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Early roots of sexual-orientation health disparities: associations between sexual attraction, health and well-being in a national sample of Australian adolescents
  1. Francisco Perales,
  2. Alice Campbell
  1. Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
  1. Correspondence to Dr Francisco Perales, Institute for Social Science Research, The University of Queensland, Brisbane 4068, Queensland, Australia; f.perales{at}


Background Research documents substantial adolescent health disparities by sexual orientation, but studies are confined to a small number of countries—chiefly the USA. We provide first-time evidence of associations between sexual orientation and adolescent health/well-being in a new country—Australia. We also add to knowledge by examining health/well-being outcomes not previously analysed in national samples, considering adolescents reporting no sexual attractions, and rank-ordering sexual-orientation health disparities by magnitude.

Methods Data from an Australian national probability sample of 14/15 years old (Longitudinal Study of Australian Children, n=3318) and regression models adjusted for confounding and for multiple comparisons were used to examine the associations between sexual attraction and 30 outcomes spanning multiple domains of health/well-being—including socio-emotional functioning, health-related quality of life, depressive symptoms, health-related behaviours, social support, self-harm, suicidality, victimisation, self-concept, school belonging and global health/well-being assessments.

Results Lesbian, gay, bisexual and questioning adolescents displayed significantly worse health/well-being than their heterosexual peers in all outcomes (p<0.05). The magnitude of the disparities ranged between 0.13 and 0.75 SD, and was largest in the domains of self-harm, suicidality, peer problems and emotional problems. There were fewer differences between the heterosexual and no-attraction groups. Worse outcomes were observed among both-sex-attracted adolescents compared with same-sex-attracted adolescents, and sexual-minority girls compared with sexual-minority boys.

Conclusions Consistent with the minority stress model and recent international scholarship, sexual-minority status is an important risk factor for poor adolescent health/well-being across domains in Australia. Interventions aimed at addressing sexual-orientation health disparities within Australian adolescent populations are urgently required.

  • adolescence
  • sexual orientation
  • health disparities
  • well-being
  • Australia

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  • Contributors FP designed the study, undertook the analyses, interpreted the results, and drafted and revised the manuscript. AC undertook the analyses, interpreted the results, and drafted and revised the manuscript.

  • Funding This research was supported by an Australian Research Council Discovery Early Career Researcher Award for a project titled ’Sexual Orientation and Life Chances in Contemporary Australia’.

  • Competing interests No, there are no competing interests for any author.

  • Patient consent for publication Not Required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available.