Today's lesbian, gay, bisexual, and transgender (LGBT) youth come out at younger ages, and public support for LGBT issues has dramatically increased, so why do LGBT youth continue to be at high risk ...for compromised mental health? We provide an overview of the contemporary context for LGBT youth, followed by a review of current science on LGBT youth mental health. Research in the past decade has identified risk and protective factors for mental health, which point to promising directions for prevention, intervention, and treatment. Legal and policy successes have set the stage for advances in programs and practices that may foster LGBT youth mental health. Implications for clinical care are discussed, and important areas for new research and practice are identified.
This study aimed to examine the relation between chosen name use, as a proxy for youths' gender affirmation in various contexts, and mental health among transgender youth.
Data come from a community ...cohort sample of 129 transgender and gender nonconforming youth from three U.S. cities. We assessed chosen name use across multiple contexts and examined its association with depression, suicidal ideation, and suicidal behavior.
After adjusting for personal characteristics and social support, chosen name use in more contexts was associated with lower depression, suicidal ideation, and suicidal behavior. Depression, suicidal ideation, and suicidal behavior were lowest when chosen names could be used in all four contexts.
For transgender youth who choose a name different from the one given at birth, use of their chosen name in multiple contexts affirms their gender identity and reduces mental health risks known to be high in this group.
The experience of minority stress is often named as a cause for mental health disparities among lesbian, gay, and bisexual (LGB) youth, including higher levels of depression and suicidal ideation. ...The processes or mechanisms through which these disparities occur are understudied. The interpersonal-psychological theory of suicide posits 2 key mechanisms for suicidal ideation: perceived burdensomeness and thwarted belongingness (Joiner et al., 2009). The aim of the current study is to assess the mental health and adjustment among LGB youth emphasizing the minority stress model (Meyer, 2003) and the interpersonal-psychological theory of suicide (Joiner et al., 2009). With a survey of 876 LGB self-identified youth, levels of coming-out stress, sexual orientation victimization, perceived burdensomeness, thwarted belongingness, depression, and suicidal ideation were examined. The results of a multigroup mediation model show that for all gender and sexual identity groups, the association of sexual orientation victimization with depression and suicidal ideation was mediated by perceived burdensomeness. For gay, lesbian, and bisexual girls coming-out stress was also found to be related to depression and suicidal ideation, mediated by perceived burdensomeness. The results suggest that feeling like a burden to "people in their lives" is a critical mechanism in explaining higher levels of depression and suicidal ideation among LGB youth. These results have implications for community and social support groups, many of which base their interventions on decreasing social isolation rather than addressing youths' beliefs of burdensomeness. Implications for future research, clinical and community settings are discussed.
During the past 50 years, there have been marked improvement in the social and legal environment of sexual minorities in the United States. Minority stress theory predicts that health of sexual ...minorities is predicated on the social environment. As the social environment improves, exposure to stress would decline and health outcomes would improve. We assessed how stress, identity, connectedness with the LGBT community, and psychological distress and suicide behavior varied across three distinct cohorts of sexual minority people in the United States. Using a national probability sample recruited in 2016 and 2017, we assessed three a priori defined cohorts of sexual minorities we labeled the pride (born 1956-1963), visibility (born 1974-1981), and equality (born 1990-1997) cohorts. We found significant and impressive cohort differences in coming out milestones, with members of the younger cohort coming out much earlier than members of the two older cohorts. But we found no signs that the improved social environment attenuated their exposure to minority stressors-both distal stressors, such as violence and discrimination, and proximal stressors, such as internalized homophobia and expectations of rejection. Psychological distress and suicide behavior also were not improved, and indeed were worse for the younger than the older cohorts. These findings suggest that changes in the social environment had limited impact on stress processes and mental health for sexual minority people. They speak to the endurance of cultural ideologies such as homophobia and heterosexism and accompanying rejection of and violence toward sexual minorities.
