Abstract
The purpose of this study was to examine rates of dating violence (DV) victimization and DV victimization outcomes as a function of sex and sexual orientation. Participants were 25,122 high school students who participated in the 2013 New Hampshire Youth Risk Behavior Survey study. Heterosexual youth, especially heterosexual male youth, were less likely to report experiencing physical and sexual DV victimization than lesbian, gay, bisexual, and questioning (LGBQ) girls and boys. Among LGBQ girls and boys, there was little variability in rates of DV victimization with the exception of questioning boys being significantly more likely to experience physical and sexual DV victimization than several other LGBQ sub-groups. Furthermore, LGBQ DV victims reported worse outcomes than heterosexual DV victims on measures of depression, binge drinking, and poor academic performance. At the sub-group level, bisexual and questioning female victims were most at risk for depression; bisexual and questioning male victims were most at risk for binge drinking; bisexual male victims were most at risk for poor academic performance. The findings underscore the importance of better understanding variability in DV incidence and outcomes within the LGBQ population and using this information to inform clinical intervention and prevention efforts.
A growing body of research has documented the alarmingly high rates of dating violence (DV) among high school youth. Researchers at the Centers for Disease Control and Prevention (CDC) conducted an epidemiological study and documented that 10.3% of high school youth were victims of physical DV in the past 12 months and that 10.4% of high school youth were victims of sexual DV in the past 12 months (Khan et al., 2014). Researchers have also documented the deleterious consequences associated with DV (Banyard & Cross, 2008; Silverman, Raj, Mucci, & Hathaway, 2001), which makes DV an important public health issue.
There is a large body of research on DV among heterosexual youth. This research consistently finds that boys and girls report similar rates of physical and psychological DV victimization, but that girls often report higher rates of sexual DV victimization than boys (for reviews, see Dardis, Dixon, Edwards, & Turchik, 2014; Hickman, Jaycox, & Aronoff, 2004; Straus, 2010). Despite gender symmetry in rates of physical and psychological DV, some research indicates that boys and young men engage in more serious forms of DV perpetration than girls and young women, and that girls and young women report greater injury, fear, and psychological consequences to DV victimization than do boys and young men (for reviews, see Dardis et al., 2014; Straus, 2015).
Despite this substantial literature on DV among heterosexual youth, there is far less research on DV among sexual minority youth. Nevertheless, preliminary research documents that lesbian, gay, bisexual, and questioning (LGBQ) youth experience DV at higher rates than heterosexual youth (Pathela & Schillinger, 2010). Differences in DV between heterosexual and sexual minority youth can be understood using a minority stress framework (Meyer, 2003), which includes both internalized (e.g., internalized homonegativity, identity concealment) and externalized (e.g., sexual-orientation-related victimization, discrimination, rejection) stressors that research suggests increase risk for DV victimization and perpetration among sexual minorities (Edwards & Sylaska, 2013; Lewis, Millentich, Kelley, & Woody, 2012). Minority stress is also associated with psychological and relational difficulties (e.g., depression, substance use, low relationship quality; Frost & Meyer, 2009; Hatzenbuehler, 2009; McKenry, Serovic, Mason, & Mosak, 2006), which may increase risk for DV experiences (see Edwards, Sylaska, & Neal, 2015, for a review). Thus, minority stress may increase risk for DV via increases in psychological and relational difficulties.
The minority stress framework can also be used to understand variability in rates of DV among LGBQ youth. For example, LGBQ youth with higher levels of minority stress would presumably be more at risk for DV experiences. However, research is mixed regarding the extent to which there is variability in minority stress experiences as a function of specific LGBQ identity, and this is further complicated when sex is considered (Dewaele, Van Houtte, & Vincke, 2014). Along these lines, the extent to which rates of DV vary as a function of sexual orientation and sex is unclear, especially in light of the few studies that have empirically examined this topic. In one of the few studies to examine DV variability among sexual minority youth, Halpern, Young, Waller, Martin, and Kupper (2004) presented data on a sample of 117 youth currently or recently in a same-sex relationship from the Add Health study and found that female youth in same-sex relationships were more likely to report physical DV victimization than male youth in same-sex relationships. Furthermore, in a sample of 521 youth sampled at a LGB rally, Freedner, Freed, Yang, and Austin (2002) found that bisexual boys reported higher rates of any type of DV victimization than heterosexual boys, and bisexual girls reported higher rates of sexual DV victimization than heterosexual girls. In the only known DV study to include male and female youth questioning their sexual orientation, Martin-Storey (2015) found that questioning boys were more likely to report DV victimization than bisexual boys, whereas questioning girls reported lower rates of DV victimization than lesbian and bisexual girls. Although these preliminary studies add to our understanding of variability in rates of DV among LGBQ youth, further research is needed, especially research that includes large samples of youth and a comprehensive assessment of sexual orientation, inclusive of questioning youth.
