Elevated risk of posttraumatic stress in sexual minority youths: mediation by childhood abuse and gender nonconformity

Am J Public Health. 2012 Aug;102(8):1587-93. doi: 10.2105/AJPH.2011.300530. Epub 2012 Jun 14.


Objectives: We examined whether lifetime risk of posttraumatic stress disorder (PTSD) was elevated in sexual minority versus heterosexual youths, whether childhood abuse accounted for disparities in PTSD, and whether childhood gender nonconformity explained sexual-orientation disparities in abuse and subsequent PTSD.

Methods: We used data from a population-based study (n=9369, mean age=22.7 years) to estimate risk ratios for PTSD. We calculated the percentage of PTSD disparities by sexual orientation accounted for by childhood abuse and gender nonconformity, and the percentage of abuse disparities by sexual orientation accounted for by gender nonconformity.

Results: Sexual minorities had between 1.6 and 3.9 times greater risk of probable PTSD than heterosexuals. Child abuse victimization disparities accounted for one third to one half of PTSD disparities by sexual orientation. Higher prevalence of gender nonconformity before age 11 years partly accounted for higher prevalence of abuse exposure before age 11 years and PTSD by early adulthood in sexual minorities (range=5.2%-33.2%).

Conclusions: Clinicians, teachers, and others who work with youths should consider abuse prevention and treatment measures for gender-nonconforming children and sexual minority youths.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child Abuse / statistics & numerical data*
  • Cohort Studies
  • Female
  • Heterosexuality
  • Homosexuality
  • Homosexuality, Female
  • Humans
  • Longitudinal Studies
  • Male
  • Minority Groups*
  • Prevalence
  • Risk Factors
  • Sex Factors
  • Sexual Behavior*
  • Stress Disorders, Post-Traumatic / epidemiology*
  • United States
  • Young Adult