The dubious assessment of gay, lesbian, and bisexual adolescents of add health

Adverse Childhood Experiences and Sexual Orientation: An Intersectional Analysis of Nationally Representative Data

INTRODUCTION

This study compared the prevalence of adverse childhood experiences across intersections of sexual orientation, gender, race/ethnicity, and economic status.

METHODS

Data collected between 1994 and 2018 from 12,519 participants in the National Longitudinal Study of Adolescent to Adult Health were analyzed in 2023 to generate adverse childhood experience prevalence estimates. Unadjusted 1-way ANOVAs and multivariate regressions were performed to compare differences in independent and cumulative adversity measures by sexual orientation, gender, race/ethnicity, and poverty status. A multilevel analysis of individual heterogeneity and discriminatory accuracy was conducted to estimate adversity scores across 24 groups that were stratified by sexual orientation, gender, race/ethnicity, and poverty status.

RESULTS

Adolescents with same-sex attractions and adults who identified with a sexual minority group reported more adverse childhood experiences overall than straight participants, although associations varied by type of adversity. Strikingly, adversity scores were higher among White youth with same-sex attractions than among Black youth with same-sex attractions, among more economically advantaged bisexual adults than among poorer ones, and among poor White participants than among poor Black and Hispanic participants, suggesting that the combination of disadvantaged and marginalized statuses does not necessarily correspond with greater childhood adversity. A multilevel analysis of individual heterogeneity and discriminatory accuracy interaction model showed that sexual orientation and poverty status contributed significant variance to cumulative adversity scores, whereas gender and race/ethnicity did not.

CONCLUSIONS

The results show that disparities in adverse experiences can be more fully and accurately represented when sexual orientation and other social identities are modeled as intersectional configurations. Given that adverse childhood experiences are linked to morbidity and mortality, the findings have salient implications for understanding health disparities that affect population subgroups.

Sex Work and Educational Mobility: Results from the National Longitudinal Study of Adolescent to Adult Health

The purpose of the study was to assess the relationship between sex work involvement and education mobility among a national sample of US young adults. Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health; N = 7732) were analyzed to explore the prospective association between lifetime sex work involvement measured in young adulthood (Wave III; ages 18-26) and educational mobility measured in adulthood (Wave V; ages 33-43). Multinomial logistic regression analyses were conducted, adjusting for relevant demographic and control variables. Results indicated that young adults who reported ever having been paid for sex by the ages of 18-26 had twofold greater risk (95% confidence interval 1.26-3.18) of having downward educational mobility compared to a stable level of education, or the same education, relative to their parents in adulthood. Given that education, by means of regular social connectedness to social supports, may be the most salient resiliency factor protecting adolescents from potential risks associated with sex work involvement (e.g., stigma, isolation from services), the findings from this study support the promotion of inclusive engagement from school settings to foster educational attainment and prevent poorer health and psychosocial outcomes that research to date has associated with sex work involvement.

Predictors of romantic partner nomination reciprocity in adolescent social networks

Network data uniquely allow relationships to be multiply reported, creating varying rates of relationship nomination reciprocation. However, what drives such variation is unclear. Variation in reciprocation may reflect substantive information about relationships (e.g., social salience or desirability) or study design (e.g., question wording or capped nominations). We examine predictors of nomination reciprocity in romantic network data from the PROSPER study to analyze individual and dyadic predictors of nomination reciprocity. Results show higher grades predict higher reciprocity, while same-sex relationships and behaviorally discordant dyads are less likely to be reciprocal.

Sexual Orientation Identity Mobility in the United Kingdom: A Research Note

Sexual identity is fluid. But just how fluid is it? How does such fluidity vary across demographic groups? How do mainstream measures fare in capturing the fluidity? In analyzing data from the United Kingdom Household Longitudinal Study (N = 22,673 individuals, each observed twice), this research note provides new, population-wide evidence of sexual identity mobility-change and continuity in individuals' sexual orientation identification-in the United Kingdom. Overall, 6.6% of the respondents changed their sexual identity reports between 2011-2013 and 2017-2019. Sexual identity mobility follows a convex pattern over the life course, with higher mobility rates at the two ends than in the middle of the age spectrum. Sexual identity mobility is more prevalent among women, ethnic minority individuals, and the less educated. Changes in people's self-reported sexual identity are closely associated with changes in their partnership status and partner's sex. However, inferring individuals' sexual identity from their partner's sex substantially underestimates the degree of sexual fluidity compared with people's self-reported sexual identity. Our findings encourage researchers and data collectors to fully examine sexual identity mobility and consider its implications for measuring sexual identity.

Stability and Change in Sexual Orientation and Genital Arousal over Time

Longitudinal work suggests that sexual orientation can change over time in men and women. These studies, however, may be susceptible to the bias of self-report. The current study therefore examined self-reported sexual orientation in addition to an objective correlate: genital arousal to erotic videos showing males or females. For 52 men (19 heterosexual, 19 bisexual, 14 homosexual) and 67 women (31 heterosexual, 18 bisexual, 18 homosexual), these measures were taken twice, with approximately 1 year between sessions. For self-reported sexual orientation, women reported lower relative stability (weaker correlation) than men over time, even though women did not change more overall (no stronger mean difference) than men between sessions. Bisexual individuals reported lower relative stability and more mean change than heterosexual and homosexual individuals. For genital arousal, across all groups, response patterns were correlated over time to a similar extent and showed little difference between sessions. Moreover, change in self-reported sexual orientation did not correspond with the change in genital arousal, regardless of sex. Perhaps self-reports overestimate changes in sexual orientation, since these changes were not reflected in physiological sexual response.

