Sexual Violence Among a State Sample of High School Students: The Impact of Gender Identity and Sexual Orientation.

Sexual violence is a pervasive public health issue that has a direct and disproportionate impact on U.S. adolescents. Sexual violence victimization (SVV) is strongly associated with adolescent depression, anxiety, post-traumatic stress, and suicidality, and sexual violence perpetration (SVP) with substance abuse and other health risk behaviors. Gender and sexual-orientation-diverse youth may be at greater risk of sexual violence and the associated mental health consequences. We used data from the 2021 Healthy Kids Colorado Survey, a school-based survey administered to a population sample of high school students, to examine the prevalence of SVV and SVP. We examined the prevalence by demographic characteristics and association with mental health outcomes. Among this sample of high school students, 13% reported SVV and 2.6% reported SVP. Prevalence of SVV was significantly higher for cisgender females and transgender students than cisgender males, and higher for lesbian/gay/bisexual youth than heterosexual youth. SVP was significantly lower among cisgender females than males, yet transgender students had significantly higher odds of SVP, as did lesbian/gay/bisexual and asexual/questioning youth, as compared to heterosexual youth. Future research, particularly those with state-representative samples, should ensure careful attention to include questions around sexual violence experiences (both victimization and perpetration), gender/sexual identity, and race/ethnicity, given the magnitude of differences of SVV and SVP among these subgroups of adolescents. Mental health and suicidality are further underscored as key associations with sexual violence experiences, highlighting the importance of additional research and interdisciplinary responses to these critical aspects of public health prevention and care.