Next Article in Journal
An Analysis of Chronic Stress, Substance Use, and Mental Health Among a Sample of Young Sexual Minority Men in New York City: The P18 Cohort Study
Previous Article in Journal
The Emergence of Ecological Consciousness: A Transformative Journey
Previous Article in Special Issue
Rural LGBTQIA+ Youth: A Review of the Literature (2015–2025)
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Youth
Volume 5
Issue 3
10.3390/youth5030077
youth-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

The Pitfalls and Promises of Sports Participation and Prescription Drug Misuse Among Sexual and Gender Minority Youth

by
Lindsay Kahle Semprevivo
1,*,
Vera Lopez
2,
Madelaine Adelman
2 and
Jon Lasser
3
1
Department of Criminal Justice, Radford University, Radford, VA 24142, USA
2
School of Social Transformation, Arizona State University, Tempe, AZ 85287, USA
3
Department of Counseling, Leadership, Adult Education & School Psychology, Texas State University, San Marcos, TX 78666, USA
*
Author to whom correspondence should be addressed.
Youth 2025, 5(3), 77; https://doi.org/10.3390/youth5030077 (registering DOI)
Submission received: 12 March 2025 / Revised: 4 July 2025 / Accepted: 6 July 2025 / Published: 31 July 2025
(This article belongs to the Special Issue Resilience, Strength, Empowerment and Thriving of LGTBQIA+ Youth)
Browse Figure
Versions Notes

Abstract

Though previous studies have demonstrated the protective benefits of sports participation against illicit drug use for a general population, how these findings apply to LGBTQ youth remains unknown. This study specifically looks at the relationship between sports participation and prescription drug misuse among sexual and gender minority youth. Using secondary data from the 2019 YRBS, we analyze associations among sports participation, sexual orientation, gender identity, and prescription drug misuse among a representative sample of U.S. high school students in Florida. Our results show that sexual and gender minority youth are at increased risk for prescription drug misuse compared to their heterosexual and cisgender peers. Moreover, sports participation is associated with higher rates of prescription drug misuse among all students, and the nuances of thes trends are discussed with particular attention paid to sexual and gender minority youth. These results challenge conventional wisdom about sports participation. Without the addition of new demographic survey questions and LGBTQ youth participation in the YRBS, common myths about sports might have persisted. Our findings point to the meaningful presence of LGBTQ youth in sports, call for research and programming on LGBTQ athletes’ unique needs regarding substance misuse risk, and encourage LGBTQ inclusive policies and practices within schools and sports programs in particular.

1. Introduction

Sport has long been celebrated as a protective factor in youth development due to its “assumed essential goodness and purity” (Coakley, 2011, p. 306). However, participation in sport is not universally positive. For youth who do not conform to hegemonic, cisheteronormative ideals of gender and sexuality, sports contexts can be exclusionary and harmful (Neary & McBride, 2024). Despite some progress in shifting attitudes and behaviors, sexual and gender minority (SGM)1 youth remain less likely than their peers to participate in organized school sports in the U.S. (Clark & Kosciw, 2022). National data indicate that LGBTQ youth are roughly half as likely as non-LGBTQ youth to participate in interscholastic (19.2% vs. 40.2%) and intramural (15.9% vs. 35.8%) sports. Among LGBTQ youth, cisgender students—those whose gender identity aligns with their gender assigned at birth—report the highest sports participation (36.4%), followed by nonbinary (29.9%) and transgender youth (20.6%).
These disparities reflect the often unwelcoming, unsupportive, and unsafe conditions that SGM youth experience in school-based physical activity and sports environments (DeChants et al., 2024; Greenspan et al., 2019; Kulick et al., 2019; Voss et al., 2023). According to the GLSEN 2019 National School Climate Survey, many LGBTQ youth avoid gym class (40.2%), locker rooms (43.7%), and athletic facilities (25%) because they feel unsafe. Transgender students, in particular, were more likely than their cisgender LGBQ peers to avoid these settings (GLSEN et al., 2019). These feelings of exclusion are supported by reports of victimization and harassment based on gender and sexual identity, especially in sports contexts. In one study, over half of LGBTQ students reported hearing “gay” used negatively in school sports settings, while 15.5% reported hearing transphobic slurs (Greenspan et al., 2019). Youth who are out to teammates as gay, lesbian, or bisexual are significantly more likely to be targets of homophobic behavior than their peers who are not out, even after accounting for variables such as gender, sport type, and country of origin (Denison et al., 2021).
These hostile climates can contribute to heightened stress and poorer health outcomes for SGM youth. According to the Minority Stress Theory (Brooks, 1981; Meyer, 1995, 2003), chronic exposure to stigma, discrimination, and social rejection increases the risk of mental health challenges for sexual and gender minority individuals. While some youth navigate these stressors through support networks and resilience strategies, others may turn to maladaptive coping, including substance use (Goldbach et al., 2014). A growing body of research shows that LGBTQ youth are more likely to misuse alcohol and other drugs than their heterosexual and cisgender peers (Day et al., 2017; De Pedro & Gorse, 2023; Fahey et al., 2023; Kidd et al., 2018; Mereish, 2019).
Although youth sports participation is often considered protective against risky behaviors, research suggests the relationship is more complex. Sports participation has been associated with increased alcohol use among adolescents (Denham, 2014; Diehl et al., 2012; Dunn, 2014; Eitle et al., 2003; Kwan et al., 2014; Veliz et al., 2017; G. C. Williams et al., 2020), while also serving as a potential buffer against illicit drug use (Kwan et al., 2014). However, most studies examine broad categories of drug use and do not disaggregate by substance type. One area that remains understudied is prescription drug misuse, which includes the nonmedical use of opioids, tranquilizers/sedatives, and stimulants (Veliz et al., 2022). The limited research on this topic presents mixed findings: while some studies suggest that sports participation is associated with reduced odds of prescription drug misuse, others indicate elevated risk, particularly among high-contact male athletes (Veliz et al., 2013; Veliz et al., 2014).
Despite the critical contributions of research on LGBTQ youth in sport (e.g., Anderson et al., 2025; Greenspan et al., 2019; Neary & McBride, 2024), no studies to date have examined whether sports participation is associated with prescription drug misuse among sexual and gender minority youth. LGBTQ youth who participate in sports may face unique pressures to conform, manage visibility, or cope with hostile environments, factors that may contribute to heightened risk for substance misuse, including prescription drug misuse.
This study addresses a key gap by testing whether sports participation is associated with prescription drug misuse among LGB and transgender youth compared to their heterosexual and cisgender peers. While we draw conceptually on the Minority Stress Theory (Meyer, 2003) to frame how identity-based stress may influence coping behaviors, we do not directly test the theory’s proposed mechanisms (e.g., distal or proximal stressors, or coping strategies). Instead, MST serves as a guiding framework to explain why LGB and transgender youth might experience sports contexts differently than their heterosexual and cisgender counterparts. Based on research documenting the exclusionary nature of cisheteronormative sports environments, we hypothesize that LGB and transgender youth will report higher rates of prescription drug misuse, potentially as a means of navigating pressures to belong or coping with marginalization. We also examine potential interactions between gender and sexual identity and team sports participation to explore how these intersecting factors may shape substance use patterns.

