Sexual orientation, adult connectedness, and risk behaviors among adolescents: Findings from the 2009 New York City Youth Risk Behavior Survey

Background: Lesbian, gay, and bisexual (LGB) adolescents experience poor social integration and feelings of loneliness, which are associated with risk-taking behaviors. Since adolescents spend a significant amount of time in school, supportive relationships with adults in this setting may have a positive impact on this group.

Methods: We analyzed data from the 2009 New York City Youth Risk Behavior Survey (n=8,910) to examine the individual and joint effects of self-identifying as LGB and lacking a connection with an adult at school on risk behaviors among high school students. Risk behaviors of interest included alcohol use, marijuana use, illicit drug use, depressive symptoms, suicidal ideation, and suicide attempt. We calculated frequencies to describe the distribution of the sample; odds ratios were calculated using logistic regression.

Results: Greater than half the sample (55%) was female, in 9th or 10th grade (57%), and heterosexual (89%). Heterosexual and LGB students similarly reported having an adult connection at school (79% vs. 78%, respectively). LGB students with no adult connection reported significantly more risk behaviors than heterosexual students with adult connections: alcohol use, OR=3.07; marijuana use, OR=5.07; illicit drug use, OR=4.94; depressive symptoms, OR=3.48; suicidal ideation, OR=6.48; suicide attempt, OR=6.15. Even when LGB adolescents had a school adult connection, their odds of all risk behaviors were significantly higher than for heterosexual adolescents.

Conclusions: LGB adolescents, particularly those who lack a connection with school adult, are at high risk for poor health outcomes. Interventions should focus on boosting social support and improving outcomes for this vulnerable group.