Table 4.

Results of multivariable multinomial logistic regression models estimating associations of sexual orientation and gender identity with outcomes of co-occurring depressive symptoms and substance use disorders among Growing Up Today Study participants aged 20–35 years, assigned female at birth (2010, 2016)

	SEXUAL ORIENTATION							GENDER IDENTITY
	Completely Heterosexual	Mostly Heterosexual			Lesbian/Gay/Bisexual			Cisgender	Gender Minority
	AOR	AOR	95% CI	p-value	AOR	95% CI	p-value	AOR	AOR	95% CI	p-value
Outcome 1: Depressive Symptoms (DS) & Nicotine Dependence (ND)
No DS, No ND	1.0	1.00			1.00			1.0	1.00
DS Only	1.0	1.72	1.53–1.92	<.0001	2.64	2.17–3.21	<.0001	1.0	1.46	0.87–2.45	0.155
ND Only	1.0	2.55	2.06–3.16	<.0001	3.80	2.64–5.46	<.0001	1.0	0.76	0.25–2.33	0.638
DS & ND	1.0	4.35	3.42–5.53	<.0001	9.80	6.95–13.8	<.0001	1.0	1.10	0.40–3.01	0.857
Outcome 2: Depressive Symptoms (DS) & Alcohol Use Disorder (AUD)
No DS, No AUD	1.0	1.00			1.00			1.0	1.00
DS Only	1.0	1.80	1.60–2.02	<.0001	3.04	2.51–3.70	<.0001	1.0	1.54	0.90–2.63	0.118
AUD Only	1.0	2.33	1.94–2.80	<.0001	2.41	1.71–3.40	<.0001	1.0	1.52	0.69–3.35	0.303
DS & AUD	1.0	3.11	2.53–3.82	<.0001	3.66	2.60–5.15	<.0001	1.0	1.49	0.54–4.10	0.445
Outcome 3: Depressive Symptoms (DS) & Drug Use Disorder (DUD)
No DS, No DUD	1.0	1.00			1.00			1.0	1.00
DS Only	1.0	1.77	1.58–1.97	<.0001	2.89	2.40–3.49	<.0001	1.0	1.37	0.81–2.32	0.246
DUD Only	1.0	4.20	3.11–5.67	<.0001	7.94	5.13–12.3	<.0001	1.0	1.63	0.49–5.44	0.429
DS & DUD	1.0	4.84	3.59–6.52	<.0001	9.04	5.96–13.7	<.0001	1.0	2.38	0.97–5.88	0.059

Note: “Completely heterosexual” and “cisgender” participants are the referent groups for the sexual orientation and gender identity independent variables. Sexual orientation and gender identity included simultaneously in generalized estimating equations models adjusted for age, race/ethnicity, cohort, and region of residence. Associations in bold are p-value <.05