Due to the increased vulnerability that lesbian, gay, bisexual, and transgender (LGBT) youth face compared to their non-LGBT peers, there are notable differences in the mental and physical health risks tied to the social interactions of LGBT youth compared to the social interactions of heterosexual youth. Youth of the LGBT 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.
LGBT 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 LGBT 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) LGBT 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 LGBT 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 LGBT 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 LGBT 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 LGBT 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 LGBT 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 LGBT 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 LGBT 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 LGBT community, and the community may be more accepting of some members than others. LGBT youth that are also racial and ethnic minorities may be met with prejudice by white members of the LGBT community. [15] Additionally, LGBT youth may be rejected by their racial and ethnic communities. Some communities of color may not be accepting of LGBT youth because homosexuality is seen as a reflection of ideals of white, urban society. [15] LGBT 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 LGBT 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 LGBT 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 LGBT youth and protecting against LGBT related bullying incidents. [19]
School counselors should be educated on issues LGBT 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 LGBT students as well as promote a more accepting school climate. [15] If school and community leaders should make programs for LGBT 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 LGBT 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 LGBT 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 LGBT 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 LGBT 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 LGBT 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 LGBT 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 LGBT community.
Transphobia consists of negative attitudes, feelings, or actions towards transgender people or transness in general. Transphobia can include fear, aversion, hatred, violence or anger towards people who do not conform to social gender roles. Transphobia is a type of prejudice and discrimination, similar to racism, sexism, or ableism, and it is closely associated with homophobia. People of color who are transgender experience discrimination above and beyond that which can be explained as a simple combination of transphobia and racism.
Gay bashing is an attack, abuse, or assault committed against a person who is perceived by the aggressor to be gay, lesbian, bisexual, transgender or queer (LGBTQ+). It includes both violence against LGBT people and LGBT bullying. The term covers violence against and bullying of people who are LGBT, as well as non-LGBT people whom the attacker perceives to be LGBT.
The field of psychology has extensively studied homosexuality as a human sexual orientation. The American Psychiatric Association listed homosexuality in the DSM-I in 1952 as a "sociopathic personality disturbance," but that classification came under scrutiny in research funded by the National Institute of Mental Health. That research and subsequent studies consistently failed to produce any empirical or scientific basis for regarding homosexuality as anything other than a natural and normal sexual orientation that is a healthy and positive expression of human sexuality. As a result of this scientific research, the American Psychiatric Association removed homosexuality from the DSM-II in 1973. Upon a thorough review of the scientific data, the American Psychological Association followed in 1975 and also called on all mental health professionals to take the lead in "removing the stigma of mental illness that has long been associated" with homosexuality. In 1993, the National Association of Social Workers adopted the same position as the American Psychiatric Association and the American Psychological Association, in recognition of scientific evidence. The World Health Organization, which listed homosexuality in the ICD-9 in 1977, removed homosexuality from the ICD-10 which was endorsed by the 43rd World Health Assembly on 17 May 1990.
GLSEN is an American education organization working to end discrimination, harassment, and bullying based on sexual orientation, gender identity and gender expression and to prompt LGBT cultural inclusion and awareness in K-12 schools. Founded in 1990 in Boston, Massachusetts, the organization is now headquartered in New York City and has an office of public policy based in Washington, D.C.
LGBTQ culture is a culture shared by lesbian, gay, bisexual, transgender, and queer individuals. It is sometimes referred to as queer culture, LGBT culture, and LGBTQIA culture, while the term gay culture may be used to mean either "LGBT culture" or homosexual culture specifically.
The questioning of one's sexual orientation, sexual identity, gender, or all three is a process of exploration by people who may be unsure, still exploring, or concerned about applying a social label to themselves for various reasons. The letter "Q" is sometimes added to the end of the acronym LGBT ; the "Q" can refer to either queer or questioning.
Youth suicide is when a young person, generally categorized as someone below the legal age of majority, deliberately ends their own life. Rates of youth suicide and attempted youth suicide in Western societies and other countries are high. Among youth, attempting suicide is more common among girls; however, boys are more likely to actually perform suicide. For example, in Australia suicide is second only to motor vehicle accidents as its leading cause of death for people aged 15 to 25.
