LGBQ Youth Research Articles

Comparing Behavioral Health of Lesbian, Gay, Bisexual, Questioning, and Heterosexual Middle School Students.

Purpose: Lesbian, gay, bisexual, and questioning (LGBQ) high schoolers experience high prevalence of poor behavioral health, but little is known about LGBQ middle schoolers. We sought to quantify behavioral health disparities of LGBQ middle school students. Methods: Using 2021 New Mexico Middle School Youth Risk and Resiliency Survey data (N = 12,400), we estimated the size of the LGBQ middle school population and calculated adjusted risk ratios to investigate behavioral health disparities between LGBQ and heterosexual youth. Results: A quarter of the sample identified as LGBQ. These youth reported significantly more suicidal behaviors and poorer mental health than heterosexual youth. LGBQ youth were more likely to use most substances compared with heterosexual youth. Conclusion: LGBQ middle school students demonstrated high prevalence of poor behavioral health. These findings show that disparities begin earlier than previously assumed and underscore that sociocultural landscapes for sexually diverse youth remain challenging.

Mitigating invalid and mischievous survey responses: A registered report examining risk disparities between heterosexual and lesbian, gay, bisexual, or questioning youth.

In a Registered Report, the authors propose a new survey-bias-mitigation method-incorporating inverse probability weighting via boosted regression-to better understand lesbian, gay, bisexual, or questioning (LGBQ)-heterosexual youth risk disparities. This method is tested using the 2019 US Centers for Disease Control and Prevention-collected Youth Risk Behavior Survey (YRBS) national data, which contain 12,847 observations (ages 12-18 [M = 16, SD = 1.25]; 49.1% male [8.7% LGBQ] and 50.9% female [22.4% LGBQ]; nationally representative regarding race and ethnicity). Looking across 44 outcomes, the authors found that the YRBS contains responses that are potentially biased against LGBQ youth in systematic ways, inflating perceived risk for this group in some outcomes. This potential bias is more pronounced among reported males than among reported females, and it is more pronounced for low-incidence outcomes. For example, the steroid-use disparity estimate among reported males reduced by 67%, while the reduction in bullying victimization was small and not statistically significant. The authors discuss robustness of results, the new method, and data policy implications.

Team sports participation, depression, and suicidal ideation in lesbian, gay, bisexual, transgender, and questioning adolescents

AbstractRates of depression and suicide are rising in adolescents, with lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth experiencing higher rates. We examined the relationship between team sports participation, depression, and suicidal ideation among a representative sample of adolescents (n = 46,537) in the Healthy Kids Colorado Survey. Logistic regression models using team sports participation to predict depression and suicidal ideation for heterosexual; lesbian, gay, bisexual, and questioning (LGBQ); cisgender; and transgender youth demonstrated that team sports participation was associated with reduced likelihood of depression in all groups and reduced likelihood of suicidal ideation in all groups except for LGBQ youth. These findings indicate that LGBTQ youth may experience similar mental health benefits of team sports participation as heterosexual and cisgender youth, supporting the importance of inclusive sports policy and programming.

The homophily and centrality of LGBQ youth: A new story?

The homophily and centrality of LGBQ youth: A new story?

Perspectives on inadequate preparation and training priorities for physicians working with sexual minority youth.

ObjectivesTo understand pediatric and family medicine residents' and practitioners' perceived ability to work with lesbian, gay, bisexual, and queer (LGBQ) youth, assessment of their prior educational experiences, and recommendations for medical training to better prepare physicians to provide quality care to this population. MethodsWe conducted semi-structured individual interviews with 24 pediatric/family medicine residents (n=20) and practicing physicians (n=4) in the U.S. Recorded interviews were professionally transcribed. Data were analyzed using Grounded Theory and qualitative content analysis approaches. ResultsMost physicians did not feel adequately prepared to provide quality care to LGBQ youth, and many who felt knowledgeable obtained their knowledge from on-the-job experiences of caring for LGBQ patients. Findings regarding physicians' recommendations for implementing a formal training program revealed three themes: (I) medical school training (implemented earlier in medical school within a structured program as part of the normal curriculum), (II) training content (LGBQ-specific health needs, self-awareness of implicit biases, interviewing techniques, and resources), and (III) training strategies (panels of LGBQ patients, role-playing/standardized patients, and online modules). ConclusionsUnderstanding physicians' assessment of abilities and recommendations for training improvements based on their experiences is important for advancing the quality of healthcare for LGBQ youth. Guidance came mostly from residents who recently completed medical school. Thus, their perspectives are especially useful to improve medical education and, ultimately, the care provided to LGBQ youth. Findings suggest a multi-pronged approach that offers several training modalities encompassing individual, intrapersonal, and institutional/systemic/community levels can improve medical school curricula on caring for LGBQ youth.