The magnitude of gender identity-related disparities in school-based outcomes is unknown because of a lack of representative studies that include measures of gender identity. By utilizing a ...representative sample generalizable to a broader population, this study elucidates the size of gender identity-related disparities, independent of sexual orientation, in school experiences associated with school connectedness and perceptions of school climate. Additionally, the inclusion of and comparison to results of a large non-representative sample allows for more direct comparisons to previous studies of the school experiences of transgender youth. The analyses in this study primarily draw on a sample of 31,896 youth representative of the middle and high school population in California who participated in the 2013–2015 California Student Survey (a subsample of the California Healthy Kids Survey, which includes the largest known sample of transgender youth). Over half the sample identified their sex as female (51.3%), and 398 identified as transgender (1.0%). The sample was racially and ethnically diverse: 30.7% identified as multiracial, 33.0% as White, 11.1% as Asian, 7.4% as Black, and 52.9% as Hispanic. Findings from multilevel analyses show that relative to non-transgender youth, transgender youth were more likely to be truant from school, to experience victimization and bias-based bullying, and to report more negative perceptions of school climate, though did not differ in self-reported grades. The findings have implications for improving school policies and practices to create safer and more supportive school climates for all youth.
The presence of Gay-Straight Alliances (GSAs) in schools has been linked to low rates of bullying for lesbian, gay, bisexual, questioning (LGBQ), transgender, and all students. However, little is ...known about how the heterogeneity in GSA functioning and school climates may affect these rates. This study examines whether a well-functioning GSA would limit the effect of a negative school climate as a risk factor for homophobic victimization experiences. The sample included 38,872 students (3401 LGBQ and 453 transgender) from 58 California high schools. Several independent databases were combined. Students reported on homophobic victimization, the school climate, and demographic information. At the school level, reports from all students were aggregated for school climate; reports from GSA members were aggregated on their perceptions of GSA functioning; publicly-available data were used for school characteristics. The results suggest that greater GSA functioning may be beneficial for all students in schools that have a negative school climate, and particularly protective for transgender students.
Abstract Students’ perceptions of their school climates are associated with psychosocial and academic adjustment. The present study examined the role of school strategies to promote safety in ...predicting students’ perceptions of safety for gender nonconforming peers among 1415 students in 28 high schools. Using multilevel modeling techniques, we examined student- and school-level effects on students’ perceptions of safety for gender nonconforming peers. We found that older students, bisexual youth, Latino youth, and youth who experienced school violence perceived their gender nonconforming male peers to be less safe. Similarly, we found that older students and students who experienced school violence and harassment due to gender nonconformity perceived their gender nonconforming female peers to be less safe. At the school-level, we found that when schools included lesbian, gay, bisexual, transgender, and queer (LGBTQ) issues in the curriculum and had a Gay-Straight Alliance, students perceived their schools as safer for gender nonconforming male peers.
Studies of adults who experienced sexual orientation change efforts (SOCE) have documented a range of health risks. To date, there is little research on SOCE among adolescents and no known studies of ...parents' role related to SOCE with adolescents. In a cross-sectional study of 245 LGBT White and Latino young adults (ages 21-25), we measured parent-initiated SOCE during adolescence and its relationship to mental health and adjustment in young adulthood. Measures include being sent to therapists and religious leaders for conversion interventions as well as parental/caregiver efforts to change their child's sexual orientation during adolescence. Attempts by parents/caregivers and being sent to therapists and religious leaders for conversion interventions were associated with depression, suicidal thoughts, suicidal attempts, less educational attainment, and less weekly income. Associations between SOCE, health, and adjustment were much stronger and more frequent for those reporting both attempts by parents and being sent to therapists and religious leaders, underscoring the need for parental education and guidance.
Utilizing a school-based sample of 895,218 students aged 10–18 years old, we examine differences in students’ school functioning, substance use, and mental health in schools with and without ...Gay-Straight Alliances (GSAs). In addition, we examine whether GSA presence is associated with these outcomes for students of color and LGBTQ students. Overall, students in schools with GSAs were found to report better school functioning, lower substance use, and better mental health. For students of color, the association between the presence of a GSA and mental health and substance use was not as strong as it was for non-Hispanic white students. Further, for LGBTQ students, the association between the presence of a GSA and school functioning was not as strong as it was for non-LGBTQ students. Future research is necessary to ascertain the function of GSAs, especially for marginalized youth.
School-based victimization is associated with poorer developmental, academic, and health outcomes. This meta-analytic review compared the mean levels of school-based victimization experienced by ...sexual minority youth to those of heterosexual youth, and examined moderators of this difference. Results from 18 independent studies (N = 56,752 participants) suggest that sexual minority youth experience moderately higher levels of school-based victimization compared to heterosexual youth (d = 0.33). This effect varied by two study characteristics: the average effect size increased over time and was larger in studies that had a greater proportion of male participants. Results highlight the need for future research on school-based victimization to include measures of sexual orientation and for interventions to include a component that addresses sexual orientation.
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