特拉华州青少年中性取向和性别认同导致的心理健康与物质使用差异
Mental Health and Substance Use Disparities by Sexual Orientation and Gender Identity Among Delaware Youth.
作者信息
Layland Eric K, Wei August X, Maurer Natalie M, Brittingham Rochelle, Bachman Ronet
机构信息
Department of Human Development and Family Sciences, University of Delaware.
Center for Drug and Health Studies, University of Delaware.
出版信息
Dela J Public Health. 2025 Jul 31;11(2):26-34. doi: 10.32481/djph.2025.07.08. eCollection 2025 Jul.
OBJECTIVE
To investigate mental health and substance use disparities by sexual orientation and gender identity among Delaware youth.
METHODS
Data were from the Delaware School Surveys (DSS) administered to 8th and 11th graders (=17,361; ages 12-17 years old) in 2022, 2023, and 2024. Frequency statistics were used to summarize sexual orientation and gender identity composition, including frequency of youth who were lesbian, gay, bisexual, transgender, and other minoritized sexual and gender identities (LGBT+). Using logistic regression, we tested associations between LGBT+ status and odds of reporting psychological distress, anxiety, underage drinking, cigarette smoking, vaping, marijuana use, and prescription drug misuse.
RESULTS
Around one in four (25-26%) Delaware youth identified as LGBT+, including 6-7% of youth who were transgender or nonbinary. Rates of lifetime mental health symptoms and underage substance use were elevated among LGBT+ youth for every health outcome. For 8th grade LGBT+ youth relative to cisgender heterosexual youth, odds were elevated by 269% for psychological distress, 276% for anxiety, 91% for drinking, 141% for cigarette smoking, 121% for vaping, 98% for marijuana use, and 86% for prescription drug misuse. In 11th grade LGBT+ youth relative to cisgender heterosexual youth, odds were elevated by 228% for psychological distress, 240% for anxiety, 33% for drinking, 71% for cigarette smoking, 51% for vaping, 57% for marijuana use, and 70% for prescription drug misuse.
CONCLUSIONS
Mental health and substance use disparities between LGBT+ youth and cisgender heterosexual youth highlight an alarming public health crisis in Delaware. With growing numbers of youth identifying as LGBT+ and persistent health disparities, state policy and clinical practice must be attuned to the needs and lived experiences of LGBT+ youth to identify and eliminate drivers of these disparities. Schools, healthcare, and policy provide important avenues for intervention.
目的
调查特拉华州青少年在性取向和性别认同方面的心理健康及物质使用差异。
方法
数据来自2022年、2023年和2024年对特拉华州八年级和十一年级学生（=17361名；年龄在12 - 17岁之间）进行的特拉华州学校调查（DSS）。频率统计用于总结性取向和性别认同构成，包括女同性恋、男同性恋、双性恋、跨性别者以及其他受边缘化的性取向和性别认同（LGBT+）青少年的频率。使用逻辑回归，我们测试了LGBT+身份与报告心理困扰、焦虑、未成年饮酒、吸烟、吸电子烟、使用大麻和滥用处方药几率之间的关联。
结果
约四分之一（25 - 26%）的特拉华州青少年认定为LGBT+，其中6 - 7%为跨性别或非二元性别青少年。在每项健康结果方面，LGBT+青少年一生中出现心理健康症状和未成年物质使用的比例都有所升高。对于八年级的LGBT+青少年而言，相对于顺性别异性恋青少年，心理困扰的几率升高了269%，焦虑升高了276%，饮酒升高了91%，吸烟升高了141%，吸电子烟升高了121%，使用大麻升高了98%，滥用处方药升高了86%。对于十一年级的LGBT+青少年而言，相对于顺性别异性恋青少年，心理困扰的几率升高了228%，焦虑升高了240%，饮酒升高了33%，吸烟升高了71%，吸电子烟升高了51%，使用大麻升高了57%，滥用处方药升高了70%。
结论
LGBT+青少年与顺性别异性恋青少年之间的心理健康及物质使用差异凸显了特拉华州令人担忧的公共卫生危机。随着认定为LGBT+的青少年数量不断增加以及健康差异持续存在，州政策和临床实践必须适应LGBT+青少年的需求和生活经历，以识别并消除这些差异的驱动因素。学校、医疗保健和政策提供了重要的干预途径。
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