Elevated risk of posttraumatic stress in sexual minority youths: mediation by childhood abuse and gender nonconformity.
OBJECTIVE
We examined whether lifetime risk of posttraumatic stress disorder (PTSD) was elevated in sexual minority versus heterosexual youths, whether childhood abuse accounted for disparities in PTSD, and whether childhood gender nonconformity explained sexual-orientation disparities in abuse and subsequent PTSD.


METHODS
We used data from a population-based study (n=9369, mean age=22.7 years) to estimate risk ratios for PTSD. We calculated the percentage of PTSD disparities by sexual orientation accounted for by childhood abuse and gender nonconformity, and the percentage of abuse disparities by sexual orientation accounted for by gender nonconformity.


RESULTS
Sexual minorities had between 1.6 and 3.9 times greater risk of probable PTSD than heterosexuals. Child abuse victimization disparities accounted for one third to one half of PTSD disparities by sexual orientation. Higher prevalence of gender nonconformity before age 11 years partly accounted for higher prevalence of abuse exposure before age 11 years and PTSD by early adulthood in sexual minorities (range=5.2%-33.2%).


CONCLUSIONS
Clinicians, teachers, and others who work with youths should consider abuse prevention and treatment measures for gender-nonconforming children and sexual minority youths.
Department of Society, Human Development, and Health, Harvard School of Public Health, Division of Adolescent/Young Adult Medicine, Children's Hospital, Boston, MA 02115, USA. aroberts@hsph.harvard.edu
Andrea L
AL
Roberts
Margaret
M
Rosario
Heather L
HL
Corliss
Karestan C
KC
Koenen
S Bryn
SB
Austin
D000293:Adolescent; D000328:Adult; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D020010:Heterosexuality; D006716:Homosexuality; D018452:Homosexuality, Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008913:Minority Groups; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012725:Sexual Behavior; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014481:United States; D055815:Young Adult