He discusses thechallenges faced by teachers in eroding negative, implicit attitudes in the face of socially acceptable, explicit expressions of these attitudes. Included here are primary data drawn from various studies that Rivers has conducted over the past two decades, along with discussions of key studies conducted by other researchers in the US, Canada, UK, Australia, and Scandinavia. Rivers explores the psycho-social correlates and potential long-term effects of bullying and homophobia, using various clinical studies as a guide to understanding the potential harm that results from school-based aggression.
An important feature of this book is theintegration of primary quantitative and qualitative data, case studies from parents, suggested lesson plans, and reports of recent legal action that highlight the dangers for students and teachers of not combating this particular form of school violence. Finally, the book looks to the future and thechanging face of schools, the gradual erosion of homophobia as an accepted 'norm' within society, and the institutions that train future generations. Ultimately, this book reflects the research journey of its author and the development of a substantive world-wide body of evidence charting the challenges faced by those who are or are simply labeled lesbian, gay, or bisexual.
National Politics and Sexuality in Transregional Perspective: I Thought It Was Curtains! These barriers include potentially limited access to romantic partners, minority stressors specific to pursuing relationships with same-sex partners, and the restriction of same-sex romantic behavior in educational settings. These obstacles, in turn, can steer youth to other social settings, such as bars and clubs, that may increase risk for poor health and health behavior Mustanski et al.
Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth
Results from a three-year longitudinal study showed that in comparison to LGB youth who dated other-sex partners, those who dated same-sex partners experienced an increase in self-esteem and a decrease in internalized homophobia for men and women, respectively Bauermeister et al.
In a more recent study, Baams and colleagues found that the presence of a romantic partner buffered the effects of minority stress on the psychological well-being of same-sex-attracted youth. Finally, coming out as LGBT involves dynamic interplay between intrapersonal development and interpersonal interaction and disclosure. In a recent study, Russell et al. Further, those who reported greater concealment of their LGBT identity were still susceptible to victimization but did not show the same benefits in psychosocial adjustment.
Such findings demonstrate the positive benefits of coming out in high school despite the risks associated with discriminatory victimization see sidebar Supporting Youth Through Coming Out. In summary, there is clear evidence for compromised mental health for LGBT youth, and research in the past decade has identified both risk and protective factors at multiple levels of influence. Important gaps remain, for example, in studies that identify intrapersonal strengths or coping strategies that may enable some LGBT youth to overcome minority stress.
Yet this body of research has begun to provide guidance for action at multiple contextual levels. Dramatic advances in understanding LGBT youth mental health during the past decade Saewyc offer multiple implications for actions. Returning to Figure 2 , the contexts that shape the lives of LGBT youth have corresponding implications for supporting mental health at multiple levels, from laws to clinical practice.
Existing research shows encouraging findings regarding laws and policies and for education and community programs, yet we are only just beginning to build a research base that provides strong grounding for clinical practice. Although only a small number of studies directly address the connection among laws, policies, and mental health, it is widely understood that laws and policies provide the broad, societal-level contexts that shape minority stress and, consequently, mental health.
Studies have documented higher psychiatric disorders among LGB adults living in US states that banned marriage for same-sex couples Hatzenbuehler et al. In recent years, several states have debated or enacted legislation specifically relevant for LGBT youth mental health. As of this writing, several US states have debated or banned sexual orientation and gender identity change efforts for minors often called conversion or reparative therapies.
These and other legislative efforts likely have mental health implications for LGBT youth, but no studies to date have specifically documented the link between these laws and youth mental health. However, a number of studies have documented the association of local laws and policies with LGBT youth mental health. Because school attendance is mandatory for youth, and because of consistent evidence of discriminatory bullying and unsafe school climate for LGBT students, education policy is particularly relevant for LGBT mental health.
A strong body of research has identified school policies and practices that promote positive school climate and individual student well-being, including feelings of safety, achievement, and positive mental health. At the level of educational programs and practice, teachers clearly play a key role in establishing a positive school climate for LGBT and all students Russell et al.
