Young People Attracted to the Same Sex or Both Sexes

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1 Youth2000 Survey Series The Health ad Wellbeig of New Zealad Secodary School Studets i 2012 Youg People Attracted to the Same Sex or Both Sexes Fidigs from the Youth 12 atioal youth health ad wellbeig survey 2014 Adolescet Health Research Group

2 Title: Youth 12 The Health ad Wellbeig of Secodary School Studets i New Zealad: Results for Youg People Attracted to the Same Sex or Both Sexes. ISBN (paperback) ISBN (electroic) To be refereced as: Lucasse, M.F.G., Clark, T. C., Mosele, E., Robiso, E.M., & The Adolescet Health Research Group. (2014). Youth 12 The Health ad Wellbeig of Secodary School Studets i New Zealad: Results for Youg People Attracted to the Same Sex or Both Sexes. Aucklad: The Uiversity of Aucklad. The Adolescet Health Research Group* (AHRG) ivestigators o the Youth 12 project are: Terrya Clark (Pricipal Ivestigator), School of Nursig Theresa (Terry) Flemig, Departmet of Paediatrics: Child ad Youth Health & Departmet of Psychological Medicie Pat Bulle ad Be Dyso, Faculty of Educatio Simo Dey, Departmet of Paediatrics: Child ad Youth Health Sarah Fortue, Departmet of Psychological Medicie Roshii Peiris-Joh ad Jeifer Utter, Sectio of Epidemiology & Biostatistics, School of Populatio Health Elizabeth Robiso ad Sue Cregle, Aucklad UiServices Limited Fioa Rosse, Social ad Commuity Health Jaie Sherida, Cetre for Addictio Research, ad School of Pharmacy Tasileta Teevale, Pacific Health, School of Populatio Health *The AHRG membership has chaged over the three surveys. The AHRG ivestigators are all based at The Uiversity of Aucklad i New Zealad. Data aalysis provided by Mathijs Lucasse ad Elizabeth Robiso. Data checkig provided by Mathijs Lucasse, Elizabeth Robiso ad Emma Mosele. Proofreadig provided by Beccy Joes. Oversight provided by Terrya Clark ad the AHRG. This report is based o the Youth 07 report The Health ad Wellbeig of Secodary School Studets i New Zealad: Results for Youg People Attracted to the Same Sex or Both Sexes, which was prepared by co-authors led by Simo Dey. Ackowledgemets A big thak you to: The studets ad staff who participated i the survey. Without their help the Youth 12 survey would ot have bee possible. The Youth 12 project maager, Sarah Masso ad admiistrator, Toi Jardie. The research team members who implemeted the survey i participatig schools. Their ames are listed uder Our Team at The Youth 07 team, led by Simo Dey, ad the Youth2000 team, led by Peter Watso. RaibowYOUTH staff ad voluteers who formed the advisory group for this report. All the photographs i this report are used with the permissio of the youg people ivolved. The Youth 12 project was fuded by the Miistries of Youth Developmet, Social Developmet, Health, Educatio ad Justice, the Departmet of Labour, the Families Commissio ad the Health Promotio Agecy (formerly ALAC). We would also like to ackowledge the support of Toshiba (Australia) Pty. Limited. This report was cotracted by the Miistry of Youth Developmet ad the Miistry of Educatio. Cotact details: Dr Terrya Clark (Youth 12 Pricipal Ivestigator) Adolescet Health Research Group School of Nursig The Uiversity of Aucklad Private Bag 92019, Victoria Street West, Aucklad, Further publicatios by the AHRG are available at

3 Foreword Kia ora, RaibowYOUTH is a peer-led charitable orgaisatio that aims to support Queer ad Tras* youg people i New Zealad. Key to our visio - The acceptace of diversity of sexuality ad geder i Aotearoa - is the educatio work that we, ad other orgaisatios, do i our atio s high schools. Educatio allows a youg perso to accept their ow sexual attractios, or beliefs about their geder, as valid ad ot as somethig to be chaged or fixed. Educatio of everyoe is importat, as the health ad wellbeig of those who are same/both-sex attracted is iflueced by the people aroud them. With the use of phrases such as gay, lesbia ad that s so gay still used commoly as isults i our schools, the impact of others is ofte egative i relatio to the youg people we work with. While our ow persoal experieces reiforce the eed for educatio, the Youth 01, Youth 07 ad ow Youth 12 reports have also provided atioally represetative data to support the eed for this educatio. With New Zealad havig the highest youth suicide rate i the OECD (Orgaisatio for Ecoomic Co-operatio ad Developmet), ad statistics from Youth 12 highlightig same/both-sex attracted youth are approximately five times more likely to have made a suicide attempt i the last 12 moths, work to address this is urgetly eeded. This Youth 12 report is the third i a series, ad it is iterestig to be able to compare treds i the health ad wellbeig of same/both-sex attracted youth with their opposite-sex attracted peers. For istace, whilst there has bee some sigificat improvemets i the health ad wellbeig of opposite-sex attracted ad same/bothsex attracted studets, such as a decrease i weekly cigarette smokig betwee 2001 ad 2012, same/both-sex attracted youth are ofte left behid. I particular same/both-sex attracted youg people have remaied over represeted i egative health statistics, with the disparities betwee opposite-sex ad same/both-sex attracted youth remaiig across the three survey waves. There are may awesome orgaisatios committed to makig life better for same/both-sex attracted youth. However it is clear that more eeds to be doe o a atioal level, especially i our schools. To ed o a more positive ote, I always otice ad value the good ews stories which come from these reports. Oe such statistic beig that same/both-sex attracted youth are more likely to do voluteer work tha their oppositesex attracted peers, highlightig the resiliece ad sese of commuity I kow our youg people have. Duca Matthews Geeral Maager, RaibowYOUTH

