Age Trends in Bias-Based Bullying and Mental Health by Sexual Orientation and Gender Identity

Abstract

Disparities in mental health and bullying between SGM youth and their heterosexual, cisgender peers are well-established. There remain questions about whether the onset and progression of these disparities differ across adolescence-knowledge critical for screening, prevention, and intervention. To address this, the current study estimates age-based patterns of homophobic bullying, gender-based bullying, and mental health across groups of adolescents defined by sexual orientation and gender identity (SOGI). Data are from the 2013-2015 cycle of the California Healthy Kids Survey (n = 728,204). We estimated the age-specific prevalence rates of past-year homophobic bullying, gender-based bullying, and depressive symptoms using three- and two-way interactions by (1) age, sex, and sexual identity and (2) age and gender identity, respectively. We also tested how adjustments for bias-based bullying alter predicted prevalence rates of past-year mental health symptoms. Results showed that SOGI differences in homophobic bullying, gender-based bullying, and mental health were already present among youth aged 11 and younger. SOGI differences by age were attenuated when adjusting models for homophobic and gender-based bullying, particularly among transgender youth. SOGI-related bias-based bullying and mental health disparities were present early and generally persisted throughout adolescence. Strategies that prevent exposure to homophobic and gender-based bullying would significantly reduce SOGI-related disparities in mental health across adolescence.

Figure 1.

Age-specific predicted probabilities of differences in homophobic and gender-based bullying by sexual orientation and gender identity. California Healthy Kids survey (2013–2015). Panel a and panel c are predicted probabilities by sexual orientation. Panel b and panel d are predicted probabilities by gender identity. All models are adjusted for covariates. All interactions are significant. Panel a: X²= 159.75, p<.001. Panel b: X²=188.82, p<.001. Panel c: X²= 48.68, p<.001. Panel d: X²= 357.07, p<.001.

Figure 2.

Age-specific predicted probabilities of differences in depressive symptoms by sexual orientation and gender identity. California Healthy Kids survey (2013–2015). Left panels are predicted probabilities by sexual orientation. Panel a is the covariate adjusted model and panel c is the model adjusted for covariates and bias-based bullying. Right-hand panels are predicted probabilities by gender identity. Panel b is the covariate adjusted model and panel b is the model adjusted for covariates and bias-based bullying. All interactions are significant. Panel a: X²= 55.07, p<.001. Panel b: X²= 521.95, p<.001. Panel c: X²= 16.62, p=.02. Panel d: X²=470.18, p<.001.