Sleep health in sexual minority youth: An intersectional approach across ethnicity-race and sex-Findings from the Adolescent Brain Cognitive Development (ABCD) Study.
Zhang Y, Yan J, Zhao Z, Wang Y • Sleep health • 2026
Sexual minority youth experience poorer sleep than heterosexual youth across multiple dimensions, with ethnically and racially minoritized girls representing the most disadvantaged group, and these disparities emerge as early as ages 10-13.
Key Findings
Results
Sexual minority youth exhibited poorer sleep than heterosexual youth across multiple dimensions of both average sleep and sleep variability.
Data drawn from 5359 youth with mean age of 11.52 years, 51% female, from the Adolescent Brain Cognitive Development (ABCD) Study
Sleep was measured using actigraphy-based, multidimensional methods capturing both average sleep and variability
Sexual orientation was youth-reported; ethnicity-race and sex were caregiver-reported
Path analyses were used to examine sleep differences by sexual orientation within the full sample
Results
Within sexual minority youth, ethnically and racially minoritized youth exhibited poorer sleep than White youth.
Analyses were conducted within the sexual minority subsample examining effects of ethnicity-race, sex, and their interaction
Disparities spanned multiple dimensions of sleep, consistent with an intersectional framework
This pattern was also observed in supplementary analyses within heterosexual youth
Results
Within sexual minority youth, girls showed poorer sleep than boys.
Sex differences were examined within the sexual minority subsample using path analyses
In supplementary analyses among heterosexual youth, sex differences were described as 'more mixed'
Both average sleep and sleep variability dimensions were assessed
Results
Ethnically and racially minoritized girls within the sexual minority subsample consistently exhibited the poorest sleep compared to all other groups with fewer marginalized social strata.
An ethnicity-race × sex interaction was examined within the sexual minority subsample
Ethnically and racially minoritized girls were described as 'representing the group with the most marginalized social strata'
This finding supports an intersectional framework where multiple marginalized identities compound sleep health disadvantages
The pattern held across multiple dimensions of both average sleep and sleep variability
Conclusions
Sleep disparities among sexual minority youth and intersectional subgroups emerge as early as ages 10-13.
The ABCD Study sample had a mean age of 11.52 years
The age range examined was approximately 10-13 years
The authors conclude that 'early, targeted intervention and policy efforts are needed to address and mitigate sleep health inequities in these vulnerable groups'
Background
Sexual minority youth are not a homogeneous group with respect to sleep health, and within-group variations by ethnicity-race and sex are critical.
The study explicitly critiques prior research for treating sexual minority youth as a homogeneous group, 'obscuring critical within-group variations'
An intersectional approach examining ethnicity-race, sex, and their interaction was applied
Two social strata—ethnicity-race and sex—were chosen because they are 'consistently linked to sleep disparities'
What This Means
This research suggests that young people who identify as lesbian, gay, or bisexual (sexual minority youth) sleep worse than their heterosexual peers in multiple ways — not just in how long they sleep, but also in how consistent their sleep is from night to night. The study used wrist-worn activity monitors to objectively measure sleep in over 5,000 children aged roughly 10-13, making the findings more reliable than studies relying solely on self-report.
Importantly, the study also found that not all sexual minority youth face the same level of sleep disadvantage. Among sexual minority youth, those who were also racial or ethnic minorities slept worse than White sexual minority youth, and girls slept worse than boys. Sexual minority girls from racial or ethnic minority backgrounds — who belong to multiple marginalized groups simultaneously — showed the worst sleep outcomes of any group studied. A similar but somewhat weaker pattern was found among heterosexual youth as well.
This research suggests that sleep problems in vulnerable youth are shaped by the combination of multiple social identities, not just one in isolation — an approach called intersectionality. Because these disparities appear as early as ages 10-13, the authors argue that early, targeted support and policy efforts are needed to address sleep inequities before they compound into longer-term health and cognitive consequences.
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Zhang Y, Yan J, Zhao Z, Wang Y. (2026). Sleep health in sexual minority youth: An intersectional approach across ethnicity-race and sex-Findings from the Adolescent Brain Cognitive Development (ABCD) Study.. Sleep health. https://doi.org/10.1016/j.sleh.2026.03.007