Investigating mental health and attendance disparities among sexual and gender minority youth in Sweden

BACKGROUND: Sexual and gender minority youth aged 12-18, whose sexual orientation, gender identity, or gender expression diverges from societal norms, encounter higher rates of bullying, violence, and depressive symptoms than their peers. METHODS: Guided by the Minority Stress Model and Keyes' definition of well-being, this cross-sectional study investigates differences between sexual and gender minority youth and their peers in well-being (emotional, psychological, social), perceived school environment, and exposure to bullying and violence (sexual, physical, psychological). Furthermore, it explores the relationship between these factors and psychological distress and school attendance among sexual and gender minority youth. Secondary data analysis was conducted using the Youth Public Health Survey in Jönköping County, Sweden. Pooled multivariable linear and logistic regression analyses were performed to assess group differences (n = 5020) and identify predictors of psychological distress and school attendance among sexual and gender minority youth (n = 456). RESULTS: Sexual and gender minority youth reported significantly lower levels of well-being, peace at school, alongside higher rates of bullying, violence, school stress, psychological distress, and increased odds of missed school compared to their peers. Among sexual and gender minority youth emotional and psychological wellbeing and teacher support were significant protective factors, while increased disability frequency, school stress, and exposure to sexual violence were significant risk factors across psychological distress and school attendance outcomes. CONCLUSION: Swedish sexual and gender minority youth experience mental health and school-related disparities, underscoring the need for targeted, school-based interventions. IMPLICATIONS TO PRACTICE: Pediatric and school-based nurses play a crucial role in these efforts.