The behavioral health needs of legally involved sexual minority female adolescents

Health Justice. 2025 Apr 30;13(1):30. doi: 10.1186/s40352-025-00335-7.

ABSTRACT

BACKGROUND: Sexual minority (SM) female adolescents involved in the legal system experience marginalization and health inequities. This study examined the differences in psychosocial functioning and risk behaviors among legally involved SM and heterosexual female adolescents to better understand their behavioral health needs. We hypothesized that SM females, as individuals at the intersection of two marginalized groups, would demonstrate greater psychiatric symptom severity and engagement in risk behaviors than their heterosexual counterparts.

METHODS: Adolescents involved in the legal system (N = 423) enrolled in a prospective cohort study and completed baseline surveys assessing their demographics, SM status, psychiatric symptoms, substance use, and engagement in self-injurious, delinquent, and sexual risk behaviors. The responses of SM and heterosexual female adolescents (n = 193) were compared using bivariate and regression analyses.

RESULTS: Participants were 12 to 18 years old (M = 14.49, SD = 1.55), ethnoracially diverse, and 38.3% identified as a SM. SM females, as compared to heterosexual females, reported more PTSD and emotional symptoms, difficulties with anger control and personal adjustment, and engagement in substance use, self-injurious, and sexual risk behaviors.

CONCLUSION: Legally involved SM female adolescents in this study had greater psychiatric, substance use, and sexual health treatment needs compared to their heterosexual peers. These findings highlight the need for enhanced understanding of how to effectively support SM female adolescents, including utilization of culturally sensitive and clinically informative screening practices that do not contribute to further discrimination within the legal system. Future work should aim to develop identity-responsive interventions tailored to this population.

PMID:40304978 | DOI:10.1186/s40352-025-00335-7