Diverse Sexual and Gender Identity, Bullying, and Depression Among Adolescents

OBJECTIVES: To estimate the prevalence of diverse sexual orientations and gender identities in a statewide surveillance survey of adolescents and examine how experiences of bias-based bullying and depressive symptoms vary. METHODS: Data come from 8th, 9th, and 11th-grade students participating in the 2019 Minnesota Student Survey (N = 124778). We examined the prevalence of sexual and gender identities and used multifactor analysis of variance models to understand experiences with sexual orientation- and gender-based bullying and depression across sexual and gender identities. RESULTS: Among 9th and 11th graders, 9.4% identified as lesbian, gay, bisexual, queer, or pansexual (1.7% pansexual, 0.4% queer). Among 8th, 9th, and 11th graders, 1.4% were transgender, genderqueer, or genderfluid, with almost half of those identifying as nonbinary; 2.1% were unsure of their gender identity. Rates of depressive symptoms were highest among pansexual students compared to other sexual orientations and among nonbinary and transmasculine youth who identified their sex as female. Rates of depression and bias-based bullying for youth who did not identify their sexual orientation as 1 of the response options were comparable to straight youth or those who did not understand the question. CONCLUSIONS: Findings provide strong support for the inclusion of a broader set of sexual and gender identity response options in epidemiologic surveys and patient forms. Pansexual and queer youth and transmasculine and nonbinary youth whose sex is female carry a particularly high burden of bias and discrimination, and clinicians should screen for additional services and supports these youth may need to thrive.