Finally, at the level of individual student daily experiences and interpersonal interactions, the presence and visibility of information and support on LGBT issues in school, as well as the presence of student-led groups or clubs such as GSAs, are strongly correlated with more affirming interactions with peers, positive school climate, and better student adjustment Poteat , ; Toomey et al. This body of evidence regarding school policies represents a major advance in the past decade; much less is known about effective program and practice strategies for community-based organizations CBOs , even though the number of CBOs that specialize in LGBT youth or offer focused programs for LGBT youth has grown dramatically in the United States and around the world.
Clearly, many school-based strategies may be transferable to the CBO context; given the numbers of programs and youth who attend CBOs, an important area for future research will be identifying guiding principles for effective community-based programs for LGBT youth. Although most existing guidelines are not specifically designed for youth, the recommendations and discussions of adult LGBT needs are typically relevant for LGBT youth.
We review two broad areas of emerging research evidence related to clinical practice. First, promising new research points to specific mental health constructs that appear to be key indicators of compromised mental health for LGBT persons and offer pathways for intervention and treatment. Second, a small number of very new studies document the clinical efficacy of specific treatment strategies to address LGBT mental health including for youth. An emerging body of studies has been designed to investigate constructs related to minority stress and other theoretical models relevant to LGBT youth mental health.
Such constructs—rumination, rejection sensitivity, and perceived burdensomeness—have implications for approaches to LGBT-affirmative mental health clinical practice. First, a recent set of studies provides evidence for a causal role of rumination in the association between minority stress and psychological distress Hatzenbuehler et al.
Drawing from two adult samples average ages in the early twenties , two studies confirmed that LGB participants who reported more stigma-related stressors also experienced more psychological distress, but that the association was strongest for those who reported more rumination following stigma-related stress.
These findings highlight the role of emotion regulation in minority stress processes and the potential of clinical approaches that directly address rumination and other maladaptive cognitive responses related to LGBT stigma. Another recent study tested two key mechanisms from the interpersonal psychological theory of suicide perceived burdensomeness and thwarted belongingness; Joiner et al. Findings showed that the link between minority stress measured as LGB victimization and stress related to coming out and mental health measured as depression and suicide ideation was mediated by perceived burdensomeness.
That is, experiences of minority stress prompted youth to feel that they were a burden to the important people in their lives, and it was these feelings of being a burden that were key correlates of depression and suicide ideation. Further, the association between thwarted belonging and mental health was fully explained by perceived burdensomeness. This latter finding is important because much of the discourse on LGBT mental health has focused on belonging i.
Rather, LGBT-specific approaches to decrease feelings of being a burden to others may be a particularly fruitful area for clinical investigation.
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Finally, a recent study conceptualized gay-related rejection sensitivity as an indicator of psychological functioning Pachankis et al. In a sample of adult gay men, experiences of parental sexual orientation—related rejection was a strong predictor of gay-related rejection sensitivity, especially among those who reported high levels of internalized homophobia.
Although these studies were conducted with adults and in one case was limited to gay men , results point to the potential of clinical interventions that focus on analysis of the meanings and experiences associated with stigma-related rejection.
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Thus, this emerging body of research identifies several psychological mechanisms that may be strategic constructs to address in clinical settings with LGBT youth. A small number of studies have begun to test treatment approaches that address the specific mental health needs of LGBT populations, including youth. First, although not specific to clinical treatment per se, one study directly asked LGB adolescents with clinically significant depressive and suicidal symptoms to describe the causes of their psychological distress Diamond et al.
Interviews with 10 youth identified family rejection of sexual orientation, extrafamilial LGB-related victimization, and non-LGB-related negative family life events as the most common causes of psychological distress. Most adolescents in the study also reported social support from at least one family member and from peers or other adults. The clinical literature also includes a number of case studies e. A new study by Pachankis and colleagues reports on the first randomized clinical control trial to assess the efficacy of an adapted cognitive-behavioral therapy CBT approach with young adult gay and bisexual men.
Participants reported decreases in depressive symptoms and alcohol use six months after treatment. Notably, the treatment also reduced sensitivity to rejection, internalized homophobia, and rumination, and increased emotional regulation, perceived social support, and assertiveness. The results are exciting and offer the potential for adaptation for women and for LGBT youth. The research on the critical role of parental rejection and acceptance in LGBT youth mental health Ryan et al. Diamond and colleagues presented preliminary results from the first empirically tested family-based treatment designed specifically for suicidal LGB adolescents.
