Associations Between Policy and Health for Sexual and Gender Minority Youth in the United States: A Scoping Review

Strengthening policy research and its translation is essential to improving sexual and gender minority youth (SGMY) health. We conducted a scoping review of studies testing the relationship between policy and health for SGMY (aged 13-26) living in the United States to document the scope of research in this area and identify opportunities to advance research in SGMY health policy. Guided by the Population, Concept, and Context framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist, we searched seven databases for English peer-reviewed studies published between 2000 and 2023 that tested the association between individual or composite measures of policy and mental health, substance use, or sexual health for SGMY aged 26 or younger. Twenty-one studies met the inclusion criteria. Most were cross-sectional and heavily relied on Youth Risk Behavior Survey data. Eighteen studies observed significant associations between policy and health for SGMY; only two assessed this association specifically for transgender youth. SGMY health and policy scholarship would advance through improved sexual orientation and (in particular) gender identity data collection in national data sources, measurement guidance and design testing, a greater use of longitudinal and quasiexperimental methods, and assessment of proximal mechanisms and implementation strategies through which policies impact health.