Demonstrating Attachment-Based Family Therapy for Transgender and Gender Diverse Youth with Suicidal Thoughts and Behavior: A Case Study.

Suicide is a growing public health issue among adolescents. While the majority of transgender and gender diverse (TGD) youth are healthy, many experience suicidal thoughts and behavior (STB). Due to discrimination and stigma, TGD youth attempt suicide at higher rates then heterosexual, cisgender and even cisgender, LGBQ youth. Despite this vulnerability to suicide, few treatments have been developed and tested for this population. One treatment, attachment-based family therapy (ABFT) has been adapted to work with LGBQ youth and may be promising for TGD adolescents at risk for suicide. This article provides an overview of our ABFT modifications for TGD youth with thoughts of suicide. Specifically, we illustrate how treatment outcomes, in a single case study, relate to processes within clinical treatment tasks. The case study demonstrates the application of these ABFT modifications with a self-identified, gender nonconforming adolescent (who had recently attempted suicide) and his caregivers. Treatment evaluation measures were collected over the course of 24 weeks to illustrate the youth's clinical progress. The youth's suicidal symptoms diminished markedly by the end of treatment. Further, the family reported an increased ability for problem solving and more open communication by treatment conclusion.

The Moderating Role of Parenting Dimensions in the Association between Traditional or Cyberbullying Victimization and Mental Health among Adolescents of Different Sexual Orientation.

Cyberbullying victimization is associated with mental health problems and reported to occur more in nonheterosexual orientation youth (lesbian, gay, bisexual, and questioning (LGBQ)) than among heterosexual youth. Parental support may protect against mental health problems after being victimized, but nonsupportive parental influences may also exacerbate harm. This study investigated whether parenting dimensions (autonomy support, psychological control) moderated the associations between bullying victimization and mental health problems among heterosexual and LGBQ adolescents. An anonymous survey was completed by 1037 adolescents (M age = 15.2 ± 1.9, 50% female). Regression analyses examined associations between victimization, sexual orientation, and mental health problems, and investigated the moderating role of parenting. Both forms of victimization were associated with higher mental health problems. LGBQ youth experienced more depressive symptoms and suicidal ideation than heterosexual youth. Lower levels of parental psychological control and higher levels of autonomy support were related to having fewer mental health problems. However, perceived autonomy support appeared less protective when adolescents experienced more frequent victimization. Moreover, parental psychological control was related to heightened risk for suicidal plans specifically among LGBQ youth and also exacerbated the association between cyberbullying victimization and stress among LGBQ youth. These findings underscore the need to address parenting in whole-school antibullying and mental health promotion programs.

Bullying and Cyberbullying among LGBQ and Heterosexual Youth from an Intersectional Perspective: Findings from the 2017 National Youth Risk Behavior Survey

ABSTRACT While LGBTQ youth may be victims of bullying at greater rates than heterosexual youth, research examining in-school bullying and cyberbullying victimization disparities through an intersectional framework is limited. Using the 2017 Youth Risk Behavior Survey, the present study examined the prevalence of in-school bullying and cyberbullying victimization across sexual orientation, gender, race, and grade (N = 13,567). Results position sexual minority youth at higher odds of experiencing in-school bullying and cyberbullying than heterosexual youth and show that bisexual youth were more likely than gay/lesbian youth to be cyberbullied. Findings from intersectional analyses show within-group variation in bullying victimization across sexual orientation based on gender, grade, and race. Specific intersectional results and implications for in-school bullying and cyberbullying prevention and intervention efforts are discussed.

Promoting Mental Health among Lesbian, Gay, Bisexual, and Questioning Youth: Implications for Practice

The experiences of adolescents who identify as lesbian, gay, bisexual, and questioning (LGBQ) are situated in pervasive heterosexism. The potential for oppression of LGBQ youth of color and/or those holding non-Christian beliefs, are exponentially increased. Historical, social, political, and cultural contexts also influence experiences of marginalization. The ecological perspective, combined with risk and resilience theory, form a conceptual basis to clarify the reciprocal relationships between LGBQ youth and their environments. Together, these theories assist in locating optimal intervention points for mental health professionals, ensuring the best possible outcomes for this population. Utilizing these theoretical frameworks, the author discusses the importance of recognizing and advocating for strategies to promote health and mental well-being among LGBQ youth.