4 Cotets Executive Summary... 5 Itroductio... 7 Do eviromets place same/ both-sex attracted youth at risk?...7 Sexuality ad termiology...7 Sex, geder idetity ad termiology...8 Comig out...8 Adolescece...9 The Adolescet Health Research Group (AHRG)... 9 Youth2000 Survey Series...9 How we did the 2012 survey...10 Ethical issues...10 Survey delivery ad cotet...10 NZ Deprivatio Idex...11 Fudig...11 How to use the iformatio i this report How reliable are these fidigs?...11 Iterpretig the results...11 Comparisos betwee 2001, 2007, ad Usig the data as a advocacy tool...13 The Results The participats Sexual attractio by sex ad age...15 Sexual attractio by ethicity...15 Sexual attractio by eighbourhood characteristics ad birthplace...16 Comig out...17 Family relatioships Comparisos 2001, 2007, ad Health ad wellbeig Geeral health ad wellbeig...20 Accessig healthcare...21 Emotioal wellbeig Depressio ad self-harm...22 Comparisos 2001, 2007, ad Suicidality...22 Comparisos 2001, 2007, ad Substace use Alcohol, cigarette, marijuaa ad other drug use...24 Comparisos 2001, 2007, ad Sexual health Sexually active studets...25 Sexual health of sexually active male ad female studets...25 Comparisos 2001, 2007, ad School Comparisos 2001, 2007, ad Safety, bullyig ad discrimiatio Comparisos 2001, 2007, ad Commuity Comparisos 2001, 2007, ad Useful Liks Appedices Refereces Youth 12 Same Both Sex Report

5 Executive Summary Almost four percet (3.8) of youg people reported beig attracted to others of the same sex or both sexes i Youth 12. This proportio is comparable to that foud i the previous surveys coducted i 2001 ad 2007, suggestig that over the past 11 years there has bee o chage i relatio to the umber of New Zealad secodary school studets who are same/both-sex attracted. Furthermore these youg people are ethically, geographically, ad socially diverse, ad atted schools from aroud the coutry. I 2012, the majority (53.1) of same/both-sex attracted youg people had come out (i.e. told people close to them about their sexuality) whilst 31.3 of same/both-sex attracted studets had come out i However, i Youth 12 oly 14.4 of these youg people said that they could easily talk to their family about their sexuality. Most same/both-sex attracted studets reported feelig positive towards school ad described carig relatioships with their parets ad frieds. Same/both-sex attracted studets were also geerous with their time i that they were more likely (tha their opposite-sex attracted couterparts) to work as voluteers i their commuities. Although most same/both-sex attracted studets are doig well, there are sigificat ad harmful disparities whe these studets are compared to their opposite-sex attracted peers. Same/both-sex attracted youg people are ofte exposed to eviromets that are challegig ad discrimiatory, ad this i tur affects their wellbeig. For example, same/both-sex attracted youth are more likely to be bullied, be physically harmed, ad to be afraid that someoe would hurt or bother them at school. Furthermore, 59.4 of same/both-sex attracted studets had deliberately self-harmed, 41.3 had sigificat depressive symptoms, 18.3 had attempted suicide i the last 12 moths, ad 35.7 had difficulty gettig help for their emotioal cocers. These metal health issues have ot improved sice 2001, ad worryigly the proportio of same/both-sex attracted studets experiecig sigificat depressive symptoms has icreased from 27.0 i 2001 to 41.3 i 2012, while the proportio of opposite-sex attracted studets with these symptoms has remaied fairly costat (9.5 i 2007 ad 11.4 i 2001 ad 2012). This suggests that poor progress is beig made i terms of addressig metal health cocers. Overall this report highlights that while may same/both-sex attracted studets are doig well, i compariso to opposite-sex attracted studets, same/both-sex attracted youg people cotiue to experiece compromised health ad wellbeig. Evidece from iteratioal studies suggest that reducig these disparities must focus o creatig safe ad urturig eviromets which build upo the youg perso s stregths ad assets, ad refrais from problematisig (or pathologisig) same/both-sex attracted youg people. Youth 12 Same Both Sex Report 5

