Soc Psychiatry Psychiatr Epidemiol. 2025 Oct 22. doi: 10.1007/s00127-025-03010-2. Online ahead of print.
ABSTRACT
PURPOSE: Mental health disparities in sexual minority adolescents have emerged as public health concerns worldwide. This study aimed to investigate the prevalence of sexual minorities and its association with mental health problems among Chinese adolescents, and explored sex difference and the role of social support in the foregoing associations.
METHODS: A total of 66,812 adolescents were included from eight provinces via a multi-stage, stratified cluster, random sampling method in 2021. Sampling weights were used to estimate the prevalence, and propensity score-weighted multivariable logistic regression models were conducted in the analyses. Stratified analyses by sex and social support were also conducted.
RESULTS: Of the total sample, the mean (SD) age was 14.9 (1.8) years, with 33,206 boys (52.4%) and 33,721 girls (47.6%). The weighted prevalence of adolescents who identified as heterosexual, homosexual, bisexual and unsure was 80.4%, 2.0%, 9.1% and 8.5%, respectively. Compared with heterosexual, homosexual adolescents were associated with higher odds of depressive symptoms (propensity score-weighted [PSW] adjusted odds ratio [AOR], 2.64; 95% CI, 2.17-3.22), anxiety symptoms (PSW AOR, 1.88; 95% CI, 1.55-2.29), non-suicidal self-injury (PSW AOR, 1.83, 95% CI, 1.55-2.17), suicidal ideation (PSW AOR, 2.34; 95% CI, 1.98-2.77), and suicidal attempt (PSW AOR, 2.39, 95% CI, 1.93-2.98). Sex-stratified analyses showed stronger associations between sexual minority status and most mental health problems for boys than for girls. Sexual minority adolescents with low social support were associated with poorer mental health compared to those with high social support.
CONCLUSION: Homosexual and bisexual adolescents experienced poorer mental health status than their heterosexual peers, with homosexual adolescents showing slightly stronger associations with mental health risks than bisexual adolescents. More support from family, school and society are recommended to improve the well-being of sexual minority adolescents.
PMID:41125936 | DOI:10.1007/s00127-025-03010-2