Sexual Identity-Behavior Discordance in Canada

This paper uses two surveys to examine sexual identity-behavior discordance in Canada. The first is the Sex in Canada survey (SCS), which is a private survey of 2,303 Canadians. The second is the 2015-2016 Canadian Community Health Survey (CCHS), which is a large nationally representative government-administered survey with 109,659 respondents. Results from the CCHS show that identity-behavior discordance and overall rates of same-sex contact are lower in Canada than in the US, UK, or Australia. An estimated .7 percent of males and 2.7 percent of females aged 15-64 who had had lifetime sex identified as heterosexual yet have had same-sex contact, figures which equate to an estimated 65,700 males and 255,100 females. Few demographic factors were associated with discordance. Results from the SCS show that about two-thirds of heterosexuals with identity-behavior discordance were moderately supportive of LGBQ rights and one-third were moderately homophobic. Future research will need to uncover why a lower proportion of Canadians report same-sex partners and identity-behavior discordance than their counterparts in the US, UK, or Australia. Cet article utilise deux enquêtes pour examiner la discordance entre l'identité sexuelle et le comportement au Canada. La première est l'enquête Sex in Canada (SCS), qui est une enquête privée menée auprès de 2 303 Canadiens. La seconde est l'Enquête sur la santé dans les collectivités canadiennes (ESCC) de 2015-2016, qui est une grande enquête représentative à l'échelle nationale administrée par le gouvernement auprès de 109 659 répondants. Les résultats de l'ESCC montrent que la discordance identité-comportement et les taux globaux de contacts entre personnes de même sexe sont plus faibles au Canada qu'aux États-Unis, au Royaume-Uni ou en Australie. On estime que 0,7 % des hommes et 2,7 % des femmes âgés de 15 à 64 ans ayant eu des rapports sexuels au cours de leur vie se sont identifiés comme hétérosexuels, mais ont eu des contacts avec des personnes du même sexe, ce qui correspond à environ 65 700 hommes et 255 100 femmes. Peu de facteurs démographiques étaient associés à la discordance. Les résultats de l'enquête SCS montrent qu'environ deux tiers des hétérosexuels présentant une discordance entre identité et comportement étaient modérément favorables aux droits des LGBQ et qu'un tiers était modérément homophobe. Les recherches futures devront découvrir pourquoi une plus faible proportion de Canadiens déclarent avoir des partenaires de même sexe et être en désaccord avec leur identité et leur comportement que leurs homologues aux États-Unis, au Royaume-Uni ou en Australie.

Investigating Protective Factors Associated With Mental Health Outcomes in Sexual Minority Youth

PURPOSE

The aim of this study is to identify and evaluate the efficacy of adolescent protective factors against mental health (MH) outcomes in young adulthood of sexual minority identifying youth (SMY).

METHODS

Using data from the National Longitudinal Study of Adolescent to Adult Health, we identified potential protective factors (e.g., individual factors like self-esteem, family factors like family communication, and community factors like caring teachers) at baseline (1994) when the sample was school-aged for SMY. SMY included those who identified their sexual identity as mostly heterosexual, bisexual, mostly homosexual, or 100% homosexual. MH outcomes (depression, anxiety, or suicidality) were assessed at 14-year follow-up.

RESULTS

Approximately 14,800 youth completed baseline and follow-up surveys, where 13.5% identified as SMY. Of SMY, 57% had a MH outcome compared to 37% of non-SMY (p < .05). Not all factors were protective for SMY. At the individual level, emotional well-being (adjusted odds ratio [AOR] .56, 95% confidence interval [CI] .41-.78) and self-esteem (AOR .79, 95% CI .66-.95) were found to be protective for MH outcomes in regression models. At the family level, family connectedness (AOR .82, 95% CI .71-.95) was found to be protective. At the community level, school connectedness (AOR .78, 95% CI .66-.92) and caring teachers (AOR .76, 95% CI .58-.99) were found to be protective for SMY.

CONCLUSION

Factors at the individual, family, and community (e.g., caring teachers) levels appear to be protective against MH outcomes unique to SMY. Developing interventions focused on protective factors have potential to prevent health disparities.

Identifying Invalid Responders in a Campus Climate Survey: Types, Impact on Data, and Best Indicators

Self-report surveys that are online, lengthy, and contain sensitive material greatly increase the probability of invalid responding (IR) on the instrument. Most research to inform our identification of invalid responders have not been able to test their methodologies where all these conditions are present. This study systematically adopted 10 IR indicators based on direct, archival, and statistic strategies to identify IR providing answers on a lengthy survey collecting campus climate/violence information that college students (N = 6,995) accessed online. Exploratory factor analysis indicated two internal factors (i.e., careless and extreme responding) underlying these IR indicators. Latent class analysis identified 4.8% of the sample as being invalid responders. Compared with honest responders, invalid responders were significantly more likely to report forms of victimization and a greater negative impact from physical abuse or sexual assault. Of importance, mean scores on victimization scales were significantly higher for invalid responders, illustrating the potential for IR data to skew prevalence rates. IR indicators differentially identified honest and invalid responders. The findings of this study contribute to the systematic investigation of IR with college students completing online and lengthy surveys that address sensitive material.

