Sexual identity inequalities in the co-occurrence between poor mental health and health risk behaviours – A national cohort study

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Khanolkar, Alexis Karamanos, Laia Becares This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5966601/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 09 Jul, 2025 Read the published version in BMC Medicine → Version 1 posted 17 You are reading this latest preprint version Abstract Background Mental health challenges (MHC) like depression and anxiety, and health and risk behaviours (HRBs) are more common among sexual minority adolescents (SMA) than in heterosexual peers. Limited studies have examined the co-occurrence between poor mental health and HRBs, whether risk for co-occurrence differs by sexual identity, and associated risks for self-harm and attempted suicide in adolescents in the UK. Methods This study included 10,233 adolescents aged 17 (51% female and 11% sexual minority) from the UK-wide Millennium Cohort Study. Sexual identity, MHC, HRBs, self-harm and attempted suicide were self-reported by adolescents. MHC were assessed using the strengths and difficulties questionnaire [SDQ] emotional symptoms subscale for depression/anxiety. Seven common HRBs (like regular smoking, drug use and risky sexual behaviour) were assessed. Associations between sexual identity and risk for co-occurrence between MHC and HRBs were assessed using multinomial logistic regression. Predicted probabilities for self-harm or attempted suicide based on sexual identity and MH-HRB co-occurrence status were estimated using logistic regression models with appropriate interactions terms (between sexual identity and MH-HRB co-occurrence status variables). Results MHC prevalence was higher in gay/lesbian (48%) and bisexual (49%) adolescents compared to heterosexual peers (19%). Prevalence of self-harm (bisexual: 64%, gay/lesbian:53%, heterosexual:19%) and attempted suicide (bisexual: 24%, gay/lesbian:17%, heterosexual:6%) were higher in sexual minority adolescents compared to heterosexual peers. Gay/lesbian and bisexual adolescents consistently reported higher risk for MH-HRB co-occurrence compared to heterosexual peers (for example, for gay/lesbian individuals: RRR3.16 [95% CI 2.14–4.68] for MH-1HRB, RRR3.54[95% CI 2.06–6.08] for MH-≥3HRB, for bisexual adolescents, RRR2.44 [95% CI 1.85–3.20] for MH-1HRB, RRR4.11[95% CI 2.99–5.66] for MH-≥3HRB). MH-HRB co-occurrence and sexual minority identity were independently associated with risk for self-harm or attempted suicide. Gay/lesbian and bisexual adolescents experienced higher probabilities of reporting self-harm than heterosexual peers with the same level of MH-HRB co-occurrence. For example, 37.2% of heterosexual adolescents with MH-1HRB reported self-harm. Corresponding numbers were more than twice as high in bisexual (75.7%) and gay/lesbian (77.9%) individuals. Similarly, 58.3% of heterosexual adolescents with MH-≥3HRBs reported self-harm, which increased to 84.6% in bisexual and 83.8% in gay/lesbian peers. Conclusions SMA are more likely to experience MH-HRB co-occurrence, which is also associated with substantially higher risks for self-harm and attempted compared to heterosexual peers. Our findings highlight the need for better public health policies to address poor mental health and associated comorbidities to reduce inequalities in adolescence. Sexual minority LGBTQ + health mental health health behaviours self-harm attempted suicide adolescence Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Adolescents who identify with a sexual identity other than heterosexual (hereon sexual minority adolescents, SMA) consistently report substantially higher levels of substance use and risk behaviours (like risky sexual behaviour, gambling, and drug and alcohol misuse) than their heterosexual peers[ 1 , 2 ]. The most commonly studied behaviours in SMA include smoking, drug and alcohol misuse, and risky sexual behaviour (for example, sex without contraceptives or protection) [ 2 , 3 ]. Evidence indicates both earlier age of initiating use and using many substances concurrently in SMA compared to heterosexual peers[ 3 , 4 ]. Some studies also report differences by gender and SMA sub-groups[ 3 ]. For example, bisexual and female sexual minority individuals report higher smoking and substance use than sexual minority men [ 1 , 5 ]. These inequalities by sexual identity are significant as persistent substance use and misuse is associated with greater morbidity and higher likelihood of addiction later in life[ 6 ]. Emerging evidence indicates that gambling (including high-risk problem gambling) is more common in SM individuals than in heterosexual peers and is associated with lower self-esteem and poorer mental health[ 7 ]. Certain health and risk behaviours (HRBs) are more likely to cluster or co-occur and are often associated with adverse health and social outcomes; for example, individuals who gamble frequently are also more likely to report substance abuse [ 7 ]. Further, some HRBs impair judgement and increase the likelihood of other HRBs, for example, SMA who misuse illicit drugs are more likely to engage in risky sexual behaviours, have higher numbers of sex partners, experience sexually transmitted diseases, violence, poor mental health, and homelessness[ 8 , 9 ]. A key driver of higher risk of health and risk behaviours in SMA is previous experience of victimisation [ 10 , 11 ]. Several sexual minority-related stressors (social and psychological) like stigma and discrimination differentially impact the lived experiences, mental health, resilience and negatively influence HRBs in SMA[ 12 – 14 ]. The higher levels of HRBs in SMA are largely thought to be a coping mechanism for having to live with minority-related stressors (these stressors are in addition to the regular stressors faced by the general population)[ 14 ]. HRBs can be further exacerbated in individuals with multiple minority identities (sexual, gender, faith, ethnic etc.) as each minority identity, in isolation and as they intersect, has a different experience of stress[ 15 ]. Some studies indicate higher rates of HRBs in individuals with ≥ 2 minority identities[ 15 , 16 ]. However, in a previous study on SMA, we found that ethnic and sexual minority adolescents were less likely to report HRBs compared to their White SM peers[ 17 ]. In general, substance use (especially cigarette smoking but also alcohol consumption) has been decreasing among youth of all sexual orientations in recent decades[ 18 ]. However, this decrease is not the same between SMA and heterosexual peers, and sexual minority inequalities in HRBs persist. These findings vary by SMA subgroup, substance type studied and gender. For example, studies from the US have found that cigarette smoking have decreased in heterosexual and gay/lesbian youth but not as much in bisexual peers[ 19 ]. Other studies report that while alcohol consumption has decreased among all youth, rates have not decreased as much in SMA, who also report more hazardous drinking patterns[ 20 ]. A substantial body of evidence highlights the increased risk for poorer mental health in SMA, consistent with multiple indicators of mental health including depression, anxiety, PTSD, self-harm, suicidality, poor quality sleep and social isolation[ 15 , 17 , 21 , 22 ]. Across adolescence and adulthood, the prevalence of common mental health problems like depression and anxiety are 3–5 times higher in SM youth relative to their heterosexual peers[ 23 ]. A smaller number of studies have examined associations between mental health problems and co-occurring HRBs in sexual minority youth. However, most of these studies are conducted in the USA, and often in relation to the most commonly studied HRBs[ 1 , 7 , 14 , 24 ]. Studies on HRBs in SMA in the UK are limited. The few studies till date have reported significantly higher levels of HRBs in SMA compared to heterosexual peers, but these studies are limited by combining all SMA subgroups together, examining a limited number of HRBs or regional study samples[ 17 , 25 ]. Even fewer studies have investigated HRBs in conjunction with co-occurring mental health problems. A study on adolescents aged 14 found a strong network between sexual minority identity, depression and victimisation which were indirectly linked to substance use. In the UK, there is limited knowledge on sexual identity-related differences in the co-occurrence between common mental health problems (like depression and anxiety) and HRBs in later adolescence. Further, whether adolescents living with co-occurring common mental problems and HRBs are more likely to report acute mental health problems like self-harm and suicidality and how this potentially varies by sexual identity remains unexplored. We explored sexual identity inequalities in 1) reporting the number of HRBs, 2) the co-occurrence between mental health problems (depression and anxiety) and HRBs, and 3) whether having co-occurrence was associated with increased risk for self-harm and attempted suicide in a large sample of British adolescents aged 17 years who are part of the ongoing Millennium Cohort Study. Methods Study design and participants The Millennium Cohort Study (MCS) is a UK birth cohort study following the lives of 19,519 children born at the start of the new millennium (2000–2002). Study participants have been followed over seven sweeps to date (9 months, 3, 5, 7, 11, 14 and 17 years). Detailed information on the study, sampling and survey design can be found at: https://cls.ucl.ac.uk/cls-studies/millennium-cohort-study/ . 14,496 families were invited to participate in the age 17 sweep. Of this number, 10,625 (73.3%) families and 10,345 (71.4%) adolescents were successfully interviewed. This cross-sectional study included N = 10,233 children (98.9% of the eligible sample) who attended the age 17 sweep (2018–2019). MCS was oversampled for higher proportions of ethnic minority (EM) and socioeconomically disadvantaged families (sample weights ensure national representativeness). Attrition at age 17 sweep was predicted by single-parent families, lower-income occupation and lower educational level, Black ethnicity, and male sex. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) were followed in the reporting in this manuscript. Measures Sexual identities: Based on self-reported answers on sexuality (from eight options listed in Supplementary Table 1), participants were categorized into: 1. Completely heterosexual, 2. Bisexual and 3. Gay or lesbian. Those who answered ‘other’, ‘do not know’ and ‘preferred not to say’ were excluded (N = 154). Mental health (MH): In this study, MH refers to symptoms of depression and anxiety. The Strengths and Difficulties Questionnaire (SDQ) is a commonly and widely used brief screening tool comprising 5 subscales (with each subscale including 5 items for a total of 25 items) that assess a range of behavioural and emotional problems in children. The SDQ is used to assess positive and negative attributes in children over the previous 6 months. In this study, we used the SDQ emotional symptoms subscale (SDQ-E) comprising 5 items or questions (for e.g., are you often unhappy?) relating to depression, worry, fear, nervousness, and somatic symptoms, which assesses symptoms of psychological distress in the preceding six months. The SDQ-E is widely validated and routinely used to capture symptoms of depression and anxiety in the general population and clinical settings[ 26 ]. Further, the SDQ-E measure has been validated against diagnostic measures of depression or anxiety disorders and is an established screening tool to distinguish those individuals who meet the diagnostic criteria for depression and anxiety from those who do not[ 27 ]. For each of the 5 items, participants could respond with: Not true, somewhat true, or certainly true (scored 0, 1 and 2, respectively). Total scores were calculated, ranging from 0–10, with higher scores indicating more emotional problems (depression and anxiety). Total scores were categorised into a binary variable based on recommended cut-off points indicating participants with ‘close to average’ (< 6) vs. ‘high/very high levels’ (≥ 6) of difficulties[ 28 ]. Outcomes of interest Health and risk behaviours were seven in number and included current smoking, frequent alcohol consumption, frequent cannabis use (in the past year), risky sexual behaviour, lack of physical activity in the previous week, antisocial behaviour in previous year (for e.g., pushed or shoved/hit/slapped/punched someone, hit someone with or used a weapon etc.) and any form of gambling in the preceding month (for e.g., have you spent on your own money in a betting shop or fruit machines?). Each HRB was coded as a binary variable (No vs. Yes). Based on these seven binary HRB variables, we created a cumulative behaviour score (hereafter HRB score) which was categorised into: 0 HRBs, 1 HRB, 2 HRBs and ≥ 3 HRBs. Mental health (MH) problems and HRB co-occurrence (MH-HRB) indicator: We created a categorical variable which indicated those individuals without and with co-occurrence and the following categories: Only MH problems or only HRBs or no-occurrence, MH problems and 1 HRB, MH problems and 2 HRBs, and MH problems and ≥ 3 HRBs. Adolescents with either only MH problems or only reporting HRBs were combined with the category of ‘Only MH problems or only HRBs or no-occurrence (hereafter No mental health problems and no HRBs). Self-harm and attempted suicide in the previous year were reported via questionnaires. Participants were asked about self-harming actions (like cutting/stabbing, burning, bruising/pinching, taking an overdose of tablets and pulling out hair). We created binary variable indicating no self-harm vs any kind of self-harm. Attempted suicide was asked with the question: ‘’Have you ever hurt yourself on purpose to end your life?’’ Responses were categorised as no vs yes. Covariates Covariates included sex assigned at birth (hereafter sex), ethnicity and parental income. Where available, parent/guardian reported participant’s ethnicity at age 3 was used (Supplementary Table 1). Subjects were grouped into either 1. White (ethnic majority) and 2. EM (mixed-ethnicity, South Asian, Black and ‘other’). The ‘other’ group included participants from Asia (excluding South Asia), the Middle East and South America. Complete details, the original questions, all component items of each MH scale, and operationalized, and all health-related indicators, and how they were categorized (including references) are listed in Supplementary Table S2. Statistical analysis A detailed description of attrition in the cohort is provided elsewhere[ 29 ]. Missing data per variable ranged from 2.4 to 62%. For the vast majority of variables missing data was < 5%. Variables with greater missingness included alcohol frequency (24%) and gambling (34%). The complete data sample included 6,494 participants with no missing data. Missing exposure, covariate and outcome data was addressed through multiple imputation using chained equations under the assumption that data were missing at random (MAR). This was suitable given that observed characteristics like ethnicity and parental income were independent predictors of missingness (i.e., ethnic minority and socioeconomically disadvantaged participants were more likely to have missing information across ≥ 1 analysis parameters). To predict missing data, the imputation model integrated all HRBs and covariates, and auxiliary variables like parental highest educational qualifications, the four other subscales of the SDQ, indicators of mental wellbeing, BMI, general health, physical health, victimisation, doctor-diagnosed depression along with combined sample and attrition weights to strengthen the imputation model[ 30 , 31 ]. Estimates were obtained by pooling results across 25 imputed data sets using the Rubin rules, and assessment of Monte Carlo errors suggested this was a suitable number of imputations[ 32 ]. The resulting imputed analytical sample included 10,223 participants. We first estimated the proportions of participants across all variables of interest by sexual identity. Multinomial logistic regression was used to assess associations between: 1) Sexual identity and risk of number of HRBs (1, 2 or ≥ 3), 2) Sexual identity and risk of poor MH-HRB co-occurrence, and 3) Poor MH-HRB co-occurrence and risk of self-harm (or attempted suicide). To assess whether risk of poor MH-HRB outcome differed by sexual identity, we ran multinomial regression models with self-harm (or attempted suicide) as the outcome and including interaction terms between sexual identity and MH-HRB co-occurrence variables. The multinomial logistic regression model calculates the relative risk ratio (RRR), which is the ratio of two relative risks (derived from the exponentiated multinomial logit coefficient) and is interpreted for a unit change in the predictor variables. The predicted probabilities for self-harm (and attempted suicide) for all possible combinations of the levels of MH-HRB co-occurrence and sexual identity indicators (i.e., nine categories generated by the interaction term between the two variables) were estimated using the ’margins’ command in Stata. This generates adjusted predictive margins or the probability for self-harm/attempted suicide in each category of interest. Predicted probabilities were visualised (by creating interaction plots using the ‘marginsplot’ command) to aid understanding of the interaction terms between the MH-HRB and sexual identity variables. All three models described above were first run without any covariates (crude models or Model 1), and then run including adjustment for sex assigned at birth, ethnicity and parental income (Model 2). All models above were also run stratified by sex at birth to assess whether associations differed between males and females. All estimates were weighted using appropriate sample and attrition weights and computed using Stata 18 (StataCorp, College Station, TX). Subgroup sample sizes were estimated from imputed proportions, weighted, and rounded and so may not sum to totals. Results Tables 1 and 2 present descriptive statistics of the study sample. Of the 10,223 participants, 11% identified as bisexual or gay/lesbian. MH problems (symptoms of depression and anxiety) was more than twice as high in bisexual (49%) and gay/lesbian (48%) compared to heterosexual (18.9%) adolescents. Bisexual (19.4%) and gay/lesbian (17.1%) adolescents were more likely to report ≥3 HRBs compared to heterosexual (12.9%) peers. Overall, 3.4% of participants reported having poor MH and ≥3 HRBs. There were significant differences in proportions of participants reporting co-occurring poor MH and 2 HRBs and ≥3 HRBs (for example, 10.3% of bisexuals reported poor MH and ≥3 HRBs compared to 2.6% of heterosexual adolescents). Similarly, proportions of individuals reporting self-harm or attempted suicide were much higher in those with co-occurring poor MH and ≥3 HRBs. Associations between sexual identity and HRBs (Table 3) In general, SM adolescents (bisexual and gay/lesbian individuals) were significantly more likely to report 1, 2 or ≥3 HRBs compared to their heterosexual peers. We did not find any differences in risk for HRBs between bisexual and gay/lesbian individuals (95% CIs overlapped for most estimates). Both bisexual (adjusted RRR2.06, 95% CI 1.58-2.70) and gay/lesbian individuals (RRR1.59, 1.02-2.48) were significantly more likely to report ≥3 HRBs compared to their heterosexual peers. Adjustment for covariates (ethnicity, parental income and sex) did not significantly change estimates. Associations between sexual identity and co-occurring poor MH and HRBs (Supplemental Table 3) We found consistent and significant associations between sexual minority identity and risk for co-occurring poor MH and HRBs. Compared to heterosexual individuals, bisexual and gay/lesbian individuals consistently had higher risk for all three categories of poor MH and co-occurring HRBs (for example, RRR4.11 [2.99-5.66] and RRR3.54 [2.06-6.08] for MH-≥3 HRBs for bisexual and gay/lesbian individuals respectively). Adjustment for covariates (ethnicity, parental income and sex) only marginally attenuated the estimates. Associations with self-harm and attempted suicide (Supplemental Table 4) In multinomial regression models with self-harm or attempted suicide as the outcome (including interactions between sexual identity and MH-HRB variables), having poor MH-HRB co-occurrence and sexual minority identity were independently associated with self-harm or attempted suicide. For example, bisexual (RRR6.64 [5.17-8.51]) and gay (RRR3.83 [2.61-5.62] adolescents had substantially higher risk for self-harm compared to heterosexual peers. Further, there was a gradient in risk for self-harm (or attempted suicide) with increasing number of poor MH and co-occurring HRBs. For example, the risk for self-harm increased progressively from RRR3.46 (2.79-4.30) to RRR4.63 (3.44-6.25) and RRR8.21 (5.91-11.41) for 1 HRB, 2HRBs and ≥3HRBs, respectively, with co-occurring poor MH. Predicted probabilities for self-harm and attempted suicide based on sexual identities and MH-HRB co-occurrence status (Table 4 and Figure 2) Predicted probabilities can be interpreted as the proportions of the sample presenting with the outcome of interest after accounting for confounders. Irrespective of sexual identity, adolescents with co-occurring poor MH and HRBs had increased probabilities of self-harm or attempted suicide (with probabilities increasing progressively with increasing number of HRBs). For example, 41.7% of adolescents with MH-1HRB reported self-harm increasing to 61.3% for those with MH-≥3HRBs. Greater proportions of SM adolescents reported self-harm and attempted suicide compared to heterosexual peers. However, the probabilities for self-harm and attempted suicide were even higher (or varied in strength) in SMA compared to heterosexual peers reporting the same level of co-occurring poor MH and HRBs . Or where individuals reported poor MH and co-occurring HRBs, the probability of self-harm and attempted suicide among SMA was higher compared to heterosexual peers. For example, 37.2% of heterosexual adolescents with MH-1HRB reported self-harm. Corresponding numbers were more than twice as high in bisexual (75.7%) and gay/lesbian (77.9%) individuals. Similarly, 58.3% of heterosexual adolescents with MH-≥3HRBs reported self-harm, which increased to 84.6% in bisexual and 83.8% in gay/lesbian peers. We observed a similar pattern for attempted suicide; but findings were larger and more evident for those with MH-≥3HRBs and bisexual individuals. 30.6% of adolescents with MH-≥3HRBs reported attempted suicide compared to 10.1% for those with MH-1HRB. Bisexual individuals with co-occurring MH-HRBs had the greatest proportions reporting attempted suicide (20.1% for MH-1HRB, 31.2% for MH-2HRBs and 51.3% for MH-3HRBs). On average, greater proportions of gay/lesbian individuals reported attempted suicide compared to heterosexual peers, but these differences were smaller with overlapping 95% CIs. Sex stratified results (Supplemental Tables 5, 6 and 7, Table 5 and Figure 3) SMA girls were significantly more likely to report any number of HRBs compared to heterosexual girls. Findings were more consistent for bisexual girls (RRR1.32 [1.00-1.73] for 1HRB, RRR1.39 [1.01-1.90] for 2 HRBs and RRR2.32 [1.70-3.17] for 3HRBs, than gay/lesbian peers. While SMA boys had higher RRR for reporting HRBs, these were largely non-significant. SMA boys and girls had significantly higher risk for MH-HRBs co-occurrence compared to heterosexual peers. However, on average, boys had higher risk for co-occurring MH-HRBs compared to girls. This was observed for all categories of co-occurring MH-HRBs (for example, for MH-≥3HRBs, boys: bisexual RRR 4.91 [2.35-10.26] and gay/lesbian RRR 5.66 [2.48-12.96] compared to girls: bisexual 3.82 [2.69-5.41] and gay/lesbian RRR 2.55 [1.22-5.34]). But for all estimates, 95% CIs were largely overlapping. Risk for self-harm and attempted suicide increased with increasing number of co-occurring HRBs and poor MH in both boys and girls. For example, risk for self-harm (boys: OR 8.49 [4.88-14.77], girls: OR7.03 [4.68-10.56]) in adolescents with MH-≥3HRBs was more than twice has high compared to those with MH-1HRB. Heterosexual individuals without co-occurring poor MH and HRBs had the lowest probabilities for self-harm and attempted suicide in both sexes (14.1 and 17.6% for self-harm in boys and girls, respectively). Bisexual (65%) and lesbian (45.7) girls had higher proportions reporting self-harm compared to bisexual (47.4%) and gay (35.5) boys. For all levels of co-occurrence, greater proportions of SMA boys and girls reported self-harm than heterosexual peers. For MH-2HRBs, greater proportions of SMA girls reported self-harm compared to SMA boys, but CIs were overlapping. Proportions of SMA with MH-≥3HRBs reporting self-harm were similar in boys and girls. A similar pattern was observed for attempted suicide. Greater proportions of SMA boys and girls reported attempted suicide compared to heterosexual peers with the same level of co-occurrence. However, there was no observable differences between boys and girls. Discussion The present study aimed to investigate sexual identity inequalities in HRBs, co-occurrence between poor MH and HRBs and whether this co-occurrence was associated with risk for self-harm and attempted suicide. We found that SMA were significantly more likely to report a greater number of HRBs compared to heterosexual peers. SMA were also more likely to report co-occurring poor MH-HRBs. Further, sexual minority status and having co-occurring poor MH-HRB were independently associated with risk for self-harm and attempted suicide (with a gradient – i.e., risk for both outcomes increased with increasing number of HRBs and co-occurring poor MH). A pertinent finding is that greater proportions of SMA reported self-harm or attempted suicide in relation to co-occurring MH-HRBs compared to heterosexual peers with the same level of co-occurrence. Differences between gay/lesbian and bisexual individuals were limited. We found no difference in proportions of gay/lesbian or bisexual individuals reporting self-harm in relation in MH-HRB co-occurrence. However, there was some evidence for greater proportions of bisexual adolescents who reported attempted suicide compared to gay/lesbians adolescents with the same level of co-occurring MH-HRB. Differences by sex were evident for some of the associations studied. Overall, female adolescents were less likely to report HRBs compared to males, regardless of sexual identity. While female SMA were more likely to report co-occurring MH-HRBs compared to heterosexual peers, their risk for co-occurrence was smaller than male SMA peers. Strengths include a large sample size drawn from a nationally representative, highly studied contemporary birth cohort with rich social, health and economic data, which facilitates generalisability to the UK adolescent population. Our indicator of MH (SDQ emotional symptoms sub-scale) is widely used in studies on adolescent mental health increasing comparability with other studies. In general, missing data on all confounders and MH were relatively low (< 5%) but we did have higher levels of missing data on two HRBs, and 9% of the sample were missing data on sexual identity. We addressed missing data using the robust multiple imputation technique. Multiple imputation relies on the MAR assumption, which is not empirically verifiable[ 33 ]. Nonetheless, we increased the plausibility of the MAR assumption by including a rich set of auxiliary variables which help increase the precision of predicting missing data and minimising non-random variation in values. Additionally, the wide range of associated variables like socioeconomic, health and HRBs data and longitudinal data on BMI, are powerful predictors of missing data which significantly strengthen the imputation model. We included HRBs like gambling and antisocial behaviour which are seldom studied in relation to sexual identity and MH-HRB co-occurrence. Like most cohort studies, the MCS has significant attrition over follow-up (of the original 19,517 children, 10,757 attended the age 17 sweep). However, some studies have indicated that the MCS remains representative of its original birth cohort, and we used survey weights to adjust for this and ensure population-representativeness. We could not examine important factors like access to MH services, peer-group support, SM-specific issues like rejection sensitivity, internalised stigma, gender-role strain and perceived burdensomeness which are strongly linked to MH and wellbeing, and self-harm and suicidality, and are known to differ between heterosexual and SM individuals[ 34 ]. As this is a cross-sectional study, we could not disentangle the direction of association between MH-HRB and self-harm/attempted suicide. However, we hypothesise that it is more likely that low mood/depression and persistent HRBs subsequently leads to self-harm and/or attempted suicide as reported by other studies[ 35 ]. Further, the cross-sectional design precludes causality. Nonetheless, we hypothesised that for most individuals’ sexual identities or orientation are likely formulated earlier in adolescence before age 17. We excluded individuals who identified as ‘mainly heterosexual’ due to discussions on whether they should be in a separate sexual identity category or combined with bisexual individuals. A recent study using MCS data combined mainly heterosexual and bisexual individuals in the same group, an approach we do not recommend[ 36 ]. The term ‘mainly heterosexual’ is not commonly used in health questionnaires in the UK and there is strong likelihood for it to be confused with ‘bisexual’. Further, individuals unsure of their sexual identity (more likely in adolescence) may be unsure of which category to choose. Thus, for this study we included individuals identifying as completely heterosexual, bisexual, or gay/lesbian who more likely to be sure about their sexual identity. Nonetheless, adolescents identifying as mainly heterosexual have increased risk for poorer mental and general health compared to heterosexual peers and we need to further examine health in this group while also understanding the similarities and differences with bisexual individuals[ 17 ]. Despite 11% of the sample identifying as SM, we had relatively small numbers of individuals with co-occurring MH-HRBs in SM subgroups, which could explain the wide confidence intervals observed for some estimates and the lack of differences between bisexual and gay/lesbian individuals. Smaller numbers also precluded us from testing for potential interactions with ethnicity and socioeconomic indicators. Future studies should also include where possible a wider range of HRBs which are higher in prevalence in adolescence and SM groups like binge eating, excessive use of mobile phones and pornography which was not included in this study. Several studies have reported higher prevalence of health risk behaviours (in particular substance use like regular smoking, alcohol misuse/binge drinking, drug use and risky sexual behaviour) in SM groups compared to heterosexual peers including adolescents and young adults[ 1 , 24 , 37 ]. However, most of this research originates from the USA[ 38 ]. While some studies show differences in prevalence between SM sub-groups (for example, higher prevalence in bisexual and female SMA), others show conflicting results of no differences[ 1 ]. Associations with substance use have been found with different indicators of sexual identity (self-identified, sexual behaviour, and sexual attraction) but associations are stronger and more consistent with self-identified sexual identity which is used in our study[ 1 ]. A systematic review focused on evidence from the UK found clustering between sexual risk behaviour, smoking, drug use and alcohol misuse (same HRBs as included in our study) was more common among young adults[ 39 ]. Most studies that have examined sexual identity related differences in HRBs in adolescents have not examined co-occurrence with poor mental health limiting comparisons. A recent study on approximately 8000 university students in Ireland found higher level of risky mental and sexual health behaviours in SM individuals compared to heterosexual peers but not for risky