2. Materials and Methods

This project utilizes secondary data from the 2019 Youth Risk Behavior Surveillance System (YRBS), which is a survey developed by the Centers for Disease Control and Prevention (CDC) to monitor health risk behaviors that contribute to causes of death, disability, and social problems among youth in the United States. The 2019 sampling frame included all public, parochial, and other nonpublic schools across all 50 states and the District of Columbia. A three-stage cluster sampling design was used to produce a nationally representative sample of students, resulting in 13,872 completed questionnaires across 136 schools (Underwood et al., 2020). Students who did not report their sexual orientation, gender identity, and sports team participation were excluded. This resulted in two representative subsamples from Broward County and the state of Florida (county-level data is counted separately from the overall state’s representative subsample). Multiple imputation was performed using SPSS 26 to deal with missing data in the remaining independent variables. The final sample size resulted in 6050 9th through 12th-grade students.

2.1. Instrumentation

2.1.1. Independent Variables

Sexual orientation was measured through self-identification, in which the respondents were asked, “which of the following best describes you?” Response items ranged from (A) heterosexual (straight), (B) gay or lesbian, (C) bisexual, and (D) not sure. Similarly to other studies (see, Kahle, 2020), students who were not sure of their sexual orientation were equally at risk (or higher) for negative outcomes compared to LGB students, thus included as a measure of “questioning” in the study’s measure of LGBQ students. In addition, students who identified as heterosexual (straight) were included as a measure of heterosexual students.
Transgender was operationalized from the following question: “some people describe themselves as transgender when their sex at birth does not match the way they think or feel about their gender. Are you transgender?” Response items ranged from (A) no, I am not transgender, (B) yes, I am transgender, (C) I am not sure if I am transgender, and (D) I do not know what this question is asking. The responses to this item were re-coded and dichotomized as (0) not transgender/not sure/do not know what question is asking and (1) transgender to indicate whether a student was transgender. In addition, the students who answered (A) no, I am not transgender, were operationalized as the measure of cisgender students.
To assess the students’ participation in sports before the survey, sports participation was measured by the question, “during the past 12 months, on how many sports teams did you play (count any teams run by your school or community?” Response items ranged from (A) 0 teams, (B) 1 team, (C) 2 teams, and (D) 3 or more teams. The responses were recoded and dichotomized as (0) no sports team participation and (1) at least 1 sports team participation.

2.1.2. Dependent Variable

This study measures the outcomes of substance use in the form of prescription drug misuse. Prescription drug misuse was operationalized from the following question: “during your life, how many times have you taken prescription pain medicine without a doctor’s prescription or differently than how a doctor told you to use it?” Response items ranged from (A) 0 times, (B) 1 or 2 times, (C) 3 to 9 times, (D) 10 to 19 times, (E) 20 to 39 times, and (F) 40 or more times. The responses were dichotomized as (0) no prescription drug misuse and (1) prescription drug misuse at least 1 or 2 times.
Controls. Sex was operationalized from the following question: “what is your sex?” Response items were dichotomized as (0) male and (1) female. Race and ethnicity were operationalized from the following question: “how do you describe yourself?”, and the responses were coded into five dichotomous variables with white youth excluded as the comparison group: (1) American Indian/Alaska Native/Native Hawaiian/other Pacific Islander and (0) not American Indian/Alaska Native/Native Hawaiian/other Pacific Islander; (1) Asian and (0) not Asian; (1) Black or African American and (0) not Black or African American; (1) Hispanic/Latino and (0) not Hispanic/Latino; (1) multiple races (non-Hispanic) and (0) not multiple races (non-Hispanic).

2.2. Data Analysis

This study investigates the role of identity and sports team participation in youth prescription drug misuse. To highlight the major trends in these interactions, binary logistic regression is utilized across four different sexual orientation and gender identity groups (LGBQ, heterosexual, transgender, and cisgender). Table 1 presents the descriptive statistics for the variables of interest in the study. Table 2 and Table 3 present odds ratios for sexual orientation, sports team participation, and prescription drug misuse, while Table 4 and Table 5 present odds ratios for gender identity, sports team participation, and prescription drug misuse. The first models in each table regress identity and the controls on prescription drug misuse. The second set of models regresses sports team participation, identity, and controls on prescription drug misuse. The third set of models regresses the interaction of identity and sports team participation, as well as the controls on prescription drug misuse. Finally, the fourth set of models—which can be considered the full models—regress sports team participation, the interaction of identity and sports team participation, identity, and the controls on prescription drug misuse.

3. Results

3.1. Descriptive Statistics

Descriptive statistics for the variables in the study are found in Table 1. Over half of the sample identified as female (54.5%), while 1.1% identified as American Indian/Alaska Native/Native Hawaiian/other Pacific Islander, 2.5% Asian, 19.8% Black or African American, 42% Hispanic/Latino, 4.4% multirace (non-Hispanic), and 30.2% white. In terms of sexual orientation and gender identity, 18.5% of the students identified as lesbian, gay, bisexual, or queer, and 1.4% identified as transgender. Fourteen percent of the students in the sample reported having taken prescription pain medicine without a doctor’s prescription or differently than how a doctor told them to use it, and 44.5% of the students in the sample participated in at least one sport, 6.3% of whom identified as LGBQ and 0.7% as transgender.

3.2. Identity

Logistic regressions evaluate sexual orientation, gender identity, sports team participation, and prescription drug misuse independently and interactionally in Table 2, Table 3, Table 4 and Table 5. As noted in Models 1 and 5, sexual orientation matters for prescription drug misuse among youth. Students who identified as LGBQ (b = 0.644, OR = 1.905, p ≤ 0.001) had higher odds, and heterosexual students (b = −0.644, OR = 0.525, p ≤ 0.001) had lower odds of reporting prescription drug misuse. Gender also presented a risk for prescription drug misuse, where females (b = 0.267, OR = 1.306, p ≤ 0.001) had higher odds of reporting misuse than males. These trends continue throughout the remainder of the analyses. Similarly, Models 9 and 13 show that transgender students (b = 1.707, OR = 5.514, p ≤ 0.001) had significantly higher odds, while cisgender students (b = −1.707, OR = 0.181, p ≤ 0.001) had significantly lower odds of reporting prescription drug misuse. Gender continued to be a risk factor for misuse, where females (b = 0.368, OR = 1.445, p ≤ 0.001) had higher odds of reporting prescription drug misuse than males. These trends continue throughout the remainder of the analyses.