Timeline of events related to sexual orientation and medicine
The Think Before You Speak campaign is a television, radio, and magazine advertising campaign launched in 2008 and developed to raise awareness of the common use of derogatory vocabulary among youth towards lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) people. It also aims to "raise awareness about the prevalence and consequences of anti-LGBTQ bias and behaviour in America's schools." As LGBTQ people have become more accepted in the mainstream culture, more studies have confirmed that they are one of the most targeted groups for harassment and bullying. An "analysis of 14 years of hate crime data" by the FBI found that gays and lesbians, or those perceived to be gay, "are far more likely to be victims of a violent hate crime than any other minority group in the United States". "As Americans become more accepting of LGBT people, the most extreme elements of the anti-gay movement are digging in their heels and continuing to defame gays and lesbians with falsehoods that grow more incendiary by the day," said Mark Potok, editor of the Intelligence Report. "The leaders of this movement may deny it, but it seems clear that their demonization of gays and lesbians plays a role in fomenting the violence, hatred and bullying we're seeing." Because of their sexual orientation or gender identity/expression, nearly half of LGBTQ students have been physically assaulted at school. The campaign takes positive steps to counteract hateful and anti-gay speech that LGBTQ students experience in their daily lives in hopes to de-escalate the cycle of hate speech/harassment/bullying/physical threats and violence.
Various issues in medicine relate to lesbian, gay, bisexual, and transgender people. According to the US Gay and Lesbian Medical Association (GLMA), besides HIV/AIDS, issues related to LGBT health include breast and cervical cancer, hepatitis, mental health, substance use disorders, alcohol use, tobacco use, depression, access to care for transgender persons, issues surrounding marriage and family recognition, conversion therapy, refusal clause legislation, and laws that are intended to "immunize health care professionals from liability for discriminating against persons of whom they disapprove."
Research has found that attempted suicide rates and suicidal ideation among lesbian, gay, bisexual, and transgender (LGBTQ) youth are significantly higher than among the general population.
LGBT sex education is a sex education program within a school, university, or community center that addresses the sexual health needs of LGBT people.
Transgender youth are children or adolescents who do not identify with the sex they were assigned at birth. Because transgender youth are usually dependent on their parents for care, shelter, financial support, and other needs, they face different challenges compared to adults. According to the World Professional Association for Transgender Health, the American Psychological Association, and the American Academy of Pediatrics, appropriate care for transgender youth may include supportive mental health care, social transition, and/or puberty blockers, which delay puberty and the development of secondary sex characteristics to allow children more time to explore their gender identity.
Bullying and suicide are considered together when the cause of suicide is attributable to the victim having been bullied, either in person or via social media. Writers Neil Marr and Tim Field wrote about it in their 2001 book Bullycide: Death at Playtime.
Research shows that a disproportionate number of homeless youth in the United States identify as lesbian, gay, bisexual or transgender, or LGBT. Researchers suggest that this is primarily a result of hostility or abuse from the young people's families leading to eviction or running away. In addition, LGBT youth are often at greater risk for certain dangers while homeless, including being the victims of crime, risky sexual behavior, substance use disorders, and mental health concerns.
The following outline offers an overview and guide to LGBTQ topics:
LGBTQ psychology is a field of psychology of surrounding the lives of LGBTQ+ individuals, in the particular the diverse range of psychological perspectives and experiences of these individuals. It covers different aspects such as identity development including the coming out process, parenting and family practices and support for LGBTQ+ individuals, as well as issues of prejudice and discrimination involving the LGBTQ community.
The health access and health vulnerabilities experienced by the lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual (LGBTQIA) community in South Korea are influenced by the state's continuous failure to pass anti-discrimination laws that prohibit discrimination based on sexual orientation and gender identity. The construction and reinforcement of the South Korean national subject, "kungmin," and the basis of Confucianism and Christian churches perpetuates heteronormativity, homophobia, discrimination, and harassment towards the LGBTQI community. The minority stress model can be used to explain the consequences of daily social stressors, like prejudice and discrimination, that sexual minorities face that result in a hostile social environment. Exposure to a hostile environment can lead to health disparities within the LGBTQI community, like higher rates of depression, suicide, suicide ideation, and health risk behavior. Korean public opinion and acceptance of the LGBTQI community have improved over the past two decades, but change has been slow, considering the increased opposition from Christian activist groups. In South Korea, obstacles to LGBTQI healthcare are characterized by discrimination, a lack of medical professionals and medical facilities trained to care for LGBTQI individuals, a lack of legal protection and regulation from governmental entities, and the lack of medical care coverage to provide for the health care needs of LGBTQI individuals. The presence of Korean LGBTQI organizations is a response to the lack of access to healthcare and human rights protection in South Korea. It is also important to note that research that focuses on Korean LGBTQI health access and vulnerabilities is limited in quantity and quality as pushback from the public and government continues.
"Suicidal ideation" or suicidal thoughts are the precursors of suicide, which is the leading cause of death among youth. Ideation or suicidal thoughts are categorized as: considering, seriously considering, planning, or attempting suicide and youth is typically categorized as individuals below the age of 25. Various research studies show an increased likelihood of suicide ideation in youth in the LGBT community.
People who are LGBT are significantly more likely than those who are not to experience depression, PTSD, and generalized anxiety disorder.