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Sexual orientation and mental health over the life course in a birth cohort

Published online by Cambridge University Press:  13 June 2019

J. K. Spittlehouse Open the ORCID record for J. K. Spittlehouse [Opens in a new window] ,
J. M. Boden  and
L. J. Horwood
J. K. Spittlehouse*
Affiliation:
Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
J. M. Boden
Affiliation:
Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
L. J. Horwood
Affiliation:
Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
*
Author for correspondence: J. K. Spittlehouse, E-mail: janet.spittlehouse@otago.ac.nz
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Abstract

Background

Sexual minority individuals consistently report higher rates of mental disorder than heterosexuals. However, much of the research has methodological limitations related to the classification of sexuality, the use of cross-sectional data and problematic sampling procedures such as using convenience samples.

Methods

We used longitudinal data from a birth cohort enrolled in the Christchurch Health and Development Study (n = 1040). Latent class analysis was used to classify participants sexuality based on self-report data of sexual behaviour, attraction, identity and fantasy, gathered over five assessments between the ages of 18 and 35 years. Mental health and substance use outcome data were gathered at four assessments between the ages of 21 and 35 years. Potential covariate variables were collected during childhood.

Results

The latent class analysis identified four groups interpreted as: ‘heterosexual’ 82%, ‘mostly heterosexual’ 12.6%, ‘bisexual’ 3.5% and ‘gay/lesbian’ 1.9%. In the sexual minority groups, women outnumbered men by at least 2:1. Pooled rates for mental health disorders of depression, anxiety disorders, suicidal ideation, cannabis abuse and total disorders, after adjustment for childhood covariate variables, were significantly higher in the sexual minority groups (p < 0.01). The strength of association between sexuality group and mental health outcomes did not differ according to sex. Fluidity in sexuality reports appeared unrelated to risk of mental health outcomes.

Conclusions

Over the life course, membership of a sexual minority group is clearly associated with mental health problems of depression, anxiety and suicidal ideation regardless of the age when same-sex attraction, behaviour, identity or fantasy is expressed.

Keywords

Birth cohortlongitudinal studymental health outcomessexual minoritiessexual orientationsubstance use
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 8 , June 2020 , pp. 1348 - 1355
Copyright
Copyright © Cambridge University Press 2019

