Second type of autism: verbal dyspraxia

Background: Sexual minority are at increased risk for mental health problems and substance use, and accumulating evidence indicates that bisexual youth are at greatest risk. However, bisexual youth are not a homogenous group and scholars have called for greater attention to the intersections of multiple marginalized identities. As such, we examined racial/ethnic differences in mental health, substance use, and bullying victimization among self-identified bisexual youth in grades 9-12 in the United States. Methods: Data from the local versions of the Youth Risk Behavior Survey (YRBS) were pooled across jurisdictions and years (2005-2015), resulting in an analytic sample of 27,967 self-identified bisexual youth (40.9% White, 18.3% Black, 30.5% Hispanic, 10.3% other races). Sex-stratified, multivariable logistic regression models were used to estimate the odds of each outcome associated with race/ethnicity, first controlling for age and survey year and then controlling for bullying victimization. Results: Compared to White bisexual female youth, Black bisexual female youth were less likely to report sadness/hopelessness (OR = 0.39), suicidal ideation (OR = 0.42), cigarette use (OR = 0.33), binge drinking (OR = 0.43), and illicit drug use (OR = 0.56); Hispanic bisexual female youth were less likely to report sadness/hopelessness (OR = 0.72), suicidal ideation (OR = 0.72), and cigarette use (OR = 0.69); and bisexual female youth of other races were less likely to report binge drinking (OR = 0.57) and marijuana use (OR = 0.55). In an exception, Black bisexual female youth were more likely to report marijuana use, but only after controlling for bullying victimization (OR = 1.42). Black bisexual male youth were also more likely to report marijuana use than White bisexual male youth (OR = 2.72), but there were no other racial/ethnic differences in the health of bisexual male youth. Finally, bisexual youth of color (female and male) were less likely to report bullying victimization than White bisexual youth (OR range from 0.29-0.70), and most of the racial/ethnic differences in mental health and substance use remained significant after controlling for bullying victimization (except the reduced odds among Hispanic bisexual female youth). Discussion: We found substantial evidence of racial/ethnic differences in mental health problems and substance use among bisexual female youth, but limited evidence among bisexual male youth. Most of the racial/ethnic differences remained significant after controlling for bullying (except the reduced odds among Hispanic bisexual female youth). Bisexual female youth of color may be less likely to report mental health problems and substance use because of unique strengths that provide resilience in the face of stigma. However, they may also be less likely to disclose their sexual orientation resulting in less exposure to stigma. Our data cannot explain why Black bisexual youth were more likely to report marijuana use. It will be important to continue to examine the mechanisms underlying racial/ethnic differences in the health of bisexual youth. In sum, our findings highlight the heterogeneity of bisexual youth and the need to consider multiple marginalized identities to understand the health disparities affecting this diverse population.