Male Sexual Minority Youth Research Articles

Growing up gay in a digital world: A double-edged sword for sexual minority young men in England

In England over the last two decades, social attitudes towards minority sexuality have improved, but some teenage boys and young men who are attracted to men continue to face homophobia and report poorer health than heterosexual peers.The digital world has integrated previously distinct online interactions together with experiences in person, with consequences for how adolescent sexuality is encountered and explored. The new possibilities of evolving digital interactions need consideration for young gay men.This study applied thematic analysis, using a deductive approach to examine data collected from online focus groups and in-depth interviews with nine sexual minority young men aged between 19 and 21 years old, who all grew up in England. Participants were invited to share retrospective accounts of their teenage years, equating to a period of approximately 2010–2015.Participants described how digital settings provided spaces to explore their sexual attractions. They also provided ways of finding some recognition and validation of new feelings in more open and liberal settings, especially if gay sexuality was not acknowledged or affirmed elsewhere.Less positively, participants critiqued the overwhelming and prescriptive nature of the sexual content they encountered online. They also expressed misgivings about location-based dating apps.Experiences of this small group indicate possible issues with adult-oriented digital spaces and a need to represent minority sexuality in more positive and diverse ways. Sexual minority male youth who still face marginalisation may need targeted support, with additional care to reach out to Black Minority Ethnic, working class, disabled and trans young men.

Exposure to Suicidal Behavior and Social Support Among Sexual- and Gender-Minority Youth.

In this study, we examine reports of exposure to suicidal behavior by youth sexual and gender identity. We explore how exposure is related to depressed mood in the context of high social support while accounting for cumulative adversity. Data from a large national sample of youth aged 14 to 15 years in the United States (N = 3979) were collected online in 2018-2019. Sexual- and gender-minority youth were more likely to know someone close to them who attempted suicide, relative to cisgender heterosexual youth. Cisgender heterosexual youth were buffered from recent depressed mood when they endorsed having high social support in the context of exposure to suicidal behavior; less social support did not provide such a buffer. For cisgender sexual-minority male and female youth, exposure to suicidal behavior was related to recent depressed mood regardless of the level of social support. For gender-minority youth assigned female at birth, the combination of exposure and high social support was significantly associated with elevated depressed mood. Cumulative adversity accounted for some but not all of these relationships, indicating the influential role of exposure to suicidal behavior on depressed mood for some youth. These findings illustrate the complexities of social support and raise questions about its potential to magnify stress rather than serve as a buffer for some youth. Although findings need to be replicated, suicide prevention efforts should carefully consider how to promote resilience among these suicide-exposed sexual- and gender-minority youth who may themselves be at risk for suicidal ideation and behavior.

Serious and persistent suicidality among European sexual minority youth.

BackgroundSuicide is a leading cause of death among adolescents and more knowledge from high risk groups is needed in order to develop effective preventive strategies. The aim of this study was to evaluate the association between sexual minority status and suicidality in a multinational sample of European school pupils.MethodsA self-report questionnaire was delivered to 2046 adolescents (mean age 15.34±1.01; 56.3% females) recruited from 27 randomly selected schools in 6 European countries. Suicidal ideation, measured with the Paykel Suicide Scale (PSS), and lifetime suicide attempts were compared between heterosexual and sexual minority (i.e. those with a non-heterosexual orientation) youth. Poisson regression analyses studied the longitudinal association between sexual minority status and the rate of serious suicidal ideation, measured at three time-points during a 4-month period. Several variables, including alcohol and illegal drugs use, bullying, family interaction, school-related stress, economic status, and religiosity, were included in multivariable analysis. Sex-stratified analyses evaluated the association respectively among females and males.ResultsOf 1958 pupils included in analysis (mean age 15.35±1.00; females 56.8%), 214 (10.9%) were categorized as sexual minority youth (SMY). When compared to heterosexual youth (HSY), SMY were significantly more exposed to substance abuse, bullying, school-related stress, and lower economic status. SMY pupils had significantly higher suicidal ideation scores (p<0.001; r 0.145) as well as higher prevalence of serious suicidal ideation (odds ratio [OR] 2.64, 95% confidence interval [CI] 1.83–3.79) and previous suicide attempts (OR 2.72, 95%CI 1.77–4.18), compared to their HSY peers. The rate of serious suicidal ideation reports during the study was significantly higher among SMY compared to HSY (rate ratio [RR] 2.55, 95%CI 1.90–3.43). A significant difference was found even when controlling for the pupils’ country as well as after adjustment for alcohol and illegal drugs use, bullying, family interaction, school-related stress, economic status, and religiosity (adjusted RR 1.73, 95%CI 1.23–2.48). Stratified analyses showed significant associations between SMY status and persistent serious suicidal ideation for both sexes, with a notably strong association among male pupils (females aRR 1.51, 95%CI 1.01–2.24; males aRR 3.84, 95%CI 1.94–7.59).ConclusionsEuropean sexual minority youth are a high-risk group for suicidality, independently from objective factors such as victimization or substance abuse. There is a need to develop primary and secondary preventive measures for sexual minority youth, including the management of context vulnerabilities and related distal stressors, before the establishment of proximal stressors. Context-targeting interventions may effectively focus on social and economic factors, as well as on the potentially different risk profile of female and male sexual minority youth.