In addition, research is needed to determine if outcomes of DV victimization vary as a function of sex and sexual orientation. Consistent with the minority stress theory, preliminary research with adults has suggested that LGBQ DV victims compared with heterosexual DV victims could have worse outcomes (e.g., depression) than heterosexual DV victims due to poorer social support systems, increased barriers to disclosure and help seeking due to identity concealment and other concerns, and less community acknowledgment and readiness to address DV among LGBQ individuals (Duke & Davidson, 2009; Edwards et al., 2015; Turell, Herrmann, Hollander, & Galletly, 2012; Walters, 2011). In the only study with youth, Dank et al. (2013) found that sexual minority intimate partner violence (IPV) victims were more likely than heterosexual IPV victims to have poorer psychological, academic, and behavioral functioning. An understanding of these potential differential outcomes is important in the development of evidence-based DV intervention and prevention efforts for youth.
Thus, the current study aimed to answer two questions: Do rates of DV victimization (conceptualized to include physical and sexual DV victimization) vary as a function of sex and sexual orientation? Do DV victimization outcomes (conceptualized to include depression, binge drinking, and poor academic performance) vary as a function of sex and sexual orientation? The author hypothesized that (a) sexual minority youth would report higher rates of DV victimization than heterosexual youth and (b) sexual minority youth compared with heterosexual youth would have worse outcomes associated with DV victimization. Although sex by sexual orientation interactions were examined, given the dearth of pre-existing research and theory, the author had no a priori hypotheses.
Method
Participants
This study included 25,122 high school students between the ages of 13 and 18+ 1 years who participated in the 2013 New Hampshire (NH) Youth Risk Behavior Survey (YRBS) study who reported dating histories (presented to youth as “dating or going out with”) during the 12 months prior to the survey and had no missing data on critical study variables (e.g., sex, sexual orientation). Although 38,181 high school students participated, only those who had dated were included to provide the most accurate estimates of DV (as students who had not dated would not have the opportunity to be exposed to DV). Also, due to missing data (<5%), sample sizes included in inferential analyses varied slightly from 25,122.
The sample was mostly White (88.0%) and heterosexual (90.5%); a slight majority (50.8%) of participants were female. See Table 1 for participant demographic characteristics. Although socioeconomic status was not collected directly from the youth, school-level rates of free or reduced-price lunch serve as a liberal index of poverty (obtained from the NH Department of Education). On average, 24.96% of youth (range = 0%-55.3%, SD = 12.26) at schools in the NH YRBS sample received free or reduced-price lunch. Moreover, youth from all 10 NH counties were represented in the sample.
Demographic Characteristics.
Note. LGBQ = lesbian, gay, bisexual, and questioning.
Procedure
The YRBS is part of a multi-decade CDC project that monitors health-risk behaviors (for more information, see http://education.nh.gov/instruction/school_health/hiv_data.htm). The data presented herein are derived from 71 public high schools in NH that volunteered to administer the YRBS survey to all students in the school during the spring of 2013. Seventy-one schools of total 83 NH public high schools (86%) participated in the whole school YRBS survey. Of the 59,528 total public high school students across 83 NH public high schools, 38,181 surveys were completed (response rate = 64%). Of the 71 schools participating in the whole school survey, the YRBS response rate was 81% of students. Although 38,181 students completed the survey, included in this article are 25,122 high school students between the ages of 13 and 18 years (youth 12 and younger were removed) who reported dating histories (those without dating histories were removed as they would not have the opportunity to experience DV) and there were no missing data on key study variables such as sex and sexual orientation (those with missing data on key variables were removed). Parental consent was obtained through local parental permission procedures. Students completed the self-administered questionnaire during one class period. The CDC’s Institutional Review Board approved all study procedures.
