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# Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9--12
- URL: https://www.foodconsumer.org/sexual_identity_0606110851/
- Published: 2011-06-06T21:45:00.000Z
- Updated: 2026-09-22T18:41:03.000Z
- Description: A CDC report uses state and local Youth Risk Behavior Surveys from January 2001 to June 2009 to describe health-risk behaviors among sexual minority students in grades 9-12, arguing local data are needed to target and evaluate public health interventions for this group.
- Author: Food Consumer
- Tags: Lifestyle, Health News, #vivvo-import

# Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9--12 --- Youth Risk Behavior Surveillance, Selected Sites, United States,  
2001--2009

## *Early Release*

June 6, 2011 / 60(Early Release);1-133

Laura Kann, PhD

Emily O'Malley Olsen, MSPH

Tim McManus, MS

Steve Kinchen

David Chyen, MS

William A. Harris, MM

Howell Wechsler, EdD

*Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, CDC*

Corresponding author: Laura Kann, PhD, Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, MS K-33, 4770 Buford Hwy, NE, Atlanta, GA 30341\. Telephone: 770-488-6181; Fax: 770-488-6156; E-mail: [LKann@cdc.gov](mailto:LKann@cdc.gov).

### Abstract

Problem: Sexual minority youths are youths who identify themselves as gay or lesbian, bisexual, or unsure of their sexual identity or youths who have only had sexual contact with persons of the same sex or with both sexes. Population-based data on the health-risk behaviors practiced by sexual minority youths are needed at the state and local levels to most effectively monitor and ensure the effectiveness of public health interventions designed to address the needs of this population.

Reporting Period Covered: January 2001--June 2009

Description of the System: The Youth Risk Behavior Surveillance System (YRBSS) monitors priority health-risk behaviors (behaviors that contribute to unintentional injuries, behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, dietary behaviors, physical activity and sedentary behaviors, and weight management) and the prevalence of obesity and asthma among youths and young adults. YRBSS includes state and local school-based Youth Risk Behavior Surveys (YRBSs) conducted by state and local education and health agencies. This report summarizes results from YRBSs conducted during 2001--2009 in seven states and six large urban school districts that included questions on sexual identity (i.e., heterosexual, gay or lesbian, bisexual, or unsure), sex of sexual contacts (i.e., same sex only, opposite sex only, or both sexes), or both of these variables. The surveys were conducted among large population-based samples of public school students in grades 9--12.

Results: Across the nine sites that assessed sexual identity, the prevalence among gay or lesbian students was higher than the prevalence among heterosexual students for a median of 63.8% of all the risk behaviors measured, and the prevalence among bisexual students was higher than the prevalence among heterosexual students for a median of 76.0% of all the risk behaviors measured. In addition, the prevalence among gay or lesbian students was more likely to be higher than (rather than equal to or lower than) the prevalence among heterosexual students for behaviors in seven of the 10 risk behavior categories (behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, and weight management). Similarly, the prevalence among bisexual students was more likely to be higher than (rather than equal to or lower than) the prevalence among heterosexual students for behaviors in eight of the 10 risk behavior categories (behaviors that contribute to unintentional injuries, behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, and weight management).

Across the 12 sites that assessed sex of sexual contacts, the prevalence among students who had sexual contact with both sexes was higher than the prevalence among students who only had sexual contact with the opposite sex for a median of 71.1% of all the risk behaviors measured, and the prevalence among students who only had sexual contact with the same sex was higher than the prevalence among students who only had sexual contact with the opposite sex for a median of 29.7% of all the risk behaviors measured. Furthermore, the prevalence among students who had sexual contact with both sexes was more likely to be higher than (rather than equal to or lower than) the prevalence among students who only had sexual contact with the opposite sex for behaviors in six of the 10 risk behavior categories (behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, and weight management). The prevalence among students who only had sexual contact with the same sex was more likely to be higher than (rather than equal to or lower than) the prevalence among students who only had sexual contact with the opposite sex for behaviors in two risk behavior categories (behaviors related to attempted suicide and weight management).

Interpretation: Sexual minority students, particularly gay, lesbian, and bisexual students and students who had sexual contact with both sexes, are more likely to engage in health-risk behaviors than other students.

Public Health Action: Effective state and local public health and school health policies and practices should be developed to help reduce the prevalence of health-risk behaviors and improve health outcomes among sexual minority youths. In addition, more state and local surveys designed to monitor health-risk behaviors and selected health outcomes among population-based samples of students in grades 9--12 should include questions on sexual identity and sex of sexual contacts.

### Introduction

Sexual minority youths may be defined in at least two ways: by sexual identity or by the sex of their sexual contacts. Sexual minority youths defined by sexual identity include those who identify themselves as gay, lesbian, or bisexual or who are unsure of their sexual identity. Sexual minority youths defined by the sex of their sexual contacts include those who have only had sexual contact with persons of the same sex or with both sexes. Youths who identify themselves as heterosexual, gay, lesbian, or bisexual might not have had any sexual contact. Furthermore, youths who have only had sexual contact with persons of the same sex or with both sexes might identify themselves as heterosexual, and youths who have only had sexual contact with persons of the opposite sex might identify themselves as gay, lesbian, or bisexual. Some youths who eventually identify themselves as a sexual minority or only have sexual contact with persons of the same sex or both sexes might not identify themselves as a sexual minority and might not have had any sexual contact. This dissonance between sexual identity and sex of sexual contacts is well documented, particularly among youths (*1--7*).