Alcohol Use and Suicidality by Sexual Orientation Among U.S. Youth, 2009–2017

Alcohol use and suicidality remain serious risks for U.S. youth. Research has established that disparities exist in these outcomes between heterosexual and sexual minority youth. However, research into the associations between alcohol use and suicidality has yet to consider the differential role of sexual orientation. Using a pooled, diverse sample from the 2009-2017 Youth Risk Behavior Survey, associations of alcohol use and suicidality by sex and sexual orientation, and changes in these outcomes over time, were investigated. Analyses were conducted in 2019. Suicidality was highest among nonheterosexuals, who ranged from twofold to sevenfold higher odds to report suicidality across all time points, with the most striking disparities among male sexual minority youth. Rates among all students remained stable or increased over time; notable exceptions included a decrease in suicide attempts among bisexual students. Among all students, current alcohol use was associated with elevated levels of suicidality. For female students, the association between drinking and suicidality did not significantly differ by sexual identity; for male students, it was significant regardless of sexual identity and most pronounced among not sure youth. These results emphasize the need for additional research into the relationship between contemporaneous alcohol use and suicidality, with attention to differences based on sex, sexual orientation, and other factors that may impact these relationships. There is a particular need for research to examine the temporal nature of the association such that evidence-informed, high-impact interventions can be developed to improve suicidality outcomes among sexual minority youth.

Diabetes Risk Behaviors Are Higher among Sexual Minority U.S. High School Students

Low physical activity (PA) and high sedentary behavior (SB) are associated with increased type 2 diabetes risk among youth. We investigated PA and SB among Youth Risk Behavior Survey (YRBS) respondents to determine if sexual minority youth may be at increased diabetes risk compared to heterosexual youth. Weighted city and state YRBS data were pooled across 44 jurisdictions biennially from 2009-2015, resulting in a sample size of 97 jurisdiction-years (350,673 students). Respondents had a median age of 16 years, were 50.3% male, and 46.8% white. Overall, 88.4% identified as heterosexual, 2.1% as gay/lesbian, 5.7% as bisexual, and 3.7% as unsure; more female (15.3%) than male (7.7%) students reported a non-heterosexual identity. Among females, bisexual and unsure (but not lesbian) youth reported significantly more hours per day of SB compared to heterosexual peers. We found no significant differences in SB among males. Both female and male sexual minority youth reported significantly fewer days per week of PA compared to sex-matched heterosexual peers. All unadjusted PA and SB findings remained significant after adjusting for age, BMI, race/ethnicity, and survey year, except among lesbian youth. Studies of type 2 diabetes and risk factors among youth need to assess and account for sexual identity to ensure sexual minority populations are a priority target for prevention. Table I. Bold text: Unadjusted p-value significant; *Adjusted p-value &amp;lt;0.001; hetero=referenceSB (95%CI) Hours/DayPA (95% CI) Days/WeekSexual IdentityMaleFemaleMaleFemaleHeterosexual3.7 (3.7-3.8)3.6 (3.6-3.7)4.4 (4.3-4.4)3.4 (3.4-3.6)Gay/Lesbian3.7 (3.4-4.0)3.9 (3.7-4.2)2.8* (2.6-3.1)3.1 (2.9-3.4)Bisexual4.0 (3.7-4.3)4.3* (4.1-4.4)3.1* (2.7-3.4)3.0* (2.8-3.1)Unsure4.0 (3.7-4.4)4.3* (4.0-4.6)3.0* (2.7-3.3)3.0* (2.7-3.4) Disclosure L.B. Beach: None. B. Turner: None. R. Marro: None. G. Phillips: None.

