Bisexual young adults showed the strongest associations with both child maltreatment exposure and at-risk cannabis use compared to heterosexual peers.
Youth health researchers, LGBTQ+ health advocates, substance use prevention specialists
7.45x increased odds of intimate partner violence for youth with uncertain sexual identity
What the researchers found
In a longitudinal study of 584 Canadian emerging adults tracked from ages 14-17 to 18-23, bisexual identity was associated with increased odds of depression, anxiety, at-risk alcohol use, and at-risk cannabis use compared to heterosexual identity. Bisexual identity also had the most robust relationships with all child maltreatment outcomes.
Why it matters
Sexual minority youth, particularly those identifying as bisexual, face compounding risks of maltreatment and substance use that demand targeted prevention. Understanding these intersecting vulnerabilities helps identify who needs early intervention most.
The numbers in context
n=584 emerging adults; bisexual identity had the most robust association with at-risk cannabis use; "I don't know" sexual identity showed 7.45 increased odds of intimate partner violence exposure
How the study worked
Data from the longitudinal Well-Being and Experiences (WE) Study in Manitoba, Canada, following 584 participants from 2017 (ages 14-17) to 2022 (ages 18-23). Descriptive statistics and logistic regression models compared outcomes across sexual identity groups.
What this study cannot tell us
Single Canadian province limits generalizability. Self-reported measures of maltreatment and substance use may underestimate true rates. Relatively small sample size for subgroup analyses across multiple sexual identity categories.
How to read the evidence
Longitudinal design with structured follow-up strengthens causal inference, though moderate sample size and single-province recruitment limit generalizability.
When this study was published
2025 publication analyzing data collected 2017-2022
The bigger picture
This study adds to growing evidence that substance use risk in young people cannot be separated from experiences of identity-based adversity and trauma, reinforcing the need for prevention approaches that address root causes rather than substances alone.
Questions still open
- Do targeted maltreatment prevention programs for sexual minority youth reduce subsequent substance use risk? What protective factors buffer against at-risk cannabis use in bisexual emerging adults?
Common questions
Which sexual identity group showed the highest risk for cannabis use?
Did the study prove maltreatment causes cannabis use in sexual minorities?
Read the original research
Sexual identity, child maltreatment, mental health, and substance use among emerging adults aged 18 to 23 years.
Canadian journal of public health = Revue canadienne de sante publique, 116(5), 674-685
Citation
Afifi, Tracie O; Osorio, Ana; Fortier, Janique; Stewart-Tufescu, Ashley; Taillieu, Tamara L; McCarthy, Julie-Anne. (2025). Sexual identity, child maltreatment, mental health, and substance use among emerging adults aged 18 to 23 years.. Canadian journal of public health = Revue canadienne de sante publique, 116(5), 674-685. https://doi.org/10.17269/s41997-024-00992-5
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