It may be tougher for young women to be bisexual or unsure of their sexual orientation than to be lesbian, a new study from Drexel University has found.

Overall, non heterosexuals of both genders showed more signs of psychological distress than straight peers. On most measures, though, lesbian and heterosexual women were not significantly different, a possible sign of greater acceptance of female homosexuality.

Annie Shearer, a research assistant with Drexel's Family Intervention Science program, led the analysis of a survey of 2,513 14- to 24-year-olds in primary care offices. She wanted to build on a previous study that found higher rates of eating disorder symptoms among bisexual and questioning girls than among lesbians and heterosexuals.

Most mental health studies, she and her colleagues wrote, have lumped non heterosexuals together, or even excluded bisexuals and questioning people altogether. The team concluded there was reason to examine these groups separately and for doctors to be alert to their needs.

The Drexel team surveyed young people at 10 primary care offices in northeastern Pennsylvania, including federally funded health centers. Sixty-one percent were female and three-quarters were white. Ninety-four percent of the males and 90 percent of the females said they were exclusively attracted to the opposite sex. Considerably more girls and women than boys and men reported being bisexual or unsure of their orientation. Among males, 2.2 percent said they were attracted to males, 1.9 percent to both genders and 1.3 percent were questioning.

Among females, 2 percent said they were lesbian, 5.3 percent were bisexual and 1.8 percent were unsure.

The research, which was published online in the Journal of Adolescent Health, used a mental health screening tool developed at Drexel called the Behavioral Health Screen. It reported results on a 0 to 3 scale in six domains: substance abuse, depression, anxiety, current and lifetime thoughts of suicide and traumatic distress.

Bisexual and questioning girls had higher scores than heterosexuals for depression, anxiety and traumatic distress. The non heterosexuals had higher lifetime suicide scores. Bisexual females had the highest scores for current suicide risk.

Among males, gays and bisexuals had higher scores for depression and traumatic distress than heterosexuals. Gay males also had higher anxiety scores.

Guy Diamond, director of the Family Intervention Science program and a co-author on the study, said that, in individuals, a score of 1.2 for depression is considered a sign of "moderate" risk that should trigger further evaluation by a doctor. The average scores for all of the non heterosexual female categories and gay and bisexual males were above that. The average scores for bisexual and questioning women were in the "severe" range.

Average scores for anxiety were barely above the threshold for concern for lesbians but higher for bisexuals and questioning young women.

Diamond said doctors should take any signs of suicide risk seriously.

One possible explanation for the emotional distress is the prejudice that LGBQ people face as members of a minority.

Shearer said sexuality may be more fluid for women, with more of them in the questioning category. She thinks discrimination likely is worse for gay men than women, but that bisexuals of both genders still face a lot of stigma.

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