Elevated Risky Sexual Behaviors Among Sexual Minority Girls: Indirect Risk Pathways Through Peer Victimization and Heavy Drinking

Abstract

Sexual minority girls (SMGs), compared with heterosexual females, are more likely to report negative sexual outcomes including earlier age of sexual intercourse debut, more lifetime and recent sexual partners, pregnancy involvement, and sex while intoxicated. Data describing the mechanisms related to these health disparities are limited. The purpose of this study was therefore to longitudinally assess the roles of sexual minority-related peer victimization and heavy episodic drinking (HED) as mediators of the relation between sexual minority status and sexual outcomes. The girls examined in this study were recruited into a longitudinal study of adolescent health from two large, urban adolescent medicine clinics affiliated with academic medical centers. The final sample for this analysis included 79 SMGs and a comparison group of 127 heterosexual girls aged between 14 and 19 years. Mediation models were run in the structural equation modeling framework. Our results provided evidence to support a serial multiple mediation pathway. SMGs were more likely to report sexual minority-related victimization, and sexual minority-related victimization predicted increased HED, which was subsequently found to prospectively predict increased sexual risk behaviors. Taken together, these novel findings indicate that both sexual minority-related victimization and HED may play important roles in explaining disparities in risky sexual behavior among SMGs.

Comparing the Sexual and Mental Health of Justice-Involved Youth Across Gender and Sexual Orientation

“…Results regarding sexual orientation point to important directions for future investigation. In contrast to those in community-based samples (Dermody et al, 2017; Garofalo et al, 1998; Goodenow et al, 2008; Kann et al, 2016), non-heterosexual youth in this study were less likely than heterosexual youth to report ever having sex or engaging in high-risk sexual behavior. These findings may reveal important differences between non-heterosexual youth from justice-involved and community samples.…”

“…Research similarly suggests that non-heterosexual youth in community samples are more vulnerable to sexual risk behaviors and internalizing and externalizing problems compared to their heterosexual peers. Non-heterosexual youth tend to report earlier age of sexual debut and more sexual partners, inconsistent condom use, suicidality, and substance use (Dermody et al, 2017; Garofalo et al, 1998; Goodenow et al, 2008; Kann et al, 2016). However, Hirschtritt et al (2018) was unable to replicate some of the differences in sexual risk behaviors between non-heterosexual and heterosexual youth in a justice-involved sample.…”

“I Do Not Like Being Me”: the Impact of Self-hate on Increased Risky Sexual Behavior in Sexual Minority People

“…Regarding differences in self-relating processes, consistently with Hypothesis 2, we found higher levels of selfhate and self-inadequacy in sexual minority participants compared to heterosexual people. Negative and continuative experiences (e.g., direct and indirect discriminations) related to their sexual minority identity may represent a possible driver of these disparities (Dermody et al, 2020;Meyer, 2003;Puckett et al, 2015). Interestingly, both types of "negative self-relationship" (self-inadequacy and self-hate), and not only the most severe form of "negative" self-relationship (i.e., self-hate), are more prevalent in sexual minority people than heterosexual individuals.…”

“…Furthermore, Dermody et al (2020) whit a longitudinal study, found that sexual minority-related victimization and heavy drinking may play important roles in explaining disparities in RSB among sexual minority girls: High levels of peer victimization among sexual minority girls predicted increased heavy episodic drinking, which was subsequently associated with RSB. Internalized sexual stigma, described as feelings of shame and low self-worth related to sexual minority identities (Herek et al, 2009), represented a significant predictor of psychological distress and mental health adverse outcomes among sexual minority people (Baiocco et al, 2015;Newcomb & Mustanski, 2010;Russell & Horn, 2016).…”

“…Traditionally, studies on RSB have prevalently focused on men participants and showed that sexual minority men reported a greater probability of RSB and HIV infection than heterosexual men (Glick et al, 2012;Mustanski et al, 2011;Weatherburn et al, 2019). Most recent research has considered other sexual minority subgroups, such as sexual minority women (Dermody et al, 2020;Poteat et al, 2019). For example, sexual minority women and women who reported at least one female sexual partner engaged in greater RSB and were at higher risk of sexually transmitted infections, including HIV infection, compared to exclusively heterosexual women (Bailey et al, 2003;Goodenow et al, 2008;Tat et al, 2015).…”