Saewyc E M, Bearinger L H, Heinz P A, Blum R W, Resnick M D
School of Nursing, Medicine, and Public Health, University of Minnesota, Minneapolis 55455, USA.
J Adolesc Health. 1998 Sep;23(3):181-8. doi: 10.1016/s1054-139x(97)00260-7.
This study explored gender differences in the health and risk behaviors of 394 self-identified bisexual and homosexual adolescents who participated in an anonymous, school-based survey.
Respondents included 182 girls and 212 boys; girls were significantly younger than boys (p < 0.001), so respondents were further grouped as younger (< or =14 years) and older (> or =15 years) for analysis. Chi-square was used to test for gender differences in health perceptions and risk behaviors. Items included general health perceptions and health care access, body image and disordered eating behaviors, sexual behaviors, alcohol use, and emotional health measures including mood, life satisfaction, and suicidal ideation and attempts.
Both younger and older girls were significantly more likely than their male age mates to report a history of sexual abuse, dissatisfaction with weight, a negative body image, more frequent dieting, and an earlier age at onset of sexual intercourse. Both younger and older boys were significantly more likely than girls to have a positive body image, to rate themselves as healthier than peers, to report no regular source of health care, to be sexually experienced, and to drink alcohol more often and in greater quantity; a significantly greater proportion of older boys than older girls reported alcohol use before school (19.0% vs. 3.9%; p < 0.05). No significant gender differences were found for measures of emotional health, including suicidal ideation and attempts; however, nearly 1 of 3 older boys and girls reported at least one suicide attempt.
Gender is a substantive source of variation in health and risk behaviors among bisexual and homosexual adolescents. Health care providers should incorporate gender-specific approaches to health promotion and risk reduction with young people who self-identify as gay, lesbian, or bisexual.
本研究探讨了394名自我认定为双性恋和同性恋的青少年在健康和风险行为方面的性别差异，这些青少年参与了一项匿名的、基于学校的调查。
受访者包括182名女孩和212名男孩；女孩的年龄显著小于男孩（p < 0.001），因此将受访者进一步分为较年轻（≤14岁）和较年长（≥15岁）两组进行分析。采用卡方检验来检测健康认知和风险行为方面的性别差异。调查项目包括一般健康认知和医疗保健获取情况、身体形象和饮食失调行为、性行为、饮酒情况以及情绪健康指标，如情绪、生活满意度、自杀意念和自杀未遂情况。
无论较年轻还是较年长的女孩，相比于同龄男孩，都显著更有可能报告有性虐待史、对体重不满、负面身体形象、更频繁节食以及初次性交年龄更早。无论较年轻还是较年长的男孩，相比于女孩，都显著更有可能拥有正面身体形象、认为自己比同龄人更健康、报告没有固定的医疗保健来源、有性经历、更频繁且大量饮酒；较年长男孩中报告上学前饮酒的比例显著高于较年长女孩（19.0%对3.9%；p < 0.05）。在包括自杀意念和自杀未遂情况在内的情绪健康指标方面，未发现显著的性别差异；然而，近三分之一的较年长男孩和女孩报告至少有过一次自杀未遂。
性别是双性恋和同性恋青少年健康和风险行为差异的一个重要来源。医疗保健提供者应该针对自我认定为同性恋、双性恋或跨性别者的年轻人，采用针对性别的健康促进和风险降低方法。
