title: Growing Up With the Right to Marry: Sexual Attraction, Substance Use, and Well-Being of Dutch Adolescents.
abstract: To assess the well-being and substance use of sexual minority adolescents growing up in a tolerant society, we examined differences among same-sex attracted (SSA), those who do not know their attraction yet (not yet attracted [NYA]), and heterosexual Dutch adolescents.
  
  
  
  Unadjusted and adjusted logistic and linear multilevel analyses were performed using representative data of the 2013 Health Behaviour in School-Aged Children study (N = 5,995; 11-16 years old). The adjusted analyses controlled for sociodemographics (gender, age, education type, ethnicity, urbanicity, and religion).
  
  
  
  Adjusted results showed that SSA adolescents substantially more often reported alcohol use (adjusted odds ratio [AOR] = 2.01), tobacco smoking (AOR = 2.37), and cannabis smoking (AOR = 3.52) than their heterosexual peers, while NYA participants less often reported alcohol use (AOR = .57) and equal levels of tobacco (AOR = .71) and cannabis smoking (AOR = .87) compared with heterosexual adolescents. SSA adolescents reported lower levels of life satisfaction (b = -1.25) and higher levels of psychosomatic complaints (b = .61) and emotional problems (b = 1.57) than heterosexual adolescents. NYA adolescents reported equal levels of life satisfaction (b = -.18) and psychosomatic complaints (b = .06) as heterosexual adolescents, but higher levels of emotional problems (b = .51).
  
  
  
  In Dutch society, with over 20 years of inclusive policies for sexual minorities and generally tolerant population attitudes toward sexual minorities, SSA adolescents are still at increased risk of substance use and have lower levels of well-being compared with peers.
authors.affiliation: Department of Education, Minorities and Methodology, The Netherlands Institute for Social Research, The Hague, The Netherlands; Research Institute of Child Development and Education, Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: l.kuyper@scp.nl.
authors.forename: Lisette
authors.initials: L
authors.lastname: Kuyper
authors.affiliation: Department of Care, Emancipation, and Time Use, The Netherlands Institute for Social Research, The Hague, The Netherlands.
authors.forename: Simone
authors.initials: S
authors.lastname: de Roos
authors.affiliation: Department of Education, Minorities and Methodology, The Netherlands Institute for Social Research, The Hague, The Netherlands.
authors.forename: Jurjen
authors.initials: J
authors.lastname: Iedema
authors.affiliation: Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands.
authors.forename: Gonneke
authors.initials: G
authors.lastname: Stevens
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology*; D002648:Child; D000073865:Cigarette Smoking / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D020010:Heterosexuality / Q000523:psychology*; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology*; D008393:Marriage / Q000331:legislation & jurisprudence; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D057566:Self Report; D000072339:Sexual and Gender Minorities / Q000523:psychology / Q000706:statistics & numerical data*
keywords: Bisexual; Gay; Lesbian; Mental health; Questioning; Same-sex attracted; Sexual minority; Substance use; Well-being