ethnic differences on the victimization measures for sexual identity subgroups. Among adolescent girls, lesbians, bisexuals, and unsure participants reported more fighting than did heterosexuals. Bisexual adolescent boys reported particularly high levels of fighting. Victimization experiences were generally more prevalent among younger youths.
TABLE 2—
Gender, Age, and Racial/Ethnic Differences in Indicators of Victimization for Sexual Identity Subgroups: Pooled Youth Risk Behavior Surveys, United States, 2005–2007
| Heterosexual, μ (95% CI) | Gay/Lesbian, μ (95% CI) | Bisexual, μ (95% CI) | Unsure, μ (95% CI) | |
| Fighting | ||||
| Gender | ||||
| Female | 7.80 (7.80, 7.96) | 9.52*** (8.73, 10.43) | 9.28*** (8.89, 9.67) | 8.50* (7.99, 9.01) |
| Male | 9.16 (9.06, 9.27) | 9.85 (8.35, 11.35) | 13.05*** (10.94, 15.16) | 10.94* (9.36, 12.52) |
| Age, y | ||||
| ≥ 16 | 8.48 (8.39, 8.57) | 9.03 (8.18, 9.87) | 9.87*** (9.20, 10.53) | 9.54** (8.75, 10.33) |
| < 16 | 8.57 (8.48, 8.68) | 11.38*** (10.33,12.43) | 10.58*** (9.71, 11.47) | 9.90 (8.65, 11.15) |
| Race/ethnicity | ||||
| Non-Hispanic White | 8.24 (8.17, 8.31) | 8.98 (7.98, 9.98) | 10.36*** (9.43, 11.30) | 8.87 (8.06, 9.79) |
| Non-Hispanic African American | 8.86 (8.73, 8.99) | 9.82 (7.67, 11.96) | 9.82 (7.65, 11.93) | 10.64* (8.95, 12.33) |
| Hispanic | 8.80 (8.66, 8.94) | 10.65 (8.67,12.63) | 9.35* (8.87, 9.83) | 9.91 (8.52, 11.29) |
| Asian | 7.96 (7.83, 8.08) | 7.66 (7.02, 8.09) | 11.72 (7.52, 14.31) | 8.28 (7.51, 9.01) |
| Native American/Pacific Islander | 9.00 (8.37, 9.21) | 12.73 (8.89, 16.98) | 12.42 (9.80, 15.04) | 12.73 (8.42, 17.05) |
| Skipping school because of feeling unsafe | ||||
| Gender | ||||
| Female | 1.10 (1.09, 1.11) | 1.21* (1.10, 1.31) | 1.21*** (1.15, 1.26) | 1.24** (1.15, 1.33) |
| Male | 1.11 (1.10, 1.12) | 1.47*** (1.29, 1.65) | 1.56*** (1.26, 1.87) | 1.40*** (1.26, 1.54) |
| Age, y | ||||
| ≥ 16 | 1.11 (1.10, 1.12) | 1.27*** (1.17, 1.37) | 1.28*** (1.19, 1.37) | 1.35*** (1.23, 1.46) |
| < 16 | 1.10 (1.08, 1.11) | 1.59** (1.43, 1.75) | 1.31*** (1.20, 1.42) | 1.25** (1.13, 1.37) |
| Race/ethnicity | ||||
| Non-Hispanic White | 1.06 (1.05, 1.07) | 1.32*** (1.18, 1.45) | 1.23*** (1.16, 1.30) | 1.28*** (1.19, 1.38) |
| Non-Hispanic African American | 1.15 (1.12, 1.18) | 1.25 (1.03, 1.47) | 1.31 (1.12, 1.50) | 1.25 (1.07, 1.42) |
| Hispanic | 1.16 (1.15, 1.18) | 1.48** (1.26, 1.70) | 1.25 (1.13, 1.38) | 1.37* (1.18, 1.56) |
| Asian | 1.11 (1.09, 1.13) | 1.56 (1.27, 1.86) | 1.58 (1.23, 1.94) | 1.26 (1.13, 1.40) |
| Native American/Pacific Islander | 1.22 (1.08, 1.35) | 1.97 (1.59, 2.35) | 1.91 (1.41, 2.41) | 1.91 (1.14, 2.67) |
| Stolen property | ||||
| Gender | ||||
| Female | 1.32 (1.30, 1.34) | 1.77* (1.41, 2.12) | 1.55*** (1.43, 1.67) | 1.44* (1.32, 1.57) |
| Male | 1.44 (1.42, 1.47) | 1.96** (1.57, 2.35) | 2.28** (1.75, 2.81) | 1.80** (1.57, 2.03) |
| Age, y | ||||
| ≥ 16 | 1.35 (1.33, 1.37) | 1.68** (1.47, 1.89) | 1.67*** (1.52, 1.83) | 1.58** (1.43, 1.74) |
