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Issues and Insights

Easing the Strain of Stigma & Stress:
What You Can Do to Help LGBT Youth

By Tony Madril, M.S.W., B.C.D.
KEY WORDS:  LGBT Youth. Psychological Stress. Prevention.  Practical Tools.
May 21, 2012

“I can’t handle this anymore!”  “I just want the pain to end!”  The stress of being sexually different from others can be life-threatening for many lesbian, gay, bisexual and transgender (LGBT) youth.  According to a 2011 study sponsored by the American Foundation for Suicide Prevention, lesbian, gay, and bisexual (LGB) youth are two times more likely than non-LGB youth to consider suicide as a viable solution to their problems, and twice as likely to make an attempt at taking their own lives.

issues_and_insightsAnother study compared the rates of suicide attempts between LGB youth and transgender youth and found that the number of transgender youth who attempted suicide related to their transgender identity was significantly higher than the number of LGB youth who attempted suicide and attributed their attempts to their sexual orientation.
“More than alarming, these statistics beg the question:  “What is causing so much stress that LGBT youth are willing to take their own lives?”  While the now, all-too-familiar phenomenon of bullying across America is certainly a critical stressor for many LGBT youth (this type of harassment is scientifically linked to suicidal behavior), social scientists now say that a number of other environmental stressors are additionally responsible:  In fact, recent studies link various outward expressions of homophobia to mental health problems in LGBT youth.  One study linked discrimination on the basis of one’s “non-heterosexual orientation” to self-harming behaviors, such as cutting and burning oneself.  Another study found that when a parent rejects their adolescent son or daughter because of their divergent sexual orientation, that youth is consequently more likely to attempt suicide, suffer from clinical depression, and engage in unprotected sex. Finally, a third study shows that LGBT teens who feel stigmatized or shameful about their sexual orientation are more likely to cope by using illicit drugs.
Bullying. Discrimination. Rejection. Stigmatization.  Shame. Separately, these words evoke a sense of dread; together they are daunting!  How can anyone help someone facing such overwhelming problems?   This is a good question.  While it is impossible to surmount these complex social problems with any swiftness of thought or action, the following are some small steps you can take today that can make a big difference in the life of a LGBT youth, whether you are his or her psychotherapist, teacher, parent, family member, or supportive ally:
Tips for Mental Health Professionals
1. Use an intake assessment that includes questions about dating, sexual orientation, and gender identity.  Some questions you might include during your mental health assessments with youth are:  “Is there anything you don’t like about being a boy/girl?” “Do you generally date boys, girls or both?” and “If you’re not dating, do you seem to find yourself more attracted to boys, girls, or both?”  These and similar questions invite candid discussions about sexual orientation, gender identity, and the “fluidity” of human sexuality.  They may also help ease any anxiety your client may be experiencing about disclosing the presence of any same-sex, bi-sexual, or gender-dysphoric feelings.  Moreover, asking these important questions equips you with the unique opportunity to give clients permission to return to the topic of sexual orientation and gender identity, at any time, if he or she doesn’t feel comfortable answering the questions in the moment.  Practice asking these questions until this component of your evaluation becomes familiar; the norm rather than something new, “taboo” or anxiety-provoking for you or your clients.
2. Demonstrate a clear understanding & appreciation for diversity.  For example, you might place a “No Hate Zone” sticker or freedom flag somewhere in your office that is highly visible along with other positive representations of human diversity.  Moreover, asking clients questions like, “Are there any cultural traditions that are important to your family?” communicates your active awareness and interest in topic of diversity.  This could build the level of trust needed for teens and parents to begin to broach more personal topics with you such as sexual orientation and gender identity.
3. Advise families of the risks posed by negative reactions to coming-out.  If parents are aware of their teen’s LGB identity and seem critical of the news, advise them that negative reactions to their teen’s non-heterosexual identity may negatively influence his or her health and mental health, now, and into adulthood.  The following are examples of harmful negative reactions caregivers of LGB youth might consider: (1) Blaming the LGB youth for any anti-gay mistreatment they experience, and (2) Making disparaging comments about the LGB youth’s sexual identity and gender expression.  Research shows that these types of negative reactions are related to health and mental health problems such as attempted suicide, depression, substance abuse, and unprotected sex.
Tips for Parents, Family Members, Teachers, and Allies
1. Challenge the assumption that everyone-in-the-room is “straight.”  The seemingly innocent act of asking a male youth if he has “any girlfriends yet?” can feel like an arrow-through-the-heart if he happens to be gay or in the process of questioning his sexual orientation.  The mere assumption that he is “straight” communicates that something must be entirely wrong with him if doesn’t happen to feel a physical attraction toward girls.  And, if this budding awareness is reinforced by other “hetero-centric” comments, the youth quickly learns that expressing his true nature within his family is openly unacceptable and, therefore, something to be hidden and suppressed.  This can lead to a host of mental health problems, including substance abuse.
What are the assumptions made and expressed about sexual orientation in your family?  Would they be upsetting to a LGBT family member if they heard them?  Here are some examples of more inclusive questions you might ask a youth-of-the-dating-age:  “Is there anyone you’re interested in dating?”  “Have you been attracted to anyone at school?”  And, even:  “Are lesbian/gay/bisexual/transgender teens able date openly in your school?”
2. Support a positive, public dialogue that affirms differences in gender and sexual orientation.  Simply mentioning a LGBT person or LGBT-related issue in a non-judgmental, supportive manner during casual conversation instantly communicates your awareness and acceptance of human diversity to the youth who is listening.  Such an acknowledgment gives a LGBT or questioning youth permission to engage you the caregiver, or steward, in an open discussion about the expressive differences in sexual orientation and gender identity–whether or not they happen to be lesbian, gay, bisexual, transgender, or “questioning.”  Who wouldn’t want to foster this type of intimate and trusting relationship with a youth knowing how it could help?
3. Create an inclusive environment at school.  The presence of supportive school staff greatly contributes to the creation and maintenance of a positive social environment for LGBT youth–without it students may suffer.  How do you create an inclusive social environment?  Educational scholars suggest that a good place to start is for school staff to examine their own biases, prejudices, and beliefs about LGBT individuals; then to consider from where they came, and how they might be corrected.  Secondly, set clear expectations for students regarding the importance of diversity and respect for all students:  “Be inclusive of LGBT students in language and actions and confront homophobic language as it happens.  For example, when you hear the comment ‘that’s so gay,’ instruct students that the phrase is hurtful and unacceptable.”  Finally, demonstrating your support for LGBT issues by adding books about LGBT issues or individuals in your book shelf, or a rainbow button on your bulletin board, can also be an effective way to communicate acceptance of the experience of all students.
While these tips don’t adequately answer the clarion call-to-action the life-threatening problems of LGBT youth rightfully demand, they are sure-footed steps in the right direction! Think of the youth who desperately wants to tell her parent’s that she is lesbian and does–instead of spiraling into depression–because she hears her mom say that Ellen Degeneres and Portia (Ellen’s spouse) seem like “a happy couple.”  Think of the youth who feels like she was born in the “wrong body” and decides to share this with her school counselor–instead of cutting herself, again–because she sees a “No Hate” sign brazenly hanging in the office. And, what about the mother who stops blaming her gay son for being bullied at school after speaking with his psychotherapist? If any of us could encourage any of these outcomes by applying any of the tips mentioned this article to the life of a LGBT youth, what a difference that could make!  You now know that LGBT youth endure more mental health problems than non-LGBT youth, and that environment is clearly linked to the onset of these mental health problems.  You now know what small steps you can take that can help.  Now that you know, what will you do?

The bibliography for this article is available upon request.