physical behaviours like alcohol and drug use, which contrasts with our findings[ 38 ]. Further, the authors found evidence for an ‘overlap’ between different forms of adverse health behaviours and mental health outcomes like depression and anxiety, but the methods used to evaluate co-occurring behaviours and adverse health was different from our study. Our findings of higher risk for multiple HRBs among males compared to females (regardless of sexual identity) is in line with existing literature. We found evidence that SMA females (especially bisexual) were more likely to report any number of HRBs compared to both heterosexual peers and male SMA, which is line with previous studies[ 24 , 40 ]. We advise caution in interpreting sex related differences due to smaller numbers in sex-stratified models. The Syndemic Health Model predicates that health behaviours and conditions often co-occur and interact across the lifecourse, increasing risk for adverse health in subpopulations further compounded by environmental conditions like socioeconomic disadvantage, which perpetuate this concentration of conditions[ 41 , 42 ]. This can be applied in the context of sexual minority inequalities where SMA experience multiple stressors (like stigma, discrimination, victimisation) associated with their identities which impact not only their mental but also physical health. SMA might use HRBs as coping mechanisms to deal with living with multiple stressors in an already volatile life period like adolescence. Substantial evidence supports greater levels of interactions between mental, physical and sexual health and behaviours in SM individuals compared to heterosexual peers[ 43 ]. Our findings clearly demonstrate that SMA are more likely to report co-occurring poor MH and HRBs, and report much higher levels of self-harm and attempted suicide. While we are unable to examine directionality between MH and HRBs, it is evident that significantly higher number of SMA with poor MH are reporting higher numbers of HRBs. Our findings and the large evidence base for SM-related inequalities highlight that current policies are falling short. Substantially more needs to be done to address health inequity among SMA. Policies that more effectively address SM stressors, in combination with health promotion, awareness and equality campaigns are needed. But these need to be addressed in multiple venues like schools, local communities and neighbourhoods, public transport and elsewhere. To conclude, SMA are more likely to report a greater number of HRBs, and co-occurring poor MH-HRBs compared to heterosexual peers. An increasing number of HRBs and co-occurring poor MH is associated with higher risk for self-harm and attempted suicide (with a gradient) in adolescents. However, significantly higher proportions of SMA were more likely to self-harm or attempt suicide compared to heterosexual peers with the same level of co-occurrence. This is a stark example of sexual minority related inequalities in a contemporary cohort of adolescents. Further, many studies focus on MH co-occurring with health-related behaviours (like substance use, risky sexual behaviour) or are restricted to samples comprising only SM populations, or those with a particular health condition like HIV or cancer [44]. Additionally, existing studies focus on older SM individuals at greater risk of chronic conditions, a few of which include multiethnic samples [43, 45]. Abbreviations SMA Sexual minority adolescents SM Sexual minority HRBs Health and risk behaviours MCS Millennium Cohort Study EM ethnic minority MH HRB–Poor mental health and health and risky behaviours co–occurrence Declarations Ethics approval and consent to participate Ethics approval for the MCS was obtained from the National Research Ethics Service Committee London— Central (reference 13/LO/1786). All data are anonymized and available to researchers via the UK Data Service. Cohort members ≥16 years provided verbal consent to take part in the study. Consent for publication Not applicable. Availability of data and materials Data for this study is from the age 17 sweep of the Millennium Cohort Study. Data can be accessed from the UK Data Service website: https://ukdataservice.ac.uk/ (after registration and agreeing to licence terms and conditions). Syntax/code used for the analysis in this study is available on request from the corresponding author. Competing interests The authors declare that they have no competing interests. Funding There are no specific funding sources for this study. Authors' contributions ARK conceived the research idea, conducted the data analysis and wrote the manuscript. AK contributed to data curation and analysis. All authors were involved in interpretation of findings. All authors contributed to writing, and read and approved the final version of the manuscript. 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Prevalence of mental ill-health, health and risk behaviours (HRB) by sexual identity in 10,233 adolescents aged 17 years from the Millennium Cohort Study Covariate % 95% CI Sexual identity Heterosexual 89 88 90 Bisexual 8 7 9 Gay/Lesbian 3 3 3 Sex at birth Male 49 48 50 Female 51 50 52 Poor mental health (yes) Heterosexual 19 18 20 Bisexual 49 46 53 Gay/Lesbian 48 42 55 Health risk behaviours 1 HRB, Heterosexual 33 32 34 Bisexual 32 29 35 Gay/Lesbian 37 31 43 2 HRBs Heterosexual 16 15 17 Bisexual 18 16 21 Gay/Lesbian 18 13 23 3 HRBs Heterosexual 13 12 14 Bisexual 19 17 22 Gay/Lesbian 17 13 22 Self-harm Heterosexual 19 18 20 Bisexual 64 60 67 Gay/Lesbian 53 47 59 Attempted suicide Heterosexual 6 5 6 Bisexual 24 21 27 Gay/Lesbian 17 13 22 Table 2. Prevalence of co-occurring mental ill-health and health and risk behaviours (HRB) by sexual identity, self-harm and attempted suicide in 10,233 adolescents aged 17 years from the Millennium Cohort Study MH-HRB co-occurrence Full sample % 95% CI Sexual identity % 95% CI No co-occurrence 85.6 84.9 86.3 Heterosexual 88 87.3 88.7 Bisexual 65.9 62.4 69.3 Gay/Lesbian 67.2 61.4 73.1 MH & 1 HRB 7.2 6.7 7.7 Heterosexual 6.1 5.6 6.6 Bisexual 14.8 12.3 17.4 Gay/Lesbian 17.3 12.7 2.2 MH & 2 HRB 3.9 3.5 4.2 Heterosexual 3.3 2.9 3.6 Bisexual 9 6.9 11.1 Gay/Lesbian 7.8 4.4 11.2 MH & ≥3 HRB 3.4 3.0 3.7 Heterosexual 2.6 2.3 2.9 Bisexual 10.3 8.1 12.4 Gay/Lesbian 7.7 4.4 10.9 MH: Mental health (assessed using the Strengths and Difficulties Questionnaire [SDQ]; emotional symptoms subscale) HRB: Health and risky behaviours (antisocial behaviour, current smoker, frequent alcohol consumption, frequency cannabis use, risky sex, no exercise, gambling). Table 3. Associations between sexual identity and health risk behaviours (HRB) in 10,223 adolescents from the Millennium Cohort Study. Estimates are from multinomial logistic regression models. Model 1 Model 2 Covariate RRR 95% CI RRR 95% CI No HRB Ref Ref 1 HRB Heterosexual Ref Ref Bisexual 1.21 0.96, 1.53 1.26 1.00, 1.59 Gay/Lesbian 1.55 1.06, 2.26 1.57 1.07, 2.30 Sex at birth Male Ref Female 0.87 0.78, 0.98 Ethnicity White Ref Ethnic-minority 1.0 0.85, 1.17 Parental income Quintile 1 1.14 0.97, 1.35 Quintile 2 1.09 0.92, 1.30 Quintile 3 0.93 0.79, 1.11 Quintile 4 0.97 0.82, 1.13 Quintile 5 (highest income) Ref 2 HRBs Heterosexual Ref Ref Bisexual 1.28 0.98, 1.68 1.35 1.03, 1.78 Gay/Lesbian 1.42 0.91, 2.21 1.42 0.91, 2.23 Sex at birth Male Ref Female 0.73 0.63, 0.85 Ethnicity White Ref Ethnic-minority 0.6 0.48, 0.76 Parental income Quintile 1 1.01 0.82, 1.25 Quintile 2 1.01 0.82, 1.25 Quintile 3 0.84 0.68, 1.05 Quintile 4 0.8 0.64, 0.99 Quintile 5 (highest income) Ref ≥ 3 HRBs Heterosexual Ref Ref Bisexual 1.77 1.36, 2.30 2.06 1.58, 2.70 Gay/Lesbian 1.57 1.02, 2.43 1.59 1.02, 2.48 Sex at birth Male Ref Female 0.51 0.44, 0.60 Ethnicity White Ref Ethnic-minority 0.38 0.28, 0.50 Parental income Quintile 1 1.30 1.03, 1.65 Quintile 2 1.30 1.03, 1.65 Quintile 3 1 0.80, 1 .26 Quintile 4 1.04 0.84, 1.30 Quintile 5 (highest income) Ref Model 2: adjusted for sex at birth, ethnicity and parental income. Text in bold indicates estimates for which 95% CI do not contain 1. Table 4. Predicted probabilities for self-harm or attempted suicide based on poor mental health and health risk behaviours co-occurrence and sexual identities in 10,223 adolescents aged 17 years from the Millennium Cohort Study. Estimates are based on multivariable logistic regression models (adjusted for sex, ethnicity and parental income). Self-harm Attempted Suicide Co-occurrence only % 95% CI % 95% CI MH & 1 HRB 41.7 37.5 45.9 10.1 8 12.3 MH & 2 HRBs 46.7 40.7 52.7 13.8 10 17.6 MH & ≥3 HRBs 61.3 54.3 68.2 30.6 24.9 36.3 Sexual identity only Heterosexual 20.1 19.1 21.2 6.1 5.4 6.7 Bisexual 58.3 53.3 63.3 18.2 14.3 22.1 Gay/lesbian 46.5 38.6 54.3 13.2 8.1 18.4 Co-occurrence & sexual identity No-occurrence & Heterosexual 16 14.9 16.9 4.4 3.8 5.1 No-occurrence & Bisexual 55 49.6 61.1 15.9 11.6 20.2 No-occurrence & Gay/Lesbian 41.9 32.9 50.1 11.7 5.9 17.5 MH & 1 HRB & Heterosexual 37.2 32.4 41.9 8.8 6.5 11.1 MH & 1 HRB & Bisexual 75.7 66.6 84.8 20.1 12.7 28.9 MH & 1 HRB & Gay/Lesbian 77.9 62.1 93.7 14.8 2.8 26.9 MH & 2 HRBs & Heterosexual 44.1 37.1 50.1 11.8 7.4 16.2 MH & 2 HRBs & Bisexual 69.9 57.2 82.6 31.2 18.7 43.6 MH & 2 HRBs & Gay/Lesbian 59.9 35.2 84.6 20.4 1.8 40.6 MH & ≥3 HRBs & Heterosexual 58.3 50.1 66 28.3 21.9 34.8 MH & ≥3 HRBs & Bisexual 84.6 75.1 94.1 51.3 38.1 64.6 MH & ≥3 HRBs & Gay/Lesbian 83.8 67.7 99 36 13.7 58.4 MH: Poor mental health, HRB: Health and risky behaviours Table 5. Predicted probabilities for self-harm or attempted suicide based on poor mental health and health risk behaviours co-occurrence and sexual identities in 10,223 adolescents aged 17 years from the Millennium Cohort Study. Estimates are based on multivariable logistic regression models (adjusted for ethnicity and parental income) stratified by sex Co-occurrence & sexual identity Self-harm Attempted Suicide Boys Girls Boys Girls Co-occurrence status % 95% CI % 95% CI % 95% CI % 95% CI No co-occurrence 15.9 14.5 17.3 24.4 22.6 26.2 3.7 3 4.4 7.8 6.7 8.9 MH & 1 HRB 39.6 31.6 47.6 45.9 41.1 50.7 6.3 2.6 9.9 13.2 10.4 16 MH & 2 HRBs 34.9 23.4 46.4 53.9 47.1 60.6 11.6 2.9 20.3 17.2 12.7 21.7 MH & ≥3 HRBs 60.3 48.2 72.3 63.8 55.8 71.7 28.4 18.1 38.6 35 27.6 42.3 Sexual Identity Heterosexual 16.3 14.9 17.7 23.8 22.2 25.4 3.8 3.1 4.5 8.2 7.2 9.3 Bisexual 47.4 38.2 56.6 65 59.6 70.5 16.4 9.2 23.7 21.8 17.3 26.3 Gay/Lesbian 35.5 24.8 46.1 56.5 45.7 67.3 11.1 4.4 17.9 15.8 8.9 22.7 Co-occurrence & sexual identity No-occurrence & Heterosexual 14.1 12.8 15.4 17.6 16 19.3 3 2.3 3.6 5.9 4.9 6.9 No-occurrence & Bisexual 44.8 34.9 54.8 61.6 55.1 68.2 15 7.2 22.7 18.4 13.2 23.7 No-occurrence & Gay/Lesbian 32.6 21.3 43.9 50.5 37.4 63.5 10.5 3.3 17.7 13 4.7 21.2 MH & 1 HRB & Heterosexual 36.7 28.1 45.4 39.8 34.2 45.4 5.2 1.4 9 11.5 8.5 14.5 MH & 1 HRB & Bisexual 76.5 56.4 96.6 77.8 68.4 87.3 17.7 9 34.5 25 15.1 34.9 MH & 1 HRB & Gay/Lesbian 80.2 56.9 1.04 78.5 59.4 97.6 27 -1.4 55.3 11.9 -3 24 MH & 2 HRBs & Heterosexual 33.6 21.3 45.8 49.9 41.7 58.1 19 1.3 20.6 13.8 8.6 19.1 MH & 2 HRBs & Bisexual 58.5 25.3 91.7 75 62.2 87.7 26.2 -6.3 58.7 36.6 22.4 50.7 MH & 2 HRBs & Gay/Lesbian 42.6 4.2 80.9 73.8 47.5 1.002 12 20.1 44.1 27.6 -3 55.5 MH & ≥3 HRBs & Heterosexual 58.1 45.2 71.1 59.8 50.5 69.2 27.2 16.3 38.1 31.2 22.8 39.7 MH & ≥3 HRBs & Bisexual 97.2 88.5 1.059 83 72.6 93.5 64.7 36.1 93.2 53.3 39.8 66.9 MH & ≥3 HRBs & Gay/Lesbian 77.5 50.3 1.046 89.8 71.6 1.08 12.9 8.8 34.5 58 23 93.1 Additional Declarations No competing interests reported. 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Estimates are based on multivariable logistic regression models (adjusted for sex, ethnicity and parental income, Table 4)\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5966601/v1/8c1839b07cb40a35639703c8.png"},{"id":76659192,"identity":"0edd739e-d722-4287-87ff-0547f8c47d73","added_by":"auto","created_at":"2025-02-19 11:42:34","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":31782,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePredicted probabilities for self-harm based on poor mental health and health risk behaviours co-occurrence and sexual identities in 10,223 adolescents aged 17 years from the Millennium Cohort Study. Estimates are based on multivariable logistic regression models (adjusted for ethnicity and parental income) stratified by sex\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-5966601/v1/fd50bbe984df807356e13538.png"},{"id":76659207,"identity":"c6d3559f-8c4c-401d-9806-8adc01553754","added_by":"auto","created_at":"2025-02-19 11:42:51","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":34516,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePredicted probabilities for attempted suicide based on poor mental health and health risk behaviours co-occurrence and sexual identities in 10,223 adolescents aged 17 years from the Millennium Cohort Study. Estimates are based on multivariable logistic regression models (adjusted for ethnicity and parental income) stratified by sex\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-5966601/v1/041c50cb0ee56cb8822652fa.png"},{"id":86699335,"identity":"a9fac7d4-5db5-4551-811e-5a6cab7e34d4","added_by":"auto","created_at":"2025-07-14 16:07:52","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2292947,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5966601/v1/77eed710-70d9-4614-9a8a-078a992da99e.pdf"},{"id":76659444,"identity":"8b431c0f-1d2e-4d54-876d-639e43310f78","added_by":"auto","created_at":"2025-02-19 11:50:34","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":64690,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementalinformation.docx","url":"https://assets-eu.researchsquare.com/files/rs-5966601/v1/c669c7931e398252d62600b5.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Sexual identity inequalities in the co-occurrence between poor mental health and health risk behaviours – A national cohort study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAdolescents who identify with a sexual identity other than heterosexual (hereon sexual minority adolescents, SMA) consistently report substantially higher levels of substance use and risk behaviours (like risky sexual behaviour, gambling, and drug and alcohol misuse) than their heterosexual peers[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. The most commonly studied behaviours in SMA include smoking, drug and alcohol misuse, and risky sexual behaviour (for example, sex without contraceptives or protection) [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Evidence indicates both earlier age of initiating use and using many substances concurrently in SMA compared to heterosexual peers[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Some studies also report differences by gender and SMA sub-groups[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. For example, bisexual and female sexual minority individuals report higher smoking and substance use than sexual minority men [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. These inequalities by sexual identity are significant as persistent substance use and misuse is associated with greater morbidity and higher likelihood of addiction later in life[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Emerging evidence indicates that gambling (including high-risk problem gambling) is more common in SM individuals than in heterosexual peers and is associated with lower self-esteem and poorer mental health[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Certain health and risk behaviours (HRBs) are more likely to cluster or co-occur and are often associated with adverse health and social outcomes; for example, individuals who gamble frequently are also more likely to report substance abuse [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFurther, some HRBs impair judgement and increase the likelihood of other HRBs, for example, SMA who misuse illicit drugs are more likely to engage in risky sexual behaviours, have higher numbers of sex partners, experience sexually transmitted diseases, violence, poor mental health, and homelessness[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA key driver of higher risk of health and risk behaviours in SMA is previous experience of victimisation [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Several sexual minority-related stressors (social and psychological) like stigma and discrimination differentially impact the lived experiences, mental health, resilience and negatively influence HRBs in SMA[\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The higher levels of HRBs in SMA are largely thought to be a coping mechanism for having to live with minority-related stressors (these stressors are in addition to the regular stressors faced by the general population)[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. HRBs can be further exacerbated in individuals with multiple minority identities (sexual, gender, faith, ethnic etc.) as each minority identity, in isolation and as they intersect, has a different experience of stress[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Some studies indicate higher rates of HRBs in individuals with \u0026ge;\u0026thinsp;2 minority identities[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. However, in a previous study on SMA, we found that ethnic \u003cem\u003eand\u003c/em\u003e sexual minority adolescents were less likely to report HRBs compared to their White SM peers[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn general, substance use (especially cigarette smoking but also alcohol consumption) has been decreasing among youth of all sexual orientations in recent decades[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. However, this decrease is not the same between SMA and heterosexual peers, and sexual minority inequalities in HRBs persist. These findings vary by SMA subgroup, substance type studied and gender. For example, studies from the US have found that cigarette smoking have decreased in heterosexual and gay/lesbian youth but not as much in bisexual peers[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Other studies report that while alcohol consumption has decreased among all youth, rates have not decreased as much in SMA, who also report more hazardous drinking patterns[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA substantial body of evidence highlights the increased risk for poorer mental health in SMA, consistent with multiple indicators of mental health including depression, anxiety, PTSD, self-harm, suicidality, poor quality sleep and social isolation[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Across adolescence and adulthood, the prevalence of common mental health problems like depression and anxiety are 3\u0026ndash;5 times higher in SM youth relative to their heterosexual peers[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. A smaller number of studies have examined associations between mental health problems and co-occurring HRBs in sexual minority youth. However, most of these studies are conducted in the USA, and often in relation to the most commonly studied HRBs[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eStudies on HRBs in SMA in the UK are limited. The few studies till date have reported significantly higher levels of HRBs in SMA compared to heterosexual peers, but these studies are limited by combining all SMA subgroups together, examining a limited number of HRBs or regional study samples[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Even fewer studies have investigated HRBs in conjunction with co-occurring mental health problems. A study on adolescents aged 14 found a strong network between sexual minority identity, depression and victimisation which were indirectly linked to substance use. In the UK, there is limited knowledge on sexual identity-related differences in the co-occurrence between common mental health problems (like depression and anxiety) and HRBs in later adolescence. Further, whether adolescents living with co-occurring common mental problems and HRBs are more likely to report acute mental health problems like self-harm and suicidality and how this potentially varies by sexual identity remains unexplored. We explored sexual identity inequalities in 1) reporting the number of HRBs, 2) the co-occurrence between mental health problems (depression and anxiety) and HRBs, and 3) whether having co-occurrence was associated with increased risk for self-harm and attempted suicide in a large sample of British adolescents aged 17 years who are part of the ongoing Millennium Cohort Study.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and participants\u003c/h2\u003e \u003cp\u003eThe Millennium Cohort Study (MCS) is a UK birth cohort study following the lives of 19,519 children born at the start of the new millennium (2000\u0026ndash;2002). Study participants have been followed over seven sweeps to date (9 months, 3, 5, 7, 11, 14 and 17 years). Detailed information on the study, sampling and survey design can be found at: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://cls.ucl.ac.uk/cls-studies/millennium-cohort-study/\u003c/span\u003e\u003cspan address=\"https://cls.ucl.ac.uk/cls-studies/millennium-cohort-study/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. 14,496 families were invited to participate in the age 17 sweep. Of this number, 10,625 (73.3%) families and 10,345 (71.4%) adolescents were successfully interviewed. This cross-sectional study included N\u0026thinsp;=\u0026thinsp;10,233 children (98.9% of the eligible sample) who attended the age 17 sweep (2018\u0026ndash;2019). MCS was oversampled for higher proportions of ethnic minority (EM) and socioeconomically disadvantaged families (sample weights ensure national representativeness). Attrition at age 17 sweep was predicted by single-parent families, lower-income occupation and lower educational level, Black ethnicity, and male sex. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) were followed in the reporting in this manuscript.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eMeasures\u003c/h3\u003e\n\u003cp\u003eSexual identities: Based on self-reported answers on sexuality (from eight options listed in Supplementary Table\u0026nbsp;1), participants were categorized into: 1. Completely heterosexual, 2. Bisexual and 3. Gay or lesbian. Those who answered \u0026lsquo;other\u0026rsquo;, \u0026lsquo;do not know\u0026rsquo; and \u0026lsquo;preferred not to say\u0026rsquo; were excluded (N\u0026thinsp;=\u0026thinsp;154).\u003c/p\u003e \u003cp\u003eMental health (MH): In this study, MH refers to symptoms of depression and anxiety. The Strengths and Difficulties Questionnaire (SDQ) is a commonly and widely used brief screening tool comprising 5 subscales (with each subscale including 5 items for a total of 25 items) that assess a range of behavioural and emotional problems in children. The SDQ is used to assess positive and negative attributes in children over the previous 6 months. In this study, we used the SDQ emotional symptoms subscale (SDQ-E) comprising 5 items or questions (for e.g., are you often unhappy?) relating to depression, worry, fear, nervousness, and somatic symptoms, which assesses symptoms of psychological distress in the preceding six months. The SDQ-E is widely validated and \u003cem\u003eroutinely used to capture symptoms of depression and anxiety\u003c/em\u003e in the general population and clinical settings[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Further, the SDQ-E measure has been validated against diagnostic measures of depression or anxiety disorders and is an established screening tool to distinguish those individuals who meet the diagnostic criteria for depression and anxiety from those who do not[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. For each of the 5 items, participants could respond with: Not true, somewhat true, or certainly true (scored 0, 1 and 2, respectively). Total scores were calculated, ranging from 0\u0026ndash;10, with higher scores indicating more emotional problems (depression and anxiety). Total scores were categorised into a binary variable based on recommended cut-off points indicating participants with \u0026lsquo;close to average\u0026rsquo; (\u0026lt;\u0026thinsp;6) vs. \u0026lsquo;high/very high levels\u0026rsquo; (\u0026ge;\u0026thinsp;6) of difficulties[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eOutcomes of interest\u003c/h3\u003e\n\u003cp\u003eHealth and risk behaviours were seven in number and included current smoking, frequent alcohol consumption, frequent cannabis use (in the past year), risky sexual behaviour, lack of physical activity in the previous week, antisocial behaviour in previous year (for e.g., pushed or shoved/hit/slapped/punched someone, hit someone with or used a weapon etc.) and any form of gambling in the preceding month (for e.g., have you spent on your own money in a betting shop or fruit machines?). Each HRB was coded as a binary variable (No vs. Yes). Based on these seven binary HRB variables, we created a cumulative behaviour score (hereafter HRB score) which was categorised into: 0 HRBs, 1 HRB, 2 HRBs and \u0026ge;\u0026thinsp;3 HRBs.\u003c/p\u003e \u003cp\u003eMental health (MH) problems and HRB co-occurrence (MH-HRB) indicator: We created a categorical variable which indicated those individuals without and with co-occurrence and the following categories: Only MH problems or only HRBs or no-occurrence, MH problems and 1 HRB, MH problems and 2 HRBs, and MH problems and \u0026ge;\u0026thinsp;3 HRBs. Adolescents with either only MH problems or only reporting HRBs were combined with the category of \u0026lsquo;Only MH problems or only HRBs or no-occurrence (hereafter No mental health problems and no HRBs).\u003c/p\u003e \u003cp\u003eSelf-harm and attempted suicide in the previous year were reported via questionnaires. Participants were asked about self-harming actions (like cutting/stabbing, burning, bruising/pinching, taking an overdose of tablets and pulling out hair). We created binary variable indicating no self-harm vs any kind of self-harm. Attempted suicide was asked with the question: \u0026lsquo;\u0026rsquo;Have you ever hurt yourself on purpose to end your life?\u0026rsquo;\u0026rsquo; Responses were categorised as no vs yes.\u003c/p\u003e\n\u003ch3\u003eCovariates\u003c/h3\u003e\n\u003cp\u003eCovariates included sex assigned at birth (hereafter sex), ethnicity and parental income. Where available, parent/guardian reported participant\u0026rsquo;s ethnicity at age 3 was used (Supplementary Table\u0026nbsp;1). Subjects were grouped into either 1. White (ethnic majority) and 2. EM (mixed-ethnicity, South Asian, Black and \u0026lsquo;other\u0026rsquo;). The \u0026lsquo;other\u0026rsquo; group included participants from Asia (excluding South Asia), the Middle East and South America.\u003c/p\u003e \u003cp\u003eComplete details, the original questions, all component items of each MH scale, and operationalized, and all health-related indicators, and how they were categorized (including references) are listed in Supplementary Table S2.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eA detailed description of attrition in the cohort is provided elsewhere[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Missing data per variable ranged from 2.4 to 62%. For the vast majority of variables missing data was \u0026lt;\u0026thinsp;5%. Variables with greater missingness included alcohol frequency (24%) and gambling (34%). The complete data sample included 6,494 participants with no missing data. Missing exposure, covariate and outcome data was addressed through multiple imputation using chained equations under the assumption that data were missing at random (MAR). This was suitable given that observed characteristics like ethnicity and parental income were independent predictors of missingness (i.e., ethnic minority and socioeconomically disadvantaged participants were more likely to have missing information across \u0026ge;\u0026thinsp;1 analysis parameters). To predict missing data, the imputation model integrated all HRBs and covariates, and auxiliary variables like parental highest educational qualifications, the four other subscales of the SDQ, indicators of mental wellbeing, BMI, general health, physical health, victimisation, doctor-diagnosed depression along with combined sample and attrition weights to strengthen the imputation model[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Estimates were obtained by pooling results across 25 imputed data sets using the Rubin rules, and assessment of Monte Carlo errors suggested this was a suitable number of imputations[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. The resulting imputed analytical sample included 10,223 participants.\u003c/p\u003e \u003cp\u003eWe first estimated the proportions of participants across all variables of interest by sexual identity. Multinomial logistic regression was used to assess associations between: 1) Sexual identity and risk of number of HRBs (1, 2 or \u0026ge;\u0026thinsp;3), 2) Sexual identity and risk of poor MH-HRB co-occurrence, and 3) Poor MH-HRB co-occurrence and risk of self-harm (or attempted suicide). To assess whether risk of poor MH-HRB outcome differed by sexual identity, we ran multinomial regression models with self-harm (or attempted suicide) as the outcome and including interaction terms between sexual identity and MH-HRB co-occurrence variables. The multinomial logistic regression model calculates the relative risk ratio (RRR), which is the ratio of two relative risks (derived from the exponentiated multinomial logit coefficient) and is interpreted for a unit change in the predictor variables. The predicted probabilities for self-harm (and attempted suicide) for all possible combinations of the levels of MH-HRB co-occurrence and sexual identity indicators (i.e., nine categories generated by the interaction term between the two variables) were estimated using the \u003cem\u003e\u0026rsquo;margins\u0026rsquo;\u003c/em\u003e command in Stata. This generates adjusted predictive margins or the probability for self-harm/attempted suicide in each category of interest. Predicted probabilities were visualised (by creating interaction plots using the \u003cem\u003e\u0026lsquo;marginsplot\u0026rsquo;\u003c/em\u003e command) to aid understanding of the interaction terms between the MH-HRB and sexual identity variables. All three models described above were first run without any covariates (crude models or Model 1), and then run including adjustment for sex assigned at birth, ethnicity and parental income (Model 2).\u003c/p\u003e \u003cp\u003eAll models above were also run stratified by sex at birth to assess whether associations differed between males and females.\u003c/p\u003e \u003cp\u003eAll estimates were weighted using appropriate sample and attrition weights and computed using Stata 18 (StataCorp, College Station, TX). Subgroup sample sizes were estimated from imputed proportions, weighted, and rounded and so may not sum to totals.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eTables 1 and 2 present descriptive statistics of the study sample. Of the 10,223 participants, 11% identified as bisexual or gay/lesbian. MH problems (symptoms of depression and anxiety) was more than twice as high in bisexual (49%) and gay/lesbian (48%) compared to heterosexual (18.9%) adolescents. Bisexual (19.4%) and gay/lesbian (17.1%) adolescents were more likely to report\u0026nbsp;\u0026ge;3\u003cins cite=\"mailto:Laia\" datetime=\"2024-10-14T15:58\"\u003e\u0026nbsp;\u003c/ins\u003eHRBs compared to heterosexual (12.9%) peers. Overall, 3.4% of participants reported having poor MH and\u0026nbsp;\u0026ge;3\u003cins cite=\"mailto:Laia\" datetime=\"2024-10-14T15:58\"\u003e\u0026nbsp;\u003c/ins\u003eHRBs. There were significant differences in proportions of participants reporting co-occurring poor MH and 2\u003cins cite=\"mailto:Laia\" datetime=\"2024-10-14T15:58\"\u003e\u0026nbsp;\u003c/ins\u003eHRBs and\u0026nbsp;\u0026ge;3\u003cins cite=\"mailto:Laia\" datetime=\"2024-10-14T15:58\"\u003e\u0026nbsp;\u003c/ins\u003eHRBs (for example, 10.3% of bisexuals reported poor MH and\u0026nbsp;\u0026ge;3\u003cins cite=\"mailto:Laia\" datetime=\"2024-10-14T15:58\"\u003e\u0026nbsp;\u003c/ins\u003eHRBs compared to 2.6% of heterosexual adolescents). Similarly, proportions of individuals reporting self-harm or attempted suicide were much higher in those with co-occurring poor MH and\u0026nbsp;\u0026ge;3\u003cins cite=\"mailto:Laia\" datetime=\"2024-10-14T15:58\"\u003e\u0026nbsp;\u003c/ins\u003eHRBs.