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Colleen S. Poon, PhD and Elizabeth M. Saewyc, PhD, RN

Colleen S. Poon and Elizabeth M. Saewyc are with the McCreary Centre Society, Vancouver, BC. Elizabeth Saewyc is also with the University of British Columbia School of Nursing, Vancouver.

Correspondence: Requests for reprints should be sent to Colleen S. Poon, The McCreary Centre Society, 3552 East Hastings St, Vancouver, BC, V5K 2A7 Canada (e-mail: colleen{at}mcs.bc.ca).

Objectives. We compared sexual-minority adolescents living in rural communities with their peers in urban areas in British Columbia, exploring differences in emotional health, victimization experiences, sexual behaviors, and substance use.

Methods. We analyzed a population-based sample of self-identified lesbian, gay, or bisexual respondents from the British Columbia Adolescent Health Survey of 2003 (weighted n = 6905). We tested rural–urban differences separately by gender with the ² test and logistic regressions.

Results. We found many similarities and several differences. Rural sexual-minority adolescent boys were more likely than were their urban peers to report suicidal behaviors and pregnancy involvement. Rural sexual-minority adolescents, especially girls, were more likely to report various types of substance use. Rural status was associated with a lower risk of dating violence and higher risk of early sexual debut for sexual-minority girls and a higher risk of dating violence and lower risk of early sexual debut for sexual-minority boys.

Conclusions. Location should be a demographic consideration in monitoring the health of sexual-minority adolescents. Lesbian, gay, and bisexual adolescents in rural communities may need additional support and services as they navigate adolescence.

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