Psychological sense of community, community civic participation, and ethnic identity on social justice orientation and psychological empowerment between LGBQ and Non-LGBQ youth of color

For lesbian, gay, bisexual, and questioning (LGBQ) youth of color, the intersection of identifying as both LGBQ and a person of color results in not only managing racial stereotypes, but also heterosexism and genderism. Developing a critical understanding of oppressive social conditions and ways to engage in social action is a form of resistance for these youth. Research is needed among LGBQ youth of color that examines the range of predictors and outcomes related to civic engagement, development, and empowerment. Drawing on data derived from a sample of urban youth of color (N = 383; 53.1% Female; 75% Hispanic; Age range = 14 to 18 years; 15% identify as LGBQ), this study will: (1) examine the relationship between community-based perceptions (e.g., psychological sense of community), ethnic identity, behaviors (e.g., community civic participation) and awareness of social justice concerns with dimensions of psychological empowerment; and (2) assess differences that these relationships have between LGBQ and non-LGBQ youth of color. Findings indicate that main predictors have a positive impact on intrapersonal and cognitive dimensions of psychological empowerment through social justice orientation, with noted variations between LGBQ and non-LGBQ youth of color.

Peer Victimization and Mental Health Outcomes for Lesbian, Gay, Bisexual, and Heterosexual Youth: A Latent Class Analysis.

Lesbian, gay, bisexual, and questioning (LGBQ) adolescents are at increased risk of poor mental health due to minority stress, a chronic stress associated discrimination, social rejection, and victimization brought on by prejudicial attitudes towards LGBQ individuals. To improve understanding of the differential impact of various kinds of victimization on mental health outcomes for LGBQ adolescents, we analyzed data from the 2015 Youth Risk Behavior Survey (YRBS) for victimization and mental health symptom clusters and associations high school youth and compared by sexual orientation and gender. Separate Latent Class Analysis (LCA) was conducted to identify profiles of both victimization and mental health symptoms for participants (N=15,624). Subsequently, stratified weighted logistic regression models were used on an eligible analytic sample of 11,458 to assess differences in the association of victimization and mental health between LGBQ and heterosexual high school students. In each LCA, participants were assigned to one of 3 classes for victimization (minimal, 81.3%; bullying, 12.5%; or physical/sexual violence, 6.2%) and 1 of 2 classes for mental health symptoms (minimal, 81.2%; severe, 18.8%). LGBQ participants were overrepresented in physical/sexual violence and bullying victimization profiles. Both bullying and physical/sexual violence profiles were associated with almost 5 times the odds of endorsing severe mental health symptoms. This study expands our understanding of the relationship between types and effect of peer victimization for LGBQ and heterosexual youth with implications for school health and prevention efforts through increased positive school climate for LGBQ students.

Characteristics, experiences, and service utilization patterns of homeless youth in a transitional living program: Differences by LGBQ identity

Homeless youth who identity as lesbian, gay, bisexual, or queer (LGBTQ) face considerable issues including victimization, mental health needs, and substance use, yet are less likely than their heterosexual homeless peers to utilize services. Although research in this area is growing, studies tend to focus on the experiences and service use of homeless youth in drop-in or emergency shelters, instead of longer-term transitional living programs (TLPs). Therefore, the purpose of this study was to expand the homeless youth literature by examining differences in sociodemographic characteristics, victimization, mental health, and substance use histories, and service utilization patterns of homeless youth by LGBQ identity (LGBQ vs. non-LGBQ) in a TLP. We extracted secondary data from closed case files of homeless youth (N = 101) ages 16–20 who accessed services in a mid-Michigan TLP between 2011 and 2018. Using independent sample t-tests and Chi-square, we assessed patterns by LGBQ. Results indicate that LGBQ homeless youth were more likely than their non-LGBQ homeless peers to identify as female, report being sexually victimized, and have greater mental health-related needs. All youth, but especially LGBQ youth underutilized available services, resulting in greater unmet mental health needs. These findings confirm the vulnerability of LGBQ homeless youth in TLPs and provide essential information regarding service utilization for homeless youth practitioners, including the need for trauma-informed and LGBTQ-specific services. Additionally, the data suggest that service providers must encourage youth engagement in services offered within TLPs.

LGBTQ Youth-Serving Organizations: What Do They Offer and Do They Protect Against Emotional Distress?