Significant decreases in suicidal ideation and depressive symptoms among adolescent participants coupled with high levels of retention demonstrated the success of this approach to treating LGB adolescents and their families. In summary, few empirical studies have tested clinical approaches to improving the mental health of LGBT youth. However, the small number of existing studies are grounded in the current literature on risk and protective factors as well as psychological mechanisms implicated in minority stress, and they represent an important basis for future clinical research and practice.
Much has been learned in the past decade to advance understanding of LGBT youth mental health. Societal changes have led to legal, policy, and structural changes, most of which will ultimately improve the lives and mental health of LGBT youth. But structural change takes time, and in the interim, individual LGBT youth need support and care in order to thrive. There have been important advances in theoretical understandings of LGBT lives, most notably through the framework of minority stress. These advances, and associated empirical research on key mechanisms and processes, point to the relevance of approaches that directly address and interrogate minority stress in the lives of youth and how minority stress processes affect youth well-being.
At the same time, given the magnitude of mental health problems experienced by LGBT youth, it is alarming that there are so few empirically supported approaches for working with LGBT youth across a variety of settings, ranging from schools and CBOs to clinical treatment. There have been extraordinary changes in public understanding and acceptance of LGBT people and issues, and significant advances have been made in scientific understanding of LGBT youth mental health.
At the same time, critical gaps in knowledge continue to prevent the most effective policies, programs, and clinical care from addressing mental health for LGBT young people. We have outlined strategies at multiple levels for which there is encouraging evidence and which provide the basis for action. As scholars and clinicians continue work to identify strategies at multiple levels to address LGBT youth mental health—from policy to clinical practice—the existing research already provides a basis for action: Across fields and professions, everyone can be advocates for the legal, policy, program, and clinical changes that promise to improve mental health for LGBT youth.
Despite advances, many argue that diagnoses unduly label and pathologize legitimate and natural gender expressions Drescher Others voice concerns that the loss of a gender identity diagnosis altogether might restrict or eliminate insurance coverage of affirming medical services, including body modification and hormone treatment. Coming out is associated with positive adjustment for adults, yet for youth, coming out is often a risk factor for discrimination and victimization.
Can coming out be healthy, despite the risks? It is developmentally normal for youth to develop an understanding of sexual orientation and identity. Prior cohorts came out as adults and young adults, often after they were financially and legally independent, and at a different stage of life experience and maturity. Adults worry for the well-being and safety of youths who come out. The role of adults is to support youth to think carefully about how they come out. Rather than come out through social media or to many people at once, youth should be encouraged to identify one or two supportive friends, adults, or family members to whom they can come out.
Beginning with people they trust, they can build a network of support, which can be leveraged if they experience rejection as they come out to others. The authors are not aware of any affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review. National Center for Biotechnology Information , U.
Annu Rev Clin Psychol. Author manuscript; available in PMC May Russell 1 and Jessica N. Author information Copyright and License information Disclaimer. The publisher's final edited version of this article is available at Annu Rev Clin Psychol. See other articles in PMC that cite the published article. LGBT, sexual orientation, gender identity, youth. Open in a separate window. Prevalence of Mental Health Problems Among LGBT Youth Adolescence is a critical period for mental health because many mental disorders show onset during and directly following this developmental period Kessler et al.
Law and Policy Although only a small number of studies directly address the connection among laws, policies, and mental health, it is widely understood that laws and policies provide the broad, societal-level contexts that shape minority stress and, consequently, mental health. School and Community Programs and Practice Because school attendance is mandatory for youth, and because of consistent evidence of discriminatory bullying and unsafe school climate for LGBT students, education policy is particularly relevant for LGBT mental health.
Psychological mechanisms and processes An emerging body of studies has been designed to investigate constructs related to minority stress and other theoretical models relevant to LGBT youth mental health. Approaches to treatment A small number of studies have begun to test treatment approaches that address the specific mental health needs of LGBT populations, including youth. Younger ages of coming out intersect with a developmental period characterized by concerns with self-consciousness, conformity, and peer regulation.
Coming out is typically stressful for LGBT youth but is also associated with positive mental health, especially over the long run. LGBT mental health must be understood in the context of other salient personal identities: Significant advances in knowledge of policies and practices have created supportive school environments and contributed to positive mental health for LGBT youth.