Measures
YRBS questions used in the current analyses assessed demographics, including sexual orientation, DV victimization, and psychological and behavioral health and academic variables. Sexual orientation was assessed by asking youth, “Which of the following best describes you?” with response options “heterosexual (straight),” “gay or lesbian,” “bisexual,” and “not sure” (which I refer to herein as questioning). Sex was assessed by asking youth, “What is your sex?” with response options “male” and “female.”
DV victimization during the past year was measured using two items assessing physical (“hurt you on purpose? [count things such as being hit, slammed into something, or injured with an object or weapon]”) and sexual (“force you to do sexual things that you did not want to do? [count things such as kissing, touching, or being physically forced to have sexual intercourse]”) victimization with response options ranging from “0 times” to “6 or more times.” Participants were assigned a score for physical DV victimization and a separate score for sexual DV victimization. For each of these DV victimization variables, participants were coded as either having no DV victimization (0 on DV item) or any DV victimization (one or more experiences on DV item). Depression was assessed with a single item (“During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities”) with response options “yes” and “no.” Binge drinking was assessed with a single item (“During the past 20 days, on how many days did you have five or more drinks of alcohol in a row, that is, within a couple of hours?”) with response options “0 days” (scored 0), “1 day” (scored 1), “2 days” (scored 2), “3 to 5 days” (scored 4 for the midpoint), “6 to 9 days” (scored 7.5), “10 to 19 days” (scored 14.5), and “20 or more days” (scored 20); binge drinking was scored and analyzed as an ordinal variable. Poor academic performance was assessed with an item assessing students’ grades (“During the past twelve months, how would you describe your grades in school”); the variable was scored ordinally, given the following response options: “mostly A’s” (scored 1), “mostly B’s” (scored 2), “mostly C’s” (scored 3), “mostly D’s” (scored 4), “mostly F’s” (scored 5).
Results
Descriptive and Basic Inferential Statistics
See Table 2 for means and standard deviations of continuous study variables and frequencies of categorical study variables. The table also depicts bivariate relationships among all study variables.
Descriptive Statistics and Bivariate Relationships Among Study Variables.
Note. OR = odds ratio; LGBQ = lesbian, gay, bisexual, and questioning; DV = dating violence.
p < .05. **p < .01. ***p < .001.
Do DV Victimization Rates Vary by Sex and Sexual Orientation?
Physical and sexual DV incidence rates: LGBQ youth compared with heterosexual youth
LGBQ youth (24.7%) reported higher rates of physical DV victimization than heterosexual youth (7.5%), χ2 = 777.87, p < .001, phi = .18, odds ratio (OR) = 4.07. LGBQ (26.1%) youth also reported higher rates of sexual DV victimization than heterosexual youth (8.9%), χ2 = 673.56, p < .001, phi = .16, OR = 3.60.
Physical and sexual DV incidence rates: Boys compared with girls
Girls (11.0%) reported significantly higher rates of physical DV victimization than boys (7.2%), χ2 = 109.83, p < .001, phi = .07, OR = 1.60. Girls (15.7%) also reported significantly higher rates of sexual (5.3%) DV victimization than boys (7.2%), χ2 = 723.48, p < .001, phi = .17, OR = 3.35.
Physical and sexual DV incidence rates: Detailed sexual orientation by sex comparisons
Using participants’ responses to the sex and sexual orientation questions, youth were categorized into one of the following categories: heterosexual girls (n = 11,122; 44.3%), heterosexual boys (n = 11,607; 46.2%), lesbian girls (n = 169; 0.7%), gay boys (n = 152; 0.6%), bisexual girls (n = 1,111; 4.4%), bisexual boys (n = 273; 1.1%), questioning girls (n = 366; 1,5%), and questioning boys (n = 322; 1.3%). Omnibus results suggested that rates of DV physical victimization (χ2 = 908.93, p < .001, phi = .19) and DV sexual victimization (χ2 = 1,346.42, p < .001, phi = .23) varied as a function of sex and sexual orientation. All possible post hoc comparisons were conducted (72 total), and an alpha correction was used (p < .001). Results are summarized below and presented in Table 3.
