Table 5.

Multinomial Logistic Regression Models Demonstrating Latent Class Correlates of Mental and Behavioral Health Risks Among Youth Assigned Female Sex at Birth (n = 12,373)

	Depressive symptomsa		Self-perceived stressb		Lifetime alcohol usec		Lifetime marijuana use		Lifetime cigarette use
	AOR (95% CI)	p	AOR (95% CI)	p	AOR (95% CI)	p	AOR (95% CI)	p	AOR (95% CI)	p
Victimization exposure class
Class 1 (“No Victimization Class”; n = 6021; 48.7%)	ref		ref		ref		ref		ref
Class 2 (“Sexual Harassment and SGM-based Bullying Class”; n = 4232; 34.2%)	6.06 (4.13–8.89)	<0.001	1.99 (1.49–2.64)	<0.001	3.71 (2.74–5.01)	<0.001	4.50 (3.00–6.76)	<0.001	5.14 (3.06–8.62)	<0.001
Class 3 (“Poly-victimization Class”; n = 2120; 17.1%)	8.19 (5.85–11.48)	<0.001	2.41 (1.89–3.07)	<0.001	6.70 (5.15–8.70)	<0.001	8.86 (6.19–12.66)	<0.001	9.46 (5.97–14.99)	<0.001
Demographic characteristics
Race/ethnicity
White	ref		ref		ref		ref		ref
People of color	1.08 (0.98–1.20)	0.059	1.07 (0.97–1.18)	0.102	0.90 (0.82–0.99)	0.018	1.21 (1.08–1.35)	0.007	1.02 (0.91–1.15)	0.356
Sexual orientation
Monosexual	ref		ref		ref		ref		ref
Non-monosexual	1.10 (1.00–1.23)	0.046	1.22 (0.98–1.22)	0.051	0.99 (0.89–1.09)	0.389	0.82 (0.73–0.92)	<0.001	0.99 (0.87–1.12)	0.425
Something else	1.36 (1.15–1.62)	<0.001	1.21 (1.03–1.43)	0.011	0.61 (0.51–0.73)	<0.001	0.54 (0.44–0.66)	<0.001	0.59 (0.48–0.74)	<0.001
Age, years	0.99 (0.96–1.03)	0.484	1.02 (0.98–1.05)	0.181	1.46 (1.40–1.52)	<0.001	1.63 (1.55–1.70)	<0.001	1.34 (1.28–1.41)	<0.001
Gender identity
Cisgender	ref		ref		ref		ref		ref
Transgender and other gender minority	1.57 (1.42–1.73)	<0.001	1.23 (1.11–1.36)	<0.001	0.97 (0.88–1.06)	0.245	1.09 (0.98–1.21)	0.063	1.27 (1.14–1.43)	<0.001
U.S. region of residence
Northeast	ref		ref		ref		ref		ref
Midwest	1.05 (0.89–1.22)	0.277	0.81 (0.70–0.94)	0.002	0.89 (0.77–1.03)	0.655	1.12 (0.95–1.32)	0.226	1.32 (1.11–1.58)	<0.001
South	0.89 (0.77–1.03)	0.058	0.90 (0.78–1.03)	0.063	0.96 (0.84–1.10)	0.352	1.06 (0.91–1.24)	0.227	1.30 (1.10–1.53)	<0.001
West	0.99 (0.85–1.16)	0.456	0.89 (0.77–1.04)	0.074	1.10 (0.95–1.27)	0.254	1.27 (1.07–1.50)	0.003	1.22 (1.11–1.47)	0.015
SGM-specific risk variables
Stigma-related stress	1.26 (1.19–1.33)	<0.001	1.21 (1.15–1.27)	<0.001	1.02 (0.96–1.08)	0.254	0.90 (0.85–0.96)	<0.001	0.93 (0.88–0.99)	0.019
Family rejection	1.55 (1.45–1.65)	<0.001	1.23 (1.16–1.30)	<0.001	1.25 (1.18–1.33)	<0.001	1.28 (1.20–1.37)	<0.001	1.36 (1.27–1.46)	<0.001
Sexual orientation disclosure to family members/parents
Not disclosed sexual orientation to family members/parents	ref		ref		ref		ref		ref
Disclosed sexual orientation to at least a few family members/parents	2.84 (2.57–3.15)	<0.001	1.055 (0.95–1.16)	0.192	2.53 (2.30–2.78)	<0.001	2.91 (2.61–3.25)	<0.001	2.55 (2.27–2.87)	<0.001
SGM-specific protective variables
Poly-strengthsd
Thriving	0.65 (0.62–0.68)	<0.001	1.23 (1.16–1.30)	<0.001	0.97 (0.93–1.01)	0.052	0.99 (0.95–1.03)	0.274	0.91 (0.87–0.95)	<0.001

All models adjusted for demographic characteristics and SGM-specific risk and protective variables. Significant AOR is indicated in bold. All models utilized the bias-adjusted maximum likelihood approach.

^a Highest tertile was used to calculate the presence of self-reported depressive symptoms.

^b Highest tertile was used to calculate the presence of self-perceived stress.

^c Highest tertile was used to calculate the presence of any alcohol use (i.e., 3 days or more).

^d Poly-strengths (i.e., a composite index of self-esteem, sense of mastery, sense of control, positive feelings about being LGBTQ, perception of LGBTQ-supportive family members, presence of a gay–straight alliance or similar club, perception of LGBTQ-affirmative teachers and school personnel, and access to LGBTQ-related support and resources).