Transcript Using LGB Data from the Oregon Healthy Teens Survey to

Using Lesbian, Gay, Bisexual
Youth Data from the
Oregon Healthy Teens Survey
to Address Health Inequities
Molly Franks, MPH
Oregon Public Health Division
[email protected]
April 2008
Purpose
Use 2007 Oregon Healthy Teens (OHT)
data to:
o Discuss key issues in
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Data collection
Analysis
Interpretation
Use
o Address health issues faced by
lesbian, gay, bisexual, transgender
and questioning (LGBTQ) youth.
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Question #1: Sexual orientation
Which of the following best describes you?
Females
Males
Total
90.1%
95.3%
92.6%
Gay or Lesbian
1.3%
1.4%
1.3%
Bisexual
6.1%
1.7%
4%
Not sure
2.5%
1.5%
2%
100%
(n=2855)
100%
(n=2705)
100%
(n=5560)
Heterosexual
Total
2007 Oregon Healthy Teen Survey, 11th grade data
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Question #2: Sexual contact
During your life, with whom have you had sexual contact?
I have never had sexual contact
Females
Males
Both males and females
Total
2007 Oregon Healthy Teen Survey, 11th grade data
Females
Males
39.9%
37.8%
3.5%
56.6%
49.5%
3.4%
7%
2.2%
100%
(n=2852)
100%
(n=2696)
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Adding them all up…
Sexual Orientation/Sexual Behavior
% of Total
Heterosexual ID
(No same-sex contact)
88.1%
Lesbian, Gay, or Bisexual ID
(With or without same-sex contact)
5.3%
Same-sex contact
(Hetero or Not sure ID)
5.0%
Not sure
(No same sex contact)
1.6%
Total
2007 Oregon Healthy Teen Survey, 11th grade data
100.0%
(n=5560)
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Sexuality data collection issues
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Lack of LGBTQ data limits understanding
and ability to improve public health
interventions
Presence and content of questions reflect
current thinking about sexuality
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Negative vs. positive focus of questions

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Discomfort discussing sexuality openly
Changing language/concepts – e.g. queer,
trans
Increasing acceptance of LGB experience
Risks vs. strengths/what helps people succeed
Stigma/social desirability may affect how
people answer
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Data analysis issues