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAssociations between sexual identity and HRBs (Table 3)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn general, SM adolescents (bisexual and gay/lesbian individuals) were significantly more likely to report 1, 2 or\u0026nbsp;\u0026ge;3 HRBs compared to their heterosexual peers. We did not find any differences in risk for HRBs between bisexual and gay/lesbian individuals (95% CIs overlapped for most estimates). Both bisexual (adjusted RRR2.06, 95% CI 1.58-2.70) and gay/lesbian individuals (RRR1.59, 1.02-2.48) were significantly more likely to report\u0026nbsp;\u0026ge;3 HRBs compared to their heterosexual peers. Adjustment for covariates (ethnicity, parental income and sex) did not significantly change estimates.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAssociations between sexual identity and co-occurring poor MH and HRBs (Supplemental Table 3)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eWe found consistent and significant associations between sexual minority identity and risk for co-occurring poor MH\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003cdel cite=\"mailto:Amal%20Khanolkar\" datetime=\"2024-10-16T12:15\"\u003e\u0026nbsp;\u003c/del\u003eand HRBs. Compared to heterosexual individuals, bisexual and gay/lesbian individuals consistently had higher risk for all three categories of poor MH and co-occurring HRBs (for example, RRR4.11 [2.99-5.66] and RRR3.54 [2.06-6.08] for MH-\u0026ge;3 HRBs for bisexual and gay/lesbian individuals respectively). Adjustment for covariates (ethnicity, parental income and sex) only marginally attenuated the estimates.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAssociations with self-harm and attempted suicide (Supplemental Table 4)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn multinomial regression models with self-harm or attempted suicide as the outcome (including interactions between sexual identity and MH-HRB variables), having poor MH-HRB co-occurrence and sexual minority identity were independently associated with self-harm or attempted suicide. For example, bisexual (RRR6.64 [5.17-8.51]) and gay (RRR3.83 [2.61-5.62] adolescents had substantially higher risk for self-harm compared to heterosexual peers. Further, there was a gradient in risk for self-harm (or attempted suicide) with increasing number of poor MH and co-occurring HRBs. For example, the risk for self-harm increased progressively from RRR3.46 (2.79-4.30) to RRR4.63 (3.44-6.25) and RRR8.21 (5.91-11.41) for 1 HRB, 2HRBs and\u0026nbsp;\u0026ge;3HRBs, respectively, with co-occurring poor MH.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ePredicted probabilities for self-harm and attempted suicide based on sexual identities and MH-HRB co-occurrence status (Table 4 and Figure 2)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003ePredicted probabilities can be interpreted as the proportions of the sample presenting with the outcome of interest after accounting for confounders. Irrespective of sexual identity, adolescents with co-occurring poor MH and HRBs had increased probabilities of self-harm or attempted suicide (with probabilities increasing progressively with increasing number of HRBs). For example, 41.7% of adolescents with MH-1HRB reported self-harm increasing to 61.3% for those with MH-\u0026ge;3HRBs. Greater proportions of SM adolescents reported self-harm and attempted suicide compared to heterosexual peers.\u003c/p\u003e\n\u003cp\u003eHowever, the probabilities for self-harm and attempted suicide were even higher (or varied in strength) in SMA compared to heterosexual peers \u003cem\u003ereporting the same level of co-occurring poor MH and HRBs\u003c/em\u003e. Or where individuals reported poor MH and co-occurring HRBs, the probability of self-harm and attempted suicide among SMA was higher compared to heterosexual peers. For example, 37.2% of heterosexual adolescents with MH-1HRB reported self-harm. Corresponding numbers were more than twice as high in bisexual (75.7%) and gay/lesbian (77.9%) individuals. Similarly, 58.3% of heterosexual adolescents with MH-\u0026ge;3HRBs reported self-harm, which increased to 84.6% in bisexual and 83.8% in gay/lesbian peers.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe observed a similar pattern for attempted suicide; but findings were larger and more evident for those with MH-\u0026ge;3HRBs and bisexual individuals. 30.6% of adolescents with MH-\u0026ge;3HRBs reported attempted suicide compared to 10.1% for those with MH-1HRB. Bisexual individuals with co-occurring MH-HRBs had the greatest proportions reporting attempted suicide (20.1% for MH-1HRB, 31.2% for MH-2HRBs and 51.3% for MH-3HRBs). On average, greater proportions of gay/lesbian individuals reported attempted suicide compared to heterosexual peers, but these differences were smaller with overlapping 95% CIs.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSex stratified results (Supplemental Tables 5, 6 and 7, Table 5 and Figure 3)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSMA girls were significantly more likely to report any number of HRBs compared to heterosexual girls. Findings were more consistent for bisexual girls (RRR1.32 [1.00-1.73] for 1HRB, RRR1.39 [1.01-1.90] for 2 HRBs and RRR2.32 [1.70-3.17] for 3HRBs, than gay/lesbian peers. While SMA boys had higher RRR for reporting HRBs, these were largely non-significant. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSMA boys and girls had significantly higher risk for MH-HRBs co-occurrence compared to heterosexual peers. However, on average, boys had higher risk for co-occurring MH-HRBs compared to girls. This was observed for all categories of co-occurring MH-HRBs (for example, for MH-\u0026ge;3HRBs, boys: bisexual RRR 4.91 [2.35-10.26] and gay/lesbian RRR 5.66 [2.48-12.96] compared to girls: bisexual 3.82 [2.69-5.41] and gay/lesbian RRR 2.55 [1.22-5.34]). But for all estimates, 95% CIs were largely overlapping.\u003c/p\u003e\n\u003cp\u003eRisk for self-harm and attempted suicide increased with increasing number of co-occurring HRBs and poor MH in both boys and girls. For example, risk for self-harm (boys: OR 8.49 [4.88-14.77], girls: OR7.03 [4.68-10.56]) in adolescents with MH-\u0026ge;3HRBs was more than twice has high compared to those with MH-1HRB.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHeterosexual individuals without co-occurring poor MH and HRBs had the lowest probabilities for self-harm and attempted suicide in both sexes (14.1 and 17.6% for self-harm in boys and girls, respectively). Bisexual (65%) and lesbian (45.7) girls had higher proportions reporting self-harm compared to bisexual (47.4%) and gay (35.5) boys. For all levels of co-occurrence, greater proportions of SMA boys and girls reported self-harm than heterosexual peers. For MH-2HRBs, greater proportions of SMA girls reported self-harm compared to SMA boys, but CIs were overlapping. Proportions of SMA with MH-\u0026ge;3HRBs reporting self-harm were similar in boys and girls.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA similar pattern was observed for attempted suicide. Greater proportions of SMA boys and girls reported attempted suicide compared to heterosexual peers with the same level of co-occurrence. However, there was no observable differences between boys and girls.\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present study aimed to investigate sexual identity inequalities in HRBs, co-occurrence between poor MH and HRBs and whether this co-occurrence was associated with risk for self-harm and attempted suicide. We found that SMA were significantly more likely to report a greater number of HRBs compared to heterosexual peers. SMA were also more likely to report co-occurring poor MH-HRBs. Further, sexual minority status and having co-occurring poor MH-HRB were independently associated with risk for self-harm and attempted suicide (with a gradient \u0026ndash; i.e., risk for both outcomes increased with increasing number of HRBs and co-occurring poor MH). A pertinent finding is that greater proportions of SMA reported self-harm or attempted suicide in relation to co-occurring MH-HRBs compared to heterosexual peers with the same level of co-occurrence. Differences between gay/lesbian and bisexual individuals were limited. We found no difference in proportions of gay/lesbian or bisexual individuals reporting self-harm in relation in MH-HRB co-occurrence. However, there was some evidence for greater proportions of bisexual adolescents who reported attempted suicide compared to gay/lesbians adolescents with the same level of co-occurring MH-HRB. Differences by sex were evident for some of the associations studied. Overall, female adolescents were less likely to report HRBs compared to males, regardless of sexual identity. While female SMA were more likely to report co-occurring MH-HRBs compared to heterosexual peers, their risk for co-occurrence was smaller than male SMA peers.\u003c/p\u003e \u003cp\u003eStrengths include a large sample size drawn from a nationally representative, highly studied contemporary birth cohort with rich social, health and economic data, which facilitates generalisability to the UK adolescent population. Our indicator of MH (SDQ emotional symptoms sub-scale) is widely used in studies on adolescent mental health increasing comparability with other studies. In general, missing data on all confounders and MH were relatively low (\u0026lt;\u0026thinsp;5%) but we did have higher levels of missing data on two HRBs, and 9% of the sample were missing data on sexual identity. We addressed missing data using the robust multiple imputation technique. Multiple imputation relies on the MAR assumption, which is not empirically verifiable[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Nonetheless, we increased the plausibility of the MAR assumption by including a rich set of auxiliary variables which help increase the precision of predicting missing data and minimising non-random variation in values. Additionally, the wide range of associated variables like socioeconomic, health and HRBs data and longitudinal data on BMI, are powerful predictors of missing data which significantly strengthen the imputation model. We included HRBs like gambling and antisocial behaviour which are seldom studied in relation to sexual identity and MH-HRB co-occurrence.\u003c/p\u003e \u003cp\u003eLike most cohort studies, the MCS has significant attrition over follow-up (of the original 19,517 children, 10,757 attended the age 17 sweep). However, some studies have indicated that the MCS remains representative of its original birth cohort, and we used survey weights to adjust for this and ensure population-representativeness. We could not examine important factors like access to MH services, peer-group support, SM-specific issues like rejection sensitivity, internalised stigma, gender-role strain and perceived burdensomeness which are strongly linked to MH and wellbeing, and self-harm and suicidality, and are known to differ between heterosexual and SM individuals[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. As this is a cross-sectional study, we could not disentangle the direction of association between MH-HRB and self-harm/attempted suicide. However, we hypothesise that it is more likely that low mood/depression and persistent HRBs subsequently leads to self-harm and/or attempted suicide as reported by other studies[\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Further, the cross-sectional design precludes causality. Nonetheless, we hypothesised that for most individuals\u0026rsquo; sexual identities or orientation are likely formulated earlier in adolescence before age 17.\u003c/p\u003e \u003cp\u003eWe excluded individuals who identified as \u0026lsquo;mainly heterosexual\u0026rsquo; due to discussions on whether they should be in a separate sexual identity category or combined with bisexual individuals. A recent study using MCS data combined mainly heterosexual and bisexual individuals in the same group, an approach we do not recommend[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. The term \u0026lsquo;mainly heterosexual\u0026rsquo; is not commonly used in health questionnaires in the UK and there is strong likelihood for it to be confused with \u0026lsquo;bisexual\u0026rsquo;. Further, individuals unsure of their sexual identity (more likely in adolescence) may be unsure of which category to choose. Thus, for this study we included individuals identifying as completely heterosexual, bisexual, or gay/lesbian who more likely to be sure about their sexual identity. Nonetheless, adolescents identifying as mainly heterosexual have increased risk for poorer mental and general health compared to heterosexual peers and we need to further examine health in this group while also understanding the similarities and differences with bisexual individuals[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Despite 11% of the sample identifying as SM, we had relatively small numbers of individuals with co-occurring MH-HRBs in SM subgroups, which could explain the wide confidence intervals observed for some estimates and the lack of differences between bisexual and gay/lesbian individuals. Smaller numbers also precluded us from testing for potential interactions with ethnicity and socioeconomic indicators. Future studies should also include where possible a wider range of HRBs which are higher in prevalence in adolescence and SM groups like binge eating, excessive use of mobile phones and pornography which was not included in this study.\u003c/p\u003e \u003cp\u003eSeveral studies have reported higher prevalence of health risk behaviours (in particular substance use like regular smoking, alcohol misuse/binge drinking, drug use and risky sexual behaviour) in SM groups compared to heterosexual peers including adolescents and young adults[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. However, most of this research originates from the USA[\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. While some studies show differences in prevalence between SM sub-groups (for example, higher prevalence in bisexual and female SMA), others show conflicting results of no differences[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Associations with substance use have been found with different indicators of sexual identity (self-identified, sexual behaviour, and sexual attraction) but associations are stronger and more consistent with self-identified sexual identity which is used in our study[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. A systematic review focused on evidence from the UK found clustering between sexual risk behaviour, smoking, drug use and alcohol misuse (same HRBs as included in our study) was more common among young adults[\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. Most studies that have examined sexual identity related differences in HRBs in adolescents have not examined co-occurrence with poor mental health limiting comparisons. A recent study on approximately 8000 university students in Ireland found higher level of risky mental and sexual health behaviours in SM individuals compared to heterosexual peers but not for risky physical behaviours like alcohol and drug use, which contrasts with our findings[\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Further, the authors found evidence for an \u0026lsquo;overlap\u0026rsquo; between different forms of adverse health behaviours and mental health outcomes like depression and anxiety, but the methods used to evaluate co-occurring behaviours and adverse health was different from our study. Our findings of higher risk for multiple HRBs among males compared to females (regardless of sexual identity) is in line with existing literature. We found evidence that SMA females (especially bisexual) were more likely to report any number of HRBs compared to both heterosexual peers and male SMA, which is line with previous studies[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. We advise caution in interpreting sex related differences due to smaller numbers in sex-stratified models.