Adolescent Sexual Behavior Patterns in a British Birth Cohort: A Latent Class Analysis

This study examined adolescent sexual behaviors patterns, and the consistency between sexual behavior and sexual orientation, in a prospective birth cohort. We used data on 5150 young people from the Avon Longitudinal Study of Parents and Children. Sexual orientation was assessed using a 5-point scale of sexual attraction at 15.5 years. Fourteen sexual activities were assessed using the Adolescent Sexual Activities Index at 13.5 and 15.5 years. Latent class analysis suggested four subgroups of adolescent sexual behaviors at 13.5: a "high-intensity sexual behaviors exclusively with other-sex, no same-sex intimacy" group (3.87%); a "moderate-intensity sexual behaviors exclusively with other-sex, no same-sex intimacy" group (16.57%); a "low-intensity sexual behaviors exclusively with other-sex, no same-sex intimacy" group (34.21%); and a "no sexual behavior" group (45.35%). There were five subgroups at 15.5 where four of them (23.42%, 18.37%, 28.12%, and 24.52%, respectively) were interpreted the same as at 13.5 years and a new "high-intensity sexual behaviors, some same-sex intimacy" subgroup (5.57%). Latent transition analysis showed approximately half the adolescents moved toward greater engagement in higher intensity sexual activities with other-sex at 15.5. Boys and girls who were in groups without same-sex intimacy were predominantly attracted to the other-sex, whereas there were moderate consistencies between same-sex intimacy and same-sex attraction for boys and low consistency for girls. Findings suggest that it may be important to include low-intensity sexual behaviors when assigning adolescents to sexual orientation groupings (via sexual behaviors) in order to reduce selection biases and increase statistical power via the increase in sample size.

Sexual Experimentation in Heterosexual, Bisexual, Lesbian/Gay, and Questioning Adolescents From Ages 11 to 15

To examine adolescent sexuality development, we analyzed data from a British cohort study (N = 5,070), which assessed the same 12-14 sexual activities at ages 11, 12, 13, and 15, and sexual orientation identity at age 15. The sexual activities ranged from low (e.g., cuddling), moderate (e.g., kissing), to high (e.g., sexual intercourse) intensity. We found that most adolescents having sexual activities of low-to-moderate intensity with same-sex individuals also had them with other-sex individuals, and adolescents having other-sex contacts of low intensity often reported them nonexclusively. Furthermore, other-sex and same-sex sexual activities did not reliably distinguish between sexual orientation identities. Sex differences in these phenomena were absent or small. These findings suggest that many adolescents have low-intensity nonexclusive sexual behaviors.

Fraternal Birth Order, Only-Child Status, and Sibling Sex Ratio Related to Sexual Orientation in the Add Health Data: A Re-analysis and Extended Findings

The fraternal birth order (FBO) effect related to men's sexual orientation refers to the finding that the number of older brothers that a man has increases his chance of being androphilic. The FBO effect has generally been well replicated in diverse samples; one instance of non-replication was by Francis (2008) using Waves I and III of the Add Health data. We attempted to replicate the FBO effect in the Add Health data taking into account family size and other limitations of Francis' (2008) analyses. Also, we examined other sibling characteristics related to the FBO effect: sibling sex ratio and only-child status. We used two subsamples from Waves I (n = 20,745) and IV (n = 15,701) of the Add Health data, consisting of adolescents who were followed longitudinally from 1994 to 1995 until 2008. Wave I data were used to compute numbers of younger and older brothers and sisters from household roster information. Wave IV information about sexual orientation identity was used. Analyses were conducted within men and within women. We found modest support for the FBO effect in men, but not in women, using the older brother odds ratio, logistic regression analyses, and sibling sex ratio, which provided the strongest support for FBO. We found that gynephilic/biphilic women, but not androphilic/biphilic men, were more likely to be only-children compared to androphilic women and gynephilic men, respectively. We discuss limitations of the Add Health data and purported mechanisms for the FBO effect in men and the only-child effect in women.

Childhood Maltreatment, Gender Nonconformity, and Adolescent Sexual Orientation: A Prospective Birth Cohort Study

This study tested whether associations between childhood maltreatment and adolescent sexual orientation were accounted for by childhood gender nonconforming behavior (GNCB) in a prospective birth cohort (N = 5,007). Childhood parental maltreatment (physical and emotional) and GNCB were assessed on multiple occasions up to age 6 years, and sexual orientation at 15.5 years. Boys with a history of maltreatment were significantly more likely to be nonheterosexual. Using propensity score weighting, maltreatment was associated with a 3.5% (p = .03) increase in the prevalence of nonheterosexuality accounting for confounders not including GNCB, and by 2.9% (p = .06) when also accounting for GNCB. These findings suggest that maltreatment is associated with an increased prevalence of nonheterosexuality in boys but may be explained by confounding factors including GNCB.

Bias From Potentially Mischievous Responders on Large-Scale Estimates of Lesbian, Gay, Bisexual, or Questioning (LGBQ)-Heterosexual Youth Health Disparities

OBJECTIVES

To determine how sensitive estimates of lesbian, gay, bisexual, or questioning (LGBQ)-heterosexual youth health disparities are to the presence of potentially mischievous responders.

METHODS

We used US data from the 2015 Youth Risk Behavior Survey, pooled across jurisdictions that included a question about sexual identity for a total sample of 148 960 students. We used boosted regressions (a machine-learning technique) to identify unusual patterns of responses to 7 screener items presumably unrelated to LGBQ identification, which generated an index of suspected mischievousness. We estimated LGBQ-heterosexual youth disparities on 20 health outcomes; then we removed 1% of suspected mischievous responders at a time and re-estimated disparities to assess the robustness of original estimates.