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References

American Psychiatry Association (1994) Diagnostic and statistical manual of mental disorders (DSM-IV). Washington, DC: American Psychiatry Association.Google Scholar
Baumeister, RF (2000) Gender differences in erotic plasticity: the female sex drive as socially flexible and responsive. Psychological Bulletin 126, 347–374.10.1037/0033-2909.126.3.347CrossRefGoogle ScholarPubMed
Beard, KW, Stroebel, SS, O'Keefe, SL, Harper-Dorton, KV, Griffee, K, Young, DH, Swindell, S, Steele, K, Linz, TD and Moore, KB (2015) Childhood and adolescent sexual behaviors predict adult sexual orientations. Cogent Psychology 2, 1067568.10.1080/23311908.2015.1067568CrossRefGoogle Scholar
Booker, CL, Rieger, G and Unger, JB (2017) Sexual orientation health inequality: evidence from understanding society, the UK longitudinal household study. Preventive Medicine 101, 126–132.CrossRefGoogle Scholar
Bränström, R (2017) Minority stress factors as mediators of sexual orientation disparities in mental health treatment: a longitudinal population-based study. Journal of Epidemiology & Community Health 71, 446–452.CrossRefGoogle ScholarPubMed
Burkill, S, Copas, A, Couper, MP, Clifton, S, Prah, P, Datta, J, Conrad, F, Wellings, K, Johnson, AM and Erens, B (2016) Using the web to collect data on sensitive behaviours: a study looking at mode effects on the British National Survey of Sexual Attitudes and Lifestyles. PLoS One 11, e0147983.CrossRefGoogle ScholarPubMed
Cochran, SD, Sullivan, JG and Mays, VM (2003) Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States. Journal of Consulting And Clinical Psychology 71, 53–61.CrossRefGoogle ScholarPubMed
Corliss, HL, Rosario, M, Wypij, D, Fisher, LB and Austin, SB (2008) Sexual orientation disparities in longitudinal alcohol use patterns among adolescents: findings from the growing up today study. Archives of Pediatrics & Adolescent Medicine 162, 1071–1078.10.1001/archpedi.162.11.1071CrossRefGoogle ScholarPubMed
Diamond, LM (2016) Sexual fluidity in male and females. Current Sexual Health Reports 8, 249–256.10.1007/s11930-016-0092-zCrossRefGoogle Scholar
Dickson, N, Paul, C and Herbison, P (2003) Same-sex attraction in a birth cohort: prevalence and persistence in early adulthood. Social Science & Medicine 56, 1607–1615.10.1016/S0277-9536(02)00161-2CrossRefGoogle Scholar
Dickson, N, van Roode, T, Cameron, C and Paul, C (2013) Stability and change in same-sex attraction, experience, and identity by sex and age in a New Zealand birth cohort. Archives of Sexual Behavior 42, 753–763.10.1007/s10508-012-0063-zCrossRefGoogle Scholar
Ellison, G and Gunstone, B (2009) Sexual Orientation Explored: A Study of Identity, Attraction, Behaviour and Attitudes in 2009. Manchester, England: Equality and Human Rights Commission of Manchester.Google Scholar
Fergusson, DM, Horwood, LJ and Beautrais, AL (1999) Is sexual orientation related to mental health problems and suicidality in young people? Archives of General Psychiatry 56, 876–880.CrossRefGoogle ScholarPubMed
Fergusson, DM, Horwood, LJ, Ridder, EM and Beautrais, AL (2005) Sexual orientation and mental health in a birth cohort of young adults. Psychological Medicine 35, 971–981.10.1017/S0033291704004222CrossRefGoogle Scholar
Fergusson, DM, McLeod, GF and Horwood, LJ (2013) Childhood sexual abuse and adult developmental outcomes: findings from a 30-year longitudinal study in New Zealand. Child Abuse & Neglect 37, 664–674.10.1016/j.chiabu.2013.03.013CrossRefGoogle ScholarPubMed
Geary, RS, Tanton, C, Erens, B, Clifton, S, Prah, P, Wellings, K, Mitchell, KR, Datta, J, Gravningen, K and Fuller, E (2018) Sexual identity, attraction and behaviour in Britain: the implications of using different dimensions of sexual orientation to estimate the size of sexual minority populations and inform public health interventions. PLoS One 13, e0189607.10.1371/journal.pone.0189607CrossRefGoogle ScholarPubMed
Government of New Zealand (2013) Marriage (Definition of Marriage) Amendment Act 2013. New Zealand: Government of New Zealand.Google Scholar
Herek, GM and Garnets, LD (2007) Sexual orientation and mental health. Annual Review of Clinical Psychology 3, 353–375.10.1146/annurev.clinpsy.3.022806.091510CrossRefGoogle ScholarPubMed
Hershberger, SL, Pilkington, NW and D'Augelli, AR (1997) Predictors of suicide attempts among gay, lesbian, and bisexual youth. Journal of Adolescent Research 12, 477–497.10.1177/0743554897124004CrossRefGoogle Scholar
Katz-Wise, SL, Williams, DN, Keo-Meier, CL, Budge, SL, Pardo, S and Sharp, C (2017) Longitudinal associations of sexual fluidity and health in transgender men and cisgender women and men. Psychology of Sexual Orientation and Gender Diversity 4, 460.10.1037/sgd0000246CrossRefGoogle ScholarPubMed
King, M, Semlyen, J, Tai, SS, Killaspy, H, Osborn, D, Popelyuk, D and Nazareth, I (2008) A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry 8, 70.CrossRefGoogle ScholarPubMed
Krueger, EA, Meyer, IH and Upchurch, DM (2018) Sexual orientation group differences in perceived stress and depressive symptoms among young adults in the United States. LGBT Health 5, 242–249.10.1089/lgbt.2017.0228CrossRefGoogle ScholarPubMed
Kuperberg, A and Walker, AM (2018) Heterosexual college students who hookup with same-sex partners. Archives of Sexual Behavior 47, 1387–1403.CrossRefGoogle ScholarPubMed
Kuyper, L, Fernee, H and Keuzenkamp, S (2016) A comparative analysis of a community and general sample of lesbian, gay, and bisexual individuals. Archives of Sexual Behavior 45, 683–693.10.1007/s10508-014-0457-1CrossRefGoogle ScholarPubMed
Matthews, DD, Blosnich, JR, Farmer, GW and Adams, BJ (2014) Operational definitions of sexual orientation and estimates of adolescent health risk behaviors. LGBT Health 1, 42–49.10.1089/lgbt.2013.0002CrossRefGoogle ScholarPubMed
Meyer, IH (2003) Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychological Bulletin 129, 674–697.CrossRefGoogle ScholarPubMed
Ministry of Justice (2004) Civil Union Act. New Zealand: Ministry of Justice.Google Scholar
Mock, SE and Eibach, RP (2012) Stability and change in sexual orientation identity over a 10-year period in adulthood. Archives of Sexual Behavior 41, 641–648.CrossRefGoogle Scholar
Muthén, LK and Muthén, BO (2013) Mplus 7.11. Los Angeles, CA: Muthén & Muthén.Google Scholar
Plöderl, M and Tremblay, P (2015) Mental health of sexual minorities. A systematic review. International Review of Psychiatry 27, 367–385.10.3109/09540261.2015.1083949CrossRefGoogle ScholarPubMed
Ross, LE, Salway, T, Tarasoff, LA, MacKay, JM, Hawkins, BW and Fehr, CP (2018) Prevalence of depression and anxiety among bisexual people compared to gay, lesbian, and heterosexual individuals: a systematic review and meta-analysis. The Journal of Sex Research 55, 435–456.CrossRefGoogle ScholarPubMed
Sandfort, TG, Bakker, F, Schellevis, FG and Vanwesenbeeck, I (2006) Sexual orientation and mental and physical health status: findings from a Dutch population survey. American Journal of Public Health 96, 1119–1125.10.2105/AJPH.2004.058891CrossRefGoogle ScholarPubMed
Savin-Williams, RC (2016) Sexual orientation: categories or continuum? Commentary on Bailey et al. (2016). Psychological Science in the Public Interest 17, 37–44.CrossRefGoogle ScholarPubMed
Savin-Williams, RC and Vrangalova, Z (2013) Mostly heterosexual as a distinct sexual orientation group: a systematic review of the empirical evidence. Developmental Review 33, 58–88.CrossRefGoogle Scholar
StataCorp (2017) Stata Stastical Software: Release 15. College Station, TX: StataCorp LLC.Google Scholar
Vrangalova, Z and Savin-Williams, RC (2014) Psychological and physical health of mostly heterosexuals: a systematic review. The Journal of Sex Research 51, 410–445.CrossRefGoogle ScholarPubMed
Wells, JE, McGee, MA and Beautrais, AL (2011) Multiple aspects of sexual orientation: prevalence and sociodemographic correlates in a New Zealand national survey. Archives of Sexual Behavior 40, 155–168.CrossRefGoogle Scholar
World Health Organisation (1993) Composite International Diagnostic Interview (CIDI), Version 1.1. Geneva: World Health Organisation.Google Scholar
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