\u003c/p\u003e \u003cp\u003eThe Syndemic Health Model predicates that health behaviours and conditions often co-occur and interact across the lifecourse, increasing risk for adverse health in subpopulations further compounded by environmental conditions like socioeconomic disadvantage, which perpetuate this concentration of conditions[\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. This can be applied in the context of sexual minority inequalities where SMA experience multiple stressors (like stigma, discrimination, victimisation) associated with their identities which impact not only their mental but also physical health. SMA might use HRBs as coping mechanisms to deal with living with multiple stressors in an already volatile life period like adolescence. Substantial evidence supports greater levels of interactions between mental, physical and sexual health and behaviours in SM individuals compared to heterosexual peers[\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. Our findings clearly demonstrate that SMA are more likely to report co-occurring poor MH and HRBs, and report much higher levels of self-harm and attempted suicide. While we are unable to examine directionality between MH and HRBs, it is evident that significantly higher number of SMA with poor MH are reporting higher numbers of HRBs. Our findings and the large evidence base for SM-related inequalities highlight that current policies are falling short. Substantially more needs to be done to address health inequity among SMA. Policies that more effectively address SM stressors, in combination with health promotion, awareness and equality campaigns are needed. But these need to be addressed in multiple venues like schools, local communities and neighbourhoods, public transport and elsewhere.\u003c/p\u003e \u003cp\u003eTo conclude, SMA are more likely to report a greater number of HRBs, and co-occurring poor MH-HRBs compared to heterosexual peers. An increasing number of HRBs and co-occurring poor MH is associated with higher risk for self-harm and attempted suicide (with a gradient) in adolescents. However, significantly higher proportions of SMA were more likely to self-harm or attempt suicide compared to heterosexual peers with the same level of co-occurrence. This is a stark example of sexual minority related inequalities in a contemporary cohort of adolescents.\u003c/p\u003e \u003cp\u003eFurther, many studies focus on MH co-occurring with health-related behaviours (like substance use, risky sexual behaviour) or are restricted to samples comprising only SM populations, or those with a particular health condition like HIV or cancer [44]. Additionally, existing studies focus on older SM individuals at greater risk of chronic conditions, a few of which include multiethnic samples [43, 45].\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSMA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSexual minority adolescents\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSexual minority\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHRBs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHealth and risk behaviours\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMCS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMillennium Cohort Study\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eethnic minority\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHRB\u0026ndash;Poor mental health and health and risky behaviours co\u0026ndash;occurrence\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cem\u003eEthics approval and consent to participate\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eEthics approval for the MCS was obtained from the National Research Ethics Service Committee London\u0026mdash; Central (reference 13/LO/1786). All data are anonymized and available to researchers via the UK Data Service. Cohort members \u0026ge;16 years provided verbal consent to take part in the study.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAvailability of data and materials\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eData for this study is from the age 17 sweep of the Millennium Cohort Study. Data can be accessed from the UK Data Service website: https://ukdataservice.ac.uk/ (after registration and agreeing to licence terms and conditions). Syntax/code used for the analysis in this study is available on request from the corresponding author.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eCompeting interests\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThere are no specific funding sources for this study.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAuthors\u0026apos; contributions\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eARK conceived the research idea, conducted the data analysis and wrote the manuscript. AK contributed to data curation and analysis. All authors were involved in interpretation of findings. All authors contributed to writing, and read and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAcknowledgements\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eMarshal MP, Friedman MS, Stall R, King KM, Miles J, Gold MA, Bukstein OG, Morse JQ. Sexual orientation and adolescent substance use: a meta-analysis and methodological review. Addiction. 2008;103(4):546\u0026ndash;56.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHughes TL, Veldhuis CB, Drabble LA, Wilsnack SC. Research on alcohol and other drug (AOD) use among sexual minority women: A global scoping review. PLoS ONE. 2020;15(3):e0229869.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDemant D, Hides L, Kavanagh DJ, White KM, Winstock AR, Ferris J. 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Addiction. 2009;104(8):1333\u0026ndash;45.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmos R, Manalastas EJ, White R, Bos H, Patalay P. Mental health, social adversity, and health-related outcomes in sexual minority adolescents: a contemporary national cohort study. Lancet Child Adolesc Health. 2020;4(1):36\u0026ndash;45.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoodman R, Meltzer H, Bailey V. The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version. Int Rev Psychiatry. 2003;15(1\u0026ndash;2):173\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArmitage JM, Tseliou F, Riglin L, Dennison C, Eyre O, Bevan Jones R, Rice F, Thapar AK, Thapar A, Collishaw S. Validation of the Strengths and Difficulties Questionnaire (SDQ) emotional subscale in assessing depression and anxiety across development. PLoS ONE. 2023;18(7):e0288882.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eScoring the Strengths. \u0026amp; Difficulties Questionnaire for age 4\u0026ndash;17. In.; 2015.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMillennium cohort study seventh sweep (MCS7.) technical report. In.: University College London; 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJo S. The Use of Multiple Imputation to Handle Missing Data in Secondary Datasets: Suggested Approaches when Missing Data Results from the Survey Structure. Inquiry. 2022;59:469580221088627.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eQuartagno M, Carpenter MQ, Goldstein JR. Multiple Imputation with Survey Weights: A Multilevel Approach. J Surv Stat Methodol. 2020;8(5):965\u0026ndash;89.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWhite IR, Royston P, Wood AM. Multiple imputation using chained equations: Issues and guidance for practice. Stat Med. 2011;30(4):377\u0026ndash;99.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eP vH. Regression with Missing Ys: An Improved Strategy for Analyzing Multiply Imputed Data. Sociol Methodol. 2007;37:83\u0026ndash;117.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePachankis JE, Goldfried MR, Ramrattan ME. Extension of the rejection sensitivity construct to the interpersonal functioning of gay men. J Consult Clin Psychol. 2008;76(2):306\u0026ndash;17.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGili M, Castellvi P, Vives M, de la Torre-Luque A, Almenara J, Blasco MJ, Cebria AI, Gabilondo A, Perez-Ara MA. Mental disorders as risk factors for suicidal behavior in young people: A meta-analysis and systematic review of longitudinal studies. J Affect Disord. 2019;245:152\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWhite J, Borgia S, Rehkopf DH. Socioeconomic inequalities in the risk of suicide attempts among sexual minority adolescents: Findings from the UK's Millennium Cohort Study. Lancet Reg Health Eur. 2023;26:100570.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFonzo M, Cocchio S, Centomo M, Baldovin T, Buja A, Majori S, Baldo V, Bertoncello C. Sexual and Gender Minorities and Risk Behaviours among University Students in Italy. Int J Environ Res Public Health 2021, 18(21).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMahon C, Fitzgerald A, O'Reilly A, Dooley B. Mental, physical and sexual health in sexual minority third-level students: Findings from My World Survey 2. Early Interv Psychiatry. 2023;17(9):864\u0026ndash;76.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMeader N, King K, Moe-Byrne T, Wright K, Graham H, Petticrew M, Power C, White M, Sowden AJ. A systematic review on the clustering and co-occurrence of multiple risk behaviours. BMC Public Health. 2016;16:657.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePaul Poteat V, Russell ST, Dewaele A. Sexual Health Risk Behavior Disparities Among Male and Female Adolescents Using Identity and Behavior Indicators of Sexual Orientation. Arch Sex Behav. 2019;48(4):1087\u0026ndash;97.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSinger M, Clair S. Syndemics and public health: reconceptualizing disease in bio-social context. Med Anthropol Q. 2003;17(4):423\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKneale D, Becares L. The influence of a hostile environment on a syndemic of depression, stress and chronic limiting illness among LGBTQ\u0026thinsp;+\u0026thinsp;people during the COVID-19 pandemic. Sociol Health Illn. 2024;46(1):114\u0026ndash;36.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMercer CH, Prah P, Field N, Tanton C, Macdowall W, Clifton S, Hughes G, Nardone A, Wellings K, Johnson AM, Sonnenberg P. The health and well-being of men who have sex with men (MSM) in Britain: Evidence from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). BMC Public Health. 2016;16:525.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Table 1. Prevalence of mental ill-health, health and risk behaviours (HRB) by sexual identity in 10,233 adolescents aged 17 years from the Millennium Cohort Study\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCovariate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSexual identity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eBisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eGay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex at birth\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePoor mental health (yes)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eBisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eGay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHealth risk behaviours\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e1 HRB, Heterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Bisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Gay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e2 HRBs Heterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Bisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Gay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e3 HRBs Heterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Bisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Gay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-harm\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eBisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eGay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttempted suicide\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eBisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eGay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Prevalence of co-occurring mental ill-health and health and risk behaviours (HRB) by sexual identity, self-harm and attempted suicide in 10,233 adolescents aged 17 years from the Millennium Cohort Study\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMH-HRB co-occurrence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFull sample %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSexual identity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eNo co-occurrence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e85.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e84.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e86.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e87.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e88.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eBisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e65.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e62.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e69.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eGay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e67.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e61.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e73.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eMH \u0026amp; 1 HRB\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e7.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e7.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e5.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eBisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e14.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e12.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e17.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eGay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e17.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e12.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eMH \u0026amp; 2 HRB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e3.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eBisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eGay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e7.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e11.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eMH \u0026amp; \u0026ge;3 HRB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e3.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eBisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e10.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e12.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eGay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e7.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e10.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eMH: Mental health (assessed using the Strengths and Difficulties Questionnaire [SDQ]; emotional symptoms subscale)\u003c/p\u003e\n\u003cp\u003eHRB: Health and risky behaviours (antisocial behaviour, current smoker, frequent alcohol consumption, frequency cannabis \u0026nbsp;use, risky sex, no exercise, gambling).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. Associations between sexual identity and health risk behaviours (HRB) in 10,223 adolescents from the Millennium Cohort Study. Estimates are from multinomial logistic regression models.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 27.2147%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel 1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 25.5255%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel 2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCovariate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRRR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRRR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eNo HRB\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e1 HRB\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eBisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e0.96, 1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.26\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.00, 1.59\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eGay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.55\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.06, 2.26\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.57\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.07, 2.30\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex at birth\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.78, 0.98\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eWhite\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eEthnic-minority\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e0.85, 1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParental income\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e0.97, 1.