RESULTS

Accounting for suspected mischievousness reduced estimates of the average LGBQ-heterosexual youth health disparity by up to 46% for boys and 23% for girls; however, screening did not affect all outcomes equally. Drug- and alcohol-related disparities were most affected, particularly among boys, but bullying and suicidal ideation were unaffected.

CONCLUSIONS

Including screener items in public health data sets and performing rigorous sensitivity analyses can support the validity of youth health estimates.

Sexual Orientation Trajectories Based on Sexual Attractions, Partners, and Identity: A Longitudinal Investigation From Adolescence Through Young Adulthood Using a U.S. Representative Sample

Defining sexual minority status longitudinally over critical developmental periods is essential for understanding the roots of health disparities. Theory supports multidimensional continuums, but current research often examines single measures of sexual activity, sexual attractions, or self-labeled identity separately. Here, a new typology of longitudinal latent classes describes dynamic multidimensional processes continuing from late adolescence (ages 16 to 18) through the late 20s. Using Add Health data (N = 6,864), longitudinal latent class analysis (LLCA), a person-centered approach, showed significant differences between the orientation experiences of males and females (invariance tests led to stratification by sex). The male LLCA model predicted four classes: straight males (87.4%), minimal sexual expression males (6.5%), mostly straight and bi males (3.8%), and emerging gay males (2.4%). The female LLCA model predicted five classes: straight females (73.8%), minimal sexual expression females (7%), mostly straight discontinuous females (10.2%), emerging bi females (7.5%), and emerging lesbian females (1.5%). Some classes represent generally consistent indicators across dimensions over time, while other classes describe more emerging or discontinuous trajectories. Substantial changes were common not only from late adolescence to the early 20s but also from the early 20s to the late 20s, indicating that sexual orientation development continues throughout emerging adulthood.

Sexual Identity and Behavior Among U.S. High School Students, 2005-2015

Sexual orientation is a multidimensional construct which is increasingly recognized as an important demographic characteristic in population health research. For this study, weighted Youth Risk Behavior Survey data were pooled across 47 jurisdictions biennially from 2005 to 2015, resulting in a national sample of 98 jurisdiction-years (344,815 students). Respondents were a median of 15.5 years, 49.9% male, and 48.8% White. Sexual identity and behavior trends from 2005 to 2015 were assessed with logistic regression analysis. Overall, 13.9% of females and 7.0% of males identified as lesbian, gay, bisexual (LGB), or not sure, while 9.1% of females and 4.2% of males indicated both same-and-different-sex behavior or same-sex behavior. In total, 17.0% of female and 8.5% of male youth reported non-heterosexual (LGB or not sure) sexual identity, same-sex sexual behavior, or both. LGB youth were approximately twice as likely as other youth to report lifetime sexual behavior. White and Asian youth were less likely to report non-heterosexual identity and/or have engaged in same-sex sexual behaviors than youth of other races/ethnicities. Prevalence of non-heterosexual identities increased over time for both sexes, but only female youth reported significantly more same-sex behavior over time. This is the first study to simultaneously assess adolescent sexual identity and behavior over time within a national dataset. These findings are critical for understanding the sexual health needs of adolescents and for informing sexual health policy and practice.

Sexual Orientation: Categories or Continuum? Commentary on Bailey et al. (2016)

Bailey et al. (2016) have provided an excellent, state-of-the-art overview that is a major contribution to our understanding of sexual orientation. However, whereas Bailey and his coauthors have examined the physiological, behavioral, and self-report data of sexual orientation and see categories, I see a sexual and romantic continuum. After noting several objections concerning the limitations of the review and methodological shortcomings characteristic of sexual-orientation research in general, I present evidence from research investigating in-between sexualities to support an alternative, continuum-based perspective regarding the nature of sexual orientation for both women and men. A continuum conceptualization has potential implications for investigating the prevalence of nonheterosexuals, sexual-orientation differences in gender nonconformity, causes of sexual orientation, and political issues.

Sexual orientation among Icelandic year 10 adolescents: Changes in health and life satisfaction from 2006 to 2014

Minority sexual orientation may add additional stresses to the period of adolescence thus affecting mental health and wellbeing. The whole population of year 10 students in 2006, 2010, and 2014 in Iceland were surveyed as part of the Health Behaviour in School-aged Children Survey. Sexual orientation could be identified in 1,994 participants from 2006 (43.8% of population; 988 girls), 3,777 from 2010 (78.6%; 1,863 girls) and 3,526 in 2014 (80.1%; 1,731 girls). About 3.1%, 3.6%, and 4.4% were identified as lesbian, gay, or bisexual (LGB) in 2006, 2010, and 2014, respectively. Given the sampling proportions, the results reflect parameters (population values) rather than statistics (sample values). LGB adolescents were worse off across most of the psychosocial measures across the three surveys as compared with adolescents of unknown sexual orientation (USO). However, the gap between LGB and USO adolescents appears to be closing, at least for the 2010 to 2014 change, suggesting that outcomes for LGB adolescents have improved compared to four years earlier. Social support, liking school and one's classmates, being bullied, and physical and mental health all seem to play an important part in life satisfaction and general wellbeing. While advances have been made for LGB adolescents, gaps between LGB and USO adolescents still exist and need to be closed through evidence-based school and society-wide programs.

