August 15, 2016
The first nationwide study to ask high school students about their sexuality found that gay, lesbian and bisexual teenagers were at far greater risk for depression, bullying and many types of violence than their straight peers.
“I found the numbers heartbreaking,” said Dr. Jonathan Mermin, a senior official at the Centers for Disease Control and Prevention, which includes a division that administered the survey.
The survey documents what smaller studies have suggested for years, but it is significant because it is the first time the federal government’s biennial Youth Risk Behavior Survey, the gold standard of adolescent health data collection, looked at sexual identity. The survey found that about 8 percent of the high school population described themselves as gay, lesbian or bisexual, which would be about 1.3 million students.
These adolescents were three times more likely than straight students to have been raped. They skipped school far more often because they did not feel safe; at least a third had been bullied on school property. And they were twice as likely as heterosexual students to have been threatened or injured with a weapon on school property.
More than 40 percent of these students reported that they had seriously considered suicide, and 29 percent had made attempts to do so in the year before they took the survey. The percentage of those who used illegal drugs was many times greater than their heterosexual peers. While 1.3 percent of straight students said they had used heroin, for example, 6 percent of the gay, lesbian and bisexual students reported having done so.
“Nations are judged by the health and well-being of their children,” said Dr. Mermin, who is the director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the C.D.C. “Many would find these levels of physical and sexual violence unacceptable and something we should act on quickly.”
These comparisons have emerged because the federal survey, which looks at more than 100 health behaviors, included two new questions last year. It asked how students identified themselves sexually, and also the sex of those with whom they had “sexual contact” — leaving students to define that term.
While transgender youth have increasingly appeared on the national radar, most recently in debates about school bathroom access, this survey did not include an option for teenagers to identify themselves as transgender. But that possibility may be coming. The C.D.C. and other federal health agencies are developing a question on gender identity to reliably count transgender teenagers which, a spokeswoman said, might be ready for a pilot test in 2017.
Some 15,600 students across the country, ages 14 to 17, took the survey. The population who identified as a sexual minority is in line with estimates from other state or local surveys, and with national studies of young adults. While the figures paint a portrait of loneliness and discrimination that is longstanding and sadly familiar, they are important because they now establish a national databank.
Dr. Debra Houry, an emergency medicine physician who directs the C.D.C.’s National Center for Injury Prevention and Control, said the numbers argued for more comprehensive intervention and prevention programs. She praised programs like Green Dot, which trains students how to support a victim of bullying or a physical altercation. Other programs teach coping skills to vulnerable students. As the data suggests, she said, these students need better access to mental health care, and support from families, schools and communities.
The report does not delve into why these students are at such risk for so many types of harm.
Dr. Elizabeth Miller, the chief of adolescent and young adult medicine at Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, said, “The intensity of homophobic attitudes and acceptance of gay-related victimization, as well as the ongoing silence around adolescent sexuality, marginalizes a whole group of young people.”
And such marginalization, added Dr. Miller, who writes extensively about dating and sexual violence, “increases their vulnerability to exploitative and violent relationships.”
Dr. Miller also pointed out that the report implicitly underscores the fluidity of adolescent sexual identity. When asked to identify themselves sexually in the survey, 3.2 percent of students chose “not sure.” Among students who said they had “sexual contact” with only people of the same sex or with both sexes, 25 percent identified as heterosexual and 13.6 percent said they were not sure of their sexual identity. Among students who had sexual contact only with someone of the opposite sex, 2.8 percent nonetheless described themselves as gay, lesbian or bisexual.
Dr. Miller, who is also a professor of pediatrics at the University of Pittsburgh School of Medicine, said that self-acceptance can begin at home. “We have to start conversations early with young people about healthy sexuality, attraction, relationships, intimacy and how to explore those feelings in as safe and respectful a way as possible,” she said.
Any survey has limitations. In this one, the respondents were students in school and so the research would not have captured dropouts or others who were not attending, a disproportionate percentage of whom are lesbian, gay and bisexual.
How students interpreted “sexual contact” or why some defined themselves as “not sure” could also be open to interpretation.
How do you keep your GLTQ students safe at school?