Mental health status of sexually diverse youth at age 23: Cross-sectional data from the Quebec Longitudinal Study of Child Development.

OBJECTIVES

Canadian population-based data show that sexually diverse youth face greater mental health challenges than their heterosexual peers. However, nuances within sexual diversity-particularly among mostly heterosexual persons-are overlooked, and psychotic-like experiences remain underexplored. We examined the mental health of sexually diverse young adults from Quebec, spanning indicators from well-being to psychotic-like experiences.

METHODS

Data were drawn from 1324 youth from the Quebec Longitudinal Study of Child Development-a representative cohort born in 1997/98 and followed up until age 23. Participants self-reported their sexual orientation and mental health across nine indicators: suicidality, depression, anxiety, binge drinking, cannabis, other drug use, psychotic-like experiences, well-being, and help-seeking. Standardized mean differences (SMD) assessed group differences, stratified by assigned sex at birth and sexual orientation.

RESULTS

A total of 324 (24.47%) youth identified as non-heterosexual. These youth reported poorer outcomes across all indicators (SMDs ranged from 0.19 for cannabis use to 0.52 for suicidality) and had higher odds of seeking psychological help (OR = 2.09, 95% CI [1.52-2.89]). Sexually diverse females reported poorer outcomes across all indicators compared to heterosexual females. Sexually diverse males had elevated risks for suicidality, depression, anxiety, and reduced well-being compared to heterosexual males. Mostly heterosexual (N = 156, 48.15%) and bisexual persons (N = 85, 26.23%) reported more symptoms than heterosexuals.

CONCLUSION

Despite Canada's inclusive stance on sexual diversity, sexually diverse youth-especially those identifying as mostly heterosexual and bisexual-continue to face significant mental health disparities. Our findings highlight the need for accessible, tailored mental health services to support this population.