Prevalence of lesbian, gay, bisexual and questioning teens in Hawaii and disparities in mental health risk behaviors

While some studies have shown lesbian, gay, bisexual and questioning (LGBQ) youth are at increased risk for many unhealthy behaviors, population-based data on risky behaviors among youth by sexual identity is sparse. To assess disparate health risks among LGBQ youth Hawaii included sexual orientation questions in the 2011 and 2013 Youth Risk Behavior Survey (YRBS). Along with standard YRBS questions, students were asked which best described them: heterosexual (straight), gay or lesbian, bisexual or not sure. This study uses a population-based survey to estimate the prevalence of youth identifying as LGBQ in Hawaii and the associations of reported depression, suicidality, and self-mutilation with sexual identity.

The sample was 8,960 public high school students (grades 9-12) and the data was weighted to represent the population.  In all, 89.8% identified as heterosexual, 2.0% as gay or lesbian, 4.8% as bisexual and 3.4% as not sure. Females were significantly more likely than males to identify as bisexual (6.6% vs. 3.0%, p<.001). In the 12 months prior to the survey LGBQ students were significantly more likely than heterosexuals to report depression (OR=2.82, 95%CI 2.18-3.66), consider suicide (OR=3.66, 95%CI 2.74-4.90), make a plan to commit suicide (OR=3.89, 95%CI 3.01-5.03), attempt suicide (OR=5.05, 95%CI 3.68-6.92) and receive medical treatment for a suicide attempt (OR=4.76,  95% CI 2.63-8.62). They were also more likely to have engaged in non-suicidal self-mutilation (OR=3.66, 95%CI 2.44-5.50).

Uniform inclusion of sexual orientation questions in public health surveillance systems is crucial to be able to assess LGBQ health and address health risk-behavior disparities.