LGBTQ youth vulnerability

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Due to the increased vulnerability that lesbian, gay, bisexual, transgender and queer (LGBTQ) youth face compared to their non-LGBTQ peers, there are notable differences in the mental and physical health risks tied to the social interactions of LGBTQ youth compared to the social interactions of heterosexual youth. Youth of the LGBTQ community experience greater encounters with not only health risks, but also violence and bullying, due to their sexual orientation, self-identification, and lack of support from institutions in society.

LGBTQ youth face a variety of stressors that affect their mental health. Due to society's tendency to discriminate against non-heterosexual sexual orientations and identities, members of the LGBTQ community are 3 times more likely to face mental health disorders.^[1] For instance, the constant fear of not being accepted after coming out to one's community can lead to an anxiety disorder, depression, PTSD, suicidal thoughts, or substance abuse.^[1] According to the National Alliance on Mental Illness (NAMI) LGBTQ teens, in particular, “are 6 times more likely to experience symptoms of depression” than their heterosexual peers as they are just beginning to navigate how to come out to friends, family, and other associates, while still developing into an adult.^[1]

Because of the crucial development stages youth experience before adolescence, it is more likely for mental disorder to be expressed if a stressor is presented. It was reported in 2012 that within the year, 10% of youth in America demonstrated a mood disorder, 25% presentes an anxiety disorder, and 8.3% presented a substance use disorder.^[2] Also, the third leading cause of death for the 10-14 age group is suicide and the second leading cause for those 15–24. Out of these statistics, youth of the LGBTQ community are three times more likely to experience and report suicidality.^[2]

Some studies that have been conducted are not completely inclusive of the entire LGBTQ community because of its rapid growth and expansion. The Centers for Disease Control and Prevention conducted a 2015 Youth Risk and Behavior Survey (YRBS), that surveyed approximately 1,285,000 LGB youth out of 16,067,000 students total in grades 9-12 nationwide and was able to provide evidence of greater physical and mental vulnerabilities among the youth of the LGBTQ community.^[3]

The survey found that 10% of LGB students were threatened with a weapon on school property, 34% were bullied at school, 28% of LGB students were bullied electronically^[4] and 18% experienced physical dating violence.^[5] Another 18% of LGB students had been forced to have sexual intercourse at some point.^[5] These results were successful in pointing out these vulnerabilities of LGB students, however, about 514,000 students included in the survey were not sure of their “sexual identity.”^[3] According to the CDC, there are a couple of things the school can do that are evidence and research based to help the school become a healthy place for all children, and those ways are: encourage respect for all children, no matter what their ethnicity is or sexual orientation and ban bullying, harassment, or violence. Then identify "safe places" on campus for the students like a counselor's office or a designated classroom where students of the LGBTQ community can find support and feel safe, and ensure the health curriculum and sex education is up to date regarding the LGBTQ community and have HIV, STD, and pregnancy prevention information that is relevant to them.^[4]

Another survey conducted by the Human Rights Campaign titled, “Growing Up LGBT in America,” acknowledges the vulnerabilities faced by about 10,000 LGBTQ youth from the age of 13 to 17.^[6] This survey found that 4 out of 10 youth felt that their neighborhoods weren't accepting of the LGBTQ community.^[6] On top of this 73% of youth surveyed admitted to being more honest about their identity online and 26% identified their largest “problems” as being related to being out and accepted at home and/or school.^[6] The contrast this survey makes to 22% of non LGBTQ youth who identified their largest “problems” as relating to academics displays the different mindsets that are present in the two groups, thus representing the different mental effects LGBTQ youth experience.^[6]

Data on COVID within the LGBTQ+ community is lacking due to many national data collection systems neglecting to gather data about sexual orientation and/or gender identities.^[7]

40% of LGBTQ people in the U.S. work in service-industry jobs, compared to 22% of non-LGBTQ people.^[8] Compared to non-LGBTQ people, LGBTQ people are 5% more likely to lack access to health insurance (17% vs. 12%), and are 6% more likely to face poverty (22% vs. 16%).^[8] Same-sex parents and single LGBTQ parents and their families are at least twice as likely to experience poverty compared with non-LGBTQ counterparts.^[8] This suggests that LGBTQ people are particularly vulnerable to changes in financial, employment, and health-insurance statuses as a result of COVID-19.^[8]

People who classify as a sexual minority have been shown to have significantly higher rates of underlying conditions that can lead to severe COVID-related illnesses and death. These include stroke (4.7%), kidney disease (4.7%), heart disease (8.0%), cancer (9.2%), chronic obstructive pulmonary disease (10.3%), diabetes (12.5%), asthma (13.8%), smoking (22.1%), obesity (34.1%), and hypertension (35.7%).^[9] High rates of mental health conditions in sexual and/or gender minorities are likely to lead to poor COVID-related physical outcomes, healthcare utilization, and treatment adherence.^[7]

An estimated one third of LGBTQ youth experience parental rejection.^[10] Suicide and depression are more likely among LGBTQ youth (8 and 6 times, respectively) who are rejected by their parents.^[11] School shut downs during the pandemic, may have confined LGBTQ youth to traumatic environments.^[12][8] LGBTQ youth, especially LGBTQ youth who are racial and ethnic minorities, homeless, undocumented immigrants, or from backgrounds of low socioeconomic status,^[13][14] who use school-provided mental health services were also put at risk.^[12]