6 6 Youth 12 Same Both Sex Report

7 Itroductio This report is the third report focused o sexual attractio from the Youth2000 survey series. The Youth2000 survey series has bee coducted by the Adolescet Health Research Group (AHRG) at the Uiversity of Aucklad. This group has carried out atioally represetative surveys of New Zealad secodary school studets i 2001, 2007, ad The curret documet follows o from the previous reports published i 2005 (Le Bru, Robiso, Warre, & Watso, 2004) ad 2009 (Rosse, Lucasse, Dey, & Robiso, 2009) which specifically focused o oheterosexual or same/both-sex attracted studets. This report presets fidigs o the studets i Youth 12 (i.e. the Youth2000 survey coducted i 2012) who reported that they were sexually attracted to others of the same sex or to both sexes. Approximately 4 of secodary school studets i New Zealad were same/both-sex attracted i 2001, 2007 ad As such, these youg people form a sizeable group, similar i proportio to other miority populatios (e.g. miority ethic groups). Iteratioally it has bee estimated from populatio based samples that betwee 2.3 ad 15.5 of adolescets report beig same/both-sex attracted (Dey et al., i press). Recet meta-aalyses have demostrated that same/bothsex attracted youg people are more likely to attempt suicide, experiece depressive symptoms (Marshal et al., 2011) ad to report higher rates of substace use (Marshal et al., 2008) tha opposite-sex attracted youg people. Furthermore, same/both-sex attracted youg people are more likely to be sexually active at a earlier age (Hillier et al., 2010). They are also at a elevated risk of bullyig at school (Birkett, Espelage, & Koeig, 2009; Hog & Garbario, 2012) with the impacts of this bullyig remaiig with the studets log after they leave high school (Herickso, 2008; Rivers, 2004). Bullyig o the basis of beig sexuality ad/or geder diverse is a especially saliet issue i New Zealad with this beig highlighted as a particular problem i secodary schools over recet years (Burford, Lucasse, Peiket, & Hamilto, 2013; Paiter, 2009; Riches, 2014). Do eviromets place same/both-sex attracted youth at risk? The elevated rates of ill-health ad other disparities for same/both-sex attracted youth are ot to do with their sexual orietatio, but are to do with miority stress (Meyer, 2003). I particular, it is hostile ad stressful surroudigs that lead to the problems experieced by may same/both-sex attracted idividuals (Adams, Dickiso, & Asiasiga, 2013; Steves, 2013). This relatioship has bee demostrated i recet studies where abuse o the basis of sexuality (ad/or geder idetity) has bee directly liked to suicidality ad depressio for same/both-sex attracted adolescets (Adams et al., 2013; Burto, Marshal, Chisolm, Sucato, & Friedma, 2013; Dey et al., i press; Duca & Hatzebuehler, 2014). Fortuately, the issues faced by same/both-sex attracted youg people ca be addressed by improvig social eviromets. However, these evirometal chages must focus o addressig heteroormative culture (i.e. where aythig other tha beig exclusively opposite-sex attracted is viewed as wrog or abormal ) ad should refrai from problematisig (or pathologisig) same/both-sex attracted youg people (Quiliva, 2002). Sexuality ad termiology I the report based o the 2001 survey (Le Bru et al., 2004) participats were categorised as either heterosexual (i.e. studets who reported beig attracted to the opposite sex) or o-heterosexual (i.e. studets who reported beig attracted to the same sex, both sexes, either sex, or ot sure). However, combiig all the latter participats ito a sigle o-heterosexual group limited the usefuless of comparisos. For the curret report based o the 2012 survey ad the oe based o the 2007 survey (Rosse et al., 2009), participats were divided ito three groups: opposite-sex attracted; same/both-sex attracted; ad ot sure/either sex attracted. Groupig studets i this way allows for cosistecy betwee the two most recet Youth2000 reports. Furthermore, the term o-heterosexual has the potetial to perpetuate heteroormativity, by placig same/both-sex attracted youg people i a o or other category. Therefore we have adopted a techically accurate (based o the survey item used) ad more ormalisig approach by usig eutral terms, such as same/both-sex attracted ad opposite-sex attracted. Youth 12 Same Both Sex Report 7

8 I all three of the Youth2000 surveys studets were asked about their sexual attractios. Focusig o sexual attractios is both useful ad developmetally appropriate whe oe cosiders the limitatios of the other key dimesios of sexual orietatio. For example, secodary school studets i Wester coutries like New Zealad mostly report ot havig had sex (Clark, Flemig, Bulle, Cregle, et al., 2013), therefore usig sexual behaviour as the primary meas of determiig adolescet sexuality is limited. Sexual idetity labels, such as lesbia, gay, bisexual (LGB) ad straight/heterosexual, are commoly used by youg people (Russell, Clarke, & Clary, 2009), yet may adolescets who are sexually attracted to people of the same sex or both sexes do ot ecessarily idetify themselves as LGB (Russell et al., 2009). Various reasos could accout for this. For istace, may of those who will evetually idetify as LGB may ot have come out (i.e. disclosed their sexuality) to themselves or others (Savi-Williams, 2001), with some youg people preferrig other terms like queer or questioig (Russell et al., 2009). Moreover, after a systematic review of school-based health surveys Saewyc ad colleagues (Saewyc et al., 2004) suggested that if oly oe sexuality item was permitted o a health survey it should be a sexual attractio questio. Sex, geder idetity ad termiology I Youth 01, Youth 07, ad Youth 12, studets were asked What sex are you? with the respose optios male ad female - o further sex respose optios were available to studets. A specific questio o sex or geder idetity with multiple respose optios was ot asked of studets i the Youth2000 survey series, hece studets could ot idicate if they were itersex (i.e. a perso whose body whe bor does ot fit ito the categories of male or female due to geital, chromosomal or hormoal variatios). I Youth 12, studets were asked if they were trasgeder. I particular all studets were asked if they were a girl who feels like she should have bee a boy, or a boy who feels like he should have bee a girl (e.g., Tras, Quee, Fa afafie, Whakawahie, Tagata ira Tae, Gederqueer)? Iformatio regardig trasgeder youth is ot icluded i this report, however a peerreviewed ope access academic paper (Clark et al., 2014) pii/s x ad fact sheet, which focus specifically o trasgeder youg people, are ow freely available https://cd.aucklad.ac.z/assets/ fmhs/faculty/ahrg/docs/youth12-trasgeder-yougpeople-fact-sheet.pdf Comig out For may adolescets, uderstadig ad makig sese of their sexuality is a challegig learig process. For about 90 of youg people the outcome of their experieces is a exclusive iterest i the opposite sex ad the acceptace of a heterosexual orietatio is take for grated (Udry & Chatala, 2005). For same/both-sex attracted youg people the process of comig to uderstad their sexuality is ofte more complex ad may ivolve may challeges. Oe particular challege arises over the disclosure of oe s sexuality or comig out, which is a importat part of sexual idetity formatio (Hega & Wichstrom, 2007). Idividuals may decide to ot disclose that they are same/both-sex attracted i order to protect themselves ad avoid egative reactios ad stigma (D Augelli & Patterso, 2001; Hega & Wichstrom, 2007). Uder these circumstaces, relatioships with frieds ad family may be based i part o fabricatios ad the creatio of a false self (D Augelli & Patterso, 2001). The creatio of a false self ca result i withdrawal, feeligs of isolatio, ad metal health problems (Mague, Floyd, Bakema, & Armistead, 2002). Others may try to dey, alter or hide their same/both-sex attractios, feeligs, or behaviour (Garofalo & Katz, 2001; Lewis, Derlega, Berdt, Morris, & Rose, 2001). While some adolescets ca be ot sure or ambivalet with regard to their sexual orietatio others may ever have felt attractios to the opposite sex, to the same sex, or to either (Udry & Chatala, 2005). Whether they have experieced this ambivalece or ot, give their developmetal stage, issues surroudig disclosure to others for same/ both-sex attracted youth ad the process of comig out are likely to be particularly relevat. Moreover, the challeges aroud this are compouded by the fact that adolescets are very cocered about peer group coformity ad acceptace throughout this developmetal stage (Sigelma & Rider, 2006). Differeces that may be celebrated later i life are therefore especially difficult for youg people to deal with because of their age. Despite these challeges, most same/both-sex attracted youth develop ito healthy idividuals (Garofalo & Katz, 2001; Lucasse 8 Youth 12 Same Both Sex Report

