Follow-up from Lesson 2
What activities did you do to grow yourself?
Did you practice using gender-inclusive language to greet individuals or groups?
Did you check out a few online support sites for LGBTQ youth?
Did you find out if your local schools have a GSA and when they meet?
Did you share this lesson with anyone?
If you answered yes to any of these, great job! If not, that’s ok. Give it a try when you feel ready.
Welcome to Lesson 3: Recognize
In this lesson, we will cover health risks and protective factors for LGBTQ youth.
Education = Preparation
When you think about the health risks LGBTQ youth face, what comes to mind? Some commonly thought of risks are bullying, violence, anxiety, depression, suicide, and self-harm. Other risks that you might not have thought about include homelessness, sexual assault, and healthcare inequality. In this lesson, we will discuss these risks, protective factors, and offer resources to help you know what can be done to help minimize them.
The following statistics regarding health risks LGBTQ youth face can be a little bit scary and depressing. Keep in mind the more you are aware of these risks the better you will be able to offer support.
Physical Health Risks
Physical and mental health risks overlap and some of the educational statistics may be repeated. We feel it is important to teach how they connect even at the cost of repetition.
Discrimination, Bullying, Harassment, Assault, Self-harm, and Healthcare Inequality
Have you ever experienced discrimination or been bullied? Have you ever stood up for someone else? Or needed someone to stand up for you? As you read the following information, think about where you can relate to your own life experience, and recall what helped you.
In our first two lessons, we reviewed how elevated the risk of bullying is among LGBTQ youth. They encounter many physical risk factors on a regular basis. Research shows that 30% of LGBTQ have experienced a threat or attack due to their sexual orientation, (Pew Research Center for the People and Press, 2013 as cited in Kassing et al., 2021).
“LGBTQ have a higher rate of “physical and sexual assault, harassment, bullying, and hate-crime victimization across the lifespan compared to their non-LGBTQ counterparts. (James et al., 2016; McKay et al., 2017, as cited in Kassing et al., 2021). In addition to higher rates of victimization among LGBTQ communities, research has demonstrated a higher level of health disparities for sexual and gender minority individuals due to factors including poor access to care and insurance coverage, which may sometimes be the result of stigma and discrimination” (McKay 2011, as cited in Kassing et al., 2021).
Why are LGBTQ youth experiencing higher rates of these types of victimization? LGBTQ youth are being excluded as full members of their culture because of the stigma attached to being LGBTQ and as a result of discrimination. Becoming educated about these issues is a helpful first step in putting an end to victimization.
An acquaintance shared her teenage experience of cutting and self-harm. She told me she would always hide her arms from her family because of the cutting. She did not want them to see that she was suffering. She chose multiple unhealthy coping mechanisms including drugs, alcohol, and sex addictions. Years of therapy and supportive family members helped her find healthy ways to cope with her traumas.
Crisis text line shares that the most common forms of self-harm are:
cutting, burning or carving words or symbols into the skin
hitting or punching oneself (including banging one’s head or other body parts against another surface)
piercing the skin with sharp objects such as hairpins
pulling out hair
picking at existing wounds
“Sexual minority youth are also at higher risk for self-harming behaviors compared to their heterosexual counterparts.” (Gnan et al., 2019)
Crisis text line continues to inform that “Everyone needs a way to cope with their emotions. People who self-harm have turned to hurting themselves as their coping mechanism to manage their emotions.”
Crisis text line shares that people might self-harm in order to:
Process their negative feelings
Distract themselves from their negative feelings
Feel something physical, particularly if they are feeling numb
Develop a sense of control over their lives
Punish themselves for things they think they’ve done wrong
Express emotions that they are otherwise embarrassed to show
Can you see the relationship between these forms of self-harm and why LGBTQ youth might use them as an outlet for their emotions?
Homelessness
When you pass a homeless person on the street what goes through your mind? Do you think they are lazy, ugly, dirty, drug addicts, crazy, dangerous, or scary? One day I heard this song by Tenille Townes “Somebody's Daughter” that put everything into a new perspective.
Stereotypes need to be reevaluated because everyone’s situation is different. To put things in perspective, CBS News said in 2019 “40% of us are just a paycheck away from poverty.”
NPR reported an increase in homelessness due to the pandemic. During the beginning of the pandemic, I had a close friend who was living in a car for a few months and suffered from malnourishment. I was glad that they allowed me to help and a month later their health improved.
Unfortunately, most of the time when I have tried to help my friends out of similar situations they refused. They would accept my money but would not let me provide means for housing or come live with me for a few months. They want to be independent and make it on their own even if it means living on the streets. Tragically, this lead to a homeless friend being sexually assaulted, and another who unfortunately passed away from drug abuse.
LGBTQ youth rates of homelessness are 30-45% directly influenced by mental illness and lead to suicidality (Rhoades et al., 2018). According to Boswell et al. (2019), “service agency providers, are the most prevalent reason for the LGBT youth to be homeless was because of sexual orientation or gender identity. The youth were either forced out of the home or ran away from home” (Choi et al., 2015, as cited in Boswell et al., 2018). Other reasons for LGBT youth to be homeless included bullying in school, neglect, abuse, or social discrimination and marginalization (Schmitt, 2016, as cited in Boswell et al., 2018). “LGBTQ youth were also less likely than their heterosexual counterparts to seek shelter after becoming homeless, which may be related to fear of prejudice and violence from shelter providers.” (Kattari & Begun 2017; Tyler & Schmitz, 2018, as cited in Boswell et al., 2018).
