Among nearly 38,000 US high school students, sexual minority females had 33% higher odds of past-month marijuana use, while sexual minority males had 30% lower odds compared to their heterosexual peers.
Public health professionals, school counselors, LGBTQ+ health advocates, and anyone interested in youth substance use disparities.
Opposite effects: 33% higher odds in girls vs 30% lower odds in boys
What the researchers found
The association between sexual minority status and marijuana use differed significantly by sex. Among females, sexual minority status was associated with 1.33 greater odds of past 30-day marijuana use. Among males, sexual minority status was associated with 0.70 lower odds. The interaction was statistically significant.
Why it matters
Assuming all sexual minority youth face the same substance use risk patterns misses important sex-based differences. These findings suggest prevention programs need to be tailored rather than treating sexual minority youth as a monolithic group.
The numbers in context
37,870 students; females: SMS OR 1.33; males: SMS OR 0.70; interaction P < 0.05; pooled from 3 YRBS cycles (2015, 2017, 2019)
How the study worked
Researchers pooled data from the 2015, 2017, and 2019 Youth Risk Behavior Surveillance surveys (n = 37,870 9th-12th graders). Interaction models and sex-stratified logistic regressions tested effect modification, adjusting for race/ethnicity, grade, tobacco use, illicit drug use, and survey year.
What this study cannot tell us
Cross-sectional self-report data. Cannot determine causation. Sexual minority status was measured by identity, not behavior or attraction. YRBS does not include non-enrolled youth.
How to read the evidence
Large nationally representative dataset pooled across three survey cycles with appropriate interaction modeling.
When this study was published
Published in 2021 using YRBS data from 2015-2019.
The bigger picture
The opposite directions of the association across sexes is striking and suggests that the social and psychological experiences of sexual minority males versus females during high school create different relationships with marijuana use.
Questions still open
- What drives the opposite patterns between sexual minority males and females? Do these sex-based differences persist into adulthood? Are there mediating factors like minority stress, social connectedness, or coping styles that explain the divergence?
Common questions
Are all sexual minority teens at higher risk for marijuana use?
How large was this study?
Read the original research
Role of sex on the relationship between sexual minority status and past 30-day marijuana use among high school students (YRBS, 2015-2019).
Addictive behaviors, 118, 106905
Citation
Mantey, Dale S; Andrew Yockey, R; Barroso, Cristina S. (2021). Role of sex on the relationship between sexual minority status and past 30-day marijuana use among high school students (YRBS, 2015-2019).. Addictive behaviors, 118, 106905. https://doi.org/10.1016/j.addbeh.2021.106905
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