9 et al., i press) ad fortuately there are kow strategies that support this. For istace, promotig peaceful ad acceptig eviromets, as well as appreciatig the importace of adolescet friedships ad family relatioships, assists i supportig same/ both-sex attracted youg people to develop as healthy idividuals (Williams, Coolly, Pepler, & Craig, 2005). Adolescece Adolescece is a importat stage i life that presets uique opportuities ad challeges. Adolescet wellbeig is of critical importace both for avigatig the challeges of the teeage years ad for establishig healthy patters for adult life. Youg people, families, schools, commuities ad govermets have made cosiderable efforts to improve adolescet health ad wellbeig more geerally. This report provides a overview of how well same/both-sex attracted teeagers are doig i 2012 ad how key health issues have chaged over the past 11 years for these youg people. This report has bee produced by the Adolescet Health Research Group (AHRG), which carries out the Youth2000 Survey Series. It provides a summary or sapshot of importat health ad wellbeig issues for same/both-sex attracted youg people from Youth 12: The Natioal Health ad Wellbeig Survey of New Zealad Secodary School Studets (Youth 12 Survey). This report is complemeted by three Youth2000 peer-reviewed joural articles which detail the health ad wellbeig of same/both-sex attracted studets (Lucasse et al., i press; Lucasse et al., 2011), as well as studets overall (Clark, Flemig, Bulle, Cregle, et al., 2013), ad chages i adolescet health ad wellbeig over time (Clark, Flemig, Bulle, Cregle, et al., 2013; Lucasse et al., i press). We cite these studies where appropriate i this report. The Adolescet Health Research Group (AHRG) The Adolescet Health Research Group (AHRG) is a multidiscipliary team of researchers that is supported by youth, cultural, ad stakeholder advisors. The purpose of the AHRG is to promote the healthy developmet ad wellbeig of all New Zealad youth through scietific research that delivers high quality useable data to stakeholders. The group was first established i Over the years the membership of the AHRG has chaged, but the visio ad commitmet remais. The AHRG works closely with may other researchers ad groups. We welcome applicatios from other researchers ad groups to use the Youth2000 Survey Series data. A protocol for potetial collaboratios ca be foud o our website. Youth2000 Survey Series The AHRG has carried out comprehesive atioal surveys of secodary school studets i 2001 (Adolescet Health Research Group, 2003), 2007 (Adolescet Health Research Group, 2008) ad ow i 2012 (Clark, Flemig, Bulle, Dey, et al., 2013). The 2001 (Youth 01) ad 2007 (Youth 07) surveys are similar to the 2012 (Youth 12) survey ad selected comparisos of fidigs from these surveys are made i this report. The group has also surveyed studets i Alterative Educatio i 2000 (Adolescet Health Research Group, 2002; Dey, Clark & Watso, 2004) ad 2009 (Clark et al., 2010), ad i 2007 the AHRG also surveyed studets i Tee Paret Uits (Johso & Dey, 2007). The Youth 07 ad Youth 12 surveys of secodary school studets were supplemeted by surveys with school staff members about school characteristics. All of these surveys together make up the Youth2000 Survey Series. The results of the Youth2000 Survey Series have bee preseted iteratioally ad are listed o our website: Youth 12 Same Both Sex Report 9