Sexual minority youths have specific health needs and are at disproportionate risk for certain health problems. However, as described in a recent Institute of Medicine (IOM) report, more data about sexual minority youths are needed (*8*). CDC developed the Youth Risk Behavior Surveillance System (YRBSS) to monitor priority health-risk behaviors and selected health outcomes among all youths and young adults ([](http://www.cdc.gov/mmwr/pdf/rr/rr5312.pdf?ref=foodconsumer.org)). The YRBSS includes biennial, school-based Youth Risk Behavior Surveys (YRBSs) conducted among population-based samples of students in grades 9--12 in participating states and large urban school districts. To address the lack of knowledge about the health-risk behaviors and selected health outcomes among sexual minority students at the state and local levels, state and local agencies participating in YRBSS may add questions to their YRBS questionnaire to measure sexual identity, sex of sexual contacts, or both. Understanding state-level and local-level differences in the prevalence of health-risk behaviors and health outcomes by sexual minority status (defined by sexual identity or by sex of sexual contacts) as reported by large population-based samples of high school students will provide additional information about sexual minority youths and might help reduce the health disparities they experience (*8,10,11*).

This report summarizes results from YRBSs conducted during 2001--2009 from seven states and six large urban school districts that included questions on sexual identity, sex of sexual contacts, or both. The prevalence of health-risk behaviors and obesity and overweight is compared among subgroups of students defined by sexual identity and by sex of sexual contacts. All surveys were conducted during the spring semester of each survey year.

### Methods

Detailed information about the state and local YRBSs has been published elsewhere ([](http://www.cdc.gov/mmwr/pdf/rr/rr5312.pdf?ref=foodconsumer.org)). Information also is available at [http://www.cdc.gov/yrbs](http://www.cdc.gov/yrbs?ref=foodconsumer.org).

#### Inclusion Criteria

States and cities that included questions on sexual identity, the sex of sexual contacts, or both and had weighted YRBS data were eligible for inclusion in this report. To ensure stable estimates, each state and city was required to have ≥75 students per subgroup defined by sexual identity and sex of sexual contacts. To meet this minimum subgroup sample size requirement, multiple years of weighted YRBS data collected during 2001--2009 were combined by site ([Table 1](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab1)).

Five states (Delaware, Maine, Massachusetts, Rhode Island, and Vermont) and four large urban school districts (Boston, Massachusetts; Chicago, Illinois; New York City, New York; and San Francisco, California) asked a question on sexual identity and met the subgroup sample size requirement. Seven states (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, and Wisconsin) and five large urban school districts (Boston; Chicago; Milwaukee, Wisconsin; New York City; and San Diego, California) asked a question on the sex of sexual contacts and met the subgroup sample size requirement. Five states (Delaware, Maine, Massachusetts, Rhode Island, and Vermont) and three large urban school districts (Boston, Chicago, and New York City) asked questions on both sexual identity and sex of sexual contacts and met the subgroup sample size requirement.

#### Sampling

Each state and local YRBS included in this report used an independent, cross-sectional, two-stage cluster sample design to produce a representative sample of public school students in grades 9--12 in their jurisdiction. In the first sampling stage in Connecticut, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Chicago, Milwaukee, and New York City, schools with any of the grades 9--12 were sampled with probability proportional to school enrollment size. In Delaware, Boston, San Diego, and San Francisco, all schools with any of the grades 9--12 were sampled. In the second sampling stage, intact classes from either a required subject (e.g., English or social studies) or a required period (e.g., homeroom or second period) were sampled randomly, and all students in the sampled classes were eligible to participate. In Vermont, all students in sampled schools were eligible to participate.

#### Data Collection Procedures and Questionnaires

Survey procedures for each state and local YRBS were designed to protect student privacy by allowing for anonymous and voluntary participation. Before survey administration, local parental permission procedures were followed. Students completed the self-administered questionnaire during one class period and recorded their responses directly on a computer-scannable booklet or answer sheet.

Each survey year, the standard YRBS questionnaire contained approximately 87 questions. Sites could add or delete questions from the standard questionnaire. A YRBS optional question list was provided to all sites and was the source for the questions on sexual identity and the sex of sexual contacts for most sites. To protect student privacy, skip patterns were not included in any YRBS questionnaire, which ensured that all students took about the same amount of time to complete the questionnaire. Information about the reliability of most of the questions on the standard questionnaire has been published elsewhere (*12*).

#### Data Processing Procedures and Response Rates

Data from each state and local YRBS were cleaned and edited for inconsistencies using standard procedures each survey year. Among the surveys included in this report, the number of completed questionnaires that failed quality control checks and were excluded from analysis ranged from 0 to 249 (median: 12). School response rates ranged from 73% to 100%, student response rates ranged from 63% to 90%, and overall response rates ranged from 60% to 90%. After the data from multiple survey years were combined by site, the total sample sizes used for this report ranged from 3,733 to 36,774 ([Table 2](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab2)). Demographic characteristics of the samples varied by site.

For most sites in most survey years, the sexual identity of students was based on responses to the optional YRBS question, "Which of the following best describes you?" and the response options 1) "heterosexual (straight)," 2) "gay or lesbian," 3) "bisexual," and 4) "not sure." This optional YRBS question was modified by three sites in selected survey years. In 2007 and 2009, New York City changed the response options for this question to "heterosexual or straight," "gay or lesbian," "bisexual," and "not sure." In 2003 and 2005, Delaware changed the response options for this question to "heterosexual (straight)," "homosexual (gay or lesbian)," "bisexual," "not sure," and "none of the above." The 49 students in 2003 and 40 students in 2005 who selected "none of the above" were excluded from the sexual identity analyses. In 2007, Delaware changed the response options for this question to "heterosexual (straight)," "homosexual (gay or lesbian)," "bisexual," and "not sure." In 2001, the San Francisco survey asked "How would you describe your sexual orientation/preference?" with response options "heterosexual, attracted to the opposite sex," "bisexual, attracted to both sexes," "homosexual, gay or lesbian," and "not sure." In this report, students who responded to the question on sexual identity were classified as heterosexual, gay or lesbian, bisexual, or unsure.