Incarceration as a Health Determinant for Sexual Orientation and Gender Minority Persons

Incarceration is considerably more prevalent among sexual and gender minority persons (SGM) than among the general population. Once behind bars, they are at the greatest risk for health-related harms. Although a growing number of studies have assessed health disparities produced by mass incarceration, scholars are yet to systematically assess the health consequences of incarceration on the basis of sexual orientation and gender identity. We invite public health scholars to study the effects of incarceration on health in the SGM population and provide a roadmap to aid these research efforts. First, we document the disproportionate presence of SGM persons in jails and prisons. Second, we note health-related risks that are the most salient for this population. Third, we recommend examining heterogeneity in the effects of incarceration by teasing out distinct risks for groups defined by sexual orientation, gender identity, and race/ethnicity. Fourth, we note methodological challenges with respect to measurement and assessing causality. Finally, we discuss the importance of health care access and quality and the need to study health during incarceration and afterward.

Have Mischievous Responders Misidentified Sexual Minority Youth Disparities in the National Longitudinal Study of Adolescent to Adult Health?

The National Longitudinal Study of Adolescent to Adult Health (Add Health) has been instrumental in identifying sexual minority youth health disparities. Recent commentary suggested that some Wave 1 youth responders, especially males, intentionally mismarked same-sex attraction and, as a result, published reports of health disparities from these data may be suspect. We use two recently developed approaches to identify "jokesters" and mischievous responding and apply them to the Add Health data. First, we show that Wave 1 same-sex attracted youth, including those who later reported completely heterosexual identities in adulthood, were no more likely than different-sex attracted youth and consistently heterosexual participants to be "jokesters." Second, after accounting for mischievous responses, we replicated six previously established disparities: depressive symptoms, suicidal ideation and behaviors, alcohol use, cocaine use, parental satisfaction, and school connectedness. Accounting for mischievousness resulted in the elimination of one observed disparity between heterosexual and sexual minority youth: suicidal ideation for males who reported romantic attraction to both sexes. Results also showed that accounting for mischievous responding may underestimate disparities for sexual minority youth, particularly females. Overall, results presented here support previous studies that identified health disparities among sexual minority youth using these data.

Challenging Conventions of Bullying Thresholds: Exploring Differences between Low and High Levels of Bully-Only, Victim-Only, and Bully-Victim Roles

Using a commonly accepted threshold of 2 to 3 times per month as a marker of bullying-involvement from noninvolvement, approximately 30% of U.S. students report being a bully, victim, or both. Although variation in the frequency of involvement exists, infrequent engagement (less than 2 to 3 times a month) is generally considered noninvolved. However, the question remains: Do these differences have implications for behavioral health patterns, including substance use, depression and school connectedness? The present study used a district-wide random cluster sample of 66 middle and high schools in a mid-size city. The study population consisted of 3,221 middle school (53.4%) and high school (45.6%) students, with 48.7% females, 44.6 males, and 6.7% youth identifying with another gender category. These youth were racially diverse, with the modal category being Black (36.0%). Based on student survey response, we report, (a) the frequency and intensity of bullying behaviors, (b) common patterns of involvement, and (c) demographic and individual-level risk factors associated with these patterns. Analyses resulted in nine bully types, with substantial differences in bullying-involvement intensity based on gender, race, school connectedness, and mental health. Perhaps most striking, the majority of youth (70.9%) were involved in some level of bullying perpetration, victimization, or both, when accounting for the accumulation of low frequency involvement (e.g., once, twice, or a few times) across multiple bullying behaviors. Implications for adolescent development and prevention are described.

Pubertal Stress and Nutrition and their Association with Sexual Orientation and Height in the Add Health Data

A number of studies have indicated that gay men tend to be shorter, on average, than heterosexual men. Less evidence exists that lesbian women are taller, on average, than heterosexual women. The most popular explanation of the association between sexual orientation and height involves prenatal factors, such that, for example, gay men may have been exposed to lower than typical androgens during fetal development, which impacts their height and sexual orientation as adults. An alternative explanation involves stress, given that stress has been associated with sexual minority identification and with lower height. Another alternative explanation involves nutrition, although its relationship is less clear with sexual minority identification. Using the Add Health data, which is a large, nationally representative and longitudinal sample of American adolescents (n = 14,786), we tested a mediation model, such that sexual orientation → pubertal stress/nutrition → height. Within men, we found that gay men (n = 126) were shorter, on average, than heterosexual men (n = 6412). None of the 24 pubertal stress-related and 15 pubertal nutrition-related variables assessed in the Add Health data mediated the relationship between sexual orientation and height in men. Within women, lesbians (n = 75) did not differ significantly in stature compared to heterosexual women (n = 6267). Thus, prenatal mechanisms (e.g., hormones, maternal immune response) are likely better candidates for explaining the height difference between gay men and heterosexual men.

Gender dysphoria and the controversy over the Safe Schools program

The Safe Schools program has attracted great controversy. On one end of the spectrum, it is defended as an anti-bullying program for young people who identify themselves as gay or lesbian, or have issues concerning their gender identity. On the other end of the spectrum, it is regarded as social engineering. This article seeks to promote a discussion of the way in which gender identity issues are addressed in the Safe Schools program. It is argued that the information in this program to Principals, teachers and young people is inaccurate and misleading. The program, as presently designed, may actually cause harm to children and young people who experience gender identity issues because it promotes gender transitioning without expert medical advice. The Safe Schools materials do not acknowledge that the great majority of children resolve gender dysphoria issues around the time of puberty. It may be much more difficult for a child to accept his or her gender at puberty if he or she has already changed name and gender identity in primary school. These deficits need to be addressed if the program is to continue.

