Results: Changes in Risk Factors Over Time

Risk factors are experiences that can negatively affect the health and well-being of LGBTQ+ young people. In this section, we track key risk exposures reported over the first year of the study, including victimization, discrimination, exposure to or threats of conversion therapy, and economic insecurity (such as houselessness or not being able to meet basic needs).

Victimization

Baseline characteristics: At baseline, 31% of the sample reported being physically threatened because of their sexual orientation in the last year. This differed across age; youth ages 13-17 were more likely to report an experience of being physically threatened (36%) than those who were 18-24 (27%). There were differences across sexual orientation as well, with gay (41%) and lesbian (34%) respondents reporting the highest rates.  Reports of threats based on sexual orientation by gender were highest among cisgender boys/men (38%), gender-questioning individuals (32%), and transgender girls/women (31%). There were also differences by race/ethnicity, with Indigenous/Native (48%) and Black/African American (37%) participants reporting the most sexual orientation-based victimization.

Among TGNB participants, 43% reported being physically threatened because of their gender identity in the last year. There were differences by sexual orientation and gender identity: queer (51%), gay (46%) and bisexual (46%) respondents reported higher rates than other sexual orientation groups. Transgender girls/women (57%) and transgender boys/men (56%) reported the highest rates overall. Gender identity-based victimization did not differ by age or race/ethnicity.

Changes over time: In the year following the start of the study, 32% of participants reported being physically threatened because of their sexual orientation in the past year, and 42% of TGNB participants reported being physically threatened because of their gender identity. Neither of these rates were statistically different from the rates reported at baseline.

Discrimination

Baseline characteristics: At baseline, 55% of the sample reported being discriminated against because of their sexual orientation in the last year. Participants ages 13-17 were more likely to report an experience of discrimination based on sexual orientation than those ages 18-24 (63% vs. 50%). There were differences across sexual orientation, with gay (75%) and lesbian (68%) participants reporting the highest rates compared to other sexual orientation groups. By gender identity, cisgender boys/men (73%) and cisgender girls/women (58%) reported the highest rates of discrimination on the basis of sexual orientation. By race/ethnicity, Black/African American (72%) and Indigenous/Native (65%) participants were most likely to report being discriminated against because of their sexual orientation compared to any other race/ethnicity.

Among TGNB participants, 62% reported discrimination based on gender identity in the last year at baseline. Rates varied by gender identity, with transgender boys/men (73%) and transgender girls/women (69%) reporting the highest rates of discrimination. There were also differences by sexual orientation, with queer (75%) and asexual (73%) respondents being more likely to report an experience of discrimination based on gender identity. There were no differences by age or race/ethnicity.

Changes over time: One year after baseline, 54% of participants reported experiencing discrimination based on their sexual orientation, and 67% of TGNB participants reported experiencing discrimination based on gender identity. Neither rate, however, was statistically different from that reported at the beginning of the study.

Conversion Therapy

Baseline characteristics: Conversion therapy refers to any threat or attempt to change a young person’s sexual orientation or gender identity. At baseline, 11% of respondents reported ever being threatened with conversion therapy, and 9% reported ever being subjected to conversion therapy. Threats differed by age: LGBTQ+ young people ages 13-17 (12%) were more likely to report ever being threatened with conversion therapy than those ages 18-24 (10%). Conversely, LGBTQ+ young people ages 18-24 (10%) were more likely to report ever being subjected to conversion therapy than those ages 13-17 (6%). Threats of conversion therapy also differed by race/ethnicity: Middle Eastern/North African (19%) and Hispanic/Latinx (16%) participants reported the highest threat levels. Actual conversion therapy exposure was greatest among Indigenous/Native (15%) and Black/African American (13%) participants. By sexual orientation, gay (13%) and lesbian (16%) respondents were more likely than their peers to report ever being threatened with conversion therapy; gay (24%) and lesbian (21%) participants were also most likely to report being subjected to conversion therapy in the past. There were no differences by gender identity.

Changes over time: One year after baseline, 22% of participants reported having ever been threatened with conversion therapy – double the baseline figure (11%). Reports of ever having been subjected to conversion therapy rose too, from 9% at baseline to 15% a year later.

Economic Security

Economic security — defined here as houselessness and difficulty meeting basic needs such as food, housing, or clothing — showed the following patterns.

Houselessness

Baseline characteristics: At baseline, 21% of the sample reported currently being houseless or having experienced houselessness in the past. This differed across age, with those 18-24 (25%) being more likely to report houselessness either currently or in the past than those who were 13-17 (17%). There were also differences across race/ethnicity, with Hispanic/Latinx (27%) and Black/African American (25%) respondents being more likely to report this than any other race/ethnicity. There were no differences by sexual orientation or gender identity.

Changes over time: One year after baseline, 10% of participants reported an experience of houselessness in the past 12 months. This rate was notably higher for those who reported a history of houselessness at baseline compared to those who had not (29% vs. 5%).

Unmet basic needs

Baseline characteristics: At baseline, 14% of participants reported that they could not meet their basic needs. This differed across age: participants ages 18-24 (17%) were more likely to report being unable to meet their basic needs than those who were 13-17 (10%). There were differences across sexual orientation as well, with pansexual (23%) and questioning (22%) participants being more likely to report being unable to meet basic needs than other sexual orientation groups. Differences also emerged by race/ethnicity: Indigenous/Native (29%) and multiracial (19%) participants were the most likely to report being unable to meet basic needs. By gender identity, TGNB respondents (18%) were more likely to report being unable to meet their basic needs than cisgender respondents (9%); transgender boys/men (19%) and nonbinary (18%) respondents were more likely to report being unable to meet basic needs than participants of other gender identities.

Changes over time: More than one in five (21%) participants reported being unable to meet their basic needs at some point during the year after baseline, a statistically significant increase compared to the 14% who reported being unable to meet their basic needs when the study began.