3.3. Sports Team Participation

When considering identity (Models 2, 6, 10, and 14), sports team participation increases prescription drug misuse across all four groups. When accounting for sexual orientation, the students who participated in at least one sports team (b = 0.259, OR = 1.296, p ≤ 0.001) had higher odds of reporting prescription drug misuse than the students who did not participate in at least one sports team. Sexual orientation continued to be significant in these models as well, with effect sizes similar to those of the previous model. With regard to transgender identity, the students who participated in at least one sports team (b = 0.204, OR = 1.227, p ≤ 0.01) had higher odds of reporting prescription drug misuse than the students who did not participate in at least one sports team. Gender identity also continued to be significant in these models, with effect sizes similar to those of the previous model.

3.3.1. Sexual Orientation and Sports Team Participation

Models 3 and 7 show that the interaction of sports team participation and sexual orientation matters concerning prescription drug misuse among youth. Lesbian or gay, bisexual, and questioning youth who played on at least one sports team had higher odds of prescription drug misuse (b = 0.457, OR = 1.579, p ≤ 0.001) than those who were not LGBQ and participated in at least one sports team, although these odds were slightly lower than students who just identified as LGBQ. The students who identified as LGBQ had higher odds (b = 0.474, OR = 1.607, p ≤ 0.001) of prescription drug misuse than the students who did not identify as LGBQ. In turn, the heterosexual students who played on at least one sports team (b = 0.192, OR = 1.212, p ≤ 0.001) had higher odds of reporting prescription drug misuse than students who were not heterosexual and played on at least one sports team. In turn, heterosexual identity alone acted as a protective factor, where heterosexual students (b = −0.734, OR = 0.480, p ≤ 0.001) had lower odds than LGBQ students of reporting prescription drug misuse.
When all of these factors were accounted for in the full models, Models 4 and 8, both identity and sports team participation were significant to prescription drug misuse among youth. Overall, LGBQ students (b = 0.563, OR = 1.757, p ≤ 0.001) continued to have higher odds of reporting prescription drug misuse, while heterosexual students (b = −0.563, OR = 0.569, p ≤ 0.001) had lower odds of reporting prescription drug misuse. The students who participated in at least one sports team had higher odds of reporting prescription drug misuse among the LGBQ students (b = 0.192, OR = 1.211, p ≤ 0.05) and heterosexual (b = 0.192, OR = 1.578, p ≤ 0.01), which may suggest that it is more of a risk factor for heterosexual students than LGBQ students.

3.3.2. Gender Identity and Sports Team Participation

Models 11 and 15 show that the interaction of sports team participation and gender matters with regard to prescription drug misuse among youth. The interaction of transgender identity and sports team participation was not significant, but it was for cisgender students. Cisgender students (b = 0.195, OR = 1.215, p ≤ 0.001) who participated in at least one sports team had higher odds of prescription drug misuse than students who were not cisgender and participated in at least one sports team. With regard to gender identity alone, students who were transgender (b = 1.458, OR = 4.298, p ≤ 0.001) had higher odds than cisgender students of prescription drug misuse, and cisgender students (b = −1.797, OR = 0.166, p ≤ 0.001) had significantly lower odds of reporting prescription drug misuse.
When all of these factors were accounted for in the full models, both identity and sports team participation were significant to prescription drug misuse among trans youth, while identity alone was significant among cisgender youth. Model 12 shows that among transgender students, those who participated in at least one sports team (b = 0.195, OR = 1.216, p ≤ 0.05) had higher odds of reporting prescription drug misuse than students who do not, and transgender students (b = 1.546, OR = 4.695, p ≤ 0.001) had higher odds of reporting prescription drug misuse than cisgender students. Model 16 shows that among cisgender students, identity was the only significant factor, where cisgender students (b = −1.546, OR = 0.213, p ≤ 0.001) had lower odds of reporting prescription drug misuse.

4. Discussion

In this study, we explore how sports participation is associated with prescription drug misuse and challenge the idea that sports team participation necessarily leads to positive developmental outcomes, especially among LGBTQ youth. This section discusses these results in the following ways: (1) how sports team participation is associated with increased prescription drug misuse for all youth; (2) how LGBQ and trans youth had significantly higher odds of prescription drug misuse, while heterosexual and cisgender youth had significantly lower odds of misuse; and (3) how the interaction of sports team participation and identity matters, the interpretation of which, however, should be approached with caution and is discussed more at length below.
This study found that any student who participated in at least one sports team was more likely to report ever taking prescription pain medication without a doctor’s prescription or differently than how a doctor told them to use it. These findings are consistent with other research linking prescription drug misuse with sports participation among youth (Veliz et al., 2013; Veliz et al., 2014) and add additional depth to the literature by showing these major trends across gender identity and sexual orientation. All the student-athletes had between 23 percent and 30 percent higher likelihood of prescription drug misuse. These findings have clear implications for educators and communities concerned with adolescent substance use, underscoring the importance of collaboration across student athletes’ ecological systems in the learning environment (e.g., students, coaches, trainers, administrators, parents, and teachers). In addition to the decisions made by doctors and athletic training staff, parents should closely and consistently monitor their child’s access to prescription pain medication and other drugs.
According to the Minority Stress Theory (Brooks, 1981; Meyer, 1995; Meyer, 2003), LGBTQ youth often face chronic stress from stigma, discrimination, and social rejection. This persistent stress can heighten their risk of mental health challenges, potentially leading to increased substance use as a way to cope, albeit one with negative effects (Goldbach et al., 2014). Based on this conceptualization, we hypothesized that sexual and gender minority students would be at increased risk of misusing drugs, and our study confirms this. As noted by Figure 1, this study finds that LGBQ youth have up to 90 percent and trans youth 551 percent higher odds of reporting prescription drug misuse, while their heterosexual and cisgender peers have significantly lower odds of reporting misuse. We cannot infer causality, but the findings reflect the Minority Stress Theory, which postulates that some LGBTQ youth cope with stressors associated with their sexual and gender identities (i.e., discrimination, harassment, violence, etc.) by engaging in negative coping mechanisms such as substance use (Goldbach et al., 2014). Substance misuse must continue to be a topic of conversation in supporting LGBTQ youth and their overall well-being.
One of the benefits of examining sports team participation across sexual orientation and gender identity was the ability to see more of the intersectional nuances. Given that past research indicates that sexual and gender minority youth often experience sports-related contexts as unwelcoming and places of heightened anxiety due to the potential for identity-based harassment (Neary & McBride, 2024), we hypothesized that the relationships (or interaction) between sports team participation and prescription drug misuse may be particularly problematic for gender and sexual minority athletes. This hypothesis was not supported. While all youth had higher odds of prescription drug misuse when participating in sports, the difference between the groups was not statistically significant. While these interactions are not additive, sports team participation does not necessarily indicate additional or heightened risk associated with being a gender and/or sexual minority athlete in particular. However, when considering the overall strength and trends in the coefficients, sports participation appears to be a greater risk factor for prescription drug misuse among heterosexual youth in particular. In addition, sports participation slightly reduced the odds of prescription drug misuse among LGBQ and trans students, leaving it unclear as to whether sports participation protects against prescription drug misuse for some LGBQ and trans youth. Overall, our findings reinforce the need to examine the positive as well as detrimental effects of sports participation on diverse groups of youth, including LGBTQ youth.

