Sexual orientation and diurnal cortisol patterns in a cohort of U.S. young adults

Psychoneuroendocrinology. 2016 Jul;69:197-208. doi: 10.1016/j.psyneuen.2016.04.012. Epub 2016 Apr 21.


Sexual minorities in the United States are at elevated risk of bullying, discrimination, and violence victimization, all stressors that have been linked to psychological and behavioral stress responses including depressive and anxious symptoms and substance use. Acute and chronic stressors may also elicit physiologic stress responses, including changes in the regulation of the hypothalamic-pituitary-adrenocortical (HPA) axis. Few studies, however, have examined the relationship between minority sexual orientation and diurnal cortisol patterns. The present study included 1670 young adults ages 18-32 years (69% female, 31% male) from the Growing Up Today Study, a prospective cohort of U.S. youth. Participants provided five saliva samples over one day to estimate diurnal cortisol patterns. Sexual orientation groups included: completely heterosexual with no same-sex partners (referent), completely heterosexual with same-sex partners/mostly heterosexual, and gay/lesbian/bisexual. Covariates included perceived stress and stressful life events in the past month. Sex-stratified multilevel models of log-transformed cortisol values were used to model diurnal cortisol patterns, and generalized estimating equations were used to model area under the curve (AUC), both with respect to ground (AUCg) and increase (AUCi). Among females, sexual minorities reported significantly more stressful life events in the past month than their heterosexual counterparts. In adjusted multilevel models, sexual orientation was not significantly associated with diurnal cortisol patterns or with AUCg or AUCi in either females or males. There were no significant interactions between sexual orientation and stressful life events. Time-varying negative mood was significantly associated with higher cortisol levels across the day for both female and male participants, after adjusting for all covariates. This study from a large cohort of U.S. young adults did not detect a relationship between sexual orientation and diurnal cortisol patterns. Despite consistent evidence indicating that, compared to heterosexuals, sexual minorities experience elevated exposure to multiple forms of stressors and adversity across the life course, we did not find differences in diurnal cortisol rhythms by sexual orientation. One possible explanation is that sexual minority participants in the study exhibited physiologic resilience.

Keywords: Cortisol; Diurnal rhythm; HPA axis; Sexual orientation; Stressful life events; Young adults.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Anxiety
  • Circadian Rhythm / physiology
  • Female
  • Heterosexuality / physiology
  • Heterosexuality / psychology
  • Humans
  • Hydrocortisone / analysis*
  • Hydrocortisone / metabolism
  • Hypothalamo-Hypophyseal System / physiology
  • Life Change Events
  • Longitudinal Studies
  • Male
  • Pituitary-Adrenal System / physiology
  • Prospective Studies
  • Saliva / chemistry
  • Sexual Behavior / physiology*
  • Sexual Behavior / psychology
  • United States
  • Young Adult


  • Hydrocortisone