Explaining disparities in depressive distress by sexual orientation among a cohort study of US emerging adults

Background: Lesbian, gay, and bisexual (LGB) youths have elevated rates of depression compared to heterosexuals. We examined a theoretical model hypothesized to explain disparities in depressive symptoms by sexual orientation, using the Growing Up Today Study (GUTS), a longitudinal U.S. cohort study. Methods: In 2005, GUTS participants (N=5,930; mean age=20.6; female=64.6%) reported their sexual orientation (completely heterosexual [CH]=86.6%, mostly heterosexual [MH]=10.1%, bisexual=1.7%, and lesbian/gay [LG]=1.7%), engagement in childhood gender nonconforming behaviors (CGNB: higher scores=more CGNB), and attachment to mother (higher scores=more secure attachment); in 2007, depressive symptomatology (higher scores=more symptomatology). In 2004, their mothers (participants in Nurses' Health Study II) reported on their negative attitudes toward homosexuality (higher scores=more discomfort) and in 2006 their maternal affection (higher scores=more affection). Path analyses assessed mediation. Results: After adjusting for demographics and sibling clustering, LGs (β=0.26, p<0.01), bisexuals (β=0.49, p<0.0001), and MHs (β=0.40, p<0.0001) reported more depressive symptomatology than CHs. This relation was mediated (i.e., rendered ns) for LGs (β=0.08) by more CGNB and less secure attachment to mother. Partial mediation by less secure attachment was found for bisexuals (β=0.31, p<0.01) and MHs (β=0.28, p<0.0001) relative to CHs. All sexual minorities reported significantly less secure attachment than CHs: β=–0.41 for LGs and MHs, and –0.61 for bisexuals. Less secure attachment was related to more depressive symptomatology (β=–0.20, p<0.0001). Conclusions: Findings suggest that attachment processes and CGNB differentially pattern depressive distress by sexual orientation. Additional research is needed on the long-term psychological sequelae of problematic parent-child relationships for sexual minorities.