4.1. Future Research

Due to the cross-sectional nature of the data and the ability of states and counties to opt out of specific questions (those that have not been mandated as standard on the survey questionnaire), this study does not exist without certain limitations. While the findings of this study remain important, the generalizability of these findings to the broader population of youth may be limited due to the limited number of localities that asked the questions pertinent to this study. More localities should include questions on sports team participation, sexual orientation, and gender identity given the important findings of this study and others. Second, since we did not include measures of victimization in our models, we cannot definitively state that prescription drug misuse is associated with gender and sexual identity stressors like victimization. However, other research does support the premise that victimization experiences, including those related to being a gender and/or sexual minority, are associated with increased substance use (Fahey et al., 2023); thus, future work focusing on these relationships is recommended. Longitudinal research is also needed to empirically test the conceptualized relationships between gender and sexual minority identity stressors, sports participation, and substance use outcomes. Finally, we understand that, seen through the lens of intersectionality, other important structural factors may be at play, including the ways in which anti-immigrant and racist policies affect the health and well-being of trans and nonbinary students. We recognize that multiply marginalized identities and associated policies that adversely affect student health merit greater attention. By addressing these research gaps and implementing inclusive, evidence-based policies, schools and athletic programs can create safer, more supportive environments for LGBTQ athletes, potentially reducing their risk of substance use, the effects of which may carry over to cisgender and heterosexual peers as well.

4.2. Implications for School Health Policy, Practice, and Equity

The vast majority of school mental health professionals (SMHPs)—who are largely white, straight, and cisgender women—consider anti-LGBTQ bias to be a significant problem for students and report that nearly one-half of trans students in their schools would not feel safe (GLSEN et al., 2019). Still, eight out of ten SMHPs report that they received little to no competency training in their graduate programs for working with trans students, and over one-third had no post-graduate professional development on LGBTQ student issues in general (GLSEN et al., 2019). Not surprisingly, SMHPs feel least confident when meeting the needs of individual transgender students (GLSEN et al., 2019). Still, SMHPs seek to serve all of their students. With the right professional development, sufficient work time, and administrative leadership, educators can enhance LGBTQ youth’s well-being and education.
With additional support and competency training, and drawing directly on the lived experiences of LGBTQ youth, SMHPs can play a significant role in countering anti-trans policies and practices both in terms of implementing the existing helpful practices and reforming harmful policies and practices (Singh & Dickey, 2017). Professional educators seeking guidance on best practices to support LGBTQ students have access to several resources from professional organizations. For example, the National Association of School Psychologists (NASP) Safe and Supportive Schools for Transgender and Gender-Diverse Students document (National Association of School Psychologist, 2014) outlines student needs with clear policy and practice recommendations (e.g., administrative policies that prohibit discrimination against LGBTQ students, an inclusive curriculum, and access to safe restrooms that align with students’ gender identities). The NASP statement empowers educators to advocate, affirm, and protect LGBTQ students. Given the known mental health benefits of physical activity and participation in sports, such advocacy should include removing barriers for LGBTQ students who wish to participate in school sporting activities (C. R. Williams et al., 2023). Advocacy efforts may include the provision of training for coaches regarding the rights and contributions of LGBTQ students and their access to sports teams; educational opportunities for school district administrators and personnel regarding the positive effects of legal protections on LGBTQ student well-being in general (Watson et al., 2021), and with respect to sports participation, in particular (Clark & Kosciw, 2022); and the removal of barriers that limit LGBTQ students’ full participation in other school activities. For example, researchers have recently found a lower prevalence of depressive and anxiety symptoms among trans and gender-diverse youth who participate in sports, even among those who are also targeted with anti-trans bullying (Kaja et al., 2025). Notably, data for the study were collected in 2022, during the trans-affirming Biden administration, and among students in Minnesota, a state where students are protected against discrimination based on protected classes, including sexual orientation and gender identity.