10 How we did the 2012 survey The Youth2000 Survey Series is desiged to provide iformatio about the health ad wellbeig of New Zealad secodary school studets. I 2012 we radomly selected 125 composite ad secodary schools i New Zealad which met the iclusio criteria 1 ad ivited them to participate i the survey. For schools which had a roll of more tha 150 Year 9-13 studets, we radomly selected 20 of this roll ad ivited these studets to take part i the survey. For participatig schools with less tha 150 Year 9 or higher studets, 30 studets were radomly selected ad ivited to take part. For more detailed iformatio o the school selectio process, please refer to the Youth 12 Prevalece Tables report which ca be foud o our website: Of the 125 schools ivited, 91 took part i the survey (73). The majority of participatig schools were state fuded, co-educatioal ad large schools (at least 350 Year 9 or higher studets). Of the 34 ivited schools that did ot participate, 26 schools declied, a further two schools iitially agreed to participate but withdrew durig 2012, ad six did ot respod to the ivitatio to participate. School participatio was lowest for state-itegrated schools (59), boys schools (40), Decile 6 (50) ad Decile 7 (64) schools, rural schools (60), ad schools i the followig regios: Welligto (50), Nelso Marlborough, Tasma ad West Coast (60) ad Otago or Southlad (54). Withi the 125 participatig schools, 12,503 studets were ivited to take part i the survey ad 8,500 participated (68). This represets 3 of the 2012 New Zealad secodary school roll. The most commo reasos why studets did ot participate were ot beig at school o the day of the survey, ot watig to take part, ad beig uavailable durig the time the survey was coducted. Ethical issues The Youth 12 survey built o the procedures used i the previous Youth2000 Survey Series. Like the previous surveys, Youth 12 was completely volutary (studets did ot have to participate ad could choose to ot aswer questios or to leave at ay time) ad aoymous (o persoal idetificatio details were collected). The survey had a brachig desig, so that studets were ot asked detailed questios about thigs that did ot apply to them. The AHRG ad a wide rage of advisors reviewed the survey cotet ad methods. Ethical approval was obtaied from The Uiversity of Aucklad Huma Participats Ethics Committee (ref 2011/206). School pricipals gave coset for their ow school to take part. A few weeks before the survey, iformatio was give to each school for distributio to parets ad studets. Parets were able to have their child excluded from the survey. O the day of the survey, a explaatio was give to selected studets ad each studet persoally coseted to participate. The survey was available i Eglish ad Te Reo Māori. Survey delivery ad cotet The survey was delivered usig hadheld digital tablets. The survey questios were displayed o the tablet ad were also available by voiceover via headphoes. Studets aswered the questios by touchig the appropriate checkbox o the tablet scree. The Youth 12 survey covered importat areas of health ad wellbeig for youg people i New Zealad, as well as risk ad protective factors. The questioaire cotaied a total of 608 questios, but studets aswered fewer tha this umber of questios due to the brachig desig of the survey. The complete list of survey questios ad full wordig for each questio is available o our website: www. youthresearch.aucklad.ac.z. Most of the questios ad measuremets were the same as those used i previous Youth 2000 surveys. Studets were also asked to provide their usual home address. We used this to ascertai their cesus meshblock (groupig of approximately 100 households) so that eighbourhood characteristics such as deprivatio levels ad urba or rural settig could be ascertaied. After the meshblock was idetified the studet s address was deleted. 1 New Zealad registered composite ad secodary schools with 50 or more studets i Year 9 or higher. 10 Youth 12 Same Both Sex Report

11 NZ Deprivatio Idex I this report, studets are grouped ito high, medium, or low deprivatio eighbourhoods, based o the New Zealad Deprivatio Idex (NZDI) for their geographical area or eighbourhood (meshblock). I 2006, the NZDI used eight dimesios of deprivatio (icludig household icome, employmet, access to a telephoe, access to a car, sigle paret families, qualificatios, overcrowdig, ad home owership) to calculate a deprivatio score for each meshblock i New Zealad. It is importat to remember that this score is a idicator of eighbourhood (rather tha persoal or family) deprivatio, ad some households might coted with quite differet levels of hardship tha is suggested by their meshblock. Fudig The Youth2000 Survey Series has had a differet set of fudig bodies i 2001, 2007, ad Without the support of these orgaisatios it would ot be possible to udertake the youth health ad wellbeig surveys atioally or to aalyse ad publish the results. Without this research, orgaisatios that are resposible for New Zealad youth would ot be able to advocate for appropriate ad accessible services, programmes ad policy o behalf of youg people. I 2012, the survey was fuded by the Miistries of Youth Developmet, Social Developmet, Health, Educatio ad Justice, the Departmet of Labour, the Families Commissio, ad the Health Promotio Agecy (formerly ALAC). The AHRG thaks these orgaisatios for their support to improve the health ad wellbeig of New Zealad youth. This report was cotracted by the Miistry of Youth Developmet ad the Miistry of Educatio. How to use the iformatio i this report The Youth2000 Survey Series is the largest dataset o the health ad wellbeig of youg people i New Zealad ad is of cosiderable importace for the purposes of plaig ad programme developmet for commuities, schools ad policy makers. However, cautio eeds to be take whe iterpretig the results, especially i relatio to whether the fidigs reflect the wider youth populatio, ad i iterpretig differeces betwee groups of studets. The sample of studets surveyed does ot iclude youg people who were abset from school o the day of the survey, those who have left school, or those i Alterative Educatio settigs; hece fidigs are likely to represet a slightly positive view of the health of studets i schools. How reliable are these fidigs? We have take steps to esure that we ca be cofidet the iformatio is correct. Our large sample size, ad rigorous methods for radomly selectig schools ad studets, esure that these fidigs represet secodary schools ad their studets throughout New Zealad. The Adolescet Health Research Group has udertake extesive quality checks to esure data codig ad aalyses are correct. Iterpretig the results This report presets fidigs about opposite-sex attracted, same/both-sex attracted, ad ot sure/ either studets from the Youth 12 Survey carried out i Whe we report statistics i this documet a umber of parameters are provided. I the tables, for each questio/item from the survey, we report N which refers to the umber of studets who aswered that particular questio/item. The N will vary by questio as studets could choose ot to aswer questios, ad studets were ot asked detailed questios which did ot apply to them. For example, oly studets who idetified as beig same/ both-sex attracted were asked whether they had come out (told people close to them of their sexuality). The refers to the umber of studets who chose the particular respose of iterest for a questio/item. For example, i the questio regardig whether a studet felt as though their parets (or someoe who acts like a paret) care about them, the umber of studets Youth 12 Same Both Sex Report 11

