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7. Mental Health and Suicide Risk Disparities among Sexual and Gender Minority Adolescents during the COVID-19 Pandemic: Findings from CDC’s Nationally-Representative COVID Experiences Surveys

      Purpose

      Sexual and gender minority (SGM) youth experience more negative mental health conditions, like depression and suicidal ideation, than cisgender and heterosexual youth. However, relatively little data exist on the COVID-19 pandemic’s effects on mental health and suicide-related disparities. Factors associated with poor mental health (e.g., physical isolation, increased time at home with parents/caregivers) changed during the pandemic and may differentially impact SGM youth. This presentation describes findings from a recent web-based, longitudinal survey of U.S. adolescents, comparing SGM to non-SGM youth across key mental health and suicide outcomes over two waves of data collected during the pandemic.

      Methods

      CDC’s Division of Adolescent and School Health contracted with NORC at the University of Chicago to conduct the longitudinal COVID Experiences Surveys, an assessment of the pandemic’s impact on the health and well-being of children and adolescents. Adolescent respondents age 13-19 were recruited using AmeriSpeak®, NORC’s probability-based survey panel representative of the U.S. household population (Wave 1: Oct-Dec 2020, n=727; Wave 2: Mar-May 2021, n=569). Respondents reporting their sexual identity as lesbian, gay, bisexual, or something else were categorized as sexual minority. Respondents reporting a gender identity different than their sex assigned at birth (e.g., assigned male at birth/identified as female, assigned female at birth/identified as male), identified as transgender, or identified as not male, female, or transgender were categorized as gender minority. Youth not identified as sexual or gender minority were categorized as non-SGM. Mental health and suicide risk were operationalized with validated measures adapted from state and local Youth Risk Behavior Surveys and the Flint Adolescent Study, including stress, mental health quality of life, symptoms of depression and anxiety, and suicide-related behaviors. Chi-square tests compared mental health and suicide outcomes across SGM status. Odds ratios (OR) and 95% confidence intervals (CI) were estimated.

      Results

      At wave 1, 12.4% adolescents identified as sexual minority and 3.6% as gender minority. Across both waves, SGM youth were more likely than non-SGM youth to report their mental health was not good half or more days in the prior two weeks (Wave 1: OR=3.08, 95% CI:1.68-5.66) (Wave 2: OR=3.20, 95%CI:1.74-5.88). SGM youth were more likely than non-SGM youth to report high or very high stress at home at wave 1 (OR=3.04, 95%CI:1.62-5.71), and at wave 2, the size of this difference increased (OR=4.57, 95%CI:2.60-8.03). At wave 1, SGM youth were likely than non-SGM youth to seriously consider attempting suicide within the last year (OR=4.62, 95%CI:2.50-8.52), and the size of this difference increased at wave 2 (OR=6.53, 95%CI:3.26-13.08).

      Conclusions

      Findings indicate that the pandemic may have exacerbated mental health and suicide related disparities between SGM and non-SGM youth, especially stress at home and suicidal ideation. Findings provide insight for mental health professionals, educators, and communities regarding the mental health needs of SGM youth during the pandemic and can inform innovative clinic-, school-, and family-level strategies among adolescents.

      Sources of Support

      Funding was provided by CDC under award 200-2019-F-06605.