Significant gaps remain in knowledge of clinically proven models for reducing mental health problems and promoting mental health in LGBT youth. Strong evidence indicates that bisexual youth have higher rates of compromised mental health, and more research and theory are needed to understand these patterns. Intersectional approaches are needed to better understand the interplay of sexual orientation and gender identity with race and ethnicity, social class, gender, and culture.
Glossary LGBT lesbian, gay, bisexual, and transgender; some scholars include Q to refer to queer or questioning Mental health broadly defined to include mental health indicators i. Diagnostic and Statistical Manual of Mental Disorders. How a romantic relationship can protect same-sex attracted youth and young adults from the impact of expected rejection.
Minority stress and mechanisms of risk for depression and suicidal ideation among lesbian, gay, and bisexual youth. Relationship trajectories and psychological well-being among sexual minority youth. LGB and questioning students in schools: Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States.
Alcohol and tobacco use patterns among heterosexually and homosexually experienced California women.
Mental health disorders in young urban sexual minority men. Mental health and substance use disorders among Latino and Asian American lesbian, gay, and bisexual adults. Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States. The DSM diagnostic criteria for gender identity disorder in adolescents and adults.
Mental health problems among lesbian, gay, and bisexual youths ages 14 to Lesbian and bisexual female youths aged 14 to Lesbian, gay, and bisexual youth and their families: Incidence and mental health impact of sexual orientation victimization of lesbian, gay, and bisexual youths in high school. Attachment-based family therapy for suicidal lesbian, gay, and bisexual adolescents: How depressed and suicidal sexual minority adolescents understand the causes of their distress. New paradigms for research on heterosexual and sexual-minority development. Homophobia, poverty, and racism: Sexual Orientation and Mental Health: Sexuality related social support among lesbian, gay, and bisexual youth.
Gender Dysphoria and Disorders of Sex Development: Progress in Care and Knowledge. Lesbian, gay, bisexual, and transgender hate crimes and suicidality among a population-based sample of sexual-minority adolescents in Boston. Same-sex sexual orientation, childhood sexual abuse, and suicidal behavior in university students in Turkey. Is sexual orientation related to mental health problems and suicidality in young people?
Sexual orientation and mental health in a birth cohort of young adults. Sexual minority trajectories, mental health, and alcohol use: Self-reported suicide attempts and associated risk and protective factors among secondary school students in New Zealand.
Coming-out across the life course: Patterns of Sexual Behavior. Similarities and differences in the pursuit of intimacy among sexual minority and heterosexual individuals: Gay and Lesbian Rights. Sexual orientation and risk of suicide attempts among a representative sample of youth. Gay male and lesbian youth suicide; pp. Risk of psychiatric disorders among individuals reporting same-sex sexual partners in the National Comorbidity Survey. School support groups, other school factors, and the safety of sexual minority adolescents.
A psychological mediation framework. The social environment and suicide attempts in lesbian, gay, and bisexual youth. Protective school climates and reduced risk for suicide ideation in sexual minority youths. Trajectories and determinants of alcohol use among LGB young adults and their heterosexual peers: Inclusive anti-bullying policies and reduced risk of suicide attempts in lesbian and gay youth. State-level policies and psychiatric morbidity in lesbian, gay, and bisexual populations. The impact of institutional discrimination on psychiatric disorders in lesbian, gay, and bisexual populations: Emotion regulation and internalizing symptoms in a longitudinal study of sexual minority and heterosexual adolescents.
The mediating role of emotion regulation. The adjustment of the male overt homosexual. Influential and authoritative report on LGBT health. Main predictions of the interpersonal-psychological theory of suicidal behavior: Social and psychological well-being in lesbians, gay men, and bisexuals: Age of onset of mental disorders: A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people.
Sexual Behavior in the Human Male. Sexual Behavior in the Human Female. The National School Climate Survey: Coping with LGBT and racial-ethnic-related stressors: Identity, stigma management, and well-being. Suicidality and depression disparities between sexual minority and heterosexual youth: Sexual orientation and adolescent substance use: Individual differences in the coming out process for gay men: Responses to discrimination and psychiatric disorders among black, Hispanic, female, and lesbian, gay, and bisexual individuals.
Guidelines for the primary care of lesbian, gay, and bisexual people: Minority stress and mental health in gay men. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Social patterning of stress and coping: Does disadvantaged social status confer more stress and fewer coping resources?
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