What are some ways you can prevent LGBTQ homelessness? What can you do to help those LGBTQ youth who are homeless in your community?
Human Trafficking and STDs
Boswell et al. (2018) stated, “As vulnerable youth, traffickers are inclined to exploit these vulnerabilities and lead LGBTQ youth into the commercial sex trade simply by providing their basic needs. LGBTQ youth experience polyvictimization and abuse earlier in life than their heterosexual counterparts (Baams, 2018; Musicaro et al., 2017, as cited in Boswell et al., 2018). There are higher rates of mental health issues, suicide, substance abuse, and sexually transmitted diseases in the LGBTQ youth population compared with the general youth population (Hafeez et al., 2017, as cited in Boswell et al., 2018). Early forms of abuse, social rejection, familial rejection, and prejudice lead to many health care disparities in these youth and make them more susceptible to revictimization later in life.” (Tyler & Schmitz, 2018, as cited in Boswell et al., 2018).
Mental Health Risks
Anxiety, Depression, and Suicidal Ideation
During high school, I had anxiety and depression. A friend told me that it is normal for everyone to struggle with depression at times in their lives and on some level. When those feelings don’t go away, that is when we need to seek help.
Suicidality
The American Psychological Association defines suicidality as “the risk of suicide, usually indicated by suicidal ideation or intent, especially as evident in the presence of a well-elaborated suicidal plan.” It can also be defined to include suicidal thoughts, plans, gestures, or attempts.
There is a stigma in our society about mental health. Getting past that is half the battle, reaching out for help is the other half. Rhoades et al. (2018) shares that poor mental health rates are higher for homeless LGBTQ youth; this includes depression, anxiety, PTSD, and aggression. The Trevor Project also reports that 48% of LGBTQ youth wanted counseling from a mental health professional but were unable to receive it in the past year.
Here are some other heartbreaking statistics from The Trevor Project:
At least one LGBTQ youth attempts suicide every 45 seconds
1.8 million LGBTQ youth seriously consider suicide each year
LGBTQ youth are 5 times more likely to attempt suicide
72% of LGBTQ youth report symptoms of generalized anxiety disorder within the last two weeks
62% of LGBTQ youth report symptoms of a major depressive disorder
Becoming aware of these statistics is sobering. One life lost to suicide is too many. What can you do to help someone who is battling mental health? Talk about it!
Bronfenbrenner’s Ecological Systems Theory
Bronfenbrenner’s Ecological Systems Theory is a great way to explain spheres of influence for LGBTQ youth. Even though Bronfenbrenner designed this model back in the 1970s, and his aim was to look at how relationships within each of the systems affected child development, his ideas are applicable to LGBTQ youth. Let’s take a look at how this works by watching the video below.
Protective factors
Using Bronfenbrenner’s model, the following image helps to illustrate how interventions can be utilized at each environment level using a slightly different take on the spheres of influence:
Asakura (2019) found that anyone has the potential to offer support to LGBTQ youth. He says some youth know exactly what they need and seek it out, while others need someone else to come to them to offer support. This could be food, money, shelter, or just offering a listening ear. According to The Trevor Project, “If you are a supportive adult for an LGBTQ person, that person is now 40% less likely to commit suicide because you have affirmed their identity.”
Snapp et al. (2015) lists other protective factors for LGBTQ youth that include:
family support, such as supporting clothing and hairstyle choices, and respecting pronouns
friend and peer support, both in school and out, where LGBTQ youth perceive a measure of safety
access to safe places such as GSAs
access to LGBTQ inclusive reading material such as books and magazines
having inclusive curricula taught at school along with teachers that model LGBTQ support
Teaching youth what consent is and being clear about what it does, and doesn’t mean, can help prevent sexual abuse. The following infographic can help.
What can I do? Stand up and speak out!
Staying silent is not the way to go. It can cause more harm to LGBTQ youth. If you witness bullying or harassment of LGBTQ youth take a stand and speak out against that behavior. Standing up for someone lets them know they are seen and have support. If you have an extra 7 minutes, watch this video from a campaign in Scotland for LGBT youth about how silence encourages homophobia.
What if you suspect abuse? According to the Child Welfare Information Gateway, almost every state and territory in the U.S. has a mandatory reporting law for suspected child abuse for professionals. Even if you are not a professional that is required to report abuse, you can, and should, report it. You may be the only one who does. The Child Help Hotline has state-specific resources to help if you are unsure of how to report abuse. You might be worried about what will happen if the person you are reporting finds out you reported them. No need to worry, privacy is ensured for those that do report abuse. Your identity will not be disclosed.
