Sexual and Gender Minority Youth’s Mental Health and Substance Use: Disparities, Mechanisms, and Protective Factors

This dissertation presents eight studies that aimed to better understand the poorer mental health and higher substance use among sexual and gender minority youth. Studies (1) improve our understanding of sexual and gender identity-based health disparities, (2) investigated driving these health disparities, and (3) examined protective factors against these health disparities. First, studies on disparities evidenced that mental health and substance use disparities between sexual and gender minority and heterosexual, cisgender youth are persistent. Thus, despite increasing societal acceptance of sexual and gender diversity, sexual and gender minority youth remain a vulnerable group. This stresses the importance of research that monitors and explains health disparities. Second, studies on mechanisms showed how stigma-related processes can contribute to poorer health among sexual and gender minority youth. Research should, however, explore other possible mechanisms that can explain poorer health outcomes among sexual and gender minority youth besides stigma-related mechanisms. Last, research that examined protective factors found that interpersonal but not structural protective factors attenuated the negative effects of stigma on health outcomes. Empirical research should further investigate which protective factors at different levels (e.g., personal, interpersonal, and structural) contribute to a better health of sexual and gender minority youth. Together, this dissertation provides a better understanding of the poorer mental health and higher substance use among sexual and gender minority youth.