| < 16 | 1.43 (1.40, 1.46) | 2.33** (2.02, 2.64) | 1.81 (1.64, 2.00) | 1.66 (1.46, 1.86) |
| Race/ethnicity | ||||
| Non-Hispanic White | 1.36 (1.34, 1.37) | 1.82** (1.56, 2.07) | 1.74*** (1.58, 1.90) | 1.62*** (1.47, 1.77) |
| Non-Hispanic African American | 1.40 (1.36, 1.45) | 1.68 (1.25, 2.11) | 1.64 (1.31, 1.97) | 1.68* (1.44, 1.93) |
| Hispanic | 1.41 (1.37, 1.45) | 2.17** (1.59, 2.75) | 1.68* (1.48, 1.92) | 1.68 (1.38, 1.97) |
| Asian | 1.41 (1.36, 1.45) | 2.02 (1.68, 2.35) | 2.07 (1.45, 2.70) | 1.45 (1.29, 1.61) |
| Native American/Pacific Islander | 1.46 (1.37, 1.55) | 2.01 (1.46, 2.56) | 2.21** (1.59, 2.84) | 1.66 (0.89, 2.43) |
Note. CI = confidence interval.
*P < .05; **P < .01; ***P < .001.
For skipping school because of feeling unsafe, scores were higher for all sexual minority than majority adolescent boys and for bisexual and unsure adolescent girls. LGB and unsure youths had higher scores than heterosexuals across age groups. LGB and unsure White youths scored higher than heterosexual Whites; Hispanic LG and unsure youths scored higher than their heterosexual or bisexual peers.
Finally, for having property stolen or damaged, LGB respondents of both genders reported higher frequencies than did heterosexuals; bisexual boys had particularly high scores. We observed consistent LGB differences across age groups. White and Hispanic LGB youths and Native American/Pacific Islander bisexual youths scored higher than heterosexuals.
Table 3 presents gender, age, and race/ethnic differences by sexual behavior subgroups. Youths who reported no sexual partners reported significantly lower levels of indicators of victimization than did other groups. Results of gender differences across indicators were similar to those derived from sexual identity. For fighting, younger youths who had had same-sex partners (whether exclusively or in addition to other-sex partners) reported more fighting, and older youths who reported partners of both genders also reported more fighting than did other groups. Among White youths, those with partners of both genders reported the most fighting.
TABLE 3—
Gender, Age, and Racial/Ethnic Differences in Indicators of Victimization for Sexual Behavior Subgroups: Pooled Youth Risk Behavior Surveys, United States, 2005–2007
| Other-Sex Partners, μ (95% CI) | Same-Sex Partners, μ (95% CI) | Both-Sex Partners, μ (95% CI) | No Sexual Partners, μ (95% CI) | |
| Fighting | ||||
| Gender | ||||
| Female | 8.09 (8.00, 8.19) | 9.35*** (8.79, 9.91) | 9.52*** (9.08, 9.97) | 7.52*** (7.47, 7.58) |
| Male | 9.88 (9.72, 10.04) | 9.98 (9.05, 10.92) | 13.80*** (12.04, 15.56) | 8.01*** (7.94, 8.09) |
| Age, y | ||||
| ≥ 16 | 8.85 (8.73, 8.96) | 9.21 (8.50, 9.91) | 10.19*** (9.58, 10.81) | 7.67*** (7.61, 7.74) |
| < 16 | 9.43 (9.24, 9.62) | 10.85** (9.56, 12.13) | 11.46** (10.28, 12.65) | 7.84*** (7.76, 7.92) |
| Race/ethnicity | ||||
| Non-Hispanic White | 8.61 (8.52, 8.72) | 9.09 (8.38, 9.80) | 10.92*** (10.08, 11.76) | 7.72*** (7.66, 7.78) |
