One in four American adolescents identifies as non-heterosexual, comparative analyzes show

A recent comparative analysis by Northwestern Medicine of the results of a national survey found that 1 in 4 American adolescents in grades 9 through 12 reported their sexual identity as non-heterosexual, according to findings published in JAMA Pediatrics.

The study, led by Gregory Phillips II, Ph.D., associate professor of Medical Social Sciences and Preventive Medicine in the Department of Epidemiology, highlights the need for an inclusive approach when working with sexual and gender minority youth in academic and health care settings. , among other things.

“These findings indicate that anyone working with youth should be aware of and skilled in addressing LGBTQIA+ youth as a common competency in practice,” said Lauren Beach, JD, Ph.D., assistant professor of assistant professor of Medical Social Sciences and Preventive Medicine in the Department of Epidemiology and senior author of the study.

The Youth Risk Behavior Surveillance System is a biennial series of surveys conducted by the Centers for Disease Control and Prevention (CDC). Established in 1991, the survey measures health-related behaviors and experiences that can lead to poor health among American high school students.

In 2015, the CDC added a question to the sexual identity question, with response options such as “heterosexual,” “gay or lesbian,” “bisexual,” or “not sure.” In 2021, the CDC expanded the survey’s “not sure” response to include the current three options:

• I define my sexual identity in a different way.
• I’m not sure about my sexual identity (asking questions).
• I don’t know what this question means.

In the current study, Phillips and colleagues examined whether the number of individuals who responded “not sure” about their sexual identity changed between 2019 and 2021.

This survey included 12,847 respondents (51% female and 49% male) in 2019, and 16,357 respondents (48% female and 52% male) in 2021.

From 2019 to 2021, researchers found a significant decrease in the number of youth who identified as heterosexual (84.5% vs. 74.7%), an increase in the number of youth who identified as gay or lesbian (2.5% vs. 3%) and an increase in the number of young people who identified as bisexual. (8.6% vs. 12%). More young people also chose ‘not sure’ in 2021 than in 2019 because of their sexual identity (5.1% versus 4.4%).

In 2019, 5.6% of women and 3.3% of men selected ‘not sure’ in response to the sexual identity question, while in 2021, 8% of women and 2.3% of men selected ‘not sure ‘ selected.

“There’s this idea that the number of people who identify as something other than heterosexual has increased over time, so that’s part of the reason we’re seeing these numbers rise. But it may also be due to the clarity of the question that we are seeing larger proportions of people,” Phillips said.

“People feel more comfortable saying they’re not heterosexual and don’t feel forced into that category,” Phillips said.

The findings also suggest that the CDC should further revise their question because of these percentage changes, Beach said.

“It suggests that there are other additional response options that could be very impactful for this age range of people who are not currently being accommodated,” Beach said, adding that the current findings underscore the importance of inclusive approaches when working with sex and sexual health issues . youth from gender minorities.

“If you are a health care provider serving youth in this age range, you should consider asking them questions to learn more about who they are, their sexual identity and behavior, their gender identity, whether or not they being transgender. “It’s all very relevant to talk to young people to understand who they are,” Beach said.

The researchers are now studying differences in responses by race, ethnicity, region, age and other factors, and how these factors influence risks for certain health outcomes among sexual minority youth.

“This will help us better communicate the health needs of non-heterosexual youth populations to health care providers, school officials and many other audiences,” Beach said.