School-based support organizations for lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth have been well studied as a protective factor, but little research has explored LGBTQ youth-serving organizations in community settings, which may be similarly beneficial. The current study describes the features and services of community-based LGBTQ youth-serving organizations and tests how the extent of LGBTQ youth-serving organizational resources is associated with emotional distress among LGBQ youth in those communities. Data from the 2013 Minnesota Student Survey were merged with community-level data from the LGBTQ Environment Inventory for multilevel logistic regression, to test whether living in an area (i.e., 15-minute drive-time buffer) with some or many LGBTQ organizational resources was associated with lower odds of internalizing symptoms, self-harm, suicidal ideation, and suicide attempts among 2454 LGBQ youth in 81 communities. Website searching identified 25 LGBTQ youth-serving organizations in the state, offering an average of 3.8 conveniences and services (range: 1–6). Approximately three-quarters of LGBQ youth lived in an area with no LGBTQ youth-serving organizations and approximately 15% had many organizational resources. Living in an areas with resources was associated with lower odds of emotional distress, even after adjusting for metropolitan location. For example, the odds of high internalizing symptoms were significantly lower for girls living in communities with many LGBTQ youth organization resources compared to those living in areas with no resources (OR = 0.83, CI = 0.70–0.99). Findings suggest that living in an area with organizational resources for LGBTQ may be beneficial for the emotional well-being of LGBQ adolescents in those areas.

LGBQ Youth’s Experiences of General and Bias-Based Bullying Victimization: the Buffering Role of Supportive School and Community Environments

Lesbian, gay, bisexual, queer, and questioning (LGBQ) adolescents experience large disparities in an array of health problems and bullying experiences. Supportive LGBTQ community and school climates may protect LGBQ youth from general and bias-based bullying victimization. We combined data from LGBQ respondents on the 2013 Minnesota Student Survey (N = 2404) with information on the presence of a GSA (N = 79 schools; 2014 School Health Profiles), and new data collection on a range of LGBTQ-supportive community indicators within a 15-min drive time around the school. Hierarchical logistic regressions assessed the role of community supportiveness, GSA presence, and prevalence of LGBQ peers on general and bias-based bullying victimization, adjusted for sociodemographic covariates. Results indicated that for birth-assigned females, attending a school with a GSA was related to lower odds of sexual orientation–based bullying and attending school in an area with more LGBTQ-supportive community resources predicted lower odds of sexual orientation- and weight/appearance-based bullying. Having more LGBQ peers was related to lower levels of race- and weight/appearance-based bullying for all LGBQ youth. These findings provide support for the assumption that more LGBTQ-supportive communities and schools protect against bias-based bullying, particularly for girls, but they are not related to general bullying. Expanding and strengthening supportive resources for LGBTQ youth in schools and communities and identifying protective factors for GBQ boys are recommended.

38. LGBTQ Youth-Serving Organizations: What do they Offer, and do they Protect Against Emotional Distress Among LGBQ Youth?

38. LGBTQ Youth-Serving Organizations: What do they Offer, and do they Protect Against Emotional Distress Among LGBQ Youth?

Health, Homelessness Severity, and Substance Use among Sexual Minority Youth Experiencing Homelessness: A Comparison of Bisexual Versus Gay and Lesbian Youth

ABSTRACT Lesbian, gay, bisexual, and questioning (LGBQ) youth are overrepresented among youth experiencing homelessness (YEH), and health disparities among LGBQ youth are well-documented. LGBQ youth are typically aggregated as a single sexual minority group; however, research suggests that bisexual youth may have greater mental health, substance use, and physical health risks relative to their gay and lesbian peers. In a probability sample of LGBQ YEH in Los Angeles County (n = 183), we examined subgroup differences in homelessness severity, depression, physical health, and substance use, focusing on differences between bisexual and gay/lesbian youth due to the small subsample of questioning youth. Indicators of homelessness severity were standalone outcomes, and also were integrated as control variables with gender, age, race/ethnicity, and education in multivariable models. Bisexual youth were more likely to have become unaccompanied homeless persons as minors (OR = 4.35, 95% CI 1.85–10.23), and to have not recently utilized emergency shelters or transitional housing at least once in the past month (OR = 6.41; 95% CI 2.41–17.03). Bisexual youth were more likely to have probable depression (OR = 4.06, 95% CI 1.41–11.68). Among sexual minority YEH, bisexual youth may be at elevated risk for depression, in addition to more severe homelessness.