Gay, Mostly Gay, or Bisexual Leaning Gay? An Exploratory Study Distinguishing Gay Sexual Orientations Among Young Men

This exploratory study assessed physiological, behavioral, and self-report measures of sexual and romantic indicators of sexual orientation identities among young men (mean age = 21.9 years) with predominant same-sex sexual and romantic interests: those who described themselves as bisexual leaning gay (n = 11), mostly gay (n = 17), and gay (n = 47). Although they were not significantly distinguishable based on physiological (pupil dilation) responses to nude stimuli, on behavioral and self-report measures a descending linear trend toward the less preferred sex (female) was significant regarding sexual attraction, fantasy, genital contact, infatuation, romantic relationship, sex appeal, and gazing time to the porn stimuli. Results supported a continuum of sexuality with distinct subgroups only for the self-report measure of sexual attraction. The other behavioral and self-report measures followed the same trend but did not significantly differ between the bisexual leaning gay and mostly gay groups, likely the result of small sample size. Results suggest that romantic indicators are as good as sexual measures in assessing sexual orientation and that a succession of logically following groups from bisexual leaning gay, mostly gay, to gay. Whether these three groups are discrete or overlapping needs further research.

Sexual Orientation and Involvement in Nonviolent and Violent Delinquent Behaviors: Findings From the National Longitudinal Study of Adolescent to Adult Health

This study examined the association between sexual orientation and nonviolent and violent delinquency across the life course. We analyzed self-reported nonviolent and violent delinquency in a sample of heterosexual males (N = 5220-7023) and females (N = 5984-7875), bisexuals (N = 34-73), gay males (N = 145-189), and lesbians (N = 115-150) from the National Longitudinal Study of Adolescent to Adult Health (Add Health). The analyses revealed, in general, that bisexuals were the most delinquent of the sexual orientation categories for both males and females. Additional analyses revealed that heterosexual males reported significantly higher levels of both violent and nonviolent delinquency than gay males, whereas lesbians reported more involvement in nonviolent delinquency and, to a lesser extent, violent delinquency relative to heterosexual females. Analyses also revealed that lesbians reported significantly more delinquent behavior, particularly for nonviolent delinquency, than gay males. Future research should explore the mechanisms that account for these observed patterns and how they can be used to more fully understand the etiology of delinquency.

In Search of Emerging Same-Sex Sexuality: Romantic Attractions at Age 13 Years

Sex-typed behavior in childhood is significantly related to sexual orientation in adulthood. In addition, same-sex attractions in early adolescence are more non-exclusive than in adulthood and can differ from later same-sex orientations. However, little research has focused on romantic attractions as they emerge during early adolescence. Drawing a sample from the Avon Longitudinal Study of Parents and Children (197 girls, 204 boys), the current study examined whether same-sex romantic attractions at age 13 years were exclusive, and whether they were predicted by sex-typed behavior at age 3.5 years. No young adolescents in this sample reported exclusive same-sex attractions, and increased same-sex attractions were not significantly related to reduced other-sex sexualities. Childhood sex-typed behavior did not significantly predict early same-sex attractions, suggesting that early same-sex attractions differ from later same-sex orientations. The current study highlights the importance of studying the development of sexuality beginning prior to adulthood.

"I Liked Girls and I Thought They Were Pretty": Initial Memories of Same-Sex Attraction in Young Lesbian and Bisexual Women

There is little research on what is meant by the concept of "feeling attracted" and even less about what same-sex attraction looks and feels like for individuals. Without insight into the phenomenon of same-sex attraction, researchers risk misunderstanding the role of sexual attraction in sexual identity development and risk mis-categorizing individuals in research designs that compare LGBTQ and heterosexual samples. The current study draws from semi-structured interviews (n = 30) with young lesbian-, bisexual-, and queer-identified women (ages 18-24) about their initial memories of same-sex attraction. Two questions were pursued using qualitative analytic strategies. We examined the age that participants remembered first experiencing same-sex attraction using content analysis. Two age groups emerged as distinct: those with experiences of same-sex attraction in childhood and those with initial attractions in later adolescence. We also examined key elements in participants' descriptions of early same-sex attraction using thematic analysis. The role of embodied feelings, relationships with other young women, and social environments including media images emerged as central to initial experiences of attraction. Findings highlight how early experiences of same-sex attraction produced different types of interpretations within individuals and, in turn, these interpretations informed how participants did or did not take up LGBTQ identity labels. These findings may help guide the development of more refined measurement tools for researchers hoping to sample sexual minorities and can contribute to developing more effective supports for individuals who experience same-sex attraction but may not adopt LGBTQ identity labels and, as a result, are routinely missed in outreach efforts.

Scrutinizing Immutability: Research on Sexual Orientation and U.S. Legal Advocacy for Sexual Minorities

We review scientific research and legal authorities to argue that the immutability of sexual orientation should no longer be invoked as a foundation for the rights of individuals with same-sex attractions and relationships (i.e., sexual minorities). On the basis of scientific research as well as U.S. legal rulings regarding lesbian, gay, and bisexual (LGB) rights, we make three claims: First, arguments based on the immutability of sexual orientation are unscientific, given what we now know from longitudinal, population-based studies of naturally occurring changes in the same-sex attractions of some individuals over time. Second, arguments based on the immutability of sexual orientation are unnecessary, in light of U.S. legal decisions in which courts have used grounds other than immutability to protect the rights of sexual minorities. Third, arguments about the immutability of sexual orientation are unjust, because they imply that same-sex attractions are inferior to other-sex attractions, and because they privilege sexual minorities who experience their sexuality as fixed over those who experience their sexuality as fluid. We conclude that the legal rights of individuals with same-sex attractions and relationships should not be framed as if they depend on a certain pattern of scientific findings regarding sexual orientation.

