Cross-sectional associations of gender identity and sexual orientation, with co-occurrence and clustering of health-related behaviours among British adolescents: Millennium cohort study.
Preventive medicine 2024
Ricardo LIC, Smith AD, Hesketh KR, Chavez-Ugalde Y, Lee EY, van Sluijs EMF
DOI : 10.1016/j.ypmed.2024.108084
PubMed ID : 39047953
PMCID :
URL : https://linkinghub.elsevier.com/retrieve/pii/S0091743524002391
Abstract
We examined whether gender identity and sexual orientation were associated with seven health-related behaviours, and with co-occurrence and clustering of these behaviours among British adolescents.
Millennium Cohort Study (age 17 wave) provided data on the exposures, gender identity (male, female, genderqueer) and sexual orientation (heterosexual, bisexual, gay or lesbian, or other), and seven self-reported health-related behaviours (binge drinking, drug use, no consumption of breakfast, no consumption of fruits or vegetables, physical inactivity, poor sleep, and smoking or vaping). Poisson regressions examined associations between the exposures and single behaviours (reporting prevalence ratios (PRs)); and multinomial logistic regressions were used for behavioural cumulative co-occurrence score (reporting PRs). Cluster patterns were identified using Ward's agglomerative hierarchical cluster analysis while associations with cluster membership were performed using logistic regressions (reporting odds ratios (ORs)).
Our sample included 6022 adolescents (55.4% female, 1.5% genderqueer, 11.6% non-heterosexual). Adolescents who identified as genderqueer had the highest prevalence of not eating breakfast (PR: 60.5% [95%CI 48.4-71.4]) and poor sleep (68.7% [95%CI 55.6-79.3]). Those who identified as bisexual had a higher PR of co-occurring behaviours (2.46 [95%CI 1.39-4.27]). Among the three clusters identified (1: Multiple risk behaviours; 2: Physical inactivity and binge drinking; 3: Poor diet and physical inactivity), adolescents who identified as genderqueer or other sexual orientation showed the highest prevalence in cluster 3.
Gender and sexual minority British adolescents showed a higher prevalence of risky health-related behaviours, and higher risk of co-occurring behaviours. Physical inactivity and poor diet behaviours commonly clustered together for these groups.
Lay Summary
Relationship between gender identity, sexual orientation and unhealthy behaviours in UK adolescents
Our recent study sheds light on the health challenges faced by gender and sexual minority adolescents in the UK. We looked at seven risky health behaviours: drinking alcohol, drug use, skipping breakfast, not eating fruits or veggies, being physically inactive, poor sleep, and smoking or vaping.
We found that teens who identify as genderqueer (those who don’t strictly see themselves as male or female) or are bisexual, gay, or lesbian are more likely to take part in these risky behaviours compared to their peers. For example, adolescents who identify as genderqueer are more likely to skip breakfast and have trouble sleeping. Teens who identify as bisexual are twice as likely to present five or more risky behaviours at the same time.
We also noticed that for many gender and sexual minority adolescents, poor diet and physical inactivity often go hand in hand.
These findings highlight the need to create more inclusive and supportive environments to help all teens, especially those from gender and sexual minority groups, lead healthier lives.