As if growing pains weren’t enough: Health disparities in sexual minorities

by Loren Hoffman

As if teens today don’t have enough to worry about, studies in the last decade have proved what all too many are already well aware of: being a sexual minority—that is gay, lesbian or bisexual—makes growing up healthy even harder.

Most of us remember the mad race of high school, desperately trying to figure out what it takes to be one of the “cool kids,” to fit in and be liked, while others rebelled and fought to stand out as much as possible. Add to that the newest technology that makes privacy a nonentity and increases the gossip circle to include the entire Internet (instead of just the halls of your high school) and suddenly, the stigma that is unfortunately still associated with coming out and being openly gay makes the prospect of bullying, harassment, and hazing exponentially more intolerable.

The unfortunate fact is that much of the education against such behaviors is still new and untried. Health class teachers are faced with not just teaching heterosexual safe sex, but homosexual as well—a still-taboo subject for the most part. However, recent studies are proving that risk factors and health disparities in non-heterosexual adolescents exist precisely because not enough protective factors are in place.

Facing the Facts

Elizabeth M. Saewyc of the University of Columbia wrote an article last year for the Journal of Research on Adolescence that looked at studies performed in the last decade on sexual orientation and development and how the data can be used to understand the “… developmental milestones, health disparities, and potential risk and protective factors affecting the health and well-being of sexual minority adolescents.”

According to Saewyc, a 2010 study “The health and health care of lesbian gay and bisexual adolescents” by T.R. Coker, S.B. Austin and M.A. Schuster, showed “a higher prevalence of sexual minority youth indicate emotional distress, depression, self-harm, suicidal isolation, and suicide attempts.”

The article discusses the prevalence of risky sexual behaviors in boys and girls who self-identify as gay, lesbian or bisexual including early first-time intercourse (as young as 13 in some cases), contraceptive use (or lack thereof) and sexual outcomes such as unwanted pregnancy (higher in girls who identify as bisexual) and STIs or STDs; their exposure to violent behaviors; drug use and abuse; and how existing protective programs (such as alliance clubs in schools or a supportive family environment) can abate or ease the stigma and development process.

Another study, performed by Carol Goodenow, PhD, Laura A. Szalacha, EdD, Leah E. Robin, PhD and Kim Westheimer, MA and published in 2008 in the American Journal of Public Health, determined that sexual behavior in adolescents does not always correspond with self-identified sexual orientation. For example, the study showed that among female adolescents who listed having only female partners, 82 percent self-identified as heterosexual.

Does this imply a lack of understanding of the term ‘heterosexual,’ a basic milestone in development of an individual’s sexual identity, or a fear of the stigma associated with non-heterosexuality? According to the study, all are possible factors, and sexual education instructors should take that into account.

The Goodenow study, “Dimensions of Sexual Orientation and HIV-Related Risk Among Adolescent Females: Evidence from a statewide survey,” also looked at how females with partners of both sexes were “nearly three times more likely to experience sexual coercion.” In other words, forced to participate in sexual behaviors against their will.

While reasons for this level of disparity are not discussed, it does allude to the lingering stigma against non-heterosexuals and the trouble many teens still face while coming into their sexual identity.

The Stigma of Sexuality

Growing up is hard enough without adding hazing, bullying, and rape to the mix. Both Goodenow and Saewyc agree that health professionals both inside and outside of schools need to be made more aware of how informing the teens of the potential risks can protect against the spread of disease and the prevalence of unwanted pregnancy but can also make the sexual majority more accepting.

The two also agree that education isn’t the only key. Supportive family environments, alliance groups and educating the student body at large to be more supportive and open to sexual minorities could decrease the extent of disparity in healthy lifestyle choices. Yet according to Saewyc, recent studies show that fewer resources for support— both direct (support groups and alliance clubs) and indirect (family and friend support)— are available to teens.

However, this lack is not conclusive in the overall health of the burgeoning adult. Some teens, despite negative influences, still manage to live healthy, satisfying adult lives. The problem lies in the ones who might not make it that far.

With the growth in technology, awareness of news of such tragedies as bullying YouTube videos causing suicides is more in the public eye. One would think such an increase would encourage dramatic change, but while strides have been made, Saewyc says, “almost no interventions have been tested to actually reduce (the health disparities) or to reduce the high rates of harassment and victimization that are associated with many of them.”

Between education—teaching tolerance and sex-ed—and being mindful of the disparities that exist, adults can, perhaps, ease the developmental process and decrease the inequality.

It’s not enough to just survive high school anymore with such an obvious imbalance between sexual minorities and their heterosexual counterparts, in terms of health—both mental and physical. It’s obvious more studies need to be done—in development, education approaches and intervention plans.

Article written by Loren Hoffman for Moxy Magazine, October 2012. 

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photo by: Chez Eskay

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