Comparing Health and Mental Health Needs, Service Use, and Barriers to Services among Sexual Minority Youths and Their Peers

Kelly A. Williams · Mimi V. Chapman

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LGBTQ Health, Identity, and Policy Adolescent Sexual and Reproductive Health Adolescent and Pediatric Healthcare

Abstract

Using a representative national sample (N = 20,745), this article explores health and mental health needs, service use, and barriers to services among sexual minority youths (SMYs) and heterosexual peers. SMYs were defined by ever having a same-sex romantic attraction or having a recent same-sex romantic relationship or sexual partner. SMYs accounted for 7.5 percent of the sample. Data were analyzed to ascertain prevalence of risks and explore group differences. Compared with peers, SMY self-reports indicated higher prevalence rates on all indicators of health and mental health need. SMYs reported more sexual activity, more sexually transmitted disease diagnoses, a higher perceived risk for HIV/AIDS, and more forgone medical care than peers.Also compared with peers, SMYs reported higher levels of anxiety depression, suicidality, and physical and sexual victimization and higher rates of unmet mental health need. SMYs also reported greater concerns about confidentiality and were less likely to use school-based services.The majority of SMYs reported same-sex attraction only. Social work and other helping professionals should incorporate same-sex attraction questions into assessment protocols to target services for this population. School- and office-based providers must consider whether their services are welcoming and offer sufficient assurances of confidentiality to facilitate access by SMYs.

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References

1977The CES-D Scale 2003Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence.1995Minority Stress and Mental Health in Gay Men 2001Adolescent Sexual Orientation and Suicide Risk: Evidence From a National Study 1991Screening for Adolescent Depression: A Comparison of Depression Scales 2002Effects of at-school victimization and sexual orientation on lesbian, gay, or bisexual youths’ health risk behavior 1998The Association Between Health Risk Behaviors and Sexual Orientation Among a School-based Sample of Adolescents 1999Is Sexual Orientation Related to Mental Health Problems and Suicidality in Young People?

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2018Patient–Provider Communication Barriers and Facilitators to HIV and STI Preventive Services for Adolescent MSM 2020Sociodemographic differences in barriers to mental health care among college students at elevated suicide risk 2017Primary care access and foregone care: a survey of transgender adolescents and young adults 2014Discrimination and Depressive Symptoms Among Sexual Minority Youth: Is Gay-Affirming Religious Affiliation a Protective Factor?

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