The Effect of a Text Messaging Based HIV Prevention Program on Sexual Minority Male Youths: A National Evaluation of Information, Motivation and Behavioral Skills in a Randomized Controlled Trial of Guy2Guy.

ClinicalTrials.gov ID# NCT02113956.

Sex Differences in School Safety and Bullying Experiences Among Sexual Minority Youth.

Schools play an integral role in creating safe, supportive environments for students, especially for sexual minority youth (SMY). Using 2016 questionnaire data from seven high schools in a Florida school district, we obtained a sample of 1,364 SMY. Logistic regressions controlling for sex (as applicable), age, grade, race/ethnicity, and school explored differences between SMY and nonsexual minority youth (non-SMY). Sex differences related to school environment perceptions and experiences related to safety, bullying, and hearing homophobic remarks were also explored. SMY were more likely than non-SMY to report several negative school environment perceptions and experiences. Where differences existed within SMY, male SMY were more likely than female SMY to have missed school in the past 30 days (odds ratio [ OR] = 1.66, p = .03), report avoiding spaces at school due to safety concerns ( OR = 1.38, p = .02), and report hearing homophobic remarks from teachers ( OR = 2.00, p = .01). Implications for school nursing are discussed.

Sexual minority youth and depressive symptoms or depressive disorder: A systematic review and meta-analysis of population-based studies.

Research has suggested that sexual minority young people are more likely to have depressive symptoms or depressive disorder, but to date most studies in the field have relied on convenience-based samples. This study overcomes this limitation by systematically reviewing the literature from population-based studies and conducting a meta-analysis to identify whether depressive disorder and depressive symptoms are elevated in sexual minority youth. A systematic review and meta-analysis were conducted and informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to determine if rates of depressive symptoms or depressive disorder differ for sexual minority youth, relative to heterosexual adolescents. MEDLINE, PsycINFO, EMBASE and ERIC databases were searched. Studies reporting depressive symptom data or the prevalence of depressive disorder in population-based samples of adolescents, which included sexual minority youth and heterosexual young people, were included in the review. A meta-analysis was conducted to examine differences between groups. Twenty-three articles met the inclusion criteria. The proportion of sexual minority youth in the studies ranged from 2.3% to 12%. Sexual minority youth reported higher rates of depressive symptoms and depressive disorder (odds ratio = 2.94, p < 0.001 and standardized mean difference, d = 0.39, p < 0.001) in comparison to heterosexual young people. Female sexual minority youth were more likely to report depressive symptoms when compared to male sexual minority youth (standardized mean difference, d = 0.34, p < 0.001). Limitations included variations in how sexuality was operationalized and how depressive symptoms or depressive disorder was measured. There is robust evidence that rates of depressive disorder and depressive symptoms are elevated in sexual minority youth in comparison to heterosexual young people. Despite the elevated risk of depressive symptoms or depressive disorder for sexual minority youth, the treatment for this group of young people has received little attention.

Disparities in Mental Well-being between Non-Minority and Sexual Minority Male Youth in Bangkok, Thailand: Quantitative Findings from a Mixed Method Study

Disparities in Mental Well-being between Non-Minority and Sexual Minority Male Youth in Bangkok, Thailand: Quantitative Findings from a Mixed Method Study

MINORITY STRESS, POSITIVE IDENTITY DEVELOPMENT, AND DEPRESSIVE SYMPTOMS: IMPLICATIONS FOR RESILIENCE AMONG SEXUAL MINORITY MALE YOUTH.

