Today's lesbian, gay, bisexual, and transgender (LGBT) youth come out at younger ages, and public support for LGBT issues has dramatically increased, so why do LGBT youth continue to be at high risk for compromised mental health? We provide an overview of the contemporary context for LGBT youth, followed by a review of current science on LGBT youth mental health. Research in the past decade has identified risk and protective factors for mental health, which point to promising directions for prevention, intervention, and treatment. Legal and policy successes have set the stage for advances in programs and practices that may foster LGBT youth mental health. Implications for clinical care are discussed, and important areas for new research and practice are identified.

Using data from the first national probability sample of Black, White, and Latinx sexual minority people in the United States, we examined whether and how sexual identity development timing and pacing differs across demographic subgroups at the intersections of cohort, sex, sexual identity, and race/ethnicity. Among a sample of 1,491 participants aged 18–60 from three distinct birth cohorts, we measured participants’ ages of sexual identity development milestones, including first same-sex attraction, first self-realization of a sexual minority identity, first same-sex sexual behavior, first disclosure to a straight friend, and first disclosure to a family member. Participants from more recent cohorts reported earlier and accelerated pacing of milestones relative to those from older cohorts. Subgroups defined by sex and sexual identity varied in milestone timing and pacing, with gay males reporting earlier onset of some milestones than other subgroups. Those who used newer identity labels (e.g., pansexual, queer) reported younger ages of milestones relative to bisexual participants but similar ages to lesbian and gay participants. Black and Latinx participants reported some milestones at younger ages than White participants. Race-stratified models testing groups at the intersection of cohort, sex, and sexual identity revealed subgroup differences in ages of first disclosure to family, as well as differences in the time between self-realization, same-sex sexual behavior, and disclosure to a straight friend. Results suggest substantial variation in the developmental timing and pacing of milestones across social identities, and the need to further examine how milestone timing is related to identity, stress, and health.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has accentuated long-standing population health disparities in the United States. We examined how the pandemic and its social consequences may differentially impact sexual minority adults, relative to heterosexual adults. Methods: Data are from a U.S. national sample of adults (n = 2996; 18.06%) collected from online panels from April to May 2020. We used eight indicators of well-being—mental health, physical health, quality of life, stress, loneliness, psychological distress, alcohol use, and fatigue—to assess the degree to which sexual identity subgroups (i.e., heterosexual, gay/lesbian, bisexual, and “other” sexual minority) varied in retrospective pre- and postpandemic onset indicators of well-being and whether groups varied in their rate of change from pre- and postpandemic onset. Results: The results showed consistent patterns of decline in well-being across sexual identity subgroups, although changes in mental health, physical health, quality of life, stress, and psychological distress were more robust among sexual minority adults in general, relative to heterosexual adults. Adjusted multivariate models testing differences in change in retrospective pre- and postpandemic onset found that well-being among bisexual men and women was most negatively impacted by the pandemic. Conclusion: The COVID-19 pandemic may have distinct health consequences for sexual minority adults in the United States. Our findings support and further legitimize calls for more comprehensive surveillance and cultural responsiveness in emergency preparedness as it relates to sexual minority people and the COVID-19 pandemic.