Bisexual Adolescents Had Nearly Double the Odds of Marijuana Use Compared to Heterosexual Peers

Among 10,361 adolescents aged 12-17, 11.2% reported past-year marijuana use. Bisexual youth had significantly higher odds of marijuana use (OR=1.85) compared to heterosexual youth. Gay/lesbian youth did not have significantly higher marijuana use odds. The disparities varied by sex and age group, with the substance use gap between bisexual and heterosexual youth being particularly pronounced.

Secondary analysis of the 2023 National Survey on Drug Use and Health (N=10,361 youth aged 12-17). Weighted logistic regression examined relationships between sexual orientation and past-year substance use (tobacco, marijuana, alcohol), stratified by age and sex assigned at birth.

Bisexual adolescents face distinct stressors from both heterosexual and gay/lesbian peers, including identity invalidation and dual discrimination. Understanding that these stressors correlate with significantly higher marijuana use can guide targeted prevention that addresses root causes rather than just substance use.

Prevention programs typically treat LGBTQ+ youth as a single group, but this data shows bisexual youth have distinctly different risk profiles from gay/lesbian youth for substance use, requiring tailored approaches.

Cross-sectional design cannot establish causation. Self-reported sexual orientation among 12-17 year olds may be unstable or underreported. Single-year survey data. Cannot assess frequency or quantity of use beyond past-year prevalence.