| Non-Hispanic African American | 9.39 (8.75, 10.86) | 9.80 (8.75, 10.86) | 10.84* (9.40, 12.28) | 7.89*** (7.78, 8.01) |
| Hispanic | 9.51 (9.31, 9.70) | 10.30 (8.86, 11.74) | 10.43* (9.47, 11.41) | 7.80*** (7.69, 7.91) |
| Asian | 9.11 (8.53, 9.69) | 11.93 (6.25, 17.62) | 13.58 (5.33, 21.83) | 7.53** (7.42, 7.63) |
| Native American/Pacific Islander | 10.14 (7.44, 9.26) | 11.65 (7.17, 16.12) | 11.33 (8.96, 13.07) | 8.46** (7.55, 9.37) |
| Skipping school because of feeling unsafe | ||||
| Gender | ||||
| Female | 1.13 (1.11, 1.14) | 1.16 (1.09, 1.24) | 1.23*** (1.18, 1.28) | 1.07*** (1.06, 1.08) |
| Male | 1.13 (1.11, 1.13) | 1.28** (1.18, 1.39) | 1.57*** (1.39, 1.74) | 1.06*** (1.05, 1.08) |
| Age, y | ||||
| ≥ 16 | 1.12 (1.11, 1.14) | 1.21* (1.13, 1.29) | 1.29*** (1.21, 1.37) | 1.07*** (1.05, 1.08) |
| < 16 | 1.13 (1.10, 1.15) | 1.28 (1.14, 1.42) | 1.39*** (1.27, 1.52) | 1.08*** (1.07, 1.10) |
| Race/ethnicity | ||||
| Non-Hispanic White | 1.09 (1.08, 1.10) | 1.22** (1.13, 1.31) | 1.27*** (1.20, 1.34) | 1.04*** (1.03, 1.04) |
| Non-Hispanic African American | 1.16 (1.13, 1.19) | 1.18 (1.06, 1.30) | 1.28 (1.14, 1.43) | 1.10*** (1.08, 1.12) |
| Hispanic | 1.20 (1.17, 1.23) | 1.23 (1.14, 1.32) | 1.26** (1.22, 1.50) | 1.12*** (1.10, 1.14) |
| Asian | 1.17 (1.09, 1.24) | 1.52 (0.95, 2.08) | 1.80 (0.95, 2.64) | 1.08** (1.05, 1.12) |
| Native American/Pacific Islander | 1.22 (1.13, 1.32) | 1.89 (0.88, 2.89) | 2.12*** (1.63, 2.61) | 1.30 (1.04, 1.56) |
| Stolen property | ||||
| Gender | ||||
| Female | 1.35 (1.33, 1.37) | 1.59* (1.40, 1.78) | 1.66*** (1.56, 1.77) | 1.28*** (1.26, 1.30) |
| Male | 1.53 (1.49, 1.57) | 1.72* (1.54, 1.91) | 2.44*** (2.09, 2.79) | 1.39*** (1.35, 1.42) |
| Age, y | ||||
| ≥ 16 | 1.40 (1.38, 1.42) | 1.67** (1.49, 1.84) | 1.86*** (1.71, 2.00) | 1.30*** (1.28, 1.32) |
| < 16 | 1.51 (1.46, 1.55) | 1.66 (1.47, 1.86) | 2.11*** (1.87, 2.36) | 1.38*** (1.36, 1.41) |
| Race/ethnicity | ||||
| Non-Hispanic White | 1.44 (1.41, 1.46) | 1.61** (1.51, 2.00) | 1.92*** (1.76, 2.09) | 1.31*** (1.29, 1.33) |
| Non-Hispanic African American | 1.42 (1.44, 1.96) | 1.70* (1.44, 1.96) | 1.64 (1.39, 1.88) | 1.38 (1.39, 1.88) |
| Hispanic | 1.49 (1.44, 1.54) | 1.66 (1.43, 1.88) | 1.82** (1.59, 2.04) | 1.34*** (1.59, 2.04) |
| Asian | 1.48 (1.33, 1.63) | 2.16 (1.78, 2.53) | 2.44 (0.88, 3.49) | 1.34 (1.28, 1.41) |
| Native American/Pacific Islander | 1.59 (1.42, 1.75) | 1.60 (1.27, 1.94) | 2.32 (1.36, 3.27) | 1.42 (1.25, 1.59) |
Note. CI = confidence interval.
*P < .05; **P < .01; ***P < .001.
Age and race/ethnicity differences were very similar for skipping school because of feeling unsafe and having property stolen or damaged. Younger youths who reported partners of both genders scored higher than other groups on both measures, as did older youths with same- or both-sex experience. Among Hispanic youths, those with partners of both genders scored highest, and White youths who reported same- or both-sex partners scored higher than other groups.