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e1.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e0.92, 1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e0.79, 1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e0.82, 1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 5 (highest income)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e2 HRBs\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eBisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e1.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e0.98, 1.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.35\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.03, 1.78\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eGay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e0.91, 2.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e0.91, 2.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex at birth\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.73\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.63, 0.85\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eWhite\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eEthnic-minority\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.48, 0.76\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParental income\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e0.82, 1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e0.82, 1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e0.68, 1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e0.64, 0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 5 (highest income)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026ge;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e3 HRBs\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eBisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.77\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.36, 2.30\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.06\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.58, 2.70\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eGay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.57\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.02, 2.43\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.59\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.02, 2.48\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eSex at birth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.51\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.44, 0.60\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eWhite\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eEthnic-minority\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.38\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.28, 0.50\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParental income\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8859%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.452%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.30\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.03, 1.65\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.30\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.03, 1.65\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e0.80, 1 .26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.9535%;\"\u003e\n \u003cp\u003e0.84, 1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.4054%;\"\u003e\n \u003cp\u003eQuintile 5 (highest income)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0736%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eModel 2: adjusted for sex at birth, ethnicity and parental income. Text in bold indicates estimates for which \u0026nbsp;95% CI do not contain 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u003c/strong\u003e Predicted probabilities for self-harm or attempted suicide based on poor mental health and health risk behaviours co-occurrence and sexual identities in 10,223 adolescents aged 17 years from the Millennium Cohort Study. Estimates are based on multivariable logistic regression models (adjusted for sex, ethnicity and parental income).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-harm\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttempted Suicide\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCo-occurrence only\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 1 HRB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e41.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e37.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e45.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e10.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e12.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 2 HRBs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e46.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e40.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e52.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e13.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e17.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp;\u0026nbsp;\u0026ge;3 HRBs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e61.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e54.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e68.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e30.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e24.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e36.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSexual identity only\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e20.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e19.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eBisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e58.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e53.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e63.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e18.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e22.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eGay/lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e46.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e38.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e54.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e13.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e18.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eCo-occurrence \u0026amp; sexual identity\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eNo-occurrence \u0026amp; Heterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e14.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e16.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e5.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eNo-occurrence \u0026amp; Bisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e49.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e61.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e15.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e20.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eNo-occurrence \u0026amp; Gay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e41.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e32.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e50.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e11.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e17.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 1 HRB \u0026amp; Heterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e37.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e32.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e41.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e8.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e6.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 1 HRB \u0026amp; Bisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e75.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e66.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e84.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e20.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e12.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e28.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 1 HRB \u0026amp; Gay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e77.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e62.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e93.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e14.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e26.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 2 HRBs \u0026amp; Heterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e44.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e37.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e50.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e7.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e16.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 2 HRBs \u0026amp; Bisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e69.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e57.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e82.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e31.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e18.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e43.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 2 HRBs \u0026amp; Gay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e59.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e35.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e84.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e20.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e40.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp;\u0026nbsp;\u0026ge;3 HRBs \u0026amp; Heterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e58.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e50.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e28.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e21.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e34.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp;\u0026nbsp;\u0026ge;3 HRBs \u0026amp; Bisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e84.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e75.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e94.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e51.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e38.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e64.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp;\u0026nbsp;\u0026ge;3 HRBs \u0026amp; Gay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e83.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e67.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e13.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e58.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;MH: Poor mental health, HRB: Health and risky behaviours\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5. Predicted probabilities for self-harm or attempted suicide based on poor mental health and health risk behaviours co-occurrence and sexual identities in 10,223 adolescents aged 17 years from the Millennium Cohort Study. Estimates are based on multivariable logistic regression models (adjusted for ethnicity and parental income) stratified by sex\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCo-occurrence \u0026amp; sexual identity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 251px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-harm\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 261px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttempted Suicide\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBoys\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGirls\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBoys\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGirls\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCo-occurrence status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eNo co-occurrence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e15.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e14.5\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e17.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e24.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e22.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e26.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e3.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e4.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e7.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e6.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e8.9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 1 HRB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e39.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e31.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e47.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e45.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e41.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e50.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e6.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e2.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e9.9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e13.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e10.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e16\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 2 HRBs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e34.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e23.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e46.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e53.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e47.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e60.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e2.9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e20.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e17.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e12.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e21.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp;\u0026nbsp;\u0026ge;3 HRBs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e60.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e48.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e72.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e63.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e55.8\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e71.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e28.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e18.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e38.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e27.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e42.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSexual Identity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e16.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e14.9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e17.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e23.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e22.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e25.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e3.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e4.5\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e8.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e7.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e9.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eBisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e47.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e38.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e56.