Rates of DV Victimization as a Function of Sex and Sexual Orientation.
Note. > means that the italicized reference group is significantly higher (p < .001); < means that the non-italicized comparison group is significantly higher (p < .001), and = means that there is no statistical difference between the groups. DV = dating violence; OR = odds ratio.
Incidence of sexual and physical DV among heterosexual girls compared with all other sexual orientation by sex groupings
Heterosexual girls had higher rates of physical and sexual DV than heterosexual boys. However, heterosexual girls had lower rates of physical DV than lesbian girls, gay boys, bisexual girls, bisexual boys, questioning girls, and questioning girls. Furthermore, heterosexual girls had significantly lower rates of sexual DV than bisexual girls, questioning girls, and questioning boys. There were no significant differences in sexual DV between heterosexual girls and youth in the following groups: lesbian girls, gay boys, and bisexual boys.
Incidence of sexual and physical DV among heterosexual boys compared with all other untested sexual orientation by sex groupings
Heterosexual boys had lower rates of physical and sexual DV than all other groups: lesbian girls, gay boys, bisexual girls, bisexual boys, questioning girls, and questioning boys.
Incidence of sexual and physical DV among lesbian girls compared with all other untested sexual orientation by sex groupings
Lesbian girls reported rates of physical and sexual DV identical to gay boys, bisexual girls, bisexual boys, questioning girls, and questioning boys. The one exception to this was questioning boys reporting significantly higher rates of sexual DV than lesbian girls.
Incidence of sexual and physical DV among gay boys compared with all other untested sexual orientation by sex groupings
Gay boys reported rates of physical and sexual DV identical to bisexual girls, bisexual boys, questioning girls, and questioning boys. The one exception to this was questioning boys reporting significantly higher rates of sexual DV than gay boys.
Incidence of sexual and physical DV among bisexual girls compared with all other untested sexual orientation by sex groupings
Bisexual girls reported rates of physical and sexual DV identical to bisexual boys, questioning girls, and questioning boys.
Incidence of sexual and physical DV among bisexual boys compared with all other untested sexual orientation by sex groupings
Bisexual boys reported rates of physical and sexual DV identical to questioning girls but significantly lower than questioning boys.
Incidence of sexual and physical DV among questioning girls compared with questioning boys
Although questioning boys and girls reported equal rates of sexual DV, questioning boys reported rates of physical DV higher than questioning girls.
Summary
Consistent with hypotheses, sexual minority youth reported higher rates of DV victimization than heterosexual youth, especially heterosexual male youth. Among LGBQ girls and boys, there was little variability in rates of DV victimization with the exception of questioning boys being significantly more likely to experience physical and sexual DV victimization than several other LGBQ sub-groups.
Do DV Victimization Outcomes Vary by Sex and Sexual Orientation?
Analysis overview
For these analyses, the author conducted a series of logistic (depression) and ordinal (binge drinking, poor academics) regression analyses. The dependent variables were depression, binge drinking, and poor academics. In the first block, I entered the bullying control variables, and in the second block I entered the contrast coded sexual orientation by gender variable. Given the large number of regression analyses conducted to test all possible comparisons for each dependent variable, an alpha correction of p < .001 was used. With the exception of the first analysis presented below, all analyses included only youth reporting physical and/or sexual DV victimization, so that outcomes among victims could be examined as a function of sexual orientation and sex. See Table 4 for sub-group means and standard deviations of variables and frequencies of the dichotomous depression variable.
Mental and Behavioral Health Variables as a Function of Sex and Sexual Orientation.
Note. ns for depression variable represent youth answering affirmatively to victimization questions that correspond to the percentages presented. Binge drinking was scored as the number of days of five or more drinks of alcohol within a few hours and scored as follows: “0 days” (scored 0), “1 day” (scored 1), “2 days” (scored 2), “3 to 5 days” (scored 4 for the midpoint), “6 to 9 days” (scored 7.5), “10 to 19 days” (scored 14.5), and “20 or more days” (scored 20). Poor academic performance was scored as follows: “mostly A’s” (scored 1), “mostly B’s” (scored 2), “mostly C’s” (scored 3), “mostly D’s” (scored 4), “mostly F’s” (scored 5). LGBQ = lesbian, gay, bisexual, and questioning; DV = dating violence.