For most sites in most survey years, the sex of the students' sexual contacts was based on responses to 1) the standard YRBS question, "What is your sex?" and the response options "female" and "male" and 2) the optional YRBS question, "During your life, with whom have you had sexual contact?" and the response options "I have never had sexual contact," "females," "males," and "females and males." This optional YRBS question was modified by seven sites in selected survey years. Maine modified this question in 2001, 2003, and 2005 to "The person(s) with whom you have had sexual contact during your life is (are)," with the response options "I have never had sexual contact," "female," "male," and "male and female." Massachusetts and Boston in 2001, 2003, and 2005 and Chicago in 2003 asked, "During your life, the person(s) with whom you have had sexual contact is (are)," with the response options "I have not had sexual contact with anyone," "female(s)," "male(s)," and "female(s) and male(s)." Delaware in 2003 and 2005; Vermont in 2001, 2003, 2005, 2007, and 2009; and San Diego in 2001, 2003, and 2005 asked, "With whom have you had sexual intercourse?" with the response options "I have never had sexual intercourse," "females," "males," and "females and males." Delaware in 2007 and 2009 asked, "During your life, with whom have you had sexual intercourse?" with the response options "I have never had sexual intercourse," "females," "males," and "females and males." In this report, students who responded to the question on the sex of sexual contacts were classified as students who only had sexual contact with the opposite sex, students who only had sexual contact with the same sex, or students who had sexual contact with both sexes. Students who had never had sexual contact were excluded from these analyses.

Since 2001, race/ethnicity has been assessed by the standard YRBS questionnaire two ways. In 2001, 2003, and 2005, race/ethnicity was based on responses to one standard YRBS question: "How do you describe yourself? (select one or more responses)," with response options "American Indian or Alaska Native," "Asian," "black or African American," "Hispanic or Latino," "Native Hawaiian or other Pacific Islander," and "white." In this report, students are classified as Hispanic/Latino and are referred to as Hispanic if they selected Hispanic or Latino only or with any other response option. Students are classified as black or African American and referred to as black if they selected black or African American and did not select Hispanic or Latino. Students who did not select Hispanic or Latino and selected white are classified as white and referred to as white.

In 2007 and 2009, race/ethnicity was based on responses to two standard YRBS questions: "Are you Hispanic or Latino?" with response options "yes" or "no" and "What is your race? (select one or more responses)," with response options "American Indian or Alaska Native," "Asian," "black or African American," "Native Hawaiian or other Pacific Islander," or "white." In this report, students are classified as Hispanic/Latino and referred to as Hispanic if they responded "yes" to the first question, regardless of how they answered the second question. Students who responded "no" to the first question and selected only black or African American for the second question are classified as black or African American and are referred to as black. Students who responded "no" to the first question and selected only white for the second question are classified as white and referred to as white. Race/ethnicity was classified as missing for students who did not answer the first question and for students who answered "no" to the first question but did not answer the second question.

Students were classified as obese or overweight based on their body mass index (BMI), measured as kilograms/metersTable 3). The percentage of students who were unsure of their sexual identity ranged from 1.3% to 4.7% (median 2.5%). Across the 12 sites that assessed sex of sexual contacts, the percentage of students who only had sexual contact with the opposite sex ranged from 37.2% to 60.9% (median: 53.5%), only had sexual contact with the same sex ranged from 0.7% to 3.9% (median: 2.5%), and had sexual contact with both sexes ranged from 1.9% to 4.9% (median: 3.3%). The percentage of students who had no sexual contact ranged from 30.4% to 59.3% (median: 40.5%).

Across the eight sites that assessed both sex of sexual contacts and sexual identity, the percentage of students who identified themselves as heterosexual ranged from 94.9% to 97.7% (median: 96.3%) among students who only had sexual contact with the opposite sex, from 17.0% to 77.8% (median: 61.7%) among students who only had sexual contact with the same sex, and from 17.3% to 63.4% (median: 29.8%) among students who had sexual contact with both sexes. The percentage of students who identified themselves as gay or lesbian ranged from 0.0% to 0.8% (median: 0.4%) among students who only had sexual contact with the opposite sex, from 10.8% to 60.0% (median: 21.7%) among students who only had sexual contact with the same sex, and from 2.3% to 14.7% (median: 9.1%) among students who had sexual contact with both sexes. The percentage of students who identified themselves as bisexual ranged from 1.2% to 3.3% (median: 2.0%) among students who only had sexual contact with the opposite sex, from 6.6% to 22.3% (median: 11.3%) among students who only had sexual contact with the same sex, and from 24.9% to 61.9% (median: 50.9%) among students who had sexual contact with both sexes. The percentage of students who were unsure of their sexual identity ranged from 0.6% to 2.1% (median: 1.4%) among students who only had sexual contact with the opposite sex, from 0.7% to 6.6% (median: 4.4%) among students who only had sexual contact with the same sex, and from 6.1% to 15.9% (median: 10.1%) among students who had sexual contact with both sexes ([Table 4](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab4)).

#### Behaviors that Contribute to Unintentional Injuries

#### Rarely or Never Wore a Seatbelt

Across the nine sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Chicago, New York City, and San Francisco) that assessed having never or rarely worn a seatbelt when riding in a car driven by someone else and sexual identity, the prevalence of having rarely or never worn a seatbelt ranged from 7.1% to 23.2% (median: 12.3%) among heterosexual students, from 13.1% to 35.8% (median: 21.0%) among gay or lesbian students, from 11.3% to 28.8% (median: 20.4%) among bisexual students, and from 11.5% to 23.5% (median: 18.7%) among unsure students ([Table 5](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab5)). The prevalence of having rarely or never worn a seatbelt was lower among heterosexual than gay or lesbian students in five sites (Delaware, Massachusetts, Rhode Island, Vermont, and Boston), lower among heterosexual than bisexual students in six sites (Delaware, Massachusetts, Rhode Island, Vermont, New York City, and San Francisco), and lower among heterosexual than unsure students in four sites (Massachusetts, Vermont, New York City, and San Francisco). The prevalence of having rarely or never worn a seatbelt was higher among gay or lesbian than bisexual students in one site (Massachusetts) and higher among gay or lesbian than unsure students in three sites (Massachusetts, Rhode Island, and Vermont).