12 who aswered this questio was 7895 (N), ad 260 () same/both-sex attracted studets respoded that they thought their parets cared about them a lot. Parets (or someoe who acts like a paret) care about me a lot (N=7895) Opposite Sex ( ) Same/Both sexes ( ) The percetage () refers to the proportio of the studets who reported that particular respose or behaviour for a questio/item. This ca be regarded as a estimate of the true proportio of the populatio. For example, 34.2 of same/both-sex attracted studets reported havig voluteered by givig time to help others i the commuity i the last 12 moths. Voluteered by givig time to help others i the commuity i the last 12 moths (N=6484) Opposite Sex ( ) Same/Both sexes ( ) The cofidece itervals idicate the precisio of the percetage estimate by providig a iterval withi which we are relatively sure the true value lies (i.e. we are 95 cofidet that the actual prevalece of that particular behaviour or respose lies betwee the two bouds give). For example, statistically speakig we are 95 certai that betwee 35.4 ad 47.1 of same/both-sex attracted studets have sigificat depressive symptoms (based o the RADS-short versio). Sigificat depressive symptoms (RADS-short versio) (N=7817) Opposite Sex ( ) Same/Both sexes ( ) Wide cofidece itervals idicate more ucertaity i the associated percetage estimate. The 95 CI are provided i the relevat tables ad they have bee icluded i the bar graphs (visually displayed as a black lie towards the top of each bar). The percetages ad 95 cofidece itervals are adjusted for weightig ad clusterig, because the Youth2000 Survey Series utilise a complex samplig desig. The percetages ad 95 cofidece itervals were used to compare resposes betwee opposite-sex attracted, same/both-sex attracted ad ot sure or either studets. As a rule of thumb, if the 95 cofidece itervals aroud two percetage estimates do ot overlap the the differeces are more likely to be real or statistically sigificat. For example, with regards to havig sigificat depressive symptoms the 95 cofidece itervals associated with the opposite-sex attracted studets (95 CI, ) ad same/ both-sex attracted studets (95 CI, ) do ot overlap (i.e is cosiderably lower tha 35.4, idicatig that same/both-sex attracted studets are more likely to have depressive symptoms tha opposite-sex attracted studets), however, it is importat ot to place too much emphasis o apparet differeces whe the umbers of studets reportig o a specific issue is small (i.e. 30). For the chages over time we refer to the relevat Youth2000 peer-reviewed papers ad other selected comparisos betwee 2001, 2007, ad Where these aalyses were doe we have oted whether there were ay statistical differeces or ot. Whe we have coducted tests of statistical sigificace we have used a coservative cut-off of p 0.01 i this report (i.e. there is less tha a 1 chace that there is a radom differece; therefore, we ca be very cofidet that the differece observed is real). For example, there have bee o sigificat chages over time with regards to studets reportig that they get to sped eough time with their parets whe opposite-sex attracted studets were compared to same/both-sex attracted studets (p=0.41). However, there was a sigificat differece over time whe same/both-sex attracted studets were compared to opposite-sex attracted studets i relatio to whether they had sigificat depressive symptoms based o the RADS-short versio (p=0.008). 12 Youth 12 Same Both Sex Report

13 Comparisos betwee 2001, 2007, ad 2012 Key comparisos for same/both-sex attracted youth betwee the 2001, 2007, ad 2012 survey fidigs are preseted i this report, where items are directly comparable. As the purpose of this report is to provide a cocise overview of major idicators oly a small umber of importat areas are compared here. For further iformatio about chages over time refer to the peer-reviewed academic paper (Lucasse et al., i press) specifically focused o this topic. It is possible to compare fidigs across the surveys as similar methods were utilised i all three surveys. For example, the procedures for samplig schools ad studets were very similar, as were the survey techology ad the questios asked. However, it is importat to realise there are some differeces betwee the surveys. The overall target sample size i 2001, 2007 ad 2012 was 10,000 studets. The respose rates amog schools ad studets have chaged somewhat betwee the three surveys. I 2012, 73 of ivited schools took part, compared to 84 i 2007, ad 86 i I 2012, 68 of ivited studets took part, compared to 74 i 2007, ad 75 i The 2001, 2007, ad 2012 surveys icluded similar proportios of studets of each age ad year of schoolig, but there were differeces i the umbers of participatig sigle sex schools. As a result, the ratio of male ad female participats differs betwee the surveys. I 2012, 54 of the sample was female ad 46 was male, while i 2007 the sample was 46 female ad 54 male. I 2001 it was 54 female ad 46 male. Some questios were ot icluded i the 2001 survey or were chaged slightly betwee the three surveys. This was doe i order to gai ew or clearer iformatio. Usig the data as a advocacy tool We ecourage people to use the iformatio i this report to advocate for the health ad wellbeig of same/both-sex attracted youg people. However, there is a tricky balace betwee advocacy ad cotributig toward the stigma associated with health disparities betwee same/both-sex attracted ad opposite-sex attracted youg people. We urge all those who utilise this data to be midful of ot stigmatisig same/ both-sex attracted youth, as these youg people are a importat ad vibrat sub-populatio. They are also diverse i terms of their experieces ad most same/ both-sex attracted youg people are healthy ad well. Youth 12 Same Both Sex Report 13

