Photo Credit: James Gathany, Centers for Disease Control and Prevention

Gay, lesbian, and bisexual (LGB) youth are more likely than their heterosexual peers to be at increased risk for unhealthy behaviors such as tobacco, alcohol, and other drug use, sexual behaviors that could lead to infection with HIV and other sexually transmitted diseases, attempting suicide, and violence, according to a groundbreaking new federal study.

The U.S. Centers for Disease Control and Prevention (CDC), part of the U.S. Department of Health and Human Services, released the results of the study, “Sexual Identity, Sex of Sexual Contacts, and Health Risk Behaviors Among Students in Grades 9–12 in Selected Sites—Youth Risk Behavior Surveillance, United States, 2001–2009,” on Monday, June 6. It represents the first time the federal government has conducted such a far-reaching analysis of LGB youth.

Researchers analyzed data from “Youth Risk Behavior Surveys” of seven states—Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, and Wisconsin—and six large urban school districts—Boston, Chicago, Milwaukee, New York City, San Diego, and San Francisco. The CDC funds these surveys of high school students every two years at the national, state, and local levels.

States and school districts may choose to collect data on the students’ sexual identity (heterosexual, gay or lesbian, bisexual, or unsure), the gender of their sexual contacts (both genders, opposite gender only, or same gender only), or both. The states and districts studied by the CDC had collected data on sexual identity and gender of sexual contacts for at least two survey cycles.

The CDC found that gay and lesbian students (and those who have sex only with a person of the same gender, regardless of how they identify themselves) had higher risks than heterosexual students in seven of 10 major health risk categories: behaviors related to violence (which could include not going to school because of safety concerns), attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, and weight management.

Bisexual students (and those who have sex with both genders, regardless of how they identify themselves) had higher risks than heterosexual students in eight of the 10 categories: behaviors that contribute to unintentional injuries (such as not wearing a seatbelt), violence, attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, and weight management.

LGB students showed no significant differences from their heterosexual peers in dietary behaviors (e.g., eating vegetables three or more times per day) or amount of physical activity.

Dr. Laura Kann, chief of the Surveillance and Evaluation Research Branch within the CDC’s Division of Adolescent and School Health, said that she attributes the “disproportionate” risks of LGB youth to the social difficulties they face, such as stigma, discrimination, and rejection by their families. This creates an environment that contributes to their higher health risk behaviors.

“If these kids had physically, emotionally acceptable environments—home, school, community, it’s unlikely that they would be practicing health risk behaviors at these rates,” she said.

She noted that their increased risk of being involved in violent behaviors is “not because of who they are, but because of what they’re pushed into.” She explained, “It’s a response” to the social disapproval, rejection, and bullying they may face.

The CDC findings confirm previous studies conducted by other researchers, including the Gay, Lesbian and Straight Education Network’s 2009 National School Climate Survey, which found that nearly 9 out of 10 LGBT students experienced harassment at school in the previous year and nearly two-thirds felt unsafe because of their sexual orientation.

And a study in the May 2011 issue of the Journal of School Health, by Dr. Stephen T. Russell, distinguished professor at the University of Arizona, and Dr. Caitlin Ryan, director of the Family Acceptance Project at San Francisco State University, found that anti-LGBT bullying at school “is strongly linked” to negative mental health for its victims. Among those risks are an increased frequency of suicide attempts and increased risk for engaging in behaviors that can lead to infection with STDs and HIV. The increased risks exist not only while the victim is in adolescence, but also in young adulthood.

Based on its report, the CDC recommends:

• Improving public health and school health policies and practices to create “safe and supportive environments for sexual minority students.” These policies might include ones to address stigma, discrimination, family disapproval, social rejection, and violence.
• Providing professional development programs for school staff and others who work with sexual minority youth.
• Adding questions about sexual identity and the sex of sexual contacts to youth risk behavior surveys in other states and districts. The CDC itself encourages states and districts to include such questions in their surveys, but does not require them to do so. In 2009, 10 states and 7 large urban school districts added questions to their YRBS questionnaire about sexual identity, sex of sexual contacts, or both.

In addition to funding the surveys, the CDC provides funding and technical assistance to 49 states, the District of Columbia, 16 large urban school districts, 6 territories, and 1 tribal government to help schools and school districts develop programs to reduce sexual risk behaviors among all youth.

Twenty-four state education agencies and 15 local education agencies used these funds in 2010 on specific activities to address LGBT youth, according to the CDC, including training staff on LGBT-inclusive health curricula, establishing gay-straight alliances and conferences, and developing guides to community resources for LGBT youth.

“If youth are going to thrive in their communities and in their schools,” Kann said, “they need to feel safe socially, emotionally, and physically. The schools and communities need to take concrete steps to establish these safe and supportive environments.”

She added, “I think this is a multifaceted problem that can be addressed at multiple levels.”

Congress is now considering eight bills that would help protect LGBT youth and reduce bullying and harassment of students because they are or are perceived to be LGBT. They include the Student Nondiscrimination Act, Safe Schools Improvement Act, and Tyler Clementi Higher Education Anti-Harassment Act in both chambers, and the Successful, Safe and Healthy Students Act and Reconnecting Youth to Prevent Homelessness Act in the Senate. But the success of the bills with a Republican-controlled House remains unlikely.

The CDC released its report in conjunction with the federal government’s first-ever summit devoted to LGBT youth, “Creating and Maintaining Safe and Supportive Environments for LGBT Youth” in Washington, D.C.

The event was hosted by the Department of Education, in partnership with the Department of Health and Human Services.