Across the 12 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed having rarely or never worn a seatbelt and sex of sexual contacts, the prevalence of having rarely or never worn a seatbelt ranged from 8.5% to 29.7% (median: 15.2%) among students who only had sexual contact with the opposite sex, from 14.3% to 29.3% (median: 22.4%) among students who only had sexual contact with the same sex, and from 13.4% to 29.8% (median: 20.2%) among students who had sexual contact with both sexes. The prevalence of having rarely or never worn a seatbelt was lower among students who only had sexual contact with the opposite sex than students who only had sexual contact with the same sex in four sites (Massachusetts, Rhode Island, Vermont, and Wisconsin) and lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in four sites (Delaware, Massachusetts, Vermont, and New York City).

#### Rarely or Never Wore a Bicycle Helmet

Across the nine sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Chicago, New York City, and San Francisco) that assessed, among students who had ridden a bicycle during the 12 months before the survey, having rarely or never worn a bicycle helmet and sexual identity, the prevalence of having rarely or never worn a bicycle helmet ranged from 58.6% to 95.3% (median: 81.0%) among heterosexual students, from 64.6% to 88.0% (median: 78.4%) among gay or lesbian students, from 61.2% to 91.7% (median: 87.0%) among bisexual students, and from 53.2% to 84.6% (median: 67.4%) among unsure students ([Table 6](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab6)). The prevalence of having rarely or never worn a bicycle helmet was lower among heterosexual than bisexual students in four sites (Delaware, Massachusetts, Rhode Island, and Vermont) and higher among heterosexual than unsure students in four sites (Boston, Chicago, New York City, and San Francisco). The prevalence of having rarely or never worn a bicycle helmet was lower among gay or lesbian than bisexual students in two sites (Delaware and Vermont), higher among gay or lesbian than unsure students in three sites (Vermont, New York City, and San Francisco), and higher among bisexual than unsure students in five sites (Massachusetts, Rhode Island, Vermont, Boston, and New York City).

Across the 12 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed having rarely or never worn a bicycle helmet and sex of sexual contacts, the prevalence of having rarely or never worn a bicycle helmet ranged from 74.0% to 96.2% (median: 89.7%) among students who only had sexual contact with the opposite sex, from 70.6% to 94.8% (median: 88.3%) among students who only had sexual contact with the same sex, and from 76.0% to 98.6% (median: 88.5%) among students who had sexual contact with both sexes. The prevalence of having rarely or never worn a bicycle helmet was lower among students who only had sexual contact with the opposite sex than students who only had sexual contact with the same sex in one site (Maine), lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in two sites (Massachusetts and Wisconsin), higher among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in one site (New York City), and higher among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in one site (Connecticut).

#### Rode with a Driver Who Had Been Drinking Alcohol

Across the nine sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Chicago, New York City, and San Francisco) that assessed having ridden, one or more times during the 30 days before the survey, in a car or other vehicle driven by someone who had been drinking alcohol and sexual identity, the prevalence of having ridden with a driver who had been drinking alcohol ranged from 17.1% to 30.5% (median: 22.9%) among heterosexual students, from 16.6% to 46.3% (median: 36.5%) among gay or lesbian students, from 20.1% to 41.6% (median: 33.6%) among bisexual students, and from 19.0% to 50.1% (median: 32.0%) among unsure students ([Table 7](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab7)). The prevalence of having ridden with a driver who had been drinking alcohol was lower among heterosexual than gay or lesbian students in three sites (Massachusetts, Vermont, and Chicago), lower among heterosexual than bisexual students in six sites (Delaware, Massachusetts, Rhode Island, Vermont, Boston, and San Francisco), and lower among heterosexual than unsure students in two sites (Maine and Vermont).

Across the 12 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed having ridden with a driver who had been drinking alcohol and sex of sexual contacts, the prevalence of having ridden with a driver who had been drinking alcohol ranged from 20.3% to 38.5% (median: 33.2%) among students who only had sexual contact with the opposite sex, from 31.8% to 45.2% (median: 37.8%) among students who only had sexual contact with the same sex, and from 27.9% to 52.6% (median: 42.1%) among students who had sexual contact with both sexes. The prevalence of having ridden with a driver who had been drinking alcohol was lower among students who only had sexual contact with the opposite sex than students who only had sexual contact with the same sex in one site (Wisconsin), lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in eight sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, and San Diego), and lower among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in three sites (Connecticut, Massachusetts, and Vermont).

#### Drove When Drinking Alcohol

Across the nine sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Chicago, New York City, and San Francisco) that assessed having driven a car or other vehicle one or more times when they had been drinking alcohol during the 30 days before the survey and sexual identity, the prevalence of having driven when they had been drinking alcohol ranged from 2.9% to 10.2% (median: 7.8%) among heterosexual students, from 7.0% to 30.2% (median: 15.4%) among gay or lesbian students, from 6.0% to 18.3% (median: 13.3%) among bisexual students, and from 2.1% to 19.5% (median: 16.3%) among unsure students ([Table 8](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab8)). The prevalence of having driven when they had been drinking alcohol was lower among heterosexual than gay or lesbian students in five sites (Delaware, Massachusetts, Vermont, Boston, and New York City), lower among heterosexual than bisexual students in seven sites (Delaware, Massachusetts, Vermont, Boston, Chicago, New York City, and San Francisco), and lower among heterosexual than unsure students in five sites (Delaware, Massachusetts, Vermont, Boston, and New York City). The prevalence of having driven when they had been drinking alcohol was higher among gay or lesbian than bisexual students in two sites (Massachusetts and Vermont), higher among gay or lesbian than unsure students in two sites (Massachusetts and Vermont), and higher among bisexual than unsure students in one site (San Francisco).

Across the 12 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed having driven when they had been drinking alcohol and sex of sexual contacts, the prevalence of having driven when they had been drinking alcohol ranged from 4.2% to 17.6% (median: 13.8%) among students who only had sexual contact with the opposite sex, from 7.2% to 22.5% (median: 16.5%) among students who only had sexual contact with the same sex, and from 9.3% to 35.0% (median: 19.3%) among students who had sexual contact with both sexes. The prevalence of having driven when they had been drinking alcohol was lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in nine sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Milwaukee, and New York City) and lower among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in four sites (Maine, Massachusetts, Rhode Island, and Vermont).