14 The Results The participats I the Youth 12 questioaire, all studets were asked the questio Which are you sexually attracted to...? ad they could choose from the respose optios: the opposite sex, the same sex, both sexes, ot sure, either or I do t uderstad this questio. Of the 8,500 studets who agreed to take part i the Youth 12 survey, 8,166 respoded to this questio, it is those 8,166 studets who respoded that costitute the sample aalysed i this report. Of the respodig studets 178 studets reported that they did ot uderstad the Youth 12 sexual attractio questio. The majority (77.1) of these studets were youger, i that they were 15 years old or less. Of ote, this respose optio was ot available i Youth 07 or Youth 01. The patter of resposes is very similar to that i the 2001 ad 2007 surveys. I all three surveys the great majority of studets (about 92) respoded that they were sexually attracted to the opposite sex. A very small proportio respoded that they were sexually attracted to the same sex (0.9 i 2007 ad 0.7 i 2012 ad 2001), with approximately four times that may reportig that they were sexually attracted to both sexes (approximately 3 i all three surveys). The combied same/both-sex attracted group thus represets 3.8 of studets i Youth 12. A further 2.3 (compared to 1.8 i 2007 ad 2.3 i 2001) were ot sure who they were sexually attracted to, ad a similar proportio 2.1 i 2012 (compared to 1.8 i 2007 ad 1.7 i 2001) were ot attracted to either sex. The combied ot sure/either group thus represets 4.3 of studets (see Table 1 for details). Table 1. Reported sexual attractios of studets i 2012 Opposite Sex Same Sex Both Sexes Not Sure Neither ( ) 0.7 ( ) 3.0 ( ) 2.3 ( ) 2.1 ( ) Same/Both Sexes Not Sure/Neither ( ) 4.3 ( ) 14 Youth 12 Same Both Sex Report

15 Sexual attractio by sex ad age I 2012 there was little differece i the prevalece of opposite-sex attractios betwee male (93.2) ad female (90.8) studets. There was also little differece i the prevalece of ot sure/either sex attractio accordig to sex, however a higher proportio of females tha males reported same/both-sex attractio i Youth 12. The proportio of studets reportig same/both-sex attractios icreased with age, from 2.0 of studets aged 13 or less to 5.2 of those aged 17 or older. There was a correspodig decrease i the proportios of studets who reported beig ot sure/either i these age brackets, while the proportio reportig opposite-sex attractio remaied fairly costat from 13 ad uder to 17 ad older. Take together this patter suggests that may studets move progressively (with icreasig age) from the ot sure/either group to the same/both-sex attracted group. Give that the Youth 12 survey results represet what studets were prepared to disclose i a private ad aoymous survey, these results apparetly reflect a process of gradual awareess of same/both-sex attractio durig the adolescet years. Some same/both-sex attracted youth reach this milestoe by age 13, but more come to this later. Table 2. Prevalece of differet sexual attractios by age ad sex i 2012 Opposite Sex Same/Both Sexes Not Sure/Neither Total ( ) ( ) ( ) Sex Female 3978 Male ( ) 93.2 ( ) ( ) 2.9 ( ) ( ) 3.9 ( ) 13 or less ( ) ( ) ( ) ( ) ( ) ( ) Age ( ) ( ) ( ) ( ) ( ) ( ) 17 or older ( ) ( ) ( ) Sexual attractio by ethicity I geeral, the results cofirm that same/both-sex attracted studets come from a rage of ethic backgrouds with about 4 of studets reportig beig same/both-sex attracted i all the mai ethic groups i New Zealad. Where the proportio of studets who were opposite-sex attracted was higher (e.g. for Europea ad Māori studets this was approximately 93), the correspodig proportio of studets who were ot sure/either was lower (e.g. about 3 for Europea ad Māori studets) relative to other ethic groups. Coversely, where the proportio of ot sure/ either studets was greater (i.e. for Pacific ad Asia studets, where this was approximately 8), the proportio of studets who reported beig opposite-sex attracted was lower relative to Europea ad Māori studets. Youth 12 Same Both Sex Report 15

16 Table 3. Prevalece of differet sexual attractios by ethicity i 2012 Opposite Sex Same / Both Sexes Not Sure / Neither Europea ( ) ( ) ( ) Māori ( ) ( ) ( ) Ethicity Pacific ( ) ( ) ( ) Asia ( ) ( ) ( ) Other ( ) ( ) ( ) Sexual attractio by eighbourhood characteristics ad birthplace No major differeces were observed i the prevalece of same/both-sex attracted studets betwee eighbourhoods of differig levels of deprivatio; urba or rural areas; or, studets bor i New Zealad or bor overseas. There were, however, differeces i both the other groups - opposite-sex attracted ad ot sure/either - i particular i eighbourhoods of high socio-ecoomic deprivatio ad amog studets bor overseas where there were lower proportios of opposite-sex attracted ad higher proportios of ot sure/either studets. Table 4. Prevalece of differet sexual attractios by eighbourhood characteristics ad birthplace i 2012 Opposite Sex Same/Both Sexes Not Sure/Neither Low deprivatio ( ) ( ) ( ) Neighbourhood deprivatio 1 Medium deprivatio ( ) ( ) ( ) High deprivatio ( ) ( ) ( ) Geography Urba 6123 Rural ( ) 93.3 ( ) ( ) 3.9 ( ) ( ) 2.8 ( ) Coutry of Birth NZ bor 5841 Bor overseas ( ) 88.7 ( ) ( ) 3.8 ( ) ( ) 7.4 ( ) 1 Usig the New Zealad 2006 Cesus meshblock data (Salmod, Crampto, Sutto, & Atkiso, 2006) A miority of studets (3.8) are same/both-sex attracted; they make a diverse group ad are represeted across age, sex, ethicity, degrees of deprivatio, geographical locatios, ad coutries of birth. 16 Youth 12 Same Both Sex Report