The information presented in this lesson was heavy and, if I am being honest, a total downer. The bright side of all this is that you can make a difference. Just by taking the time to read this blog you are gaining new knowledge of the risks LGBTQ youth face. You now know what signs to look for when someone is struggling and might be afraid to reach out for help. You are also learning about resources that you can access when the time comes for you to help someone. It is likely that time will come sooner than you think.
Grow Yourself
Choose one, or more, of the following challenges to help you put into practice what you learned from reading this lesson material.
Stand up and speak out when you witness bullying in any form.
Consider signing up for newsletters from any of the sites we have linked in this lesson.
Add one or more of the crisis lines listed below to your phone so you have it at the ready when needed.
Share this lesson with a friend that you think would benefit from learning the information presented here.
Be sure to check out Lesson 4 where we will discuss communication.
Additional Resources for Help
This lesson was full of information, but if you are looking for more, here are some additional resources that might be useful for you:
National Suicide Prevention Lifeline is available 24/7
call 1-800-273-8255
text “HELLO” to 741741
The Trevor Project Crisis Counselors are available 24/7
call 1-866488-7386
text “START” to 678-678
chat online at https://www.thetrevorproject.org/get-help/
American Foundation for Suicide Prevention
Trans Lifeline
1-877-565-8860
RAINN, National Sexual Assault Hotline is available 24/7
Call 1-800-656-4673
Chat online at https://www.rainn.org/about-national-sexual-assault-telephone-hotline
Crisis Text Line
To help end human trafficking check out Operation Underground Railroad
National Human Services Crisis Number is available 24/7 for any human service concerns
Dial 211
Great video teaching about consent using a tea analogy
“Disclaimer: The authors of this online curriculum are not therapists, and are not authorized to give personalized advice to any of the readers. The content of this lesson plan is the creation of the authors alone and does not represent any other entity or organization.”
References
American Psychological Association. (2022). Suicidality. APA dictionary of psychology. https://dictionary.apa.org/suicidality
Asakura, K. (2017). Paving pathways through the pain: A grounded theory of resilience among lesbian, gay, bisexual, trans, and queer youth. Journal of Research on Adolescence, 27(3), 521-536. https://doi.org/10.1111/jora.12291
Boswell, K., Temples, H. & Wright, M. E. (2019). LGBT youth, sex trafficking, and the nurse practitioner’s role. National Association of Pediatric Nurse Practitioners, 33(5), 555-560. https://doi.org/10.1016/j.pedhc.2019.02.005
Child Welfare Information Gateway. (2019). Mandatory reporters of child abuse and neglect. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau. https://www.childwelfare.gov/pubPDFs/manda.pdf
Fessler, P. (2021, March 18). HUD: Growth of homelessness during 2020 was ‘devastating,’ even before the pandemic. All Things Considered; NPR. https://www.npr.org/2021/03/18/978244891/hud-growth-of-homelessness-during-2020-was-devastating-even-before-the-pandemic
Gnan, G. H., Rahman, Q., Ussher, G., Gaker, D., West, E., & Rimes, K. A. (2019). General and LGBTQ-specific factors associated with mental health and suicide risk among LGBTQ students. Journal of Youth Studies, 22(10), 1393-1408. https://doi.org/10.1080/13676261.2019.1581361
Guy-Evans, O. (2020). Bronfenbrenner’s ecological systems theory. Simply Psychology. https://www.simplypsychology.org/Bronfenbrenner.html
How to deal with self harm. (n.d.) crisistextline.org, Retrieved February 18, 2022, from https://www.crisistextline.org/topics/self-harm/#pass-741741-on-to-a-friend-8
Kassing, F., Casanova, T., Griffin, J. A., Wood, E., & Stepleman, L. M. (2021). The effects of polyvictimization on mental and physical health outcomes in a LGBTQ sample. Journal of traumatic stress, 341(1), 161. https://doi.org/10.1002/jts.22579
LGBT Youth Scotland. (2014, March 4). Shh! Silence helps homophobia-LGBT youth Scotland [Video]. YouTube. https://www.youtube.com/watch?v=XQKGigb5l28
Paely, A. (2021). National survey on LGBTQ youth mental health 2021. The Trevor Project. https://www.thetrevorproject.org/survey-2021/?section=Introduction
Picchi, A. (2019, January 29). 40% of Americans only one missed paycheck away from poverty. CBS News. https://www.cbsnews.com/news/40-of-americans-one-step-from-poverty-if-they-miss-a-paycheck/
Rhoades, H., Rusow, J. A., Goldbach, J. T., Bond, D., Lanteigne, A., & Fulginiti, A. (2018). Homelessness, mental health and suicidality among LGBTQ youth accessing crisis services. Child Psychiatry and Human Development, 49(4), 643–651. https://doi.org/10.1007/s10578-018-0780-1
Snapp, S. D., Watson, R. J., Russell, S. T., Diaz, R. M. & Ryan, C. (2015). Social support networks for LGBT young adults: Low cost strategies for positive adjustment. Family Relations, 64(July 2015), 420-430. https://doi.org/10.1111/fare.12124
Townes, T. [Tenille Townes]. (2018, September, 24) Tenille Townes - Somebody's Daughter, [Video].Youtube. https://www.youtube.com/watch?v=36GhNNoYfOU
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