When Sex and Power Collide: An Argument for Critical Sexuality Studies

Attentive to the collision of sex and power, we add momentum to the ongoing development of the subfield of critical sexuality studies. We argue that this body of work is defined by its critical orientation toward the study of sexuality, along with a clear allegiance to critical modalities of thought, particularly feminist thought. Critical sexuality studies takes its cues from several other critical moments in related fields, including critical psychology, critical race theory, critical public health, and critical youth studies. Across these varied critical stances is a shared investment in examining how power and privilege operate, understanding the role of historical and epistemological violence in research, and generating new models and paradigms to guide empirical and theoretical research. With this guiding framework, we propose three central characteristics of critical sexuality studies: (a) conceptual analysis, with particular attention to how we define key terms and conceptually organize our research (e.g., attraction, sexually active, consent, agency, embodiment, sexual subjectivity); (b) attention to the material qualities of abject bodies, particularly bodies that are ignored, overlooked, or pushed out of bounds (e.g., viscous bodies, fat bodies, bodies in pain); and (c) heteronormativity and heterosexual privilege, particularly how assumptions about heterosexuality and heteronormativity circulate in sexuality research. Through these three critical practices, we argue that critical sexuality studies showcases how sex and power collide and recognizes (and tries to subvert) the various power imbalances that are deployed and replicated in sex research.

Stability of Self-Reported Same-Sex and Both-Sex Attraction from Adolescence to Young Adulthood

This study examined how sexual attraction varied across age, gender of participant, and gender of romantic partner, from adolescence to early adulthood. Comparisons between same-sex and both-sex attracted individuals were of particular interest. Using the National Longitudinal Study of Adolescent Health (AddHealth), we examined the responses of participants who reported experiencing same-sex attractions or both-sex attractions at least once within four waves (n = 1889). Results indicated that same-sex attractions became more stable over time, whereas both-sex attraction remained unstable even into adulthood. Compared with males, females were less stable in same-sex attraction, but more stable in both-sex attraction. The majority of people who reported same-sex attraction did not report having a same-sex romantic partner before they entered adulthood, and those who reported a same-sex romantic partner were more likely to maintain their same-sex attraction than those who did not. As males got older, the gender of their romantic partner tended to become more consistent with their sexual attraction. However, for females, the consistency between the gender of their romantic partner and sexual attraction did not change over time.

The Temporal Stability of Lack of Sexual Attraction Across Young Adulthood

There is a large and growing literature on the stability of sexual orientation across the lifespan. However, virtually no studies have been conducted on the longitudinal stability of any dimension of asexuality. Here I utilized Kinsey scale-type data from Wave III and Wave IV of the Add Health survey to measure the stability of indicating "not sexually attracted to either males or females" in a forced-choice, Kinsey-type scale and during the time participants were moving through early adulthood (18-26 years in Wave III and 24-32 years in Wave IV). I found that, for the most part, individuals who reported no sexual attraction in Wave III were not the same individuals who reported no sexual attraction in Wave IV, with only three out of the 25 in Wave III who indicated no sexual attraction going on to do the same in Wave IV. This inter-wave consistency was lower than it was for other sexual minorities. However, indicating no sexual attraction in one wave was still a statistically significant predictor of indicating no sexual attraction in the other wave, as was refusing to answer or indicating the "don't know" option in the other wave. These findings do not necessarily denote change in sexual attraction across waves; the fact that not answering the question in one wave was a significant predictor of indicating no sexual attraction in the other wave provides quantitative evidence for the ambiguities involved in sexual identities when sexuality is taken for granted in the broader culture. This ambiguity affects the operationalization and quantification of asexuality.

Sexual (Minority) Trajectories, Mental Health, and Alcohol Use: A Longitudinal Study of Youth as They Transition to Adulthood

Lesbian, gay, bisexual, and queer/questioning youth health disparities are well documented; however, study limitations restrict our understanding of how the temporal interplay among domains of sexuality (attraction, behavior, and identity) situate individuals to be more or less at risk for poor mental health and alcohol use across the transition to adulthood. Four waves of data from the National Longitudinal Study of Adolescent to Adult Health (n = 12,679; 51.29 % female) were used with repeated measures latent class analysis to estimate sexual trajectory groups designated by prospective reports of romantic attraction, sexual/romantic behavior, and sexual identity from adolescence to adulthood. Five unique trajectories emerged: two heterosexual groups (heterosexual early daters [58.37 %] and heterosexual later daters [29.83 %]) and three sexual minority groups (heteroflexible [6.44 %], later bisexually identified [3.32 %], and LG[B] identified [2.03 %]). These sexual trajectories differentiate risk for depressive symptomology, suicidal thoughts and behaviors, and alcohol use during adolescence and early adulthood. Groups where individuals first reported same-sex attraction and sexual minority identities in adulthood (heteroflexible and later bisexually identified) had similar levels of depression, suicidality, and greater substance use than those who largely reported same-sex attraction and behavior during adolescence (the LG[B] identified group). These later recognition groups showed greater risk for poor outcomes in waves where they also first reported these changes in attraction, behaviors, and identities. The emergence of three sexual minority groups reveal within-group differences in sexuality and sexual trajectories and how these experiences relate to risk and timing of risk across the transition to adulthood.

