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Background Sexual minority youth have an increased risk for depression, anxiety disorders and bullying. In addition, particularly boys have an increased risk for sexual harassment. However, information on their general health and wellbeing is scarce. The purpose of this study is to examine the general health and wellbeing of sexual minority youth compared to heterosexual youth. Methods Data from the national School Health Promotion study 2019 were used including youth from comprehensive (N = 87026), upper secondary (N = 44498) and vocational schools (N = 23366). The proportion of sexual minority youth in comprehensive school was 8.5%, in upper secondary school 10.3% and in vocational school 7.5%. Each of the following issues was asked by using one question: general health, life satisfaction, loneliness, and worry about own mental health. Anxiety was measured by GAD-7 (Generalized anxiety disorder) and depression by PHQ-2 (Patient health questionnaire). Data were analyzed by school level and sex using cross-tabulations with Chi-square tests. Results Response rate at comprehensive school was 73% and at upper secondary school 69% but at vocational schools it couldn't be estimated reliably. Sexual minority youth reported significantly more often poor or average general health (44.2% vs. 18.2%) and loneliness (26.5% vs. 8.5%) but less often life satisfaction (50.0% vs. 78.5%) compared to heterosexual youth. They had significantly more often experienced depression (40.4% vs. 14.5%) and anxiety (31.4% vs. 10.4%) and worried more often about their mental health (65.6% vs. 28.5%) than other youth. Differences remained after stratifying the data by school level and sex. Conclusions This large population-based study including both sexual minority and heterosexual youth suggests that sexual minority youth have poorer outcomes in general health and wellbeing than heterosexual youth. More detailed analyses are needed to find out associated factors. Key messages Sexual minority youth at each school level and all sexes had poorer outcomes in each studied health and wellbeing indicator compared to heterosexual youth. Low-threshold services and support as well as more accepted atmosphere in society are essential to guaranteeing better health and wellbeing for sexual minority youth.

Health and wellbeing of sexual minority youth – the School Health Promotion study in 2019 in Finland