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According to a new study published in the Lancet, adolescents who identified as sexual minorities (LGBQ - lesbian, gay, bisexual, questioning) at 16 years of age were at an increased risk of depression compared to heterosexuals from very early on in adolescence, even as young as ten years of age. The results of the study point to potential mental-health problems before a teen’s conscious identification of their sexual orientation.

“There is not enough research on the mental health of LGBQ young people,” study author Gemma Lewis told us. “Importantly,  there is not enough research tracking the mental health of LGBQ young people over time (longitudinally). Most studies use datasets restricted to one point in time (cross-sectional surveys).”

The theory researchers based their study on is called the ‘minority stress theory’ which explains that sexual minority groups experience more stressful life experiences than heterosexuals, resulting from stigma, discrimination and prejudice.

Lewis and her colleagues tracked 4828 adolescents born between April 1, 1991 and December 31, 1992. They looked at symptoms of depression in LGBQ adolescents compared to heterosexuals, from early adolescence (ten years of age) to early adulthood (21 years of age). They looked at recent self-harm in the past year at ages 16 and 21. 

“We used data from a large sample of children born in 1990 in the South West of the UK,” Lewis told us. “This study followed the children over the course of their lives and collected multiple sources of information on their health and development.”

A recent survey found that in the UK, there are approximately nine million gay, bisexual and lesbian people. In the U.S., a Gallup poll found that 4.5 per cent of adults identified as lesbian, gay, bisexual or transgender. According to the Center for Disease Control and Prevention, nearly eight per cent of adolescents aged 18 to 19 identify as being bisexual or gay. 

Lewis says the results of her study are concerning given that these young people have lived through a period when same-sex relationships have been increasingly accepted by society.

“We know that depression symptoms increase during adolescence anyway, but in sexual minority teenagers, depression symptoms increase at a faster rate compared to the heterosexual population,” Lewis told us. “Sexual-minority adolescents persistently experience more depression and self-harm than heterosexuals throughout their school years, and these mental-health problems persist until young adulthood (21 years of age).”

Lewis says the findings suggest that clinicians who encounter young people, whether in primary or secondary care, sexual health services, the emergency department, or as school nurses, should be mindful about sexuality in considering the wider context for depressive symptoms or self-harm. 

“Clinicians should use language and questions that reflect openness about sexuality, and not assume heterosexuality,” Lewis told us. “In gaining a history of the problem clinicians should be aware that a young person who identifies as not exclusively heterosexual may have struggled with mental health problems from very early on in adolescence. From a preventive perspective, public health practitioners should consider how to address heteronormative environments in schools, healthcare settings, and society at large, so that young people who are becoming aware of their sexuality or coming out feel more accepted by their peers, teachers and other professionals around them and have a more positive experience during a critical period of social, emotional and vocational development.”