Minority stress processes have been shown to have significant associations with negative mental health outcomes among sexual minority populations. Given that adversity may be experienced growing up as a sexual minority in heteronormative, if not heterosexist, environments, our research on resilience among sexual minority male youth proposes that positive identity development may buffer the effects of a range of minority stress processes. An ethnically diverse sample of 200 sexual minority males ages 16-24 (mean age, 20.9 years) was recruited using mixed recruitment methods. We developed and tested two new measures: concealment stress during adolescence and sexual minority-related positive identity development. We then tested a path model that assessed the effects of minority stressors, positive identity development, and social support on major depressive symptoms. Experience of stigma was associated with internalized homophobia (β=.138, p<.05) and major depressive symptoms (β=1.076, OR=2.933, p<.001), and internalized homophobia partially mediated experience's effects on major depression (β=.773, OR=2.167, p<.001). Concealment stress was associated with positive identity development (β=.155, p<.05) and internalized homophobia (β=.418, p<.001), and positive identity development partially mediated concealment stress's effects on internalized homophobia (β=-.527, p<.001). Concealment stress demonstrated a direct effect on major depression (β=1.400, OR=4.056, p<.001), and indirect paths to social support through positive identity development. With these results, we offer an exploratory model that empirically identifies significant paths among minority stress dimensions, positive identity development, and major depressive symptoms. This study helps further our understanding of minority stress, identity development, and resources of resilience among sexual minority male youth.

The Social Context of Depression Symptomology in Sexual Minority Male Youth: Determinants of Depression in a Sample of Grindr Users

ABSTRACTThe purpose of this study was to understand which social context factors most influence depression symptomology among sexual minority male youth (SMMY). In 2011, 195 SMMY who use Grindr were recruited to complete an online survey in Los Angeles, California. Items focused on social context variables and depression symptomology. Hierarchical multiple regressions were conducted using an ecological framework. The best fitting model accounted for 29.5% of the variance in depression. Experiences of homophobia, gay community connection, presence of an objecting network member, and emotional support were found to be significant predictors. Past experiences of homophobia continuing to affect youth indicates the need for intervention to reduction of homophobia in youths’ social contexts. Interventions that teach youth skills to manage objecting viewpoints or help youth to reorganize their social networks may help to reduce the impact of an objecting network alter.

Sexual risk behaviors and steroid use among sexual minority adolescent boys

BackgroundPrevious research has extensively examined the relationship between the use of alcohol and illicit substances with sexual risk behaviors among sexual minority (i.e., gay and bisexual) male youth; however, no known studies have assessed the association of steroid use to risk behaviors among this population. MethodsParticipants were 556 sexually active sexual minority adolescent boys (M age=16.2, SD=1.3), taken from a pooled dataset of the 14 jurisdictions from the 2005 and 2007 Youth Risk Behavior Surveys that assessed sexual orientation. The association between lifetime use of steroids and sexual risk behaviors were examined. ResultsControlling for number of sexual partners, depression, victimization, and race, boys who reported increased steroid use were at increased odds of engaging in condomless sex, OR=1.55, p=.003, and use of alcohol/drugs during sex, OR=1.48, p=.002. ConclusionsSteroid use among sexual minority adolescent boys is prevalent and associated with HIV/STI sexual transmission risk behaviors.

Non-parental adults in the social and risk behavior networks of sexual minority male youth

The presence of non-parental adults (NPAs), or adults outside of caregivers (e.g., extended family and natural mentors), in the lives of adolescents and emerging adults has received a rapidly expanding amount of empirical attention in the last decade. Compared to their heterosexual counterparts, sexual minority male youth (SMMY) experience disproportionate rates of abuse and victimization from parents and peers. Yet, despite the fact that this group, therefore, may be potentially vulnerable to negative interpersonal influences but also poised to benefit from additional relationships, NPA involvement in the lives of SMMY is currently not well understood in the extant literature. This study sought to examine and characterize the involvement of NPAs in the social and risk networks of SMMY (n=175; 54% African American, 21% Hispanic/Latino, 14% Caucasian; ages: 17–23). Most SMMY identified at least one NPA, such as friends and grandparents, in their networks. Three categories of relationships were identified, Strictly Social, which only involved social interactions; Complex, which were both social and involved substance use and/or sexual activity; and Risky, which purely consisted of substance use or sexual activity. Relationships were rated as emotionally “closer” among ethnic minority SMMY, although, racial/ethnic similarity between SMMY and NPAs was not associated with relationship closeness. In addition, relationships involving female and heterosexual NPAs were also rated as stronger. These findings suggest the potential usefulness of considering multiple types of relationships between SMMY and NPAs when designing intervention and prevention efforts. Moreover, African American and Latino SMMY, who represent the most vulnerable sub-groups of SMMY in terms of HIV-risk, may be particularly poised to benefit from positive NPA relationships.

