CDC report finds gay, lesbian and bisexual students at greater risk for unhealthy, unsafe behaviors

Students who report being gay, lesbian or bisexual and students who report having sexual contact only with persons of the same sex or both sexes are more likely than heterosexual students and students who report having sexual contact only with the opposite sex to engage in unhealthy risk behaviors such as tobacco use, alcohol and other drug use, sexual risk behaviors, suicidal behaviors, and violence, according to a study by the Centers for Disease Control and Prevention.

“This report should be a wake-up call for families, schools and communities that we need to do a much better job of supporting these young people,” said Howell Wechsler, director of the CDC’s Division of Adolescent and School Health. “Any effort to promote adolescent health and safety must take into account the additional stressors these youth experience because of their sexual orientation, such as stigma, discrimination, and victimization.

“We are very concerned that these students face such dramatic disparities for so many different health risks.”

The report represents the first time that the federal government has conducted an analysis of such magnitude across a wide array of states, large urban school districts, and risk behaviors. Researchers analyzed data from Youth Risk Behavior Surveys conducted during 2001–2009 in seven states — Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, and Wisconsin — and six large urban school districts — Boston, Chicago, Milwaukee, New York City, San Diego, and San Francisco.

The sites collected data on high school students’ sexual identity (heterosexual, gay or lesbian, bisexual, or unsure), sex of sexual contacts (sexual contact with the opposite sex only, with the same sex only, or with both sexes), or both.

The study, “Sexual Identity, Sex of Sexual Contacts, and Health Risk Behaviors Among Students in Grades 9–12 in Selected Sites –Youth Risk Behavior Surveillance, United States, 2001–2009,” was published as a Morbidity and Mortality Weekly Report Surveillance Summary.

Findings across 76 health risks in the following 10 categories are highlighted:

— Behaviors that contribute to unintentional injuries (e.g., rarely or never wore a seat belt)

— Behaviors that contribute to violence (e.g., did not go to school because of safety concerns)

— Behaviors related to attempted suicide (e.g., made a suicide plan)

— Tobacco use (e.g., ever smoked cigarettes)

— Alcohol use (e.g., binge drinking)

— Other drug use (e.g., current marijuana use)

— Sexual behaviors (e.g., condom use)

— Dietary behaviors (e.g., ate vegetables 3 or more times per day)

— Physical activity and sedentary behaviors (e.g., physically active at least 60 minutes per day for 7 days)

— Weight management (e.g., did not eat for 24 hours or more to lose weight or to keep from gaining weight)

Across the sites that assessed sexual identity, gay or lesbian students had higher prevalence rates for 49 percent to 90 percent of all health risks measured. Specifically, gay or lesbian students had higher rates for seven of the 10 health risk categories (behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, and weight management).

Similarly, bisexual students had higher prevalence rates for 57 percent to 86 percent of all health risks measured.

They also had higher rates for eight of the 10 health risk categories (behaviors that contribute to unintentional injuries, behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, and weight management).

National, state, and local YRBSs are conducted every two years among high school students throughout the United States. The surveys monitor health risk behaviors, including unintentional injuries and violence; tobacco, alcohol, and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases, including HIV infection; unhealthy dietary behaviors; and physical inactivity.

The surveys also monitor the prevalence of obesity and asthma. Interested states and large urban school districts may add questions to measure sexual identity and the sex of sexual contacts.

Youth Risk Behavior Survey results are available at http://www.cdc.gov/yrbs.

California study reports more gay men survive cancer

More gay men reported being cancer survivors than straight men in a new study from California, according to Reuters Health news.

That suggests they may need targeted interventions to prevent cancer, the researchers said, but more studies are needed to answer lingering questions. For example, are gay men more likely to be diagnosed with cancer than straight men? Or, are they just more likely to survive if they do get cancer?

“A lack of hard data” on how sexual orientation affects the risk of cancer is “one of the biggest problems we have,” said Liz Margolies, executive director of The National LGBT Cancer Network. Margolies, who was not involved in the research, told Reuters Health, “It’s critical that we know that for funding and for program planning.”

As a step toward addressing the lack of data, researchers looked at three years of responses to the California Health Interview survey, which included more than 120,000 adults living in the state.

Among other health-related questions, participants were asked if they had ever been diagnosed with cancer and whether they identified as gay, lesbian, bisexual, or straight.

The findings are published in the journal Cancer.

Out of 51,000 men, about 3,700 said they had been diagnosed with cancer as an adult. While just over eight percent of gay men reported a history of cancer, that figure was only five percent in straight men. The disparity could not be attributed to differences in race, age, or income between gay and straight men.

About 7,300 out of 71,000 women in the study had been diagnosed with cancer, but overall cancer rates did not differ among lesbian, bisexual, and straight women.

However, among women who were cancer survivors, lesbian and bisexual women were more likely to report fair or poor health than straight women.

Ulrike Boehmer, the study’s lead author from the Boston University School of Public Health, said higher rates of human immunodeficiency virus (HIV) may be related to the increased risk of cancer in gay men, but the study couldn’t address that question specifically.

Margolies thinks there is more going on.

Gay men as a group have a bunch of risk factors for cancer,” she said.

For instance, gay men and lesbian women are more likely to smoke and abuse alcohol than straight men and women. They’re also more likely to avoid going to see their doctor for routine physicals or cancer screening, Margolies added, since healthcare providers may not all be tolerant and accepting of their identity.

“I don’t think that we’re going to get people to have early screening or see doctors except in emergencies … until they can be guaranteed a safe and welcoming experience” at the doctor’s office, she said.