LGBQ youth DV victims compared with LGBQ youth non-victims
The author first confirmed that, after controlling for bullying victimization, LGBQ youth who were victims of DV reported more binge drinking (parameter estimate = 1.43, p < .001), poor academic performance (parameter estimate = 0.27, p < .001), and depression (β = .68, p < .001) than LGBQ youth who were not victims of DV.
LGBQ youth DV victims compared with heterosexual youth DV victims
After controlling for bullying victimization, LGBQ youth DV victims reported more binge drinking (parameter estimate = 1.43, p < .001), poor academic performance (parameter estimate = 0.53, p < .001), and depression (β = .57, p < .001) than heterosexual youth DV victims.
Female youth DV victims compared with male youth DV victims
After controlling for bullying victimization, male youth DV victims reported more binge drinking (parameter estimate = 0.97, p < .001) and poor academics (parameter estimate = 0.53, p < .001) than female youth DV victims, whereas female DV victims reported more depression than male youth DV victims (β = .62, p < .001).
Detailed sexual orientation by sex comparisons among DV victims on depression, binge drinking, and poor academics variables
Using participants’ responses to the sex and sexual orientation questions, youth were categorized into one of the following categories: heterosexual girls, heterosexual boys, lesbian girls, gay boys, bisexual girls, bisexual boys, questioning girls, or questioning boys. In what follows, I describe the results of the regression analyses for depression, binge drinking, and poor academics. Table 4 shows descriptive statistics for sub-groups, and Table 5 displays the standardized beta or parameter estimates from the regression analyses (p < .001 alpha correction).
Summary of Regression Analyses Examining Differences Among IPV Victims as a Function of Sex and Sexual Orientation While Controlling for Bullying Victimization.
Note. > means that the italicized reference group is significantly higher (p < .001); < means that the non-italicized comparison group is significantly higher (p < .001), and = means that there is no statistical difference between the groups.
Depression
Regarding depression, after controlling for bullying victimization, heterosexual female victims reported significantly higher rates than heterosexual male victims and significantly lower rates than bisexual female victims. Heterosexual male victims reported significantly lower rates of depression than lesbian female victims, bisexual female victims, bisexual male victims, and questioning female victims. Furthermore, questioning male victims were less likely to be depressed than questioning female victims, and bisexual female victims were more likely to be depressed than questioning male victims. No other significant differences were documented on any of other comparisons.
Binge drinking
Regarding binge drinking, after controlling for bullying victimization, heterosexual male victims reported significantly more days of binge drinking than heterosexual female victims and fewer days of binge drinking than bisexual male victims and questioning male victims. Heterosexual female victims reported fewer days of binge drinking than gay male victims, bisexual female victims, bisexual male victims, and questioning male victims. Lesbian female victims reported fewer days of binge drinking than bisexual male victims and questioning male victims. Bisexual female victims reported fewer days of binge drinking than bisexual male victims and questioning male victims. Bisexual male victims reported more days of binge drinking than questioning female victims. Questioning male victims reported more days of binge drinking than questioning female victims. No other significant differences were documented on any of other comparisons.
Poor academic performance
Regarding poor academic performance, after controlling for bullying victimization, heterosexual male victims, bisexual female victims, and bisexual male victims all had significantly poorer academics than heterosexual female victims. Bisexual male victims had poorer academic performance than questioning female victims. No other significant differences were documented on any of other comparisons.
Summary
Consistent with hypotheses, LGBQ DV victims reported worse outcomes than heterosexual DV victims on measures of depression, binge drinking, and poor academic performance. At the sub-group level, bisexual and questioning female victims were most at risk for depression; bisexual and questioning male victims were most at risk for binge drinking; bisexual male victims were most at risk for poor academic performance.