5. Conclusions

We conclude by directly addressing the theme of the Special Issue and then turning to the policy implications of our findings. Strengths-based approaches to LGBTQ youth well-being seek to shift consideration of this marginalized population from the putatively “at-risk” to existing “beyond risk” by, for example, considering contextual and structural factors that produce negative outcomes at the individual level (Russell, 2005; Swadener, 1990). Scholars and advocates also have focused on the resilience of LGBTQ youth as they face systemic oppression, eschew negative representations, or choose to feature the healthy, creative, and joyful experiences of LGBTQ youth (Holloway, 2023). A third way to employ a strengths-based approach has emerged, which is to examine “how LGBTQ youth confront, challenge, and strive to upend the dominant relations in society such as challenging heteronormativity and the gender binary” (Robinson & Schmitz, 2021, p. 2).
We argue that our analysis follows this third approach by amplifying the experiences of sexual and gender minority youth who do confront and challenge ideological, institutionalized, and interpersonal forms of heteronormativity and the gender binary, and they do this by participating in sports qua LGBTQ youth. And, while we acknowledge limitations of a dataset designed to “measure risky behaviors,” the fact remains that LGBTQ youth across the U.S. also have been willing to share their demographic selves with an official, state-based data collection mechanism distributed at school. Without their active engagement with the survey, we would not be able to bring any such nuance to the study of sexual and gender minority youth, substance use, and sports participation. Notably, despite efforts to cease the circulation of existing data and curtail the collection of new data related to gender identity, the current federal administration has been under court order since 11 February 2025 to restore the contents of the YRBS website (Stone, 2025). We hope that moving forward, researchers will be able to rely consistently on CDC data and design new LGBTQ-inclusive and youth-centered research.
Next, we wish to address the relevant public policy implications of our findings. Beginning in 2020, state legislators, litigants backed by national organizations, electoral candidates, and citizen groups began overtly targeting transgender students and school districts with anti-trans bills, lawsuits, and messaging across the U.S. The goal of these efforts is to enforce a rigid gender binary and erase the existence of transgender and nonbinary youth from the public square. The mechanisms used include eliminating trans youth at the district or state level from gender-affirming sports activities, school facilities, and health care, excluding trans-inclusive curriculum, and withdrawing or limiting legal protections, such as those found in Title IX. Beginning in January 2025, trans youth (and adults) have been targeted by a set of presidential executive orders, which impose similar restrictions, but now at the national level from the executive branch of the federal government.
Before these recent discriminatory efforts, trans and nonbinary youth—and LGBQ youth—were already less likely to participate in school sports than their straight and cisgender peers. The unfortunate results of this escalating anti-trans climate include high rates of substance use and suicidality among trans and nonbinary youth, along with a reluctance among some trans and nonbinary youth to participate in sports, particularly if they are less “out” than some of their similarly situated peers (The Trevor Project, 2020, 2021).
Given the pernicious health effects of heightened negative public policy attention directed toward trans youth and sports (Nath et al., 2024), our analysis calls for investments in interdisciplinary youth-centered research on youth health and well-being that (1) holistically assesses multi-modal universal and targeted interventions (Silverstone et al., 2017) for and by LGBTQ youth across differences such as age, racial/ethnic/tribal identities, religion, and ability; (2) corrects deficit-based approaches with a resistance-oriented strengths-based framework to understand trans youth by (a) locating a root cause of health disparities within harmful school policies and practices rather than within the young people they harm, and (b) learning from LGBTQ youth how they navigate increasingly hostile environments; and (3) evaluates the short- and long-term effects of professional development and school community education on the reform and implementation of LGBQ and trans-inclusive school policies and practices (Cruz et al., 2023; Owens & Mattheus, 2022).
Schools play a significant role in supporting the education and wellness of LGBQ and trans and nonbinary youth. Opportunities include the provision of inclusive health education programs, such as mental health and substance use programming grounded in universal design to meet the needs of all students. Coaches and school staff who support student athletes may also be well-positioned to create affirming and safe environments for LGBTQ students. Should needs assessments determine that adult educators lack the knowledge and skills needed to provide these supports, professional development opportunities may address those deficits. Ultimately, the entire school community is responsible for and should collaborate to ensure that all youth can enjoy themselves while playing with dignity and free from discrimination (Aspen Institute, n.d.).

Author Contributions

Conceptualization, L.K.S., V.L., M.A., and J.L.; methodology, L.K.S., V.L., and M.A.; software, L.K.S.; validation, L.K.S. and V.L.; formal analysis, L.K.S.; data curation, L.K.S.; writing—original draft, L.K.S., V.L., M.A., and J.L.; writing—review and editing, L.K.S., V.L., M.A., and J.L.; visualization, L.K.S. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

The data presented in this study are openly available on the Centers for Disease Control—Youth Risk Behavior Surveillance System website https://www.cdc.gov/yrbs/index.html (accessed on 7 July 2020).

Conflicts of Interest

The authors declare no conflicts of interest.

Abbreviations

The following abbreviations are used in this manuscript:
CDCCenters for Disease Control
YRBSYouth Risk Behavior Survey

Note

1
Explanation of terminology choice—authors use a variety of terms when conducting research on or with youth who are not heterosexual and/or cisgender. Some use acronyms, while others use the phrase “sexual and/or gender minority youth.”

