August 22, 2013

A July study in the American Journal of Obstetrics and Gynecology is reporting that heterosexual adolescents may be at a lower risk for experiencing a teen pregnancy than are those who self-identify as a sexual minority.

The data come from the large, longstanding Nurses’ Health Study (NHSII)—a panel of over 90,000 nurses born between 1947 and 1964—and over 6,000 of their children (GUTS) born between 1982-1987.

Teen pregnancy by sexual orientation2In the GUTS study, only 2% of "entirely heterosexual" respondents reported a teen pregnancy, the lowest rate in the study. In fact, risk ratios for teen pregnancy among self-reported lesbian or bisexual women were estimated as being between 1.61 and 5.82 times higher than those who identified themselves as "entirely heterosexual."

So what’s behind this non-intuitive result? The authors offer several explanations, including sexual abuse/violence, heterosexual sex as a way of dealing with stigma, and the observation that sexual minorities often comprise a disproportionate share of the youthful homeless population, a group that is at elevated risk of both being victimized as well as trading sex for material resources.

While these explanations no doubt account for some of the disparity in teen pregnancy, it’s unlikely that they account for the entirety of the gap in a large dataset. Instead it seems, as the authors suggest, that those who do not identify as "entirely heterosexual," especially those who identify as heterosexual but with same-sex partners, are more prone to risky behaviors--such as substance abuse--which may in turn be linked to a variety of sexual activity, including heterosexual sex.

While the study authors’ conclusions focused primarily on improving sexual education and access to contraception, as well as eliminating the stigma associated with same-sex attractions, the study also suggests the fluidity of sexual identity, a phenomenon commonly documented by scholars of female sexuality but largely absent from legal and political debates concerning the sexual orientation of adolescents.