Mental Health in LGBTQ Youth: Review of Research and Outcomes

By Taylor, Janelle | National Association of School Psychologists. Communique, November 2019 | Go to article overview

Mental Health in LGBTQ Youth: Review of Research and Outcomes


Taylor, Janelle, National Association of School Psychologists. Communique


LGBTQ youth report higher rates of emotional distress, symptoms of anxiety and depression, hopelessness, self-harm, alcohol/substance abuse, suicidal ideation, and suicidal behavior compared to heterosexual youth (Almeida et al., 2009; McConnell, Birkett, & Mustanski, 2015a; Russell & Fish, 2016). The minority stress theory provides a framework that can potentially explain these mental health disparities.

MINORITY STRESS THEORY

The minority stress theory proposes that sexual minorities experience distinct and chronic stress that leads to disproportionately adverse behavioral and mental health outcomes (Meyer, 2003; Hatzenbuehler, Nolen-Hoeksema, & Erickson, 2008; Russell & Fish, 2016). It is theorized that LGBTQ youth experience both internal and external chronic stress related to having a stigmatized identity (although attitudes toward same-sex couples have improved over the years, there is still a stigma associated with homosexuality and deviation from socially normed gender roles; Almeida et al., 2009). Because individuals experience identity development in adolescence, having a stigmatized identity during this phase of development can be particularly damaging. For example, the adolescent could internalize the stigma and subsequent negative beliefs, experience actual discrimination (institutional or specific acts), or anticipate that others will stigmatize or discriminate them if they disclosed their identity, which are all related to lower psychological well-being (Quinn & Earnshaw, 2013). Meyer (2003) suggests that the minority stress theory both describes conceptual views of stress experienced by LGBTQ individuals and highlights areas of prevention and intervention that can lead to a reduction in mental health problems.

RISK FACTORS

Victimization. Victimization can include verbal harassment, physical harassment, and physical assault (Reitman et al., 2013) and has been found to lead to increased negative health outcomes (McConnell, Birkett, & Mustanski, 2015b). Specifically, experiencing victimization can result in posttraumatic stress disorder, sleep disturbances, anxiety, depression, nightmares, somatization, illegal drug use, property damage, and suicide attempts (McConnell, Birkett, & Mustanski, 2016; Reitman et al., 2013). Furthermore, Meyer (2003) notes that victimization threatens the victim's sense of security and invulnerability and causes them to respond with self-recrimination and self-devaluation.

LGBTQ youth experience victimization disproportionately compared to their heterosexual and cisgender peers (Mustanski et al., 2016), making the issue of victimization increasingly important for this population. This targeting is typically biased-based (e.g., bullying related to their sexual minority status), which has been found to further amplify the negative outcomes associated with victimization (Russell & Fish, 2016). LGTBQ adolescents who are exposed to high levels of victimization have been shown to have higher rates of suicide attempts than heterosexual youth who are exposed to the same level of victimization (Almeida et al., 2009). Additionally, LGBTQ youth who experience victimization have been found to be at higher risk for depression and posttraumatic stress disorder (Mustanski et al., 2016).

Perceived discrimination. In this context, perceived discrimination is defined as “the extent to which LGBT youth perceived that they had been discriminated against on the basis of sexual orientation” (Almeida et al., 2009, p. 1004). This means that actual discrimination does not need to occur for an individual to perceive that they are being discriminated against. Rather, perceived discrimination is measured based on self-report of personal experience with discrimination.

Perceived discrimination can lead to worsened mental health and social functioning (Meyer, 2003) and LGBTQ youth have been found to experience substantially higher levels of perceived discrimination compared to their heterosexual, nontransgendered peers (Almeida et al. …

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