NATURAL MENTORING IN THE LIVES OF SEXUAL MINORITY YOUTH

This retrospective, mixed method study examined the natural mentoring experiences of a national sample of lesbian, gay, and bisexual youth from the National Longitudinal Study of Adolescent Health. Sexual minority youth were found to be less likely than heterosexual youth to have family members as mentors, but more likely to be mentored by school adults. A paradox was noted wherein sexual minority youth, while more likely to be mentored, miss out on the cumulative benefit of mentoring since they meet their mentors almost a year later than heterosexual youth. Findings also suggest that the prevailing same‐sex pairing of mentors and mentees in formal mentoring programs warrants re‐examination for sexual minority youth, as male sexual minority youth were found to be more likely to have female natural mentors than heterosexual male youth. Implications for mentoring programs with a particular focus on positive youth development for sexual minority youth were also discussed.

Mental Health Disorders in Young Urban Sexual Minority Men

PurposeVery few studies have examined mental disorders among male sexual minority youth. We describe demographic correlates, comorbidity, and history of mental disorders and suicidality in a large sample of male sexual minority youth. MethodsStructured diagnostic interviews were conducted with 449 racially diverse urban sexual minority males, aged 16–20 years, who were recruited using a social network–driven sampling methodology. ResultsLifetime major depressive episode (MDE) affected 33.2% of the youth. Lifetime conduct disorder (23.6%), alcohol abuse/dependence (19.6%), posttraumatic stress disorder (PTSD; 16.0%), and nicotine dependence (10.7%) were also common. Black participants were less likely than white participants to be diagnosed with lifetime MDE, alcohol abuse/dependence, nicotine dependence, suicidal ideation, and anorexia, as well as past 12-month alcohol abuse/dependence (odds ratios [ORs] range from .08 to .46). Relative to participants identifying as gay, bisexual identified youth were at higher risk for lifetime PTSD (OR = 2.04), and participants who did not identify as gay or bisexual were at higher risk for both lifetime and past 12-month nicotine dependence (OR = 4.36 and 3.46, respectively). Most participants with mental disorders never received treatment, and comorbidity was common. ConclusionsMDE, conduct disorder, alcohol abuse/dependence, PTSD, and nicotine dependence are common and infrequently treated in young sexual minority men. Some within-group disparities emerged, suggesting that factors related to racial background and self-identification may help to understand resilience to the unique stressors experienced by these young men.

Intersecting Identities and the Association Between Bullying and Suicide Attempt Among New York City Youths: Results From the 2009 New York City Youth Risk Behavior Survey

We examined the intersections of sexual minority, gender, and Hispanic ethnic identities and their interaction with experiences of bullying in predicting suicide attempt among New York City youths. We performed secondary data analysis of the 2009 New York City Youth Risk Behavior Survey, using logistic regression to examine the association of sexual identity, gender, ethnicity, and bullying with suicide attempt. We stratified results on these measures and reported adjusted odds ratios. Compared with non-sexual minority youths, sexual minority youths had 4.39 and 1.96 times higher odds, respectively, of attempting suicide and reporting bullying. Identity variables did not interact with bullying in predicting suicide attempt individually; however, a four-way interaction term was significant. The effect of bullying on suicide attempt was strongest among non-Hispanic sexual minority male youths (odds ratio = 21.39 vs 1.65-3.38 for other groups). Sexual minority, gender, and ethnic identities interact with bullying in predicting suicide attempt among New York City youths. Interventions to limit both the prevalence and the effect of bullying among minority youths should consider an intersectional approach that considers ethnic, gender, and sexual identities.