References

  1. Anderson, E., Alder, J., Turner, G., Batten, J., & Hardwicke, J. (2025). The experiences of transgender student-athletes. Journal for the Study of Sports and Athletes in Education. [Google Scholar] [CrossRef]
  2. Aspen Institute. (n.d.). Children’s bill of rights in sports. Available online: https://projectplay.org/childrens-rights-and-sports (accessed on 10 September 2024).
  3. Brooks, V. R. (1981). Minority stress and lesbian women. Lexington Books. [Google Scholar]
  4. Clark, C. M., & Kosciw, J. G. (2022). Engaged or excluded: LGBTQ youth’s participation in school sports and their relationship to psychological well-being. Psychology in the Schools, 59(1), 95–114. [Google Scholar] [CrossRef]
  5. Coakley, J. (2011). Youth sports: What counts as “positive development?”. Journal of Sport and Social Issues, 35(3), 306–324. [Google Scholar] [CrossRef]
  6. Cruz, T. H., Ross-Reed, D. E., FitzGerald, C. A., Overton, K., Landrau-Cribbs, E., & Schiff, M. (2023). Effects of school policies and programs on violence among all high school students and sexual and gender minority students. Journal of School Health, 93(8), 679–689. [Google Scholar] [CrossRef]
  7. Day, J. K., Fish, J. N., Perez-Brumer, A., Hatzenbuehler, M. L., & Russell, S. T. (2017). Transgender youth substance use disparities: Results from a population-based sample. Journal of Adolescent Health, 61(6), 729–735. [Google Scholar] [CrossRef]
  8. DeChants, J. P., Green, A. E., Price, M. N., & Davis, C. K. (2024). “I get treated poorly in regular school—Why add to it?”: Transgender girls’ experiences choosing to play or not play sports. Transgender Health, 9(1), 61–67. [Google Scholar] [CrossRef]
  9. Denham, B. E. (2014). High school sports participation and substance use: Differences by sport, race, and gender. Journal of Child & Adolescent Substance Abuse, 23(3), 145–154. [Google Scholar] [CrossRef]
  10. Denison, E., Jeanes, R., Faulkner, N., & O’Brien, K. S. (2021). The relationship between ‘coming out’ as lesbian, gay, or bisexual and experiences of homophobic behaviour in youth team sports. Sexuality Research and Social Policy, 18(3), 765–773. [Google Scholar] [CrossRef]
  11. De Pedro, K. T., & Gorse, M. M. (2023). Substance use among transgender youth: Associations with school-based victimization and school protective factors. Journal of LGBT Youth, 20(2), 390–406. [Google Scholar] [CrossRef]
  12. Diehl, K., Thiel, A., Zipfel, S., Mayer, J., & Litaker, D. G. (2012). How healthy is the behavior of young athletes? A systematic literature review and meta-analyses. Journal of Sports Science & Medicine, 11(2), 201–220. [Google Scholar]
  13. Dunn, M. S. (2014). Association between physical activity and substance use behaviors among high school students participating in the 2009 youth risk behavior survey. Psychological Reports, 114(3), 675–685. [Google Scholar] [CrossRef]
  14. Eitle, D., Turner, R. J., & Eitle, T. M. (2003). The deterrence hypothesis reexamined: Sports participation and substance use among young adults. Journal of Drug Issues, 33(1), 193–221. [Google Scholar] [CrossRef]
  15. Fahey, K. M. L., Kovacek, K., Abramovich, A., & Dermody, S. S. (2023). Substance use prevalence, patterns, and correlates in transgender and gender diverse youth: A scoping review. Drug and Alcohol Dependence, 250, 1–38. [Google Scholar] [CrossRef]
  16. GLSEN, ASCA, ACSSW & SSWAA. (2019). Supporting safe and healthy schools for lesbian, gay, bisexual, transgender, and queer students: A national survey of school counselors, social workers, and psychologists. Available online: https://www.glsen.org/sites/default/files/2019-11/Supporting_Safe_and_Healthy_Schools_%20Mental_Health_Professionals_2019.pdf (accessed on 3 January 2025).
  17. Goldbach, J. T., Tanner-Smith, E. E., Bagwell, M., & Dunlap, S. (2014). Minority stress and substance use in sexual minority adolescents: A meta-analysis. Prevention Science, 15(3), 350–363. [Google Scholar] [CrossRef]
  18. Greenspan, S. B., Griffith, C., Hayes, C. R., & Murtagh, E. F. (2019). LGBTQ+ and ally youths’ school athletics perspectives: A mixed-method analysis. Journal of LGBT Youth, 16(4), 403–434. [Google Scholar] [CrossRef]
  19. Holloway, B. T. (2023). Highlighting trans joy: A call to practitioners, researchers, and educators. Health Promotion Practice, 24(4), 612–614. [Google Scholar] [CrossRef]
  20. Kahle, L. (2020). Are sexual minorities more at risk? Bullying victimization among lesbian, gay, bisexual, and questioning youth. Journal of Interpersonal Violence, 35(21–22), 4960–4978. [Google Scholar] [CrossRef] [PubMed]
  21. Kaja, S. M., Gower, A. L., Parchem, B., Adler, S. J., Mcguire, J. K., Rider, G. N., & Eisenberg, M. E. (2025). Sports team participation, bias-based bullying, and mental health among transgender and gender diverse adolescents. Research Quarterly for Exercise and Sport, 1–9. [Google Scholar] [CrossRef] [PubMed]
  22. Kidd, J. D., Jackman, K. B., Wolff, M., Veldhuis, C. B., & Hughes, T. L. (2018). Risk and protective factors for substance use among sexual and gender minority youth: A scoping review. Current Addiction Report, 5(2), 158–173. [Google Scholar] [CrossRef]
  23. Kulick, A., Wernick, L. J., Espinoza, M. A. V., Newman, T. J., & Dessel, A. B. (2019). Three strikes and you’re out: Culture, facilities, and participation among LGBTQ youth in sports. Sport, Education and Society, 24(9), 939–953. [Google Scholar] [CrossRef]
  24. Kwan, M., Bobko, S., Faulkner, G., Donnelly, P., & Cairney, J. (2014). Sport participation and alcohol and illicit drug use in adolescents and young adults: A systematic review of longitudinal studies. Addictive Behaviors, 39(3), 497–506. [Google Scholar] [CrossRef]
  25. Mereish, E. H. (2019). Substance use and misuse among sexual and gender minority youth. Current Opinion in Psychology, 30, 123–127. [Google Scholar] [CrossRef] [PubMed]
  26. Meyer, I. H. (1995). Minority stress and mental health in gay men. Journal of Health and Social Behavior, 36(1), 38–56. [Google Scholar] [CrossRef] [PubMed]
  27. Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychology Bulletin, 129(5), 674–697. [Google Scholar] [CrossRef]
  28. Nath, R., Matthews, D. D., DeChants, J. P., Hobaica, S., Clark, C. M., Taylor, A. B., & Muñoz, G. (2024). 2024 U.S. national survey on the mental health of LGBTQ+ young people. The Trevor Project. Available online: https://www.thetrevorproject.org/survey-2024 (accessed on 18 January 2025).
