Development of Anxiety Symptoms Among LGBTQ and Cisgender Heterosexual Adolescents: The Protective Role of Self-Esteem.

Abstract

Objective: Anxiety often rises after the transition to high school, yet little is known about how these changes occur for lesbian, gay, bisexual, transgender, and queer (LGBTQ) adolescents who face unique minority stressors. This study examined longitudinal differences in anxiety trajectories between LGBTQ and cisgender heterosexual adolescents and evaluated whether self-esteem served as a protective factor.

Method: Participants were 367 adolescents (M_age = 14.05 years; 60.5% cisgender girls; 46.6% White, 18.8% Black, 17.4% Asian, 5.7% Arab/Middle Eastern/North African, 5.2% Multiracial, 3.5% Hispanic/Latinx; 22% [n = 80] LGBTQ, 78% [n = 287] cisgender heterosexual) from 38 Michigan high schools. Anxiety symptoms (Generalized Anxiety Disorder-7) and self-esteem (Rosenberg Self-esteem Scale) were assessed across five waves during ninth and tenth grade. Multiple-group latent curve modeling evaluated group differences and self-esteem's predictive role.

Results: LGBTQ adolescents entered high school with significantly higher anxiety symptoms than their cisgender heterosexual peers. Although their symptoms declined over time, they remained significantly higher than those of cisgender heterosexual adolescents, whose anxiety levels were stable. Higher initial self-esteem predicted lower initial anxiety for both groups; however, decreases in anxiety over time emerged only among LGBTQ adolescents with self-esteem at least 1 SD above the group mean.

Conclusions: Self-esteem emerges as a critical protective factor against the development of anxiety symptoms. Given heightened anxiety symptoms for LGBTQ adolescents following the transition to high school, interventions bolstering self-esteem may be especially beneficial for reducing anxiety in this population.