Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts;
Department of Pediatrics, Harvard Medical School.
Pediatrics. 2018 Apr;141(4). doi: 10.1542/peds.2017-2278. Epub 2018 Mar 12.
Young women who are sexual minorities (eg, bisexual and lesbian) are approximately twice as likely as those who are heterosexual to have a teen pregnancy. Therefore, we hypothesized that risk factors for teen pregnancy would vary across sexual orientation groups and that other potential risk factors exist that are unique to sexual minorities.
We used multivariable log-binomial models gathered from 7120 young women in the longitudinal cohort known as the Growing Up Today Study to examine the following potential teen pregnancy risk factors: childhood maltreatment, bullying victimization and perpetration, and gender nonconformity. Among sexual minorities, we also examined the following: sexual minority developmental milestones, sexual orientation-related stress, sexual minority outness, and lesbian, gay, and bisexual social activity involvement.
Childhood maltreatment and bullying were significant teen pregnancy risk factors among all participants. After adjusting for childhood maltreatment and bullying, the sexual orientation-related teen pregnancy disparities were attenuated; these risk factors explained 45% of the disparity. Among sexual minorities, reaching sexual minority developmental milestones earlier was also associated with an increased teen pregnancy risk.
The higher teen pregnancy prevalence among sexual minorities compared with heterosexuals in this cohort was partially explained by childhood maltreatment and bullying, which may, in part, stem from sexual orientation-related discrimination. Teen pregnancy prevention efforts that are focused on risk factors more common among young women who are sexual minorities (eg, childhood maltreatment, bullying) can help to reduce the existing sexual orientation-related teen pregnancy disparity.
性少数群体(例如双性恋和女同性恋)的年轻女性怀孕的可能性大约是异性恋女性的两倍。因此,我们假设,青少年怀孕的风险因素在不同的性取向群体中会有所不同,并且存在其他特定于性少数群体的潜在风险因素。
我们使用了来自纵向队列“今天成长研究”中的 7120 名年轻女性的多变量对数二项式模型,来研究以下可能的青少年怀孕风险因素:儿童期虐待、欺凌受害和施害,以及性别不一致。在性少数群体中,我们还研究了以下因素:性少数群体发展里程碑、与性取向相关的压力、性少数群体的公开程度,以及女同性恋、男同性恋和双性恋的社交活动参与度。
儿童期虐待和欺凌是所有参与者青少年怀孕的重要风险因素。在调整了儿童期虐待和欺凌因素后,性取向相关的青少年怀孕差异减弱了;这些风险因素解释了 45%的差异。在性少数群体中,更早达到性少数群体发展里程碑也与青少年怀孕风险增加有关。
与该队列中的异性恋女性相比,性少数群体中的青少年怀孕率更高,部分原因是儿童期虐待和欺凌,这可能部分源于与性取向相关的歧视。针对性少数群体中更为常见的年轻女性(例如儿童期虐待、欺凌)的风险因素,开展青少年怀孕预防工作,可以帮助减少现有的与性取向相关的青少年怀孕差异。