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Few societal attitudes and opinions have changed as quickly as those regarding sexual minority people and rights. In the context of dramatic social change, there have been multiple policy changes toward social inclusion and rights for lesbian, gay, and bisexual (LGB) people, and perceptions that the sociocultural context for LGB people—perhaps particularly for youth—has improved. Yet recent evidence from the developmental sciences points to paradoxical findings: in many cases there have been growing rather than shrinking health disparities. The authors suggest that there is a developmental collision between normative adolescent developmental processes and sexual minority youth identities and visibility.

In the United States, sexual minority (SM) status is associated with a number of health disparities. Based on mounting evidence, stigma and discrimination have been cited as key barriers to health equity for this population. We estimated the prevalence of three types of discrimination as a function of age among SM adults from the National Epidemiological Study of Alcohol Use and Related Conditions III (NESARC-III) (2012–2013). Among SM adults, reports of past-year general discrimination, victimization, and healthcare discrimination varied by age, with peaks in early adulthood and again in midlife. Age trends varied by biological sex, with males experiencing significantly more general discrimination, victimization, and healthcare discrimination at specific ages. Age trends also varied by sexual identity, as LGB-identifying SMs were significantly more likely to experience all forms of discrimination across all ages. Policies preventing homophobic discrimination and victimization are necessary given the pervasiveness of these experiences across adulthood.

Abstract Purpose: The purpose of this study was to assess sexual orientation differences in high-intensity binge drinking using nationally representative data. Methods: Data were from the National Epidemiologic Survey on Alcohol and Related Conditions III (N = 36,309), a nationally representative sample of U.S. adults collected in 2012–2013. Sex-stratified adjusted logistic regression models were used to test sexual orientation differences in the prevalence of standard (4+ for women and 5+ for men) and high-intensity binge drinking (8+ and 12+ for women; 10+ and 15+ for men) across three dimensions of sexual orientation: sexual attraction, sexual behavior, and sexual identity. Results: Sexual minority women, whether defined on the basis of sexual attraction, behavior, or identity, were more likely than sexual majority women to engage in high-intensity binge drinking at two (adjusted odds ratios [aORs] ranging from 1.52 to 2.90) and three (aORs ranging from 1.61 to 3.27) times the standard cutoff for women (4+). Sexual minority men, depending on sexual orientation dimension, were equally or less likely than sexual majority men to engage in high-intensity binge drinking. Conclusion: This study is the first to document sexual orientation-related disparities in high-intensity binge drinking among adults in the United States using nationally representative data. The results suggest that differences in alcohol-related risk among sexual minority individuals vary depending on sex and sexual orientation dimension.

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