1. Female sexual minorities, such as those identifying as lesbian or bisexual, were at increased risk of experiencing teen pregnancy when compared to their heterosexual peers.
2. The increased rate of teen pregnancy in sexual minorities was associated with increased rates of childhood maltreatment and bullying, as well as earlier age of identifying as a sexual minority.
Evidence Rating Level: 1 (Excellent)
Study Rundown: Though previous studies reveal higher rates of teen pregnancy among sexual minorities, little research has explored the specific risk factors sexual minorities experience that put them at risk for teen pregnancy. In this study, researchers examined established risk factors for teen pregnancy and compared the rate of these risk factors in sexual minorities to those in a similar heterosexual cohort. The study results confirmed the previously-elucidated increased rate of teen pregnancy among sexual minorities, as well as clarified several specific risk factors associated with teen pregnancy in the sexual minority population, including childhood maltreatment and bullying victimization or perpetration. Additionally, earlier identification of self as a sexual minority was associated with an increased risk for teen pregnancy. Though the study is limited in its generalizability given study participants were largely white and from a higher socioeconomic class, the findings provided more nuance than previous studies into the influence of various risk factors, such as both bullying victimization and perpetration. Moreover, the findings provide a launching point for more targeted interventions aimed at preventing teen pregnancy in this high-risk population.
In-Depth [prospective cohort]: Researchers utilized data from The Growing Up Today Study (GUTS), a longitudinal study beginning in 1996 which enrolled children ages 9 to 14 whose mothers had participated in the Nurses’ Health Study 2. Of the 27 793 children enrolled, researchers studied only the 7970 who responded to questions regarding their sexual orientation and about suspected risk factors. The risk factors assessed included childhood maltreatment, bullying victimization or perpetration, gender nonconformity of all subjects. Additionally, researched evaluated sexual minority milestone development – or age at which sexual minorities first identified themselves as such – sexual orientation-related stress, sexual minority outness, and LGB social activity involvement in the sexual minority portion of the cohort. A total of 2% (N=166) of participants had a teen pregnancy. Completely heterosexual teenagers with no same-sex partners had no increased risk of teen pregnancy when compared to the reference group (RR: 1.51; 95% CI: 0.58– 4.03). Mostly heterosexuals (RR: 1.78; 95% CI: 1.18–2.69) and lesbians (RR: 2.37; 95% CI: 0.76–7.37) had almost double the risk, while bisexuals (RR: 4.67; 95% CI: 2.74–7.97) had an increased risk nearly five times that of the reference group. Childhood sexual abuse (RR: 2.97, 95% CI: 1.52-5.79) and bully victimization or perpetration (RR: 1.98, 95% CI: 1.09-3.62) were both associated with increased risk of teen pregnancy in the sexual minority population, as was earlier sexual minority milestone development (RR 5.67, 95% CI 1/30 – 24.82).