Supporting Sexual Minority Youth: Protective Factors of Adverse Health Outcomes and Implications for Public Health

Purpose: Sexual and gender minority (SGM) youth (e.g., gay, lesbian, bisexual, questioning, transgender) are systemically impacted by victimization and poor mental health because of discrimination in society. To prevent adverse outcomes, we must understand factors that help communities support and protect SGM youth. This study examined to what extent protective factors longitudinally predict outcomes 2 years later in an effort to inform more sensitive prevention efforts. Methods: Students from nine Colorado high schools (N = 2,744) completed surveys across four consecutive school semesters (T1 to T4). Structural equation modeling was conducted to determine the longitudinal associations between baseline protective factors (access to medical and counseling services, help-seeking beliefs, trusted adults, family support, peer support, spirituality) and distal adverse outcomes (substance use, depression, suicidal ideation, peer victimization, bullying perpetration, sexual violence victimization and perpetration, homophobic name-calling victimization, and perpetration), by sexual orientation. Results: All protective factors examined, except for access to medical services, were associated with lower likelihood of adverse outcomes. Associations differed across sexual orientations. For students identified as questioning or something other than heterosexual, lesbian, gay, or bisexual, family support is a notable protective factor of depression, peer victimization, bullying perpetration, and sexual violence perpetration. Family support was not significantly protective for these outcomes among heterosexual, lesbian, gay, and bisexual students. Conclusions: There is no singular protective factor or universally impactful intervention for public health. Public health initiatives should recognize intersectional identities of young people and build strategies that are relevant to specific identities to create more comprehensive and effective programing. (C) 2021 Society for Adolescent Health and Medicine. All rights reserved.