504 - Sexual Orientation among Gender-Diverse Youth

Poster Number: 504
Publication Number: 504.100

Nicholas Szoko, UPMC Childrens Hospital of Pittsburgh, Pittsburgh, PA, United States; Gina Sequeira, Seattle Children's, Seattle, WA, United States; Robert Coulter, University of Pittsburgh, Pittsburgh, PA, United States; Kacie M. Kidd, West Virginia University School of Medicine, Morgantown, WV, United States

Background: Many youth identify as gender-diverse (GDY). Providing comprehensive sexual/reproductive healthcare to GDY remains a national focus; however, our understanding of sexuality among GDY is limited.

Objective: We sought to compare sexual identity, attraction, and contact between cisgender youth and GDY and to describe these characteristics across GDY subgroups.

Design/Methods: We analyzed cross-sectional data from school-based surveys administered to 4,207 high school students in Pittsburgh, PA. A two-step gender identity question was used to identify GDY. Youth indicated their sexual identity as: asexual, bisexual, gay/lesbian, heterosexual, mostly heterosexual, queer, or not sure (marking all that apply). We considered sexual minority youth (SMY) those who selected response(s) aside from only heterosexual. Sexual attraction and contact were assessed by asking respondents “Who are you sexually attracted to?” and “During your life, with whom have you had sexual contact?” Response options included boys, girls, and several gender-diverse identities (marking all that apply). Participants with responses for gender identity and sexual orientation measures were included in analyses (Nf3,091; 73% of all respondents). Two-sample t-tests or chi-square tests were used to compare characteristics between GDY and cisgender youth. Sexual attraction and contact were summarized with frequencies/proportions and stratified by transmasculine, transfeminine, and non-binary identities.

Results: 281 (9.1%) youth identified as GDY (Table 1). Among GDY, mean age was 15.6±1.4 years. 47.7% were assigned female sex at birth. 32.0% were non-Hispanic Black, 30.9% were non-Hispanic White, and 32.4% endorsed other racial/ethnic identities. Compared to cisgender peers, GDY were more likely to be SMY and to report attraction to other GDY. 31.2% of GDY identified as transmasculine, 37.1% as transfeminine, and 30.5% as non-binary (Table 2). Many transmasculine (44%) and transfeminine (58%) youth were heterosexual, whereas most non-binary youth (85%) were SMY. For heterosexual transgender youth, sexual attraction/contact varied. For example, heterosexual transmasculine youth reported attraction to boys (53%) and girls (43%) at similar frequencies. Many GDY who identified as SMY reported attraction to other GDY.Conclusion(s): Most GDY in our sample were SMY; however, many transmasculine/transfeminine youth were heterosexual with attraction to people of the same gender. Our results show the complexity of sexuality among GDY and highlight the importance of an individualized approach to sexual/reproductive healthcare in this population.
Szoko CV 2021Szoko CV 2021 Pitt Format.pdf
Table 2Sexual Attraction and Contact by Self-Reported Sexual Identity among Gender-Diverse Youth