Abstract
Sexual minority youth are at higher risk of substance use than heterosexual youth. However, most evidence in this area is from North America, and it is unclear whether the findings can be generalized to other cultures and countries. In this investigation, we used data from the 2014 Health Behaviour in School-aged Children (HBSC) study to compare substance use in same- and both-gender attracted 15-year-old adolescents from eight European countries (n = 14,545) to that of their peers who reported opposite-gender attraction or have not been romantically attracted to anyone. Both-gender attracted, and to a lesser extent, same-gender attracted adolescents were significantly more likely to smoke cigarettes, consume alcohol, get drunk and use cannabis, or be involved in multiple substance use in the last 30 days compared to their opposite-gender attracted peers. Those adolescents who have not been in love had significantly lower odds for substance use than all other youth. The pattern of results remained the same after adjusting for country, gender and family affluence. These findings are compatible with the minority stress and romantic stress theories. They suggest that sexual minority stigma (and love on its own) may contribute to higher substance use among adolescents in European countries.
Highlights
Many young people who identify as Lesbian, Gay, Bisexual (LGB), other sexual or gender minority, or report being attracted to same- or both-gender partners, have poorer health than their peers who identify as heterosexual, cisgender or as exclusively attracted to members of the opposite gender [1,2]
While acknowledging the importance of all dimensions of sexual orientation, we argue that asking whether adolescents are attracted to girls, boys or both-gender partners may be easier for young people to answer, be more accurate, and can be used to subsequently categorize sexual minority youth’ (SMY) based on same- or both-gender romantic attraction
This study aimed to explore the association between different romantic attraction patterns and substance use across national representative samples of adolescents from eight European countries and regions with various geographical location, history and level of tolerance towards sexual minorities
Summary
Many young people who identify as Lesbian, Gay, Bisexual (LGB), other sexual or gender minority (for example Queer, Transgender or Intersex), or report being attracted to same- or both-gender partners, have poorer health than their peers who identify as heterosexual, cisgender or as exclusively attracted to members of the opposite gender [1,2]. The studies show a large variation in the use of (biological) sex or (socially constructed) gender. They employ various sexual identity terms or classify youth based on other dimensions of sexual orientation, such as gender of sexual or love partner(s). We use the term ‘gender’ to describe whether the respondents identified themselves as boys or girls. The ‘sexual minority youth’ (SMY) term is used, as this is the most inclusive, unless we refer to studies that used more specific terminology (such as LGB). Extensive research indicates that SMY are more likely to engage in substance use [3,4]. The validity of the evidence is limited by the fact that most investigations have been conducted in
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