3 - (SYM 108) Trajectories of Depression in Multiple Cohorts of Sexual and Gender Minority Youth: Does It “get Better?”

Background: Young sexual and gender minorities (SGM) are at elevated risk for depression relative to their cisgender heterosexual peers, which is largely driven by stigma and discrimination. The goal of these analyses was to test the thesis of the “It Gets Better” campaign; i.e., to examine in multiple cohorts of SGM youth whether: a) depression improved from adolescence to young adulthood; and b) generational cohorts differed in these effects.

Method: We drew data from 5 cohorts followed in 2 longitudinal studies of SGM youth: RADAR (3 cohorts) and FAB400 (2 cohorts). All 5 cohorts had similar inclusion criteria (i.e., aged 16-20 at recruitment; identified as SGM or had sex with a member of the same sex) but varied in sex assigned at birth. RADAR, a study of young SGM assigned male at birth (AMAB) included 3 cohorts recruited in 2007 (N=65), 2010 (N=162), and 2015 (N=468). FAB400, a study of young SGM assigned female at birth (AFAB), included 2 embedded cohorts recruited in 2007 (N=88) and 2017 (N=400). Each of the 5 cohorts completed multiple assessments, at 6-month intervals (observed age range 16-24+). We used latent growth curve models in MPlus to examine developmental changes in depression from late adolescence to young adulthood, and tested for cohort differences in intercepts and slopes.

Results: Depression at age 16 (intercept) was highest in the 2007 AMAB, 2007 AFAB, and 2017 AFAB cohorts. Depression decreased significantly with age (slope) in the 2010 AMAB, 2015 AMAB, and 2017 AFAB cohorts, but not in the 2007 AMAB or AFAB cohorts.

Conclusions: Age effects indicated that depression did “get better” for SGM youth as they aged from late adolescence to young adulthood, though some effects differed by cohort. While depression did not decrease with age in the 2007 AMAB or AFAB cohorts, it did decrease significantly in the 3 younger cohorts. Interestingly, cohort effects found that depression did not necessarily “get better” from the oldest to newest cohorts (i.e., generational change). For example, depression was consistently lowest in the 2010 AMAB cohort compared to the 2007, 2015, and 2016 cohorts. In the early 2010s, the sociopolitical context reflected increasing acceptance of, and legal protections for, SGM people. However, increasingly hostile attitudes on the conservative political right in more recent years may be leading to increased depression in younger cohorts. We must continue to advocate for structural changes and protections for SGM young people, while also supporting their resilience in the context of ongoing stigma and victimization.