One-third of adolescents who are first-time offenders identify as LGBTQ
Adolescents who identify as a sexual minority made up almost one-third of first-time, court-involved, nonincarcerated youth, researchers reported. Depression, self-harm and alcohol and drug use are also more frequently reported among the cohort, according to recently published study results.
“Because the vast majority of adolescents involved in justice system live in the community, many pediatricians are likely to interact with these youth in their clinical practice,” Matthew E. Hirschtritt, MD, MPH, a clinical fellow in the department of psychiatry and the Weill Institute for Neurosciences at University of California San Francisco, told Infectious Diseases in Children. “Court-involved, nonincarcerated (CINI) adolescents are at higher risk than their non-court-involved peers for high-risk sexual behavior, alcohol and illicit drug use, and more severe mental health issues.”
Hirschtritt and colleagues used data from Epidemiologic Study Involving Children in the Court, which included a cohort of 423 first-time CINI adolescents (mean age, 14.6 years; 46% female) who were recruited from a family court system. The researchers compared sexual minority and nonsexual minority adolescents for demographic and behavioral health characteristics.
The researchers reported that 133 adolescents (31.4%) reported as a sexual minority, by choosing one of five criteria;
- nongender binary or choosing “other” for gender;
- previous sexual behavior with a person of the same sex;
- sexual attraction to people with the same sex;
- nonheterosexual sexual orientation, including undecided or questioning orientation; or
- victim of sexual orientation or gender identity-based victimization, including having been kicked out their home or bullied because of gender expression or sexual orientation in the prior year.
Eighty-one adolescents (19.6%) identified as having a nonheterosexual orientation, including gay, lesbian or bisexual.
The adolescents who identified as a sexual minority were more likely to identify as female (71.5% vs. 34.6%, P < .001), to have used psychiatric services (82.7% vs. 65.9%; P = .002) or have been prescribed psychotropic medication (46.6% vs. 30%; P = .003), and to report lifetime use of alcohol (46.6% vs. 26.6%; P < .001) and cannabis (59.9% vs. 44/3%; P = .009) compared with nonsexual minority adolescents. Adolescents who identified as a sexual minority were also more likely to report more severe mental health problems (24.8% vs. 10.5%; P = .001) and inattention/hyperactivity (22.7% vs. 12%; P = .012), more post-traumatic symptoms (P = .001), and to have engaged in self-harm (46.5% vs. 12.6%; P < .001).
Sexual minority and nonsexual minority adolescents reported similar rates of lifetime sexual behavior (45.9 vs. 37.5%) and sexual behavior in the prior 4 months (33.8% vs. 28%). School performance or delinquent behavior characteristics did not differ between the two cohorts, either.
“Our study adds to this growing literature to suggest that LGBTQ CINI are at even higher risk for hazardous behaviors and mental health issues,” Hirschtritt said. “Our study results may prompt pediatricians to proactively screen their patients for justice involvement (for instance, if they’re on probation or have been charged with an offense) and LGBTQ status to offer tailored drug use, sexual health and mental health counseling and treatment for this particularly vulnerable population.” – by Bruce Thiel
Disclosures: The authors report no relevant financial disclosures.