Table 4 presents multivariate analyses of the indicators of victimization, combining the measures of sexual identity and behavior into 12 groups (with heterosexual youths who reported sexual partners of the other gender only as the reference group). After adjustment for gender, age, and race/ethnicity, heterosexuals who were not sexually active reported low frequencies across indicators of victimization. Sexually active youths who were unsure about their sexual identity reported higher frequencies across measures than did heterosexuals with other-sex partners. For LG youths, having no sexual partners was associated with lower scores than for heterosexuals with other-sex partners on fighting and stolen or damaged property, but for bisexual youths, having no sexual experience did not appear to be protective. Finally, among LGB youths, it appeared that reporting sexual activities with both genders was the distinguishing factor for indicators of victimization (with the exception of LG youths and fighting, for which we detected no difference).
TABLE 4—
Ordinary Least Squares and Poisson Regression Results Predicting Indicators of Victimization: Pooled Youth Risk Behavior Surveys, United States, 2005–2007
| Fighting (n = 28 770), B (95% CI) | Skipping School Because of Feeling Unsafe (n = 48 842), IRR (95% CI) | Stolen Property (n = 43 939), IRR (95% CI) | |
| Sexual orientation–sexual partner gender | |||
| Heterosexual–opposite gender (Ref) | 1.00 | 1.00 | 1.00 |
| Heterosexual–same/both genders | 0.72 (0.16, 1.28) | 1.08** (1.02, 1.14) | 1.18*** (1.09, 1.28) |
| Heterosexual–none | −1.34*** (−1.46, −1.23) | 0.95*** (0.94, 0.96) | 0.92*** (0.90, 0.94) |
| Bisexual–other gender | 0.57 (−0.16, 1.31) | 1.16 (1.04, 1.30) | 1.19** (1.04, 1.36) |
| Bisexual–same/both genders | 2.06*** (1.20, 2.92) | 1.13*** (1.05, 1.22) | 1.28*** (1.16, 1.41) |
| Bisexual–none | −0.31 (−1.02, 0.40) | 1.04 (0.96, 1.12) | 1.04 (0.94, 1.16) |
| Gay/lesbian–other gender | 1.04 (−2.65, 4.72) | 1.43* (1.08, 1.89) | 1.45 (1.18, 1.79) |
| Gay/lesbian–same/both genders | 0.69 (−0.61, 2.00) | 1.22*** (1.07, 1.39) | 1.45*** (1.18, 1.79) |
| Gay/lesbian–none | −1.37*** (−2.15, −0.58) | 0.96 (0.90, 1.02) | 0.79*** (0.71, 0.89) |
| Unsure–other gender | 1.61** (0.12, 3.11) | 1.21*** (1.08, 1.35) | 1.27** (1.11, 1.46) |
| Unsure–same/both genders | 2.59 (0.17, 5.00) | 1.33*** (1.14, 1.56) | 1.42*** (1.13, 1.78) |
| Unsure−none | −1.23** (−1.81, −0.66) | 1.00 (1.03, 1.08) | 0.90*** (0.83, 0.97) |
| Female | −1.21*** (−1.34, −1.08) | 0.99 (0.97, 1.00) | 0.91*** (0.89, 0.93) |
| Age | 0.16 (0.04, 0.28) | 1.03*** (1.01, 1.04) | 0.99 (0.98, 1.01) |
| Race/ethnicity | |||
| Non-Hispanic White (Ref) | 1.00 | 1.00 | 1.00 |
| Non-Hispanic African American | 0.41*** (0.25, 0.60) | 1.06*** (1.03, 1.08) | 1.00 (0.97, 1.04) |
| Hispanic | 0.42*** (0.25, 0.60) | 1.08*** (1.06, 1.10) | 1.03 (0.99, 1.06) |
| Asian | 0.03 (−0.21, 0.27) | 1.07*** (1.03, 1.10) | 1.05* (1.00, 1.09) |
| Native American/Pacific Islander | 1.07** (0.52, 1.61) | 1.25*** (1.11, 1.40) | 1.06 (1.00, 1.12) |
| Grade | −0.45*** (−0.57, −0.32) | 0.96*** (0.95, 0.98) | 0.95*** (0.93, 0.97) |
| Constant | 11.47*** (10.51, 12.43) |
Note. CI = confidence interval; IRR = incidence rate ratio.
*P < .05; **P < .01; ***P < .001.
DISCUSSION
Our analyses of pooled YRBS data from across the United States confirmed previous work by showing a strong link between sexual minority status and indicators of victimization. Our study was among the first to use population-based data to disaggregate risk for the sexual minority youth population by key demographic characteristics.