Making generalizations based on a
sample
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Sampling frame
Sampling strategy
Sample size
Weighting
Prevalence of specific subgroups
Statistically significant vs. clinically
significant differences
Combining behavior and ID questions in
OHT data
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Should we combine questions?
Males only – Sexual Identity by Sexual Contact
No
sexual
contact
Heterosexual
Sexual Contact
Females
Males
Males
and
Females
Total
38.1%
58.3%
2.5%
1.0%
100% (n=2556)
3.5%
24.6%
44.7%
27.2%
100% (n=27)
Bisexual
35.2%
11.7%
13.1%
40.0%
100% (n=43)
Not sure
46.6%
39.1%
4.5%
9.8%
100% (n=47)
Gay
Both female and male Non-concordants are between, and
significantly different from, Hetero Concordants and LGB
identified youth on outcomes such as: mental health,
physical health, suicide attempts, forced sex, harassment.
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Physical Health by Sexual Orientation and Gender
Mental Health Status Scale by Sexual Orientation
and Gender
Mental Health (1-6 scale)*
5
4
3
2
n=2586
n=247
n=2550
n=122
Physical Health (1-5 scale)*
5
6
4
3
2
1
n=2571
n=2600
Hetero
LGBQ
n=246
Sexual Orientation
Sexual Orientation
Reported Grades Last Year by Sexual Orientation
and Gender
Supportive Parent/Adult by Sexual Orientation
and Gender
3
2
n=221
n=2385
n=2221
n=102
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Hetero
LGBQ
Sexual Orientation
Grades Last Year (1-5 scale)*
Male
5
4
Supportive Parent/Adult (1-4 scale)*
Female
n=123
1
4
3
2
n=2314
n=2126
n=209
n=97
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Hetero
LGBQ
Sexual Orientation
*Higher values are more positive. All comparisons showed significant differences between hetero and
LGBQ identified youth on within gender comparisons, p<.01
2007 Oregon Healthy Teen Survey, 11th grade data
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Positive Youth Development Benchmark by
Sexual Orientation and Gender
% Meeting PYD Benchmark
100%
80%
60%
40%
20%
n=1660
Female
n=1549
n=102
n=49
0%
Male
Hetero
LGBQ
Sexual Orientation
LGBQ youth were significantly less likely to meet the PYD benchmark, p<.01
Ns are number of youth who meet the benchmark.
2007 Oregon Healthy Teen Survey, 11th grade data
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Female
% Reporting Harassment
in Past 30 Days
Harassment in Past 30 Days by Sexual Orientation
and Gender
80%
60%
40%
20%
n=754
n=723
n=133
n=76
0%
Hetero
Male
LGBQ
Sexual Orientation
LGBQ youth were significantly more likely to report harassment, p<.01
Ns are number of youth who report harassment.
2007 Oregon Healthy Teen Survey, 11th grade data
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Smoking in Past 30 Days by Sexual Orientation and
Gender
% Reporting Smoking in Past 30
Days
60%
Female
50%
40%
30%
20%
10%
n=409
n=388
n=80
n=31
0%
Hetero
Male
LGBQ
Sexual Orientation
LGBQ youth were significantly more likely to report smoking in the past 30 days, p<.01
Ns are number of youth who report smoking.
2007 Oregon Healthy Teen Survey, 11th grade data
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Substance abuse in past 30 days
Females
Binge
drinking
Marijuana
Other drugs
Prescription
drugs
Males
Hetero
LBQ
Hetero
GBQ
26%
25%
29%
39%
(N=634)
(N=60)
(N=702)
(N=38)
16%
31%
20%
24%
(N=403)
(N=68)
(N=440)
(N=27)
7%
17%
9%
29%
(N=128)
(N=31)
(N=169)
(N=27)
7%
15%
7%
13%
(N=155)
(N=32)
(N=160)
(N=16)
Chi-squares for cross-tabulations between substance and sexual
orientation, split by gender. Shaded pairs show significant
differences, p<.05.
2007 Oregon Healthy Teen Survey, 11th grade data
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Suicide Attempts in Past 12 Months by Sexual
Orientation and Gender
% Reporting Suicide Attempts in
Past 12 Months
30%
n=54
25%
n=26
20%
2 or more attempts
1 attempt
15%
10%
n=127
5%
n=96
0%
Hetero female
Hetero male
LGBQ female
LGBQ male
Sexual Orientation
LGBQ youth were significantly more likely to report a suicide attempt in the past 12
months, p<.001. Ns are number of youth who report any suicide attempts.
2007 Oregon Healthy Teen Survey, 11th grade data
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Ever Physically Forced to Have Sex by Sexual
Orientation and Gender
% Ever Had Intercourse
100%
80%
*
60%
*
40%
20%
n=1180
n=1133
n=136
n=57
0%
% Ever Physically Forced to
Have Sex
Ever Had Intercourse by Sexual Orientation and
Gender
40%
30%
*
10%
*
**
n=212
LGBQ
Hetero
Sexual Orientation
LGBQ
Physically Hurt by Intimate Partner in Past 12 Months by
Sexual Orientation and Gender
40%
20%
% Physically Hurt by Intimate
Partner
% Drank/Used Drugs Before Last
Sex
n=20
Sexual Orientation
Drank or Used Drugs Before Last Sex by Sexual
Orientation and Gender
Male
n=48
n=59
0%
Hetero
Female
**
20%
30%
20%
10%
n=228
n=256
n=24
n=16
0%
Hetero
LGBQ
Sexual Orientation
*
**
15%
10%
5%
**
*
n=137
n=142
n=35
n=22
0%
Hetero
LGBQ
Sexual Orientation
* values are significantly different from one another, and ** values are significantly
different from one another, p<.01. Ns are number of youth who report intercourse, forced
sex, drug use, and being hurt. 2007 Oregon Healthy Teen Survey, 11th grade data.
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Interpretation issues

Correlation vs. causality
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Two things happening simultaneously doesn’t mean one causes the
other
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Mediating variables
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Confounders
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An extraneous variable may be causing the effect shown
Small numbers
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A third variable may effect how dependent and independent
variables relate
Small samples may limit generalizability or statistical power
Cross-sectional sample
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Looking at only a single point in time limits ability to determine
causality
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Using OHT results - key messages
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Sexuality is fluid and difficult to categorize
with discrete labels.
Almost 12% of Oregon 11th graders
identify as LGBQ or have had same-sex
sexual contact.
It appears there are significant differences
among LGBQ youth, but small numbers
necessitate combining the groups for
analyses.
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Key messages (continued)


Many youth who challenge heterosexual
norms experience harassment and
violence and are more likely to struggle
with poor mental health, smoking and
other drug use, and unsafe sexual
behavior.
It’s important to take these problems
seriously, but we shouldn’t only dwell on
negative outcomes.
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Moving forward - recommendations
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Include positive, strengths-based indicators in data
collection and interventions.
Expand data collection, e.g., include gender identity,
focus on subgroups such as youth of color.
Combine qualitative and quantitative methodologies.
Use data to increase awareness of LGBTQ issues and
motivate action in support of LGBTQ youth.
Use data to inform policy development on a state
and local level.
Work with LGBTQ youth to develop and evaluate
targeted programs, e.g., using “youth action
research.”
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More recommendations…
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Include gender identity, sexual orientation and
same-sex sexual behavior questions on intake and
screening forms.
Support development of gay straight alliances.
Develop and systematically implement anti-bias
curricula in schools.
Include sexual orientation and gender identity in
anti-bullying policies.
Tailor drug and violence prevention programs to
meet the needs of LGBTQ youth.
Develop supportive resources for parents to increase
their support for their LGBTQ children.
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