  29. National Association of School Psychologist. (2014). Safe schools for transgender and gender diverse students. Available online: https://www.nasponline.org/assets/Documents/Research%20and%20Policy/Position%20Statements/Transgender_PositionStatement.pdf (accessed on 3 January 2025).
  30. Neary, A., & McBride, R. S. (2024). Beyond inclusion: Trans and gender diverse young people’s experiences of PE and school sport. Sport, Education and Society, 29(5), 593–606. [Google Scholar] [CrossRef]
  31. Owens, M., & Mattheus, D. (2022). Addressing health disparities in LGBTQ youth through professional development of middle school staff. Journal of School Health, 92, 1148–1154. [Google Scholar] [CrossRef]
  32. Robinson, B. A., & Schmitz, R. M. (2021). Beyond resilience: Resistance in the lives of LGBTQ youth. Sociology Compass, 15(12), e12947. [Google Scholar] [CrossRef]
  33. Russell, S. T. (2005). Beyond risk: Resilience in the lives of sexual minority youth. Journal of Gay & Lesbian Issues in Education, 2(3), 5–18. [Google Scholar] [CrossRef]
  34. Silverstone, P. H., Bercov, M., Suen, V. Y. M., Allen, A., Cribben, I., Goodrick, J., Henry, S., Pryce, C., Langstraat, P., Rittenbach, K., Chakraborty, S., Engles, R. C., & McCabe, C. (2017). Long-term results from the Empowering a Multimodal Pathway Toward Healthy Youth Program, a multimodal school-based approach, show marked reductions in suicidality, depression, and anxiety in 6227 students in grades 6–12 (aged 11–18). Frontiers Psychiatry, 8, 81. [Google Scholar] [CrossRef]
  35. Singh, A. A., & Dickey, L. M. (2017). Affirmative counseling and psychological practice with transgender and gender nonconforming clients. In K. A. DeBord, A. R. Fischer, K. J. Bieschke, & R. M. Perez (Eds.), Handbook of sexual orientation and gender diversity in counseling and psychotherapy (pp. 157–182). American Psychological Association. [Google Scholar]
  36. Stone, W. (2025, February 11). Judge orders restoration of federal health websites. NPR. Available online: https://www.npr.org/sections/shots-health-news/2025/02/11/nx-s1-5293387/judge-orders-cdc-fda-hhs-websites-restored (accessed on 1 March 2025).
  37. Swadener, E. B. (1990). Children and families “at risk”: Etiology, critique, and alternative paradigms. The Journal of Educational Foundations, 4(4), 17. [Google Scholar]
  38. The Trevor Project. (2020). LGBTQ youth sports participation: June 2020. Available online: https://www.thetrevorproject.org/wp-content/uploads/2021/08/June-2020-Brief-LGBTQ-Youth-Sports-Participation-Research-Brief.pdf (accessed on 3 January 2025).
  39. The Trevor Project. (2021). LGBTQ youth sports participation: September 2021. Available online: https://www.thetrevorproject.org/wp-content/uploads/2021/09/LGBTQ-Youth-and-Sports_-September-Research-Brief-2.pdf (accessed on 3 January 2025).
  40. Underwood, J. M., Brener, N., Thornton, J., Harris, W. A., Bryan, L. N., Shanklin, S. L., Deputy, N., Roberts, A. M., Queen, B., Chyen, D., Whittle, L., Lim, C., Yamakawa, Y., Leon-Nguyen, M., Kilmer, G., Smith-Grant, J., Demissie, Z., Jones, S. E., Clayton, H., & Dittus, P. (2020). Overview and methods for the youth risk behavior surveillance system—United States, 2019. MMWR Supplements, 69(1), 1–10. [Google Scholar] [CrossRef]
  41. Veliz, P., Boyd, C., & McCabe, S. E. (2013). Playing through pain: Sports participation and nonmedical use of opioid medications among adolescents. American Journal of Public Health, 103(5), e28–e30. [Google Scholar] [CrossRef]
  42. Veliz, P., Epstein-Ngo, Q. M., Meier, E., Ross-Durow, P. L., McCabe, S. E., & Boyd, C. J. (2014). Painfully obvious: A longitudinal examination of medical use and misuse of opioid medication among adolescent sports participants. Journal of Adolescent Health, 54(3), 333–340. [Google Scholar] [CrossRef]
  43. Veliz, P., Schulenberg, J., Patrick, M., Kloska, D., McCabe, S. E., & Zarrett, N. (2017). Competitive sports participation in high school and subsequent substance use in young adulthood: Assessing differences based on level of contact. International Review for the Sociology of Sport, 52(2), 240–259. [Google Scholar] [CrossRef]
  44. Veliz, P., Schulenberg, J. E., Zdroik, J., Werner, K. S., & McCabe, S. E. (2022). The initiation and developmental course of prescription drug misuse among high school athletes during the transition through young adulthood. American Journal of Epidemiology, 191(11), 1886–1896. [Google Scholar] [CrossRef]
  45. Voss, R. V., Kuhns, L. M., Phillips, G., Wang, X., Wolf, S. F., Garofalo, R., Reisner, S., & Beach, L. B. (2023). Physical inactivity and the role of bullying among gender minority youth participating in the 2017 and 2019 Youth Risk Behavior Survey. Journal of Adolescent Health, 72(2), 197–206. [Google Scholar] [CrossRef]
  46. Watson, R. J., Fish, J. N., Denary, W., Caba, A., Cunningham, C., & Easton, L. (2021). LGBTQ state policies: A lever for reducing SGM youth substance use and bullying. Drug and Alcohol Dependence, 221, 108659. [Google Scholar] [CrossRef]
  47. Williams, C. R., McKenna, J. L., Artessa, L., & Moore, L. B. M. (2023). Team effort: A call for mental health clinicians to support sports access for transgender and gender diverse youth. Journal of the American Academy of Child Adolescent Psychiatry, 62(8), 837–839. [Google Scholar] [CrossRef]
  48. Williams, G. C., Burns, K. E., Battista, K., De Groh, M., Jiang, Y., & Leatherdale, S. T. (2020). High school sport participation and substance use: A cross-sectional analysis of students from the COMPASS study. Addictive Behaviors Reports, 12, 100298. [Google Scholar] [CrossRef]
Youth 05 00077 g001
Figure 1. Odds ratios for prescription drug misuse across gender and sexual orientation.
Figure 1. Odds ratios for prescription drug misuse across gender and sexual orientation.
Youth 05 00077 g001
Table 1. Descriptive statistics.
Table 1. Descriptive statistics.
RangeFrequencyμSD
Independent Variables
Sports Team Participation0–1269444.5%0.497
LGBQ0–1111918.5%0.388
Trans0–1871.4%0.119
LGBQ*Sports Team Participation0–13836.3%0.245
Trans*Sports Team Participation0–1430.7%0.084
Dependent Variables
Prescription Drug Misuse0–186314%0.350
Controls
Sex (female)0–1329654.5%0.498
Am Ind/Alas Native/Haw other PI0–1661.1%0.104
Asian0–11522.5%0.157
