Sexual Orientation and Gender Identity/Expression Related Peer Victimization in Adolescence: A Systematic Review of Associated Psychosocial and Health Outcomes

Abstract

This article reviews research on psychosocial and health outcomes associated with peer victimization related to adolescent sexual orientation and gender identity or expression. Using four electronic databases and supplementary methods, we identified 39 relevant studies. These studies were published between 1995 and 2012 and conducted in 12 different countries. The studies were diverse in terms of their approaches to sampling participants, assessing participants' sexual orientation, operationalizing peer victimization, and with regard to the psychosocial and health outcomes studied in relation to peer victimization. Despite the methodological diversity across studies, there is fairly strong evidence that peer victimization related to sexual orientation and gender identity or expression is associated with a diminished sense of school belonging and higher levels of depressive symptoms; findings regarding the relationship between peer victimization and suicidality have been more mixed. Peer victimization related to sexual orientation and gender identity or expression is also associated with disruptions in educational trajectories, traumatic stress, and alcohol and substance use. Recommendations for future research and interventions are discussed.

Acknowledgments

The preparation of this manuscript was supported by NIMH center grant P30-MH43520 (P.I.: Anke A. Ehrhardt, PhD) to the HIV Center for Clinical and Behavioral Studies.

Notes

Note. Studies are listed alphabetically by first author's last name. The second author's last name determines the order of multiple entries by one lead author, but we have omitted coauthor names to conserve space. N.S. = Not specified.

^a For studies conducted in the United States, region is also noted if this information was provided and participants were from one region: MW = Midwest; NE = Northeast; S = South; W = West.

^b Sample sizes provided are the size of samples used for data analysis in the respective study.

^c Sexual minority samples were defined differently from study to study. Here we have included the total percentage of sexual minorities in each sample. This percentage may refer to LGB-identified participants, LGB and questioning (LGBQ) participants, or same-sex-attracted participants, for example.

^d V = verbal victimization; P = physical victimization; G = general victimization; R = relational victimization; S = sexual victimization; SH = sexual harassment; I = indirect victimization; C = cyberbullying. We made determinations to the extent possible based on the study authors' descriptions of the measures used. Types of victimization refer to types that were assessed independently; when multiple types of victimization were assessed with a single survey item we have categorized this as general victimization (G).

^e SO = victimization based on sexual orientation; GIE = victimization based on gender identity or expression; SPL = victimization that involved the use of sexually prejudiced language or homophobic slurs. We made determinations to the extent possible based on the study authors' descriptions of the measures used.

^f An additional 3.2% of participants were defined as mostly heterosexually attracted but were categorized with exclusively heterosexually attracted students in comparisons against same-sex-attracted and bisexually attracted participants.

^g Although analyses for this study were limited to female participants, males also participated; the 5% of sexual minorities is based on the full sample that includes both males and females.

References marked with an asterisk (*) indicate studies included in the literature review.