#### Behaviors that Contribute to Violence

#### Carried a Weapon

Across the eight sites (Delaware, Maine, Massachusetts, Rhode Island, Boston, Chicago, New York City, and San Francisco) that assessed having carried a weapon (e.g., a gun, knife, or club) on at least 1 day during the 30 days before the survey and sexual identity, the prevalence of having carried a weapon ranged from 9.8% to 17.6% (median: 13.6%) among heterosexual students, from 19.8% to 31.0% (median: 22.9%) among gay or lesbian students, from 18.9% to 36.5% (median: 22.5%) among bisexual students, and from 8.1% to 34.5% (median: 20.4%) among unsure students ([Table 9](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab9)). The prevalence of having carried a weapon was lower among heterosexual than gay or lesbian students in five sites (Delaware, Massachusetts, Rhode Island, New York City, and San Francisco), lower among heterosexual than bisexual students in all eight sites, and lower among heterosexual than unsure students in two sites (Massachusetts and New York City). The prevalence of having carried a weapon was higher among gay or lesbian than bisexual students in one site (Massachusetts), higher among gay or lesbian than unsure students in one site (San Francisco), and higher among bisexual than unsure students in one site (San Francisco).

Across the 11 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed having carried a weapon and sex of sexual contacts, the prevalence of having carried a weapon ranged from 13.0% to 22.9% (median: 18.4%) among students who only had sexual contact with the opposite sex, from 18.4% to 34.3% (median: 25.8%) among students who only had sexual contact with the same sex, and from 20.0% to 45.0% (median: 25.5%) among students who had sexual contact with both sexes. The prevalence of having carried a weapon was lower among students who only had sexual contact with the opposite sex than students who only had sexual contact with the same sex in four sites (Delaware, Massachusetts, Rhode Island, and New York City), lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in seven sites (Connecticut, Delaware, Massachusetts, Rhode Island, Wisconsin, New York City, and San Diego), and lower among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in one site (San Diego).

#### Carried a Gun

Across the seven sites (Delaware, Maine, Massachusetts, Boston, Chicago, New York City, and San Francisco) that assessed having carried a gun on at least 1 day during the 30 days before the survey and sexual identity, the prevalence of having carried a gun ranged from 2.3% to 5.3% (median: 3.8%) among heterosexual students, from 6.7% to 18.2% (median: 12.1%) among gay or lesbian students, from 5.1% to 20.7% (median: 8.4%) among bisexual students, and from 2.3% to 23.5% (median: 10.4%) among unsure students ([Table 10](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab10)). The prevalence of having carried a gun was lower among heterosexual than gay or lesbian students in four sites (Delaware, Massachusetts, Boston, and New York City), lower among heterosexual than bisexual students in three sites (Massachusetts, New York City, and San Francisco), and lower among heterosexual than unsure students in five sites (Delaware, Maine, Massachusetts, Boston, and New York City). The prevalence of having carried a gun was higher among gay or lesbian than bisexual students in one site (Massachusetts), lower among bisexual than unsure students in one site (Massachusetts), and higher among bisexual than unsure students in one site (San Francisco).

Across the nine sites (Delaware, Maine, Massachusetts, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed having carried a gun and sex of sexual contacts, the prevalence of having carried a gun ranged from 4.2% to 10.3% (median: 6.3%) among students who only had sexual contact with the opposite sex, from 6.0% to 20.6% (median: 7.9%) among students who only had sexual contact with the same sex, and from 5.6% to 22.1% (median: 9.9%) among students who had sexual contact with both sexes. The prevalence of having carried a gun was lower among students who only had sexual contact with the opposite sex than students who only had sexual contact with the same sex in three sites (Delaware, Maine, and Massachusetts), lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in four sites (Delaware, Massachusetts, New York City, and San Diego), higher among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in one site (Milwaukee), and lower among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in one site (San Diego).

#### In a Physical Fight

Across the nine sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Chicago, New York City, and San Francisco) that assessed having been in a physical fight one or more times during the 12 months before the survey and sexual identity, the prevalence of having been in a physical fight ranged from 23.5% to 40.4% (median: 29.0%) among heterosexual students, from 35.7% to 50.5% (median: 41.8%) among gay or lesbian students, from 41.5% to 50.3% (median: 42.8%) among bisexual students, and from 23.5% to 51.2% (median: 35.0%) among unsure students ([Table 11](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab11)). The prevalence of having been in a physical fight was lower among heterosexual than gay or lesbian students in seven sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, and San Francisco), lower among heterosexual than bisexual students in eight sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, New York City, and San Francisco), and lower among heterosexual than unsure students in five sites (Delaware, Maine, Massachusetts, Rhode Island, and Vermont). The prevalence of having been in a physical fight was higher among gay or lesbian than unsure students in four sites (Massachusetts, Vermont, Boston, and San Francisco) and higher among bisexual than unsure students in six sites (Massachusetts, Rhode Island, Vermont, Boston, New York City, and San Francisco).

Across the 12 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed having been in a physical fight and sex of sexual contacts, the prevalence of having been in a physical fight ranged from 31.5% to 50.0% (median: 38.7%) among students who only had sexual contact with the opposite sex, from 32.2% to 47.9% (median: 42.0%) among students who only had sexual contact with the same sex, and from 43.3% to 72.4% (median: 49.8%) among students who had sexual contact with both sexes. The prevalence of having been in a physical fight was lower among students who only had sexual contact with the opposite sex than students who only had sexual contact with the same sex in one site (Vermont), lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in eight sites (Connecticut, Delaware, Massachusetts, Rhode Island, Vermont, Wisconsin, New York City, and San Diego), and lower among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in six sites (Connecticut, Delaware, Massachusetts, Vermont, Wisconsin, and San Diego).