Intersections Between Multiple Forms of Bias-Based Bullying Among Lesbian, Gay, Bisexual, and Queer Youth

Lesbian, gay, bisexual, and queer (LGBQ) youth experience more heterosexist bullying victimization than their straight peers, which contributes to mental health disparities. However, LGBQ youth may simultaneously experience other types of bias-based bullying (e.g., racist, cis-sexist, and able-ist bullying). Informed by intersectionality theory, this study describes intersections of LGBQ students’ experiences of multiple forms of bias-based bullying and explores demographic correlates of individual types and typologies of bias-based bullying. This study uses 2016 state-wide survey data from 9th and 11th grade students in Minnesota schools. The analytic sample was limited to students who reported a LGBQ sexual orientation and responded to bullying items (N = 8313). Typology indicators were six items assessing bias-based bullying in the previous 30 days (race, gender, gender expression, sexual orientation, ability, weight). Covariates (age, sexual orientation, assigned sex, gender identity, race, perceived gender presentation, individualized education program (IEP), weight status) also predicted class membership. A latent class analysis (LCA) was conducted, and the three-class model was best fitting, with classes characterized by high levels of all types of bias-based bullying (6.3%), gender expression and sexual orientation bullying (35.2%), and low levels of bias-based bullying (58.4%). LGBQ youth who also identified as transgender or gender diverse, had an IEP, reported perceived nonconforming gender presentation, and youth of color were more likely to belong to the multiple bias-based bullying typology. Future work should leverage an intersectional lens to design multilevel interventions and strategies to prevent bias-based bullying that attend to broader issues of stigma within school systems.

Large-Scale Estimates of LGBQ-Heterosexual Disparities in the Presence of Potentially Mischievous Responders: A Preregistered Replication and Comparison of Methods

Although numerous survey-based studies have found that students who identify as lesbian, gay, bisexual, or questioning (LGBQ) have elevated risk for many negative academic, disciplinary, psychological, and health outcomes, the validity of the types of data on which these results rest have come under increased scrutiny. Over the past several years, a variety of data-validity screening techniques have been used in attempts to scrub data sets of “mischievous responders,” youth who systematically provide extreme and untrue responses to outcome items and who tend to falsely report being LGBQ. We conducted a preregistered replication of Cimpian et al. with the 2017 Youth Risk Behavior Survey to (1) estimate new LGBQ-heterosexual disparities on 20 outcomes; (2) test a broader, mechanistic theory relating mischievousness effects with a feature of items (i.e., item response-option extremity); and (3) compare four techniques used to address mischievous responders. Our results are consistent with Cimpian et al.’s findings that potentially mischievous responders inflate LGBQ-heterosexual disparities, do so more among boys than girls, and affect outcomes differentially. For example, we find that removing students suspected of being mischievous responders can cut male LGBQ-heterosexual disparities in half overall and can completely or mostly eliminate disparities in outcomes including fighting at school, driving drunk, and using cocaine, heroin, and ecstasy. Methodologically, we find that some methods are better than others at addressing the issue of data integrity, with boosted regressions coupled with data removal leading to potentially very large decreases in the estimates of LGBQ-heterosexual disparities, but regression adjustment having almost no effect. While the empirical focus of this article is on LGBQ youth, the issues discussed are relevant to research on other minority groups and youth generally, and speak to survey development, methodology, and the robustness and transparency of research.

Increased mental health and psychosocial risks in LGBQ youth accessing Australian youth AOD services

Research has consistently demonstrated that young people who identify as lesbian, gay, bisexual, or queer (LGBQ) show greater levels of psychosocial risk than general cohorts of young people. Young people engaged with youth alcohol and other drug (AOD) services are some of the most marginalized of all young people. Hitherto research is yet to investigate if young people identifying as LGBQ fare worse in these psychosocial domains than their non-LGBQ co-clients within AOD services. This study compared outcomes for 103 matched pairs of LGBQ identified and non-LGBQ identified young people (N = 206) using youth AOD services in Australia from a youth needs census. The results indicated that youth identifying as LGBQ reported more family dysfunction; and had experienced more violent crime, sexual, physical, and emotional abuse; and accumulated trauma than the non-LGBQ group. They had significantly more substance related harms, greater polysubstance use, and greater severity in their substance use. The LGBQ group also demonstrated poorer psychological health, quality of life, and were more likely to report a history of mental illness, and non-suicidal self-injury according to their youth worker. Overall these data indicate a need to direct more support to this particularly at risk group of young people.

School safety experiences of high school youth across sexual orientation and gender identity

School safety is considered a public health crisis with severe consequences on students' physical and emotional wellbeing. Although previous research highlights the disparities regarding safety in schools for LGBQ and transgender students, few studies examine the nuances between sexual orientation and gender identity. This study (N = 11,986) uses the 2015 Healthy Kids Colorado Study to examine differential experiences of school safety when looking at the various intersections of gender identity and sexual orientation. Logistic regression results indicate that school safety feeling safe at school), bullying, and skipping school due to feeling unsafe are shared experiences, especially among LGBQ and transgender youth, and that these experiences are differentially based on the intersection of sexual orientation and gender identity.