Mental health status of sexually diverse youth at age 23: Cross-sectional data from the Quebec Longitudinal Study of Child Development
AI Summary
Sexually diverse young adults (24.5%) exhibited poorer outcomes across nine mental health indicators, notably increased suicidality and higher psychological help-seeking.
Mostly heterosexual and bisexual participants reported substantially more symptoms than heterosexuals, indicating important heterogeneity within sexually diverse groups.
Findings emphasise urgent need for accessible, tailored mental health services to address persistent disparities despite Canada’s inclusive policies.
Can J Public Health. 2026 Jul 22. doi: 10.17269/s41997-026-01235-5. Online ahead of print.
ABSTRACT
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.
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