Association Between Sexual Orientation and Gender Identity Discrimination and Youth Physical Health: Findings From a Nationally Representative Sample.

Abstract

Purpose: Adverse childhood experiences (ACEs), including discrimination, are known risk factors for negative outcomes later in life. Recently, sexual orientation or gender identity (SOGI)-based discrimination was recognized as an ACE. However, its association with health outcomes among youth remains understudied. We aim to identify socio-demographic characteristics associated with caregiver-reported SOGI-based discrimination and assess the association of SOGI-based discrimination with youth health outcomes.

Methods: We analyzed 2020-2022 National Survey of Children's Health data on youth who are 6-17 years old (n = 91,093), whose caregivers answered the question on SOGI-based discrimination. We used unadjusted and adjusted logistic regression models to identify socio-demographic characteristics associated with SOGI-based discrimination and the association between SOGI-based discrimination and adverse health outcomes.

Results: Two percent of youth (n = 1,834) experienced SOGI-based discrimination, with significantly higher odds among adolescents (aOR = 4.29, 95% CI = 3.35, 5.51), females (aOR = 2.67, 95% CI = 2.18, 3.28), non-Hispanic multiracial (aOR = 1.42, 95% CI-1.09, 1.86), and youth in English-speaking households (aOR = 2.41, 95% CI = 1.32, 4.37). SOGI-based discrimination was significantly associated with poorer health (aOR = 3.27, 95% CI = 2.09, 5.13), ≥1 chronic health conditions (aOR = 3.35, 95% CI = 2.39, 4.35), and having special health care needs (aOR = 3.81, 95% CI = 3.10, 4.68). This significance persisted after adjusting for socio-demographics and other ACEs.

Discussion: Our study quantitatively links SOGI-based discrimination with adverse health outcomes and identifies youth with higher odds of SOGI-based discrimination. These results underscore the importance of addressing SOGI-based discrimination when treating youth who may be at risk.