17 Comig out Of those studets who reported beig same/both-sex attracted may had bee aware of their sexual attractios at a relatively youg age, but the majority became aware of their same-sex attractios durig their secodary school years. I each of the surveys approximately a third of same/both-sex attracted studets were aware of their sexual attractios by the age of 11 (see Figure 1). About half the same/both-sex attracted studets first became aware of their sexual attractios durig the secodary school years (i.e. from the age of 13 years upwards), with a small proportio of approximately 5 (for the 2001, 2007, ad 2012 surveys) probably becomig aware of their same/ both-sex attractios i the last year of school (at 17 or older). Figure 1. Age whe same/both-sex attracted studets were first aware of same-sex attractio i 2001, 2007, ad 2012 While reportig a same-sex sexual attractio i the aoymity of the Youth 12 survey amouts to a form of disclosure it was evidetly ot perceived as equivalet to comig out as 46.9 of the studets who idetified as beig same/ both-sex attracted i the Youth 12 survey reported that they had ot come out. The proportio of same/both-sex attracted studets who had come out had icreased sigificatly betwee the survey waves p< (see Lucasse et al., i press for more details). I 2001 approximately a third (31.3) of same/both-sex attracted studets reported that they were out compared to 40.0 i 2007, ad over half (53.1) i However, as Table 5 highlights, of those studets who had come out less tha 15 reported that they could easily talk to their family about their sexuality i the most recet Youth2000 survey. I 2001, 2007, ad 2012 may same/both-sex attracted studets were aware of their same-sex attractios by the time they started secodary school. I 2012 the majority of same/both-sex attracted studets had come out, whereas i 2001 about a third had come out. Across all three surveys less tha a quarter of same/both-sex attracted studets were able to easily talk to their family about their sexuality. Youth 12 Same Both Sex Report 17

18 Table 5. Comig out by same/both-sex attracted studets i 2001, 2007, ad Have you come out? (Told people close to you opely of your sexuality?) Yes ( ) ( ) ( ) No ( ) ( ( ) Studets who have come out (told people close to you opely of your sexuality) by sex Female ( ) ( ) ( ) Male ( ) ( ) ( ) Studets who have come out (told people close to you opely of your sexuality) by age 13 or less ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 17 or older ( ) ( ) ( ) Were you able to talk to your family about this? Yes I could easily talk with them ( ) ( ) ( ) Yes but it was difficult ( ) ( ) ( ) No, I could ot talk to my family ( ) ( ) ( ) Does t apply to me ( ) ( ) ( ) 18 Youth 12 Same Both Sex Report

19 Family relatioships All youg people eed adults who care about them, support them, supervise ad look after them. They also eed meaigful participatio i family life, high expectatios for their behaviour, ad safety from harm (Gray & Steiberg, 1999). Supportive, safe ad carig families are particularly importat for the health ad wellbeig of same/both-sex attracted youg people as these youth are at a elevated risk of physical ad emotioal harm (Lucasse et al., i press; Lucasse et al., 2011). I all three surveys, studets were asked questios about their family ad their perceptios of themselves withi their family. I 2012, the great majority of same/both-sex attracted studets felt that their parets (or someoe who acts like a paret) cared about them a lot (86.7), ad may reported that they got to sped eough time with their parets (49.6), had fu together as a family (54.6), ad were happy with their family relatioships (69.4). However, o all these measures, same/both-sex attracted studets relatioships with their families (though mostly positive) were proportioately less so tha the relatioships ejoyed by opposite-sex attracted studets. Furthermore, same/both-sex attracted studets appeared to be more tha twice as likely to have ru away from home overight (25.8) tha opposite-sex attracted studets (10.6). Figure 2. Paretal ad family relatioships i This figure ad all the followig figures exclude data o ot sure/either studets. Same/both-sex attracted studets were more likely to fid it difficult to talk to their mothers ad fathers about problems or worries whe compared to their opposite-sex attracted peers. For example, oly 12.1 of same/both-sex attracted studets reported that they could talk to their dad a lot about problems or worries, compared to 24.7 of opposite-sex attracted studets. O a more positive ote, same/both-sex attracted studets appeared almost as comfortable as their opposite-sex attracted peers talkig to sibligs ad other family members (see Figure 3). Figure 3. Ability to talk to family members about problems/worries i 2012 Over 80 of same/both-sex attracted studets felt that their parets cared about them a lot i 2001, 2007, ad Same/both-sex attracted studets reported less positive family relatioships ad fuctioig compared to their opposite-sex attracted peers. Youth 12 Same Both Sex Report 19

20 Comparisos 2001, 2007, ad 2012 Across the three surveys, over 80 of same/both-sex attracted studets felt that their parets cared about them a lot ad about half got to sped eough time with their parets. However, opposite-sex attracted studets were proportioately more likely to report positive family relatioships tha same/both-sex attracted studets i 2001, 2007, ad This patter was cosistet across survey waves, as the chages over time (whe opposite-sex attracted studets were compared to same/both-sex attracted studets) were ot sigificat for parets care about me a lot (p=0.45) ad gets to sped eough time with parets (p=0.41) (see Figures 4 & 5). Health ad wellbeig Geeral health ad wellbeig I 2012, half (50.3) of the same/both-sex attracted studets were categorised as havig good emotioal wellbeig, based o a WHO-5 Well-beig Idex Score, whilst more tha three-quarters of oppositesex attracted studets had good emotioal wellbeig (77.2). The majority of same/both-sex attracted studets reported good to excellet geeral health (77.4). However, this was ot as high as the proportio amog opposite-sex attracted studets (91.9). Furthermore, a greater proportio of same/ both-sex attracted studets reported havig a log term health problem (34.0), compared to their opposite-sex attracted peers (19.9). Oly 22.2 of same/both-sex attracted studets were very satisfied or happy with life, compared to 49.6 of opposite-sex attracted studets. Approximately oe i te (10.6) same/both-sex attracted studets reported havig severe difficulties with their emotios, cocetratio, behaviour, or gettig alog with others. Figure 4. Parets care about me a lot i 2001, 2007, ad 2012 Figure 6. Overall health, wellbeig ad health problems i 2012 Figure 5. Gets to sped eough time with parets i 2001, 2007, ad 2012 The overall health ad wellbeig of same/bothsex attracted studets is compromised relative to opposite-sex attracted studets. 20 Youth 12 Same Both Sex Report

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