To examine contraceptive methods used by adolescent/young adult women of diverse sexual orientations.
We collected data from 12,902 females, born 1982–1995, from the longitudinal Growing Up Today Study.
Compared to heterosexuals, lesbians were half as likely to use contraceptives; other sexual minority subgroups (e.g., bisexuals) were more likely to use any method, particularly long-acting reversible contraceptives.
Many sexual minority women use contraception throughout adolescence/young adulthood, though use is low among lesbians.
With limited contraception use, lesbians miss opportunities for care and need to be brought into the healthcare system in other ways.