Sexual Violence Associated With Sexual Identity and Gender Among California Adults Reporting Their Experiences as Adolescents and Young Adults.

Importance: Disproportionate levels of violence exist in lesbian, gay, bisexual, queer, asexual, and other sexual identity (LGBQA+) communities, often starting in adolescence and young adulthood, but little research exists on the range of sexual violence (SV) experiences. Objective: To assess risk of experiences of sexual violence among California LGBQA+ adults during adolescence and young adulthood. Design, Setting, and Participants: This survey study analyzed data from Cal-VEX 2020, a state-representative survey of California residents aged 18 years and older, to assess associations between LGBQA+ identification and types of SV experienced in adolescence (ages 13-17 years) and young adulthood (ages 18-24 years) using gender-stratified adjusted logistic regression. Forms of SV included verbal, cyber, and coercion or physically aggressive sexual harassment; homophobic or transphobic slurs; and forced sex. Exposure: Sexual identity. Main Outcomes and Measures: The outcome of interest was experiences with any 5 forms of sexual violence (verbal sexual harassment, homophobic or transphobic slurs, cyber sexual harassment, sexual coercion or physically aggressive sexual harassment, and forced sex) during adolescence or young adulthood. Results: A total of 2102 contacted individuals (response rate, 26.2%) completed the Cal-VEX survey and were included in these analyses. Among these, the mean (SD) age was 46.6 (17.7) years, 1149 identified as female, 953 identified as male, and 214 respondents (9.6%) identified as LGBQA+. Compared with heterosexual individuals, LGBQA+ individuals had significantly higher odds of having experienced homophobic or transphobic slurs (women: AOR, 14.65; 95% CI, 5.14-41.77; men: AOR, 14.17; 95% CI, 6.96-28.86) and forced sex (women: AOR, 5.35; 95% CI, 2.74-10.43; men: AOR, 2.68; 95% CI, 1.01-7.10) in adolescence. LGBQA+ women also had higher odds of having experienced verbal and coercion or physically aggressive sexual harassment in adolescence (AOR, 2.33; 95% CI, 1.30-4.19). In young adulthood, LGBQA+ individuals also had higher odds of having experienced homophobic or transphobic slurs (women: AOR, 18.58; 95% CI, 7.12-48.49; men: AOR, 16.73; 95% CI, 8.26-33.92) in young adulthood. LGBQA+ men also had higher odds of having experienced homophobic or transphobic slurs (AOR, 16.73; 95% CI, 8.26-33.92); verbal (AOR, 3.29; 95% CI, 1.44-7.53), cyber (AOR, 6.32; 95% CI, 1.50-26.52), and coercion or physically aggressive (AOR, 5.54; 95% CI, 2.08-14) sexual harassment; and forced sex (AOR, 21.26; 95% CI, 5.63-80.35) in young adulthood. Conclusions and Relevance: This survey study found that adult LGBQA+ individuals were at increased risk for having experienced SV across the continuum during adolescence and young adulthood, consistent with prior research. Multifold solutions are needed to support LGBQA+ youth, including altering social norms accepting SV and homophobia, creating safer schools and other institutional environments, and supporting healthy sexual and romantic partnerships.