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e59.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e70.5\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e16.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e9.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e23.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e21.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e17.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e26.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eGay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e35.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e24.8\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e46.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e56.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e45.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e67.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e4.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e17.9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e15.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e8.9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e22.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eCo-occurrence \u0026amp; sexual identity\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eNo-occurrence \u0026amp; Heterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e14.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e12.8\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e15.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e17.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e16\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e19.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e2.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e3.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e4.9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e6.9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eNo-occurrence \u0026amp; Bisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e44.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e34.9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e54.8\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e61.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e55.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e68.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e7.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e22.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e18.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e13.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e23.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eNo-occurrence \u0026amp; Gay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e32.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e21.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e43.9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e50.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e37.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e63.5\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e3.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e17.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e4.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e21.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 1 HRB \u0026amp; Heterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e36.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e28.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e45.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e39.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e34.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e45.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e5.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e1.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e11.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e8.5\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e14.5\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 1 HRB \u0026amp; Bisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e76.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e56.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e96.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e77.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e68.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e87.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e17.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e34.5\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e15.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e34.9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 1 HRB \u0026amp; Gay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e80.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e56.9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e1.04\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e78.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e59.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e97.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e-1.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e55.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e11.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e-3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e24\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 2 HRBs \u0026amp; Heterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e33.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e21.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e45.8\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e49.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e41.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e58.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e1.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e20.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e13.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e8.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e19.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 2 HRBs \u0026amp; Bisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e58.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e25.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e91.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e62.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e87.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e26.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e-6.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e58.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e36.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e22.4\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e50.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp; 2 HRBs \u0026amp; Gay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e42.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e4.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e80.9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e73.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e47.5\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e1.002\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e20.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e44.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e27.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e-3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e55.5\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp;\u0026nbsp;\u0026ge;3 HRBs \u0026amp; Heterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e58.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e45.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e71.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e59.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e50.5\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e69.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e27.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e16.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e38.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e31.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e22.8\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e39.7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp;\u0026nbsp;\u0026ge;3 HRBs \u0026amp; Bisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e97.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e88.5\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e1.059\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e72.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e93.5\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e64.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e36.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e93.2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e53.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e39.8\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e66.9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMH \u0026amp;\u0026nbsp;\u0026ge;3 HRBs \u0026amp; Gay/Lesbian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e77.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cem\u003e50.3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e1.046\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 44px;\"\u003e\n \u003cp\u003e89.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e71.6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e1.08\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e8.8\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e34.5\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003e23\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cem\u003e93.1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmed","sideBox":"Learn more about [BMC Medicine](http://bmcmedicine.biomedcentral.com/)","snPcode":"12916","submissionUrl":"https://submission.nature.com/new-submission/12916/3","title":"BMC Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Sexual minority, LGBTQ + health, mental health, health behaviours, self-harm, attempted suicide, adolescence","lastPublishedDoi":"10.21203/rs.3.rs-5966601/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5966601/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eMental health challenges (MHC) like depression and anxiety, and health and risk behaviours (HRBs) are more common among sexual minority adolescents (SMA) than in heterosexual peers. Limited studies have examined the co-occurrence between poor mental health and HRBs, whether risk for co-occurrence differs by sexual identity, and associated risks for self-harm and attempted suicide in adolescents in the UK.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis study included 10,233 adolescents aged 17 (51% female and 11% sexual minority) from the UK-wide Millennium Cohort Study. Sexual identity, MHC, HRBs, self-harm and attempted suicide were self-reported by adolescents. MHC were assessed using the strengths and difficulties questionnaire [SDQ] emotional symptoms subscale for depression/anxiety. Seven common HRBs (like regular smoking, drug use and risky sexual behaviour) were assessed. Associations between sexual identity and risk for co-occurrence between MHC and HRBs were assessed using multinomial logistic regression. Predicted probabilities for self-harm or attempted suicide based on sexual identity and MH-HRB co-occurrence status were estimated using logistic regression models with appropriate interactions terms (between sexual identity and MH-HRB co-occurrence status variables).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eMHC prevalence was higher in gay/lesbian (48%) and bisexual (49%) adolescents compared to heterosexual peers (19%). Prevalence of self-harm (bisexual: 64%, gay/lesbian:53%, heterosexual:19%) and attempted suicide (bisexual: 24%, gay/lesbian:17%, heterosexual:6%) were higher in sexual minority adolescents compared to heterosexual peers. Gay/lesbian and bisexual adolescents consistently reported higher risk for MH-HRB co-occurrence compared to heterosexual peers (for example, for gay/lesbian individuals: RRR3.16 [95% CI 2.14\u0026ndash;4.68] for MH-1HRB, RRR3.54[95% CI 2.06\u0026ndash;6.08] for MH-\u0026ge;3HRB, for bisexual adolescents, RRR2.44 [95% CI 1.85\u0026ndash;3.20] for MH-1HRB, RRR4.11[95% CI 2.99\u0026ndash;5.66] for MH-\u0026ge;3HRB). MH-HRB co-occurrence and sexual minority identity were independently associated with risk for self-harm or attempted suicide. Gay/lesbian and bisexual adolescents experienced higher probabilities of reporting self-harm than heterosexual peers with the same level of MH-HRB co-occurrence. For example, 37.2% of heterosexual adolescents with MH-1HRB reported self-harm. Corresponding numbers were more than twice as high in bisexual (75.7%) and gay/lesbian (77.9%) individuals. Similarly, 58.3% of heterosexual adolescents with MH-\u0026ge;3HRBs reported self-harm, which increased to 84.6% in bisexual and 83.8% in gay/lesbian peers.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eSMA are more likely to experience MH-HRB co-occurrence, which is also associated with substantially higher risks for self-harm and attempted compared to heterosexual peers. Our findings highlight the need for better public health policies to address poor mental health and associated comorbidities to reduce inequalities in adolescence.\u003c/p\u003e","manuscriptTitle":"Sexual identity inequalities in the co-occurrence between poor mental health and health risk behaviours – A national cohort study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-02-19 11:42:28","doi":"10.21203/rs.3.rs-5966601/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-04-03T16:14:58+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-01T21:16:07+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-31T22:32:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"145201861520501164845661139451222788741","date":"2025-03-31T08:39:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"259662233368931196221681738969069086167","date":"2025-03-30T21:15:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"288062800786495020944287832427913099588","date":"2025-03-28T19:48:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"264786121743862985787450844541549532679","date":"2025-03-28T19:42:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"20038787333632363222192980091158041124","date":"2025-03-28T17:20:53+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-21T20:57:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"128745788913550172489947421682816248868","date":"2025-03-05T19:36:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"71794921257171071493389905800466958263","date":"2025-02-26T13:40:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"102763227132372209577560200195494888141","date":"2025-02-23T12:11:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"11042060974974228242783102939439177752","date":"2025-02-18T17:16:50+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-02-18T11:55:49+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-02-06T09:32:38+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-02-06T08:33:20+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medicine","date":"2025-02-05T14:25:32+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmed","sideBox":"Learn more about [BMC Medicine](http://bmcmedicine.biomedcentral.com/)","snPcode":"12916","submissionUrl":"https://submission.nature.com/new-submission/12916/3","title":"BMC Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"68c143c4-35cc-4bb5-adea-01615305d8ab","owner":[],"postedDate":"February 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-07-14T15:59:51+00:00","versionOfRecord":{"articleIdentity":"rs-5966601","link":"https://doi.org/10.1186/s12916-025-04236-2","journal":{"identity":"bmc-medicine","isVorOnly":false,"title":"BMC Medicine"},"publishedOn":"2025-07-09 15:57:10","publishedOnDateReadable":"July 9th, 2025"},"versionCreatedAt":"2025-02-19 11:42:28","video":"","vorDoi":"10.1186/s12916-025-04236-2","vorDoiUrl":"https://doi.org/10.1186/s12916-025-04236-2","workflowStages":[]},"version":"v1","identity":"rs-5966601","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5966601","identity":"rs-5966601","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}