#### Injured in a Physical Fight

Across the nine sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Chicago, New York City, and San Francisco) that assessed having been in a physical fight one or more times during the 12 months before the survey in which they were injured and had to be treated by a doctor or nurse and sexual identity, the prevalence of having been injured in a physical fight ranged from 2.3% to 4.6% (median: 3.4%) among heterosexual students, from 3.7% to 20.3% (median: 15.5%) among gay or lesbian students, from 7.3% to 14.1% (median: 8.8%) among bisexual students, and from 3.9% to 13.4% (median: 9.8%) among unsure students ([Table 12](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab12)). The prevalence of having been injured in a physical fight was lower among heterosexual than gay or lesbian students in eight sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Chicago, and San Francisco), lower among heterosexual than bisexual students in eight sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Chicago, and San Francisco), and lower among heterosexual than unsure students in seven sites (Delaware, Maine, Massachusetts, Vermont, Boston, Chicago, and New York City). The prevalence of having been injured in a physical fight was higher among gay or lesbian than bisexual students in three sites (Delaware, Massachusetts, and Vermont), higher among gay or lesbian than unsure students in four sites (Massachusetts, Rhode Island, Vermont, and San Francisco), and higher among bisexual than unsure students in one site (San Francisco).

Across the 12 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed having been injured in a physical fight and sex of sexual contacts, the prevalence of having been injured in a physical fight ranged from 2.2% to 6.6% (median: 4.9%) among students who only had sexual contact with the opposite sex, from 5.8% to 20.3% (median: 11.3%) among students who only had sexual contact with the same sex, and from 8.5% to 22.7% (median: 12.1%) among students who had sexual contact with both sexes. The prevalence of having been injured in a physical fight was lower among students who only had sexual contact with the opposite sex than students who only had sexual contact with the same sex in five sites (Maine, Massachusetts, Vermont, Wisconsin, and Boston), lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in nine sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, and San Diego), higher among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in one site (Maine), and lower among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in one site (Vermont).

#### Dating Violence

Across the eight sites (Delaware, Maine, Rhode Island, Vermont, Boston, Chicago, New York City, and San Francisco) that assessed having been hit, slapped, or physically hurt on purpose by their boyfriend or girlfriend during the 12 months before the survey (i.e., dating violence) and sexual identity, the prevalence of dating violence ranged from 6.1% to 13.8% (median: 10.2%) among heterosexual students, from 19.1% to 29.2% (median: 27.5%) among gay or lesbian students, from 17.7% to 28.0% (median: 23.3%) among bisexual students, and from 7.7% to 29.9% (median: 19.3%) among unsure students ([Table 13](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab13)). The prevalence of dating violence was lower among heterosexual than gay or lesbian students in six sites (Delaware, Maine, Vermont, Chicago, New York City, and San Francisco), lower among heterosexual than bisexual students in all eight sites, and lower among heterosexual than unsure students in five sites (Delaware, Maine, Rhode Island, Vermont, and New York City). The prevalence of dating violence was higher among gay or lesbian than bisexual students in one site (Vermont), higher among gay or lesbian than unsure students in two sites (New York City and San Francisco), and higher among bisexual than unsure students in two sites (Chicago and San Francisco).

Across the 11 sites (Connecticut, Delaware, Maine, Rhode Island, Vermont, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed dating violence and sex of sexual contacts, the prevalence of dating violence ranged from 11.5% to 17.1% (median: 14.2%) among students who only had sexual contact with the opposite sex, from 16.3% to 26.2% (median: 19.9%) among students who only had sexual contact with the same sex, and from 26.3% to 39.6% (median: 29.8%) among students who had sexual contact with both sexes. The prevalence of dating violence was lower among students who only had sexual contact with the opposite sex than students who only had sexual contact with the same sex in three sites (Connecticut, Rhode Island, and Vermont), lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in all 11 sites, and lower among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in four sites (Delaware, Vermont, New York City, and San Diego).

#### Forced to Have Sexual Intercourse

Across the seven sites (Delaware, Maine, Rhode Island, Boston, Chicago, New York City, and San Francisco) that assessed ever having been physically forced to have sexual intercourse when they did not want to and sexual identity, the prevalence of having been forced to have sexual intercourse ranged from 5.2% to 8.4% (median: 7.2%) among heterosexual students, from 14.1% to 31.0% (median: 23.7%) among gay or lesbian students, from 16.6% to 32.1% (median: 22.6%) among bisexual students, and from 10.4% to 25.3% (median: 19.8%) among unsure students ([Table 14](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab14)). The prevalence of having been forced to have sexual intercourse was lower among heterosexual than gay or lesbian students in five sites (Delaware, Maine, Rhode Island, Chicago, and New York City), lower among heterosexual than bisexual students in six sites (Delaware, Maine, Rhode Island, Chicago, New York City, and San Francisco), and lower among heterosexual than unsure students in six sites (Delaware, Maine, Rhode Island, Chicago, New York City, and San Francisco). The prevalence of having been forced to have sexual intercourse was higher among bisexual than unsure students in two sites (Delaware and San Francisco).

Across the eight sites (Connecticut, Delaware, Maine, Rhode Island, Boston, Chicago, New York City, and San Diego) that assessed having been forced to have sexual intercourse and sex of sexual contacts, the prevalence of having been forced to have sexual intercourse ranged from 9.6% to 15.3% (median: 10.6%) among students who only had sexual contact with the opposite sex, from 14.6% to 29.4% (median: 17.3%) among students who only had sexual contact with the same sex, and from 19.9% to 53.4% (median: 27.3%) among students who had sexual contact with both sexes. The prevalence of having been forced to have sexual intercourse was lower among students who only had sexual contact with the opposite sex than students who only had sexual contact with the same sex in three sites (Delaware, Chicago, and New York City), lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in seven sites (Connecticut, Delaware, Maine, Rhode Island, Chicago, New York City, and San Diego), and lower among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in five sites (Delaware, Maine, Rhode Island, New York City, and San Diego).

