Sheree Schrager, PhD, MS, an investigator at Children's Hospital Los Angeles, and fellow investigator, Jeremy Goldbach, PhD, of the USC Suzanne Dworak-Peck School of Social Work, have been awarded $3.7 million by the National Institute on Minority Health and Health Disparities of the NIH to study the behavioral health risks of sexual minority adolescents -those who identify as lesbian, gay or bisexual. The proposed research will study a large national sample of youth - looking across diverse areas of social context including family, school/peers, religion and racial/ethnic community - to discover how different stress triggers, over time, can set the stage for poor health outcomes such as depression, self-harm, and substance use . The findings will be used to enable the development of targeted and effective behavioral health interventions to improve health outcomes for this vulnerable population.
"Many adolescents who identify as lesbian, gay, or bisexual and pansexual struggle with challenges such as stigma, discrimination, family disapproval, social rejection, and violence," explained Schrager, who is also an investigator at California State University, Northridge. "Because of the resulting stress, many are at increased risk for poor health."
LGB youth consistently report poor health outcomes compared to their heterosexual peers. According to Schrager, the underlying causes behind these health disparities have been poorly understood and until now, there has not been a way to measure the unique stress experienced by this population.
For a previous NIH-funded study, Schrager and Goldbach recently completed the development and validation of the "Sexual Minority Adolescent Stress Inventory," which is the first tool to measure minority stress among LGB youth. In the new study, the investigators will use this tool to discover the underlying causes of stress and the resulting health risks. Following a large national sample of youth over several years, they will seek to understand how sexual minority stress changes over time, especially as adolescents age out of high school, enter the workforce or go on to college.
"We now have some fairly sophisticated analytical techniques that allow us to look at individual change over time," said Schrager. "For example, a person who experiences a lot of stress for a year and a half and then moves out of their family home or moves away from their small town and finds themselves surrounded by more like-minded peers - does their stress level go down? And what does that do to their depression, thoughts of suicide or potential desire to use illicit substances?"
In addition to studying individuals, Schrager and Goldbach will also look at groups of LGB youth within communities to learn if group trends are different. For instance, bisexual youth tend to have higher rates of alcohol use and higher rates of drug use, even compared to gay and lesbian identified youth. The investigators hope to discover what unique stressors they are experiencing that same-sex attracted youth are not.
"By looking at individual and group experiences across racial and ethnic lines, age and gender, and even rural versus urban communities, we hope to enable the design of effective intervention programs to improve health outcomes for sexual minority youth," added Schrager.