Social networks and risk for depressive symptoms in a national sample of sexual minority youth

The aim of the study was to examine the social networks of sexual minority youths and to determine the associations between social networks and depressive symptoms. Data were obtained from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative cohort study of American adolescents (N = 14,212). Wave 1 (1994–1995) collected extensive information about the social networks of participants through peer nomination inventories, as well as measures of sexual minority status and depressive symptoms. Using social network data, we examined three characteristics of adolescents' social relationships: (1) social isolation; (2) degree of connectedness; and (3) social status. Sexual minority youths, particularly females, were more isolated, less connected, and had lower social status in peer networks than opposite-sex attracted youths. Among sexual minority male (but not female) youths, greater isolation as well as lower connectedness and status within a network were associated with greater depressive symptoms. Moreover, greater isolation in social networks partially explained the association between sexual minority status and depressive symptoms among males. Finally, a significant 3-way interaction indicated that the association between social isolation and depression was stronger for sexual minority male youths than non-minority youths and sexual minority females. These results suggest that the social networks in which sexual minority male youths are embedded may confer risk for depressive symptoms, underscoring the importance of considering peer networks in both research and interventions targeting sexual minority male adolescents.

Measuring Love: Sexual Minority Male Youths’ Ideal Romantic Characteristics

Research examining how sexual minorities characterize love within same-sex relationships is scarce. In this study, the authors examined the validity of Sternberg's triangular theory of love in a sample of sexual minority male youth (N = 447). To test the adequacy of the theory for our population, the authors examined the psychometric properties of the Triadic Love Scale (TLS) and tested whether the three underlying constructs of the theory (intimacy, passion, and commitment) emerged when participants were asked to consider their ideal relationship with another man. Using confirmatory factor analysis, the authors found support for the three-factor solution to characterize sexual minority male youths’ ideal romantic relationship, after minimizing item cross-loadings and adapting the content of the Passion subscale. The authors discuss the implications of their findings regarding the measurement of the TLS among sexual minority male youth and propose ways to enhance its measurement in future research.

Suicide Attempts Among Sexual-Minority Male Youth

The purpose of this study was to provide data addressing Diamond's (this issue) 4 problem areas in sexual orientation research by comparing gay, bisexual, and questioning male youth who report attempting suicide with those who do not. Secondary analyses were conducted with 2 datasets, 1 with a gay support group (n = 51) and the other with online youth (n = 681). Reported suicide attempts ranged from 39% among support-group youth, to 25% among Internet gay support group youth, to 9% among Internet non-support group youth. Sexual orientation, behavior, and identity did not predict suicidal attempt status, but suicide attempters experienced higher levels of both generic life stressors (low self-esteem, substance use, victimization) and gay-related stressors, particularly those directly related to visible (femininity) and behavioral (gay sex) aspects of their sexual identity. Support-group attendance was related to higher levels of suicidality and life stressors, as well as certain resiliency factors. Results suggest that there exists a minority of sexual-minority youth who are at risk but that it would be inappropriate to characterize the entire population as such.

Friendship and Attachment Among Heterosexual and Sexual-Minority Youths: Does the Gender of Your Friend Matter?

One-hundered and sixty-eight sexual-minority and heterosexual youths aged 15–24 completed questionnaires to assess gender and sexual orientation differences in the percentage of same-gender peers in youths' friendship networks, the gender of their best friends, and their degree of attachment to these friends. Most youths had predominantly same-gender peer networks and same-gender best friends. Notable gender differences emerged among sexual minorities. Female sexual-minority youths reported heightened participation in close same-gender friendships, whereas sexual-minority male youths showed the opposite pattern. Unlike all other groups, male sexual-minority youths had more cross-gender than same-gender friends and were more attached to their best friends than were heterosexual males. They were also less attached to their romantic partners than were heterosexual males. It is suggested that male sexual-minority youths might become highly attached to friends to compensate for low expectations of intimacy with male romantic partners. Cultural factors contributing to these gender differences in sexual-minority youths' experiences are discussed.