Sexual minority youth face higher rates of child maltreatment and at-risk cannabis use
Bisexual young adults showed the strongest associations with both child maltreatment exposure and at-risk cannabis use compared to heterosexual peers.
Quick Facts
What This Study 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.
Key Numbers
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 They Did This
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.
Why This Research 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 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.
What This Study Doesn't 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.
Questions This Raises
- ?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?
Trust & Context
- Key Stat:
- 7.45x increased odds of intimate partner violence for youth with uncertain sexual identity
- Evidence Grade:
- Longitudinal design with structured follow-up strengthens causal inference, though moderate sample size and single-province recruitment limit generalizability.
- Study Age:
- 2025 publication analyzing data collected 2017-2022
- Original Title:
- Sexual identity, child maltreatment, mental health, and substance use among emerging adults aged 18 to 23 years.
- Published In:
- Canadian journal of public health = Revue canadienne de sante publique, 116(5), 674-685 (2025)
- Authors:
- Afifi, Tracie O(2), Osorio, Ana, Fortier, Janique, Stewart-Tufescu, Ashley, Taillieu, Tamara L, McCarthy, Julie-Anne
- Database ID:
- RTHC-05870
Evidence Hierarchy
Follows a group of people over time to track how outcomes develop.
What do these levels mean? →Frequently Asked Questions
Which sexual identity group showed the highest risk for cannabis use?
Bisexual identity had the most robust association with at-risk cannabis use compared to heterosexual identity, along with stronger links to depression and anxiety.
Did the study prove maltreatment causes cannabis use in sexual minorities?
No. The study found associations between sexual minority identity, maltreatment, and substance use, but the observational design cannot establish that maltreatment directly causes cannabis use.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-05870APA
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
MLA
Afifi, Tracie O, et al. "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, 2025. https://doi.org/10.17269/s41997-024-00992-5
RethinkTHC
RethinkTHC Research Database. "Sexual identity, child maltreatment, mental health, and subs..." RTHC-05870. Retrieved from https://rethinkthc.com/research/afifi-2025-sexual-identity-child-maltreatment
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.