The Impact of Sexual Identity Development on the Sexual Health of Youth Formerly in the Foster Care System

Abstract

Youth in the foster care system receive less sexual and reproductive health education, experience higher levels of negative sexual health outcomes, and engage in more risky sexual behaviors than peers not in the foster care system. Counteracting these concerns requires understanding the processes that contribute to these outcomes. A conceptual model interfacing traditional identity development theories and social constructionist theories of social sexualization was developed that posited sociosexual input factors of sexual education and socialization, sexual abuse history, and adverse childhood experiences affect youths’ sexual identity development, which then impacts youths’ level of sexual health. Hierarchical linear regression determined the level of impact of sexual socialization on sexual health within a sample of youth formerly in the foster care system (n = 219). Whether sexual identity development level mediated the relationship between sexuality-related discussions and sexual health was tested as well as how relationship quality moderates the effects of sexuality-related topic discussions on sexual identity development. Further analysis explored differences between the experiences of youth who identified as sexual minorities and their peers who identified as heterosexual. Results indicated that gender identity, sexual orientation, adverse childhood experiences, sexual abuse history, and sexuality-related discussions with foster parents and with peers all impact sexual health. All four dimensions of sexual identity development significantly contributed to sexual health outcomes. Mediation occurred with two of the four sexual identity development dimensions, whereas no moderation effects were indicated. Youth who identified as sexual minorities and youth who identified as heterosexual had significantly different scores on three of four sexual identity development dimensions and youth who identified as sexual minorities had worse sexual health outcomes. Results indicate the importance of the sexual identity development process on sexual health and that youths’ sexual orientation identity must be considered when designing interventions to improve sexual health outcomes.