Increasing Trend for Youth in the US to Identify as Nonheterosexual

With the national Youth Risk Behavior Survey including questions since 2015 that assess sexual identity and the sex of respondents’ sexual contacts, this has provided the opportunity to assess longitudinal trends that can be generalized to high school students in the US.

Youth in the US have been identifying as nonheterosexual at an increasing rate. These findings were published in a research letter in JAMA Pediatrics.

Data from the national Youth Risk Behavior Survey (YRBS) collected biennially between 2015 and 2019 were analyzed for this study. High school students were surveyed about their sexual identity and sexual contacts.

A total of 41,884 students participated. The students who were aged median 16 (interquartile range [IQR], 15-17) years and 50.4% were boys.

Nonheterosexual identity increased by 41.4% between 2015 (8.3%) and 2019 (11.7%), corresponding with increased odds of identifying as nonheterosexual (adjusted odds ratio [aOR], 1.10; 95% CI, 1.05-1.15).

Stratified by gender, girls reported a more pronounced increase of 45.8% (12.2% vs 17.8%; aOR, 1.12; 95% CI, 1.07-1.18) compared with boys who reported a 27.8% increase (4.5% vs 5.7%; aOR, 1.07; 95% CI, 1.00-1.14).

Despite shifting identification of nonheterosexual identities, among all youths the prevalence of same-sex sexual contact did not differ significantly from 11.5% in 2015 to 13.3% in 2019 (aOR, 1.04; 95% CI, 0.99-1.10).

This trend of same-sex sexual contact was similar among girls (18.2% vs 20.5%; aOR, 1.05; 95% CI, 0.99-1.11) and boys (5.5% vs 6.4%; aOR, 1.04; 95% CI, 0.97-1.11).

This study may have been biased by the self-reported nature of the study. It remains unclear whether the apparent change in sexual identity is an actual change or whether youth feel more comfortable with disclosing their feelings than previous cohorts. Responses to the sexual contact question may have been biased as there was no explicit definition of sexual contact nor was there a differentiation between same-sex and same-gender sexual contact which together may have led to some ambiguity.

The letter authors concluded there has been an increase of youth in the United States to identify as nonheterosexual. These youth may be at increased risk for bullying or negative mental health consequences and clinicians should be aware of these trends.


Rapoport E, Athanasian CE, Adesman A. Prevalence of nonheterosexual identity and same-sex sexual contact among high school students in the US From 2015 to 2019. JAMA Pediatr. Published online June 14, 2021. doi:10.1001/jamapediatrics.2021.1109