Peer Victimization and Sexual Risk Differences Between Lesbian, Gay, Bisexual, Transgender, or Questioning and Heterosexual Youths in Grades 7–12

High school---aged youths who self-identify as lesbian, gay, bisexual, transgender, or questioning (LGBTQ) tend to exhibit more risk with regard to sexual behavior (such as the number of sex partners, use of protection, and prevalence of sexually transmitted infections [STIs]) than do their self-identified, nontransgendered, heterosexual peers. Across middle and high school, LGBTQ youths are also disproportionately the victims of bullying. Given LGBTQ youths’ high levels of both sexual risk and victimization, a recent meta-analysis suggested that abuse (including peer victimization, but also parental physical abuse and childhood sexual abuse) may actually contribute to sexual risk disparities between LGBTQ and heterosexual youths. Victimization may lead to increased sexually risky behavior through several pathways, including heightened feelings of isolation leading to increased desires for sexual fulfillment, psychological distress leading to unprotected sex, and stigmatization leading to lack of knowledge about sexual-minority identity in turn leading to seeking out same-sex activities to navigate identity. In a recent retrospective study of LGBT young adults, those who recalled greater peer victimization during their teenage years were more likely to have ever had an STI and to have been at HIV risk in the past 6 months.The focus on victimization has also caught on in the media and in some education reform. However, researchers have noted that victimization may be only one component in explaining LGBTQ---heterosexual suicide-related risk disparities; thus, it stands to reason that victimization may explain part of LGBTQ---heterosexual sexual risk disparities, but that substantial disparities may remain after victimization is accounted for. We sought to provide a rigorous assessment of sexually risky attitudes and behaviors before and after accounting for peer victimization among a large population-based sample of LGBTQand heterosexual-identified youths in middle and high school. In the process, we implemented a novel procedure for screening out potentially mischievous survey responders and a series of propensity-score-matching analyses to estimate LGBTQ---heterosexual sexual risk disparities among matched LGBTQand heterosexual-identified students with the same demographic characteristics and levels of peer victimization. The methodological advances implemented here provide a more nuanced view of LGBTQ-identified youths and, thus, may improve the effectiveness of future prevention efforts. METHODS