#### Carried a Weapon on School Property

Across the nine sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Chicago, New York City, and San Francisco) that assessed having carried a weapon (e.g., a gun, knife, or club) on school property on at least 1 day during the 30 days before the survey and sexual identity, the prevalence of having carried a weapon on school property ranged from 3.7% to 8.3% (median: 4.6%) among heterosexual students, from 9.9% to 30.5% (median: 16.1%) among gay or lesbian students, from 7.8% to 19.3% (median: 12.8%) among bisexual students, and from 5.9% to 16.6% (median: 10.1%) among unsure students ([Table 15](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab15)). The prevalence of having carried a weapon on school property was lower among heterosexual than gay or lesbian students in seven sites (Delaware, Massachusetts, Rhode Island, Vermont, Boston, New York City, and San Francisco), lower among heterosexual than bisexual students in eight sites (Delaware, Massachusetts, Rhode Island, Vermont, Boston, Chicago, New York City, and San Francisco), and lower among heterosexual than unsure students in three sites (Massachusetts, Vermont, and New York City). The prevalence of having carried a weapon on school property was higher among gay or lesbian than bisexual students in two sites (Massachusetts and Vermont), higher among gay or lesbian than unsure students in three sites (Rhode Island, Vermont, and San Francisco), lower among bisexual than unsure students in one site (Massachusetts), and higher among bisexual than unsure students in one site (San Francisco).

Across the 12 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed having carried a weapon on school property and sex of sexual contacts, the prevalence of having carried a weapon on school property ranged from 4.5% to 13.3% (median: 7.0%) among students who only had sexual contact with the opposite sex, from 7.5% to 26.4% (median: 11.5%) among students who only had sexual contact with the same sex, and from 9.4% to 38.2% (median: 14.7%) among students who had sexual contact with both sexes. The prevalence of having carried a weapon on school property was lower among students who only had sexual contact with the opposite sex than students who only had sexual contact with the same sex in four sites (Massachusetts, Rhode Island, Vermont, and New York City), lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in 10 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, New York City, and San Diego), and lower among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in three sites (Connecticut, Vermont, and San Diego).

#### Threatened or Injured with a Weapon on School Property

Across the nine sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Chicago, New York City, and San Francisco) that assessed having been threatened or injured with a weapon (e.g., a gun, knife, or club) on school property one or more times during the 12 months before the survey and sexual identity, the prevalence of having been threatened or injured with a weapon on school property ranged from 5.3% to 10.7% (median: 6.1%) among heterosexual students, from 12.0% to 28.1% (median: 18.5%) among gay or lesbian students, from 12.3% to 28.1% (median: 15.5%) among bisexual students, and from 8.4% to 25.7% (median: 17.1%) among unsure students ([Table 16](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab16)). The prevalence of having been threatened or injured with a weapon on school property was lower among heterosexual than gay or lesbian students in eight sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, New York City, and San Francisco), lower among heterosexual than bisexual students in all nine sites, and lower among heterosexual than unsure students in seven sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, and New York City). The prevalence of having been threatened or injured with a weapon on school property was higher among gay or lesbian than bisexual students in two sites (Massachusetts and Vermont), lower among gay or lesbian than bisexual students in one site (Chicago), higher among gay or lesbian than unsure students in three sites (Massachusetts, Rhode Island, and Vermont), and higher among bisexual than unsure students in one site (San Francisco).

Across the 12 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed having been threatened or injured with a weapon on school property and sex of sexual contacts, the prevalence of having been threatened or injured with a weapon on school property ranged from 6.7% to 13.3% (median: 8.1%) among students who only had sexual contact with the opposite sex, from 10.6% to 21.8% (median: 17.7%) among students who only had sexual contact with the same sex, and from 13.8% to 33.4% (median: 18.3%) among students who had sexual contact with both sexes. The prevalence of having been threatened or injured with a weapon on school property was lower among students who only had sexual contact with the opposite sex than students who only had sexual contact with the same sex in six sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, and Boston), lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in 10 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, New York City, and San Diego), and lower among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in two sites (Vermont and New York City).

#### In a Physical Fight on School Property

Across the nine sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Chicago, New York City, and San Francisco) that assessed having been in a physical fight on school property one or more times during the 12 months before the survey and sexual identity, the prevalence of having been in a physical fight on school property ranged from 8.4% to 18.1% (median: 10.5%) among heterosexual students, from 13.5% to 33.3% (median: 22.2%) among gay or lesbian students, from 12.7% to 26.4% (median: 19.1%) among bisexual students, and from 10.5% to 29.2% (median: 15.7%) among unsure students ([Table 17](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab17)). The prevalence of having been in a physical fight on school property was lower among heterosexual than gay or lesbian students in seven sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, and San Francisco), lower among heterosexual than bisexual students in seven sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, New York City, and San Francisco), and lower among heterosexual than unsure students in five sites (Delaware, Maine, Massachusetts, Vermont, and Chicago). The prevalence of having been in a physical fight on school property was higher among gay or lesbian than bisexual students in two sites (Massachusetts and Boston), lower among gay or lesbian than bisexual students in one site (New York City), higher among gay or lesbian than unsure students in four sites (Massachusetts, Rhode Island, Boston, and San Francisco), and higher among bisexual than unsure students in one site (San Francisco).

Across the 12 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed having been in a physical fight on school property and sex of sexual contacts, the prevalence of having been in a physical fight on school property ranged from 11.4% to 22.9% (median: 13.5%) among students who only had sexual contact with the opposite sex, from 16.8% to 25.0% (median: 19.6%) among students who only had sexual contact with the same sex, and from 17.4% to 41.1% (median: 23.0%) among students who had sexual contact with both sexes. The prevalence of having been in a physical fight on school property was lower among students who only had sexual contact with the opposite sex than students who only had sexual contact with the same sex in five sites (Maine, Massachusetts, Vermont, Boston, and New York City), lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in nine sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, New York City, and San Diego), and lower among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in two sites (Massachusetts and Vermont).