Discussion
The current study examined incidence and outcomes of DV victimization as a function of sex and sexual orientation among high school youth. Consistent with previous research and study hypotheses, results demonstrated that LGBQ youth were more at risk for DV victimization than heterosexual youth (Martin-Storey, 2015; Pathela & Schillinger, 2010). Furthermore, this was the second study (in addition to Martin-Storey, 2015) to document that questioning boys were the most at risk to experience DV, with 35% and 33% of questioning boys in this sample reporting physical and sexual DV victimization, respectively, in the past year. In light of research suggesting that there is more stigma surrounding male sexual minorities than female sexual minorities (Herek, 2009), questioning male youth may be less likely to tell others or seek help for the DV. Although speculative, less disclosure could potentially result in higher past year incidence than other sexual minority groups as youth who are less likely to disclose may be less likely to terminate abusive relationships, thus increasing the likelihood for ongoing exposure to DV. Furthermore, research suggests that questioning male youth engage in more risky behaviors (e.g., binge drinking; Martin-Storey, 2015) than other sexual minority youth, which could also increase their risk for DV victimization.
Consistent with hypotheses, findings also documented that LGBQ DV victims were at increased risk for negative outcomes compared with heterosexual DV victims, and that some sexual minority girls were at especially increased risk for depression, and some sexual minority boys were especially at risk for poor academic performance and binge drinking. Potential reasons for LGBQ victims having worse outcomes include poorer social support systems, increased barriers to disclosure and help seeking, and less community acknowledgment, and readiness to address DV among LGBQ individuals compared with heterosexual individuals (Duke & Davidson, 2009; Turell et al., 2012; Walters, 2011). Given the cross-sectional design of the study, however, it is possible that some of these variables, such as depression or binge drinking, could have indeed preceded the instance of DV and could thus rather explain why LGBQ youth are at increased risk for DV.
Clearly, a critical area of future investigation is to utilize longitudinal methodologies that will allow for an understanding of temporal sequencing of DV victimization and mental and behavioral health and academic variables. Also, although the study included a large sample, individual cell sizes in several analyses were rather small, and the sample was racially homogeneous, geographically, and socioeconomically homogeneous. Gender identity diversity (e.g., transgender, genderqueer) was not assessed in the YRBS study. Thus, future research using larger and more diverse samples and measurements is needed. Furthermore, future research that examines explanatory mechanisms underlying higher rates of DV among LGBQ youth and negative DV-related outcomes among LGBQ victims is especially needed to most effectively translate research into intervention. Another limitation of the study was that all of the study variables were assessed using single-item indices, and there was no collection of contextual information (e.g., sex of the perpetrator, presence of mutual violence, injury).
It is also important to note that the item assessing physical DV includes the phrasing “hurt on purpose,” which may have led to underreporting on this item if an individual was indeed a DV victim but did not believe that the behavior was intended to hurt him or her. The “hurt on purpose” phrasing may also explain the higher rates of physical DV among female youth in the NH YRBS sample, compared with male youth. Although previous research consistently documents similar rates of physical DV among boys and girls, physical and psychological consequences are often more severe for girls than for boys, and thus the phrasing “hurt on purpose” included in the DV victimization item could have led more girls to endorse the physical DV item than boys (Dardis et al., 2014; Straus, 2010, 2015). It is also interesting to note that most of the relationships among victimization and outcome variables were relatively small in magnitude, which could be related to the one item measurement used in the YRBS. Taken together, future research would benefit from more comprehensive and validated assessments of IPV and associated outcome and contextual variables.
Preliminarily, these data suggest that practitioners, researchers, and policymakers should be aware that LGBQ youth, especially questioning boys, are at increased risk of DV victimization. Further professionals would benefit from an awareness that DV outcomes may be worse for LGBQ DV victims, and that for LGBQ female DV victims, intervention and prevention efforts may need to focus more on addressing internalizing symptoms, whereas for LGBQ male DV victims interventions may need to address behavioral problems. With increased research that aims to better understand why LGBQ youth are at increased risk for DV victimization and potentially worse outcomes for LGBQ youth DV victims, practitioners, researchers, and policymakers can more readily address these factors in intervention and prevention efforts.
Footnotes
Acknowledgements
The author thanks Jeffrey Metzger and the New Hampshire Department of Education for providing the New Hampshire YRBS data. She also thanks Dr. Christine Gidycz, Dr. Mary Moynihan, Kara Anne Rodenhizer-Stämpfli, and Kateryna Sylaska for their review and feedback on drafts of this article.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
