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BACKGROUND: Preliminary evidence suggests that sexual minority (e.g. lesbian, gay, bisexual, and same-sex attracted) youth are overrepresented in child welfare services. Yet, no study to date has been able to test this hypothesis with national data. OBJECTIVE: Using a two-study design, we test whether sexual minority youth are overrepresented in child welfare, foster care, and out-of-home placement using nationally representative data from the United States. PARTICIPANTS AND SETTING: Study 1 data are from the National Longitudinal Study of Adolescent to Adult Health (n = 14,154; Mean age = 15.4). Study 2 data are from wave three of the National Survey of Child and Adolescent Well-Being II (n = 1309; Mean age = 15.0). METHODS: For Study 1, we use adjusted logistic regression models to test differences in lifetime foster care involvement between sexual minority and heterosexual youth. In Study 2, we calculate a Disproportionality Representation Index (DRI) - a ratio of sample prevalence relative to the general population - to estimate whether sexual minority youth were overrepresented in child welfare and out-of-home care. RESULTS: Study 1 results indicate that sexual minority youth are nearly 2.5 times as likely as heterosexual youth to experience foster care placement (aOR = 2.43, 95% CI 1.40, 4.21, p = .002). Results from Study 2 show that sexual minority youth were largely overrepresented in child welfare services (DRI = 1.95-2.48) and out-of-home placement (DRI = 3.69-4.68). CONCLUSIONS: Findings are the first to demonstrate sexual minority youth's overrepresentation in child welfare, foster care, and out-of-home placement using nationally representative data and emphasizes the need for focused research on sexual minority youth involved in the child welfare system.

Purpose:  Sexual minorities experience signi fi cant health disparities across a variety of mental, behav ioral, and physical health indicators. Yet, an understanding of the etiology and progression of sexual minority health disparities across the lifespan is limited. Methods:  We used the U.S. National Epidemiologic Survey of Alcohol and Related Conditions III to  evaluate the association between sexual minority status and seven past-year health outcomes (alcohol  use disorder, tobacco use disorder, drug use disorder, major depressive episode, generalized anxiety  disorder, sexually transmitted infection, and cardiovascular conditions). To do this, we used unadjusted  and adjusted logistic regression among our study sample (n ¼ 30,999; aged 18 e 65 years) and time- varying effect models to evaluate how sexual orientation differences in these outcomes vary across  adulthood. Results:  Relative to heterosexuals, sexual minorities had elevated odds of past-year alcohol use disorder  and drug use disorder across all ages (18 e 65 years) although the magnitude of the disparity varies by  age. Sexual minorities were also more likely to experience major depressive episode, generalized anxiety  disorder, tobacco use disorder, sexually transmitted infection, and cardiovascular disease, but only at  speci fi c ages. Conclusions:  Sexual minority health disparities vary appreciably across the adult lifespan, thus eluci dating critical periods for focused prevention efforts.