Measurement, methods, and divergent patterns: Reassessing the effects of same-sex parents

Scholars have noted that survey analysis of small subsamples-for example, same-sex parent families-is sensitive to researchers' analytical decisions, and even small differences in coding can profoundly shape empirical patterns. As an illustration, we reassess the findings of a recent article by Regnerus regarding the implications of being raised by gay and lesbian parents. Taking a close look at the New Family Structures Study (NFSS), we demonstrate the potential for misclassifying a non-negligible number of respondents as having been raised by parents who had a same-sex romantic relationship. We assess the implications of these possible misclassifications, along with other methodological considerations, by reanalyzing the NFSS in seven steps. The reanalysis offers evidence that the empirical patterns showcased in the original Regnerus article are fragile-so fragile that they appear largely a function of these possible misclassifications and other methodological choices. Our replication and reanalysis of Regnerus's study offer a cautionary illustration of the importance of double checking and critically assessing the implications of measurement and other methodological decisions in our and others' research.

Exploring the social integration of sexual minority youth across high school contexts

Mental health disparities between sexual minority and other youth have been theorized to result in part from the effects of the stigmatization on social integration. Stochastic actor-based modeling was applied to complete network data from two high schools in the National Longitudinal Study of Adolescent Health (Mage  = 15 years, N = 2,533). Same-sex attracted youth were socially marginalized in a smaller predominantly White school but not in a larger, more racially diverse school. For both schools, homophily was a critical network feature, and could represent social support for and social segregation of such youth. These findings emphasize the school context in studying the social lives of sexual minority youth and suggest that youth may be better off socially in larger and more diverse schools.

Future directions in research on sexual minority adolescent mental, behavioral, and sexual health

This article describes current knowledge on sexual, mental, and behavioral health of sexual minority (SM) youth and identifies gaps that would benefit from future research. A translational sciences framework is used to conceptualize the article, discussing findings and gaps along the spectrum from basic research on prevalence and mechanisms, to intervention development and testing, to implementation. Relative to adults, there has been much less research on adolescents and very few studies that had longitudinal follow-up beyond 1 year. Due to historical changes in the social acceptance of the SM community, new cohorts are needed to represent contemporary life experiences and associated health consequences. Important theoretical developments have occurred in conceptualizing mechanisms that drive SM health disparities and mechanistic research is underway, including studies that identify individual and structural risk/protective factors. Research opportunities exist in the utilization of sibling-comparison designs, inclusion of parents, and studying romantic relationships. Methodological innovation is needed in sampling SM populations. There has been less intervention research and approaches should consider natural resiliencies, life-course frameworks, prevention science, multiple levels of influence, and the importance of implementation. Regulatory obstacles are created when ethics boards elect to require parental permission and ethics research is needed. There has been inconsistent inclusion of SM populations in the definition of "health disparity population," which impacts funding and training opportunities. There are incredible opportunities for scholars to make substantial and foundational contributions to help address the health of SM youth, and new funding opportunities to do so.

Sexting and sexual behavior among middle school students

OBJECTIVE

It is unknown if "sexting" (i.e., sending/receiving sexually explicit cell phone text or picture messages) is associated with sexual activity and sexual risk behavior among early adolescents, as has been found for high school students. To date, no published data have examined these relationships exclusively among a probability sample of middle school students.

METHODS

A probability sample of 1285 students was collected alongside the 2012 Youth Risk Behavior Survey in Los Angeles middle schools. Logistic regressions assessed the correlates of sexting behavior and associations between sexting and sexual activity and risk behavior (ie, unprotected sex).

RESULTS

Twenty percent of students with text-capable cell phone access reported receiving a sext and 5% reported sending a sext. Students who text at least 100 times per day were more likely to report both receiving (odds ratio [OR]: 2.4) and sending (OR: 4.5) sexts and to be sexually active (OR: 4.1). Students who sent sexts (OR: 3.2) and students who received sexts (OR: 7.0) were more likely to report sexual activity. Compared with not being sexually active, excessive texting and receiving sexts were associated with both unprotected sex (ORs: 4.7 and 12.1, respectively) and with condom use (ORs: 3.7 and 5.5, respectively).

CONCLUSIONS

Because early sexual debut is correlated with higher rates of sexually transmitted infections and teen pregnancies, pediatricians should discuss sexting with young adolescents because this may facilitate conversations about sexually transmitted infection and pregnancy prevention. Sexting and associated risks should be considered for inclusion in middle school sex education curricula.

Psychological and physical health of mostly heterosexuals: a systematic review

We reviewed whether mostly heterosexuals, a sexual orientation group characterized by a small amount of same-sex sexuality, differ from heterosexuals and bisexuals on a variety of mental and physical health outcomes (e.g., internalizing problems, body dissatisfaction and disordered eating, obesity, sexual/reproductive health, physical health), health risk behaviors (e.g., substance use, sexual risk taking), and risk and protective factors (e.g., victimization, stressful/risky environment, socioeconomic status, personal and social relationships, gender nonconformity). A narrative and quantitative literature review was conducted of 60 papers covering 22 samples from five Western countries. Individual, mean, and median effect sizes (Cohen ds) were calculated whenever possible. Mostly heterosexuals reported higher levels of risk in most reviewed outcomes compared to heterosexuals (unweighted mean effect sizes ranged from 0.20 to 0.50) but typically somewhat lower than bisexuals (unweighted mean effect sizes ranged from -0.10 to -0.30). Various risk factors frequently reduced, but rarely eliminated, health disparities between mostly heterosexuals and heterosexuals. Findings are discussed through the lens of three potential explanations of elevated health risks among nonheterosexuals: minority stress, nonheterosexual lifestyles, and common causes. Because data on many outcomes were scarce or missing, particularly for men and in comparison with bisexuals, further research is needed.