Mental Health Among Sexual Minority Youth

Abstract

The term sexual minority youth (SMY) encompasses youth who are not exclusively heterosexual. These are youth whose sexual orientations, identities, and/or behaviors are not exclusively heterosexual. Sexual identity is one’s personal identity as a sexual being, a label used in regard to oneself, such as “gay,” “lesbian,” “queer,” “pansexual,” or “asexual.”1 Sexual identity may not be indicative of sexual behaviors and, thus, understanding both identity and behavior are essential to providing excellent care— particularly as SMY youth often face health disparities.2 SMY youth, like their heterosexual peers, have strengths and vulnerabilities. Although the majority of sexual minority children and adolescents do well, they are likely to experience mental health issues such as anxiety, depression, substance abuse, and suicidality at higher rates than their heteronormative peers.1,3 This phenomenon may be due to stigma, microaggressions, victimization, and/or discrimination regarding their sexual identities, which in turn effects overall health.4 In a 2013 survey performed by the Gay, Lesbian & Straight Education Network, 55% of sexual and gender minority youth surveyed stated that they felt unsafe at school due to perceived/experienced harassment from peers.5 This harassment can lead to an increase in suicidal ideation and attempts6 due to internalized shame and stigma, social isolation, and conflict about their identities. Microaggressions, stigma, and shame may also be experienced at home and in the community. Healthcare providers are in a unique position to support minority youth across multiple domains if they are aware and informed of social supports and experiences of conflict.