Romantic Involvement and Anxiety, Depression, and Substance Use Among Sexual and Gender Minority Adolescents

This study aimed to examine associations between romantic involvement and depression symptoms, anxiety symptoms, substance use problems, and recent substance use, as well as assess the moderating roles of internalized stigma, parental acceptance, and demographic characteristics.

Participants were drawn from the 2022 LGBTQ+ National Teen Survey, an online cross-sectional study of sexual and gender minority (SGM) adolescents; a total of 6248 participants were included in the present study. Multivariable linear and logistic regression models were performed to assess associations between romantic involvement and depression symptoms, anxiety symptoms, substance use problems, and recent alcohol, heavy alcohol, marijuana, and nicotine use, with additional models for each stigma-based or demographic moderator.

Romantic involvement was significantly associated with increased depression symptoms, anxiety symptoms, recent substance use, and substance use problems. Both lower internalized stigma and higher parental acceptance diminished the associations between romantic involvement and substance use problems, but not other outcomes. Age also moderated the effect of romantic involvement across recent substance use measures.

Given consistent associations between romantic involvement and adverse mental and behavioral health observed in this study, clinicians and researchers should further explore protective influences for SGM adolescents in romantic relationships and promote individual and relationship interventions for romantically involved SGM adolescents.