Gender differences in health and risk behaviors among bisexual and homosexual adolescents

Objective: This study explored gender differences in the health and risk behaviors of 394 self-identified bisexual and homosexual adolescents who participated in an anonymous, school-based survey. Methods: Respondents included 182 girls and 212 boys; girls were significantly younger than boys (p < 0.001), so respondents were further grouped as younger (≤14 years) and older (≤15 years) for analysis. Chi-square was used to test for gender differences in health perceptions and risk behaviors. Items included general health perceptions and health care access, body image and disordered eating behaviors, sexual behaviors, alcohol use, and emotional health measures including mood, life satisfaction, and suicidal ideation and attempts. Results: Both younger and older girls were significantly more likely than their male age mates to report a history of sexual abuse, dissatisfaction with weight, a negative body image, more frequent dieting, and an earlier age at onset of sexual intercourse. Both younger and older boys were significantly more likely than girls to have a positive body image, to rate themselves as healthier than peers, to report no regular source of health care, to be sexually experienced, and to drink alcohol more often and in greater quantity; a significantly greater proportion of older boys than older girls reported alcohol use before school (19.0% vs. 3.9%; p < 0.05). No significant gender differences were found for measures of emotional health, including suicidal ideation and attempts; however, nearly 1 of 3 older boys and girls reported at least one suicide attempt. Conclusions: Gender is a substantive source of variation in health and risk behaviors among bisexual and homosexual adolescents. Health care providers should incorporate gender- specific approaches to health promotion and risk reduction with young people who self-identify as gay, lesbian, or bisexual.