#### Did Not Go to School Because of Safety Concerns

Across the nine sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Chicago, New York City, and San Francisco) that assessed having not gone to school on at least 1 day during the 30 days before the survey because they felt they would be unsafe at school or on their way to or from school and sexual identity, the prevalence of having not gone to school because of safety concerns ranged from 3.6% to 11.4% (median: 4.8%) among heterosexual students, from 10.8% to 30.3% (median: 21.1%) among gay or lesbian students, from 11.1% to 24.9% (median: 12.7%) among bisexual students, and from 11.8% to 19.6% (median: 17.4%) among unsure students ([Table 18](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab18)). The prevalence of having not gone to school because of safety concerns was lower among heterosexual than gay or lesbian students in eight sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Chicago, and San Francisco), lower among heterosexual than bisexual students in eight sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Chicago, New York City, and San Francisco), and lower among heterosexual than unsure students in all nine sites. The prevalence of having not gone to school because of safety concerns was higher among gay or lesbian than bisexual students in three sites (Massachusetts, Rhode Island, and Vermont), higher among gay or lesbian than unsure students in one site (Rhode Island), lower among gay or lesbian than unsure students in one site (New York City), and lower among bisexual than unsure students in three sites (Massachusetts, Vermont, and Boston).

Across the 12 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed having not gone to school because of safety concerns and sex of sexual contacts, the prevalence of having not gone to school because of safety concerns ranged from 5.1% to 12.6% (median: 5.9%) among students who only had sexual contact with the opposite sex, from 12.6% to 28.9% (median: 15.2%) among students who only had sexual contact with the same sex, and from 11.4% to 33.0% (median: 15.7%) among students who had sexual contact with both sexes. The prevalence of having not gone to school because of safety concerns was lower among students who only had sexual contact with the opposite sex than students who only had sexual contact with the same sex in 10 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, Chicago, and New York City), lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in 10 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Milwaukee, New York City, and San Diego), lower among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in two sites (Vermont and San Diego), and higher among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in one site (Chicago).

#### Behaviors Related to Attempted Suicide

#### Felt Sad or Hopeless

Across the nine sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, Chicago, New York City, and San Francisco) that assessed having felt so sad or hopeless that they stopped doing some usual activities almost every day for 2 or more weeks in a row during the 12 months before the survey and sexual identity, the prevalence of having felt sad or hopeless ranged from 19.3% to 29.0% (median: 24.8%) among heterosexual students, from 28.8% to 52.8% (median: 41.3%) among gay or lesbian students, from 47.2% to 62.9% (median: 56.3%) among bisexual students, and from 33.3% to 50.7% (median: 37.6%) among unsure students ([Table 19](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab19)). The prevalence of having felt sad or hopeless was lower among heterosexual than gay or lesbian students in five sites (Delaware, Massachusetts, Rhode Island, Vermont, and Chicago), lower among heterosexual than bisexual students in all nine sites, and lower among heterosexual than unsure students in eight sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, Boston, New York City, and San Francisco). The prevalence of having felt sad or hopeless was lower among gay or lesbian than bisexual students in seven sites (Delaware, Maine, Massachusetts, Rhode Island, Vermont, New York City, and San Francisco), higher among gay or lesbian than unsure students in two sites (Massachusetts and Chicago), lower among gay or lesbian than unsure students in one site (Maine), and higher among bisexual than unsure students in seven sites (Delaware, Massachusetts, Rhode Island, Vermont, Boston, Chicago, and San Francisco).

Across the 12 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed having felt sad or hopeless and sex of sexual contacts, the prevalence of having felt sad or hopeless ranged from 24.9% to 37.1% (median: 28.5%) among students who only had sexual contact with the opposite sex, from 28.4% to 52.8% (median: 38.5%) among students who only had sexual contact with the same sex, and from 49.8% to 75.1% (median: 54.8%) among students who had sexual contact with both sexes. The prevalence of having felt sad or hopeless was lower among students who only had sexual contact with the opposite sex than students who only had sexual contact with the same sex in seven sites (Connecticut, Delaware, Massachusetts, Rhode Island, Vermont, New York City, and San Diego), lower among students who only had sexual contact with the opposite sex than students who had sexual contact with both sexes in all 12 sites, and lower among students who only had sexual contact with the same sex than students who had sexual contact with both sexes in 11 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin, Boston, Milwaukee, New York City, and San Diego).

#### Seriously Considered Attempting Suicide

Across the eight sites (Delaware, Maine, Massachusetts, Rhode Island, Boston, Chicago, New York City, and San Francisco) that assessed having seriously considered attempting suicide during the 12 months before the survey and sexual identity, the prevalence of having seriously considered attempting suicide ranged from 9.9% to 13.2% (median: 11.7%) among heterosexual students, from 18.8% to 43.4% (median: 29.6%) among gay or lesbian students, from 35.4% to 46.2% (median: 40.3%) among bisexual students, and from 17.5% to 40.4% (median: 23.7%) among unsure students ([Table 20](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s%5Fcid=ss60e0606a1%5Fw&ref=foodconsumer.org#Tab20)). The prevalence of having seriously considered attempting suicide was lower among heterosexual than gay or lesbian students in six sites (Delaware, Maine, Massachusetts, Rhode Island, Chicago, and New York City), lower among heterosexual than bisexual students in all eight sites, and lower among heterosexual than unsure students in seven sites (Delaware, Maine, Massachusetts, Rhode Island, Boston, New York City, and San Francisco). The prevalence of having seriously considered attempting suicide was lower among gay or lesbian than bisexual students in four sites (Rhode Island, Boston, New York City, and San Francisco), higher among gay or lesbian than unsure students in one site (Massachusetts), and higher among bisexual than unsure students in six sites (Massachusetts, Rhode Island, Boston, Chicago, New York City, and San Francisco).

Across the 11 sites (Connecticut, Delaware, Maine, Massachusetts, Rhode Island, Wisconsin, Boston, Chicago, Milwaukee, New York City, and San Diego) that assessed having seriously considered attempting suicide and sex of sexual contacts, the prevalence of having seriously considered attempting suicide ranged from 11.7% to 23.6% (median: 14.3%) among students who only had sexual contact with the opposite se