Diversity exists within the LGBTQ community, and the community may be more accepting of some members than others. LGBTQ youth that are also racial and ethnic minorities may be met with prejudice by white members of the LGBTQ community.^[15] Additionally, LGBTQ youth may be rejected by their racial and ethnic communities. Some communities of color may not be accepting of LGBTQ youth because homosexuality is seen as a reflection of ideals of white, urban society.^[15] LGBTQ youth of color may struggle to integrate their identity because their religious beliefs.^[16] For example, the Latinx community traditionally practices Catholicism – a religion that considers homosexuality a sin.^[16]

Bisexual individuals can also face rejection from other members of the LGBTQ community. Homophobia has resulted in our society dichotomizing sexual orientation (homosexual or heterosexual) rather than viewing sexual orientation as a variable construct.^[15] Transgender individuals have a gender identity that does not match their biological sex and can belong to any sexual orientation.^[15] Transgender individuals are victimized at higher rates than lesbian, gay, and bisexual youth, and they also have worse mental health outcomes.^[15]

Transgender youth aged 12–29 have been shown to be 3 times more likely to present a depression/anxiety diagnosis, or suicide ideation/attempt. Also, they are shown to be 4 times more likely to engage in self-harm compared to cisgender youth.^[17] Another study amongst Canadian transgender youth found that there was 5 times the risk of suicidal thoughts among transgender 14–18 year olds, with almost two-thirds having considered suicide in the past year. Compared to less than one in five students in the general population, three-quarters of 14–18 year olds reported self-harming in the past year.^[18] These youth present worse symptomatology than lesbian, gay, or bisexual youth.^[18] and non-binary youth consistently presented the worst mental health on average.^[18]

Schools should enact anti-discrimination regulations for LGBTQ students.^[19] School administrators should create safe communities for students and staff to work openly.^[19] Districts and staff should conduct trainings to ensure cultural competency in teaching LGBTQ youth and protecting against LGBTQ related bullying incidents.^[19]

School counselors should be educated on issues LGBTQ students face and be aware of their own biases.^[15] School counselors should not assume that students are heterosexual, and it is important for them to use gender neutral language when asking students about their relationships.^[15] School counselors can display LGBTQ books as well as posters to signal to students that their office is a safe space.^[15] School counselors can also provide psychoeducation to school faculty and administrators on risk of victimization among LGBTQ students and advocate for the safety of all students.^[15]

Schools are encouraged to address bullying proactively and educate students on anti-bullying policies.^[16] If policies are not already in place, schools should enact policies that prohibit harassment.^[15] Schools should have GSA to support LGBTQ students as well as promote a more accepting school climate.^[15] If school and community leaders should make programs for LGBTQ youth available in the community, and can reach out to groups, such as the Trevor Project for education on such topics.^[16]

Parents are also encouraged to take a proactive approach and let their children know they are loved regardless of the sexual orientation and gender identity.^[16] When children do come out as LGBT, parents should react with support.^[16]

Gender-Affirming Hormone Therapy (GAHT) involves taking hormone-blockers or supplementing hormones in order to prevent the development of physical characteristics related to the sex assigned at birth and/or induce physical characteristics of the desired sex.

A 2-year study on gender dysphoric adolescents showed that puberty blockers significantly decreased depression and increased overall mental functioning.^[20] A follow-up study revealed that the same population which went on to receive GAHT and/or sexual reassignment surgery reported that gender dysphoria was resolved, general psychological function improved, and sense of well-being had no significant differences from the general population.^[20] A survey of transgender and nonbinary youth found that GAHT was associated with lower odds of depression and serious suicidal ideation in comparison to those who did not receive GAHT.^[21]

Also, significantly lower likelihood of life-time suicidal ideation was found in transgender adults who had been treated with puberty blockers in adolescence compared to those who had not.^[22]

Online platforms have become a way to communicate common, and uncommon, standpoints globally. Hashtags and campaigns are present methods of spreading the word about public issues and topics. As the LGBTQ community uses online platforms to interact with society and run campaigns that advocate for the community, it embraces vulnerability in order to overcome it.^[23]

National Coming Out Day takes place on October 11 and is a day for LGBTQ individuals to willingly disclose their sexual orientation or identity. This can take place in many ways that include, but are not limited, to social media announcements and coming out to close family members. Because of current technology platforms that allow for social networking, much of National Coming Out Day can be observed on sites such as Facebook, Twitter, Instagram, and YouTube. The Human Rights Campaign has conducted a survey tracking the impact of National Coming Out Day nationwide.^[24] 91% of LGBTQ youth who participated in the survey came out to close friends and reported more overall happiness as they continued to live in their communities and interact with friends, family, and classmates.^[24]

Another holiday that was created to celebrate The LGBTQ community and is celebrated in the month of October is called LGBTQ History Month, created in October 1994 by Rodney Wilson, the first openly gay teacher in Missouri. In 2009, U.S. president Barack Obama officially made it a National History Month, dedicating to learning about LGBTQ rights, expressing openness, and celebrating the LGBTQ community.^[25] There are other countries besides the United States that honor the month such as The United Kingdom, Hungary, Brazil, Canada, and Australia.^[26]

A similar initiative taken online in the LGBTQ community is International Transgender Day of Visibility. This day takes place on March 31 and recognizes transgender individuals in an effort to empower those who identify as transgender in the LGBTQ community. Rachel Crandell founded this day in 2009 and it has since fought against “cissexism” and “transphobia.” [3] Initiatives like National Coming Out Day and the International Transgender Day of Visibility are public reminders of the potential social media holds in educating the masses and raising awareness of the LGBTQ community.

• Audre Lorde Project
• The Trevor Project
• It Gets Better Project
• Keith Haring Foundation

• LGBTQ psychology
• Suicide among LGBTQ youth