Consistent with other studies, we found that sexual minority adolescent boys often reported more victimization indicators than sexual minority adolescent girls,7 but comparisons of sexual identity and behavior measures showed that gender differences were concentrated among bisexual youths and youths who reported both male and female sexual partners. By age, sexual minority differences in fighting were strong, particularly for younger respondents, but we observed a less clear difference for skipping school because of feeling unsafe and having property stolen or damaged. Thus, fighting declined with age overall, whereas the nonphysical forms of school victimization persisted for sexual minorities even as they declined for the general student population. It may be that overt homophobic victimization declines over the adolescent years, but indirect or subtle forms persist; this pattern has implications for community and school efforts to reduce victimization and bullying and bears further study.
We also found strong sexual minority disparities among White and Hispanic youths and among Native American/Pacific Islander youths who identified as LGB. Perhaps the most notable finding was few sexual minority differences for African American youths, who reported high levels across measures, and for Asian American youths, who had the lowest average scores. These findings are provocative: research on school discipline and juvenile justice disparities point to persistent overrepresentation of African American youths—both male and female—in rates of school suspension and expulsion and in the juvenile justice system.10 Such racial disparities for African American youths may be so endemic that they overshadow disparities stemming from sexual minority status.
Limitations
Although pooled YRBS data allowed for novel analyses of differences in sexual minority disparities in indicators of victimization by gender, age, and race/ethnicity, other social, economic, and geographic statuses (e.g., urban or rural) also may be important, as well as personal characteristics of sexual minority youths, such as their disclosure to others or their available social supports. In fact, other studies document that African American LGB youths may be less likely to disclose their sexual minority status11; we cannot know the degree to which cultural differences in disclosure influenced self-reports by youths in this survey. Furthermore, much of the Midwest, South, and Southwest were not represented.
The scale for fighting was complex yet robust: in this pooled sample, experiences with fighting (including severity of injuries), being threatened with a weapon, as well as carrying a weapon were highly correlated. Other studies have shown that violence perpetration is strongly predicted by victimization experiences among sexual minorities3; few studies have examined the links between fighting victimization versus perpetration, threats, injuries, and strategies for self-protection in which sexual minority youths may engage.
Our results did not account for a key concern for sexual minority youths: specifically anti-LGBT victimization. Several recent studies have used state-level population-based data sources to document the links between discriminatory victimization, including specifically anti-LGB bullying, and students’ emotional and behavioral health.12,13 Results show that student health risks are much greater when victimization is discriminatory. Several states and cities included questions about discriminatory bullying on their versions of the YRBS, yet we were unable to present analyses of those questions because they differed across sites and because some of those surveys did not also include measures of sexual minority status. Thus, although other studies show that discriminatory victimization carries significantly greater health risks for youths, no systematic tracking mechanism exists. The absence of these critical measures—of sexual minority status and of discriminatory victimization—is a serious flaw that should be addressed through the YRBS core survey and included in other large-scale population surveys of youths.
Conclusions
Our study of the victimization experiences of sexual minority youths was unique because its geographically diverse sample was large enough to allow examination of subgroups according to sexual identity and behavior, gender, age, and race/ethnicity. Whether identified by sexual identity or behavior, sexual minority youths reported consistently higher levels across indicators related to victimization than did sexual majority youths. Bisexual and youths reporting partners of both sexes reported consistently high scores on indicators of victimization.
Youths who are unsure of their sexual identity deserve more research attention: in our study they reported higher scores than other youths on each measure (and consistently so across categories of gender and age). Although fighting appears to be most common for younger sexual minority youths, nonphysical forms of victimization (skipping school because of feeling unsafe and stolen property) are common across ages. Finally, consistent racial/ethnic group differences emerged. Further study of the intersections of race, gender, sexuality, and victimization are warranted.
Acknowledgments
This project was supported by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (award R21HD051178); the Fitch Nesbitt Endowment, Frances McClelland Institute for Children, Youth, and Families (grant to S. T. R.); the Office of Research on Women’s Health and NICHW (grant K12HD055892 to B. G. E.); and the IMPACT LGBT Health and Development Program, Northwestern University (grant to M. A. B.).
Assistance from the Centers for Disease Control and Prevention (CDC) Division of Adolescent and School Health and the work of the state and local health and education departments who conduct the Youth Risk Behavior Survey (YRBS) made the project possible.
Note. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the CDC, or any agencies involved in collecting the data.
Human Participant Protection
No protocol approval was needed for this study because deidentified secondary data were used. Data use agreements were obtained from all departments of health that required them for access to YRBS data at the time of the data request, including the Vermont Department of Health and the Rhode Island Department of Health.
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