Sexual Orientation Differences in Adolescent Health Care Access and Health-Promoting Physician Advice

J Adolesc Health. 2017 Nov;61(5):555-561. doi: 10.1016/j.jadohealth.2017.05.032. Epub 2017 Aug 19.


Purpose: Physician screening and advice on health-related behaviors are an integral part of adolescent health care. Sexual minority adolescents encounter more barriers to health services; yet, no prior research has examined whether they also experience disparity in physician screening and advice. We examined possible sexual orientation disparities in health care access, physician screening, and advice on six health-related behaviors.

Methods: Data were from a national sample of U.S. adolescents who participated in wave 2 of the NEXT Generation Health Study (n = 2023). Poisson regressions were conducted separately for males and females to estimate sexual orientation differences in health care access and health-related screening and advice.

Results: Compared with heterosexual males, sexual minority males were more likely to report unmet medical needs in the past year (adjusted relative risk [ARR] = 2.23) but did not differ with respect to receiving physician advice concerning health-related behaviors. Compared with heterosexual females, sexual minority females were more likely to report no routine physical checkup in the past year (ARR = 1.67) but were more likely to receive physician advice to reduce or stop drinking, smoking, drug use, increase physical activity, and improve diet (ARRs = 1.56-1.99), even after controlling for corresponding health-related behaviors. Sexual minority females were also more likely to receive advice about risk associated with sexual behavior (ARR = 1.35) and advice to avoid sexually transmitted diseases (ARR = 1.49).

Conclusions: Both sexual minority males and females experienced disparities in some aspects of health care access. Improved health-promoting advice would better serve sexual minority males.

Keywords: Diet; Gender difference; Health care; Physical activity; Physician advice; Physician screening; Sexual minority; Sexual risk behaviors; Substance use.

MeSH terms

  • Adolescent
  • Adolescent Health / statistics & numerical data*
  • Female
  • Health Services Accessibility*
  • Health Surveys
  • Humans
  • Male
  • Practice Patterns, Physicians'*
  • Sexual Behavior / psychology
  • Sexual Behavior / statistics & numerical data*
  • Sexual and Gender Minorities / psychology
  • Sexual and Gender Minorities / statistics & numerical data*
  • Sexually Transmitted Diseases / prevention & control