The Effects of Gender- and Sexuality-Based Harassment on Lesbian, Gay, Bisexual, and Transgender Substance Use Disparities

Robert W.S. Coulter, Melina Bersamin, Stephen T. Russell, Christina Mair

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Purpose: We tested three competing models about whether gender- and sexuality-based harassment at school have nonindependent, additive, or interactive effects on adolescents' electronic cigarette use (i.e., vaping), cigarette smoking, alcohol use, and heavy episodic drinking (HED). We also tested whether harassment mediated substance use disparities between lesbian, gay, bisexual, transgender (LGBT) adolescents and their cisgender heterosexual peers. Methods: We analyzed cross-sectional data from the 2013–2014 California Healthy Kids Survey, including 316,766 students in grades 7, 9, and 11 from more than 1,500 middle and high schools. We used logistic regression models and interaction terms to estimate associations of past-year gender- and sexuality-based harassment at school on past-month substance use, and the Karlson-Holm-Breen method to test whether harassment mediated LGBT disparities in substance use. Results: Vaping, smoking, drinking, HED, and gender- and sexuality-based harassment were higher for transgender adolescents than for cisgender males and females, and for adolescents who were lesbian, gay, or bisexual only versus heterosexual only. Gender- and sexuality-based harassments were independently associated with greater odds of using each substance in every grade. These two types of harassment had positive interactions with each other for vaping in grade 11, smoking in grade 11, and HED in grades 9 and 11. Gender- and sexuality-based harassment significantly mediated many of the LGBT disparities in substance use. Conclusions: Gender- and sexuality-based harassment at school independently or interactively produced LGBT disparities in substance use. Reducing these types of discrimination in schools will likely mitigate these disparities.

Original languageEnglish (US)
Pages (from-to)688-700
Number of pages13
JournalJournal of Adolescent Health
Volume62
Issue number6
DOIs
StatePublished - Jun 2018

Keywords

  • Alcohol use
  • Cigarette use
  • Electronic cigarette use
  • Harassment
  • Lesbian, gay, bisexual, and transgender

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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