Black or African American0–1119619.8%0.398
Hispanic/Latino0–1254042%0.493
Multiple races (non-Hispanic)0–12684.4%0.205
White0–1182830.2%0.459
Table 2. Sexual orientation, sports team participation, and prescription drug misuse.
Table 2. Sexual orientation, sports team participation, and prescription drug misuse.
(LGBQ Students)Prescription MisusePrescription MisusePrescription MisusePrescription Misuse
Model 1Model 2Model 3Model 4
βEXP(B)SEβEXP(B)SEβEXP(B)SEβEXP(B)SE
Sports team participation------0.2591.296 ***0.075------0.1921.211 *0.087
LGBQ*Sports------------0.4571.579 **0.1480.2651.3030.172
LGBQ0.6441.905 ***0.0860.6731.960 ***0.0860.4741.607 ***0.1040.5631.757 ***0.113
Sex (female)0.2671.306 ***0.0770.2861.332 ***0.0770.2651.304 ***0.0770.281.324 ***0.078
Am Ind/Alas Native/Haw other PI−0.1830.8330.386−0.1940.8230.386−0.1970.8210.386−0.200.8190.386
Asian0.2161.2410.2310.2671.3060.2310.211.2340.2310.251.2840.232
Black or African American0.1471.1580.1060.1441.1550.1060.1211.1290.1060.130.2210.106
Hispanic/Latino0.0181.0180.0890.0321.0330.0900.0091.0090.0890.0230.7960.090
Multiple races (non-Hispanic)−0.1160.890.195−0.1190.5420.195−0.1270.8810.195−0.1250.5230.195
Chi-square80.13 89.495 94.328
Log Likelihood4871.192 4861.826 4856.994
Nagelkerke R20.024 0.026 0.028
Constant−2.1240.120 ***0.083−2.2670.104 ***0.094−2.1130.121 ***0.083−2.2230.108 ***0.098
*** p ≤ 0.001; ** p ≤ 0.01; * p ≤ 0.05.
Table 3. Sexual orientation, sports team participation, and prescription drug misuse.
Table 3. Sexual orientation, sports team participation, and prescription drug misuse.
(Heterosexual Students)Prescription MisusePrescription MisusePrescription MisusePrescription Misuse
Model 5Model 6Model 7Model 8
βEXP(B)SEβEXP(B)SEβEXP(B)SEβEXP(B)SE
Sports team participation------0.2591.296 ***0.075------0.4561.578 **0.148
Heterosexual*Sports------------0.1921.212 *0.087-0.2650.7670.172
Heterosexual−0.6440.525 ***0.086−0.6730.510 ***0.086−0.7340.480 ***0.095−0.5630.569 ***0.113
Sex (female)0.2671.306 ***0.0770.2861.332 ***0.0770.2821.326 ***0.0780.281.324 ***0.078
Am Ind/Alas Native/Haw other PI−0.1830.8330.386−0.1940.8230.386−0.1860.8300.386−0.20.8190.386
Asian0.2161.2410.2310.2671.3060.2310.2561.2920.2310.251.2840.232
Black or African American0.1471.1580.1060.1441.1550.1060.1551.1680.1060.131.1390.106
Hispanic/Latino0.0181.0180.0890.0321.0330.090.0321.0330.090.0231.0230.09
Multiple races (non-Hispanic)−0.1160.890.195−0.1190.5420.195−0.1140.8930.195−0.1250.8830.195
Chi-square80.13 91.976 84.997 94.328
Log Likelihood4871.192 4859.346 4866.324 4856.994
Nagelkerke R20.024 0.027 0.025 0.028
Constant−1.480.228 ***0.109−1.5950.203 ***0.115−1.50.223 ***0.110−1.6590.190 ***0.124
*** p ≤ 0.001; ** p ≤ 0.01; * p ≤ 0.05.
Table 4. Gender identity, sports team participation, and prescription drug misuse.
Table 4. Gender identity, sports team participation, and prescription drug misuse.
(Transgender Students)Prescription MisusePrescription MisusePrescription MisusePrescription Misuse
Model 9Model 10Model 11Model 12
βEXP(B)SEβEXP(B)SEβEXP(B)SEβEXP(B)SE
Sports team participation------0.2041.227 **0.075------0.1951.216 *0.076
Trans*Sports------------0.5081.6620.4380.3151.3700.445
Trans1.7075.514 ***0.2211.7015.481 ***0.2211.4584.298 ***0.3101.5464.695 ***0.313
Sex (female)0.3681.445 ***0.0760.3881.474 ***0.0760.371.448 ***0.0760.3881.475 ***0.077
Am Ind/Alas Native/Haw other PI−0.1740.8410.387−0.1840.8320.388−0.1930.8240.389−0.1960.8220.390
Asian0.1611.1740.2330.2031.2250.2330.1561.1690.2330.1981.2190.234
Black or African American0.1441.1550.1060.1451.1560.1060.141.1510.1060.1431.1530.106
Hispanic/Latino0.0371.0370.0890.0511.0520.0900.0351.0360.0890.0491.050.090
Multiple races (non-Hispanic)−0.1040.9010.196−0.1030.9020.196−0.10.9050.195−0.1000.9040.196
Chi-square79.191 86.606 80.544 87.109
Log Likelihood4872.13 4864.716 4870.777 4864.75
Nagelkerke R20.023 0.025 0.024 0.026
Constant−2.0840.124 ***0.083−2.1960.111 ***0.093−2.0840.124 ***0.083−2.1910.112 ***0.093
*** p ≤ 0.001; ** p ≤ 0.01; * p ≤ 0.05.
Table 5. Gender identity, sports team participation, and prescription drug misuse.
Table 5. Gender identity, sports team participation, and prescription drug misuse.
(Cisgender Students)Prescription MisusePrescription MisusePrescription MisusePrescription Misuse
Model 13Model 14Model 15Model 16
βEXP(B)SEβEXP(B)SEβEXP(B)SEβEXP(B)SE
Sports team participation------0.2041.227 **0.075------0.5101.6660.439
Cis*Sports------------0.1951.215 **0.076−0.3150.730.445
Cisgender−1.7070.181 ***0.221−1.7010.182 ***0.221−1.7970.166 ***0.224−1.5460.213 ***0.313
Sex (female)0.3681.445 ***0.0760.3881.474 ***0.0760.3861.471 ***0.0760.3881.475 ***0.077
Am Ind/Alas Native/Haw other PI−0.1740.8410.387−0.1840.8320.388−0.1760.8380.387−0.1960.8220.39
Asian0.1611.1740.2330.2031.2250.2330.2031.2250.2330.1981.2190.243
Black or African American0.1441.1550.1060.1451.1560.1060.1461.1580.1060.1431.1530.106
Hispanic/Latino0.0371.0370.0890.0511.0520.090.0511.0520.090.0491.050.09
Multiple races (non-Hispanic)−0.1040.9010.196−0.4950.9020.196−0.1050.9010.196−0.1000.9040.196
Chi-square4872.13 86.606 85.746 87.109
Log Likelihood0.023 4864.716 4865.576 4864.213
Nagelkerke R20.023 0.025 0.025 0.026
Constant−0.3760.6860.228−0.4950.610 *0.233−0.3940.6740.229−0.6450.525 *0.316
*** p ≤ 0.001; ** p ≤ 0.01; * p ≤ 0.05.
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Semprevivo, L.K.; Lopez, V.; Adelman, M.; Lasser, J. The Pitfalls and Promises of Sports Participation and Prescription Drug Misuse Among Sexual and Gender Minority Youth. Youth 2025, 5, 77. https://doi.org/10.3390/youth5030077

AMA Style

Semprevivo LK, Lopez V, Adelman M, Lasser J. The Pitfalls and Promises of Sports Participation and Prescription Drug Misuse Among Sexual and Gender Minority Youth. Youth. 2025; 5(3):77. https://doi.org/10.3390/youth5030077

Chicago/Turabian Style

Semprevivo, Lindsay Kahle, Vera Lopez, Madelaine Adelman, and Jon Lasser. 2025. "The Pitfalls and Promises of Sports Participation and Prescription Drug Misuse Among Sexual and Gender Minority Youth" Youth 5, no. 3: 77. https://doi.org/10.3390/youth5030077

APA Style

Semprevivo, L. K., Lopez, V., Adelman, M., & Lasser, J. (2025). The Pitfalls and Promises of Sports Participation and Prescription Drug Misuse Among Sexual and Gender Minority Youth. Youth, 5(3), 77. https://doi.org/10.3390/youth5030077

Article Metrics

Back to TopTop