LGB Identifying Adolescent Females Presenting to a Pediatric Emergency Department in Newark, New Jersey

Background: According to the CDC’s Division of Adolescent and School Health (DASH) report from 2019, 2.3% of teens surveyed in New Jersey identified as gay/lesbian, 6.6% as bisexual, and 4.0% were unsure. Moreover, the CDC cites the need for increased research concerning populations of young lesbian, bisexual, and other women who have sex with women. Overall, gender and sexual minority youth are at increased risk for negative health outcomes, including but not limited to disproportionately higher rates of bullying and harassment, illicit drug use, suicidality, mental health challenges, and risky sexual behaviors. LGBTQ+ youth are also more likely to report having a history of sexual intercourse, having a first sexual encounter prior to 13 years old, having more than three lifetime sexual partners, and a pregnancy prevalence two times higher than their heterosexual peers. Despite the well documented vulnerability of these patients, only 29% of physicians self-report asking about sexual orientation while interviewing adolescent patients.

Methods: This was a prospective, observational subcomponent of a survey-based study of females aged 15-19 years old presenting to a Pediatric Emergency Department (PED) in Newark, New Jersey. The purpose of the original study was to assess the level of awareness in adolescent females about long acting reversible contraception (LARC) during a routine presentation to a PED. Enrolled patients completed a survey via REDCap that gathered demographic data, sexual identity preference, sexual history, and assessed existing knowledge and interest in contraception. Exclusion criteria included documented history of medical instability, altered mental status, sexual assault, male gender, procedural necessity, and language barriers. Pearson chi-square, Fisher exact, and Wilcoxon Rank Sum were used for statistical analyses.

Results: The study sample included 190 patients, with a mean age of 17.9 years old and 78.9% (n=150) identifying as Black or African American and 16.8% (n=32) identifying as Hispanic or Latino. The sample was stratified by sexual identity preference with 28.6% (n=54) identifying as lesbian, gay, or bisexual and 7.9% (n=15) unsure of their sexual preference. Bivariate analyses were completed comparing heterosexual vs. LGB identifying patients (Table 2). Compared to heterosexual patients, LGB identifying patients reported an increased use of pregnancy prevention methods (p=0.04), increased use of the morning after pill (p=0.01), and a higher reported number of past sexual partners (p=0.04).

Conclusion: In this study female Black and Latinx youth in Newark, NJ identified as LGB at a higher rate that previously reported by the CDC. Pediatric providers should be aware of this demographic to better support gender and sexual minoritized diverse adolescents and their families.