Psychological Supports for LGBT Youth

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Psychological Supports for LGBT Youth Young
Adults Where Weve Been and New Initiatives

• Laura M. I. Saunders, Psy.D.
• Lsaunde_at_harthosp.org
• Richard Stillson, Ph.D.
• Richard.stillson_at_po.state.ct.us

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Today

• Action plan to take back to schools/programs
• Developmental perspective on the Coming Out
  process
• Impact of homonegativity on GLBT youth who
  struggle with mental illness
• Nurturing alternative families
• Community Efforts in CT
• Future directions/interventions/recommendations

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Gender vs. Sexual Orientation

• Gender is a combination of ones
• Birth sex
• Gender role
• Gender identity

• Sexual orientation encompasses
• Sexual Attraction
• Sexual Identity
• Sexual Behavior

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InternalizedHomophobia vs. Homo-negativity

• The irrational fear of homosexuals and
  homosexuality

• Negative perceptions of homosexuality
  internalized by persons w/ a same sex orientation
• (Rosser, et al., 2008)
• Herek (1996) argued that this is a principal
  social factor impacting on queer mental and
  sexual health
• Also referred to as
• Sexual Identity Distress

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Identity formation- Sexual Orientation

• Gay/lesbian/bisexual identity development
  (Cooley, 1998)
• 4 Adjustment/phases
• Sensitization discovering same sex feelings of
  attraction
• Identity confusion reacting to same sex
  attraction
• Identity assumption discovering/accepting same
• sex attraction
• Commitment adopting glb identity

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Identity Formation Gender Variance

• Developmental Stages
• -One to two years of age- become conscious of
  physical differences between boys and girls
• -By age 3 can identify self as boy or girl
• -By age 4- gender identity is stable and, in
  typical development, congruent with biological
  sex
• -Entering kindergarten gender identity is well
  established

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Perspective of SO GV the last 20 years

• How has the process of exploring ones sexual
  orientation and gender variance changed over the
  last 20 years?
• -Regional differences
• -By identification/label
• -Role of the internet
• -Age of coming out

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Jackson, R. (2008)
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Jackson, R. (2008)
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Jackson, R. (2008)
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Age of Coming Out - 1996

• Girls aware of attraction to same gender age 10
• First same-sex experience at age 15
• Boys first awareness of attraction to same
  gender age 9
• First same-sex experiences at age 13
• Identification as glb began around age 16 for
  both genders
• Herdt Boxer, Children of Horizons, 1996

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Age of Coming Out - 2009

• Girls awareness of same sex attraction age 11 ½
  to 12
• Girls coming out to self age 14 ½ to 15
• Girls coming out to family just over age 16
• Boys awareness of same sex attraction age 9 ½
• Boys coming out to self age 14
• Boys coming out to family age15 ½ to 16
• C. Ryan study in Pediatrics, 2009

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Risk Factors Sexual Abuse

• Risk factors for violence among stigmatized
  populations?
• Sexual physical abuse most powerful
  predictors of high risk behavior
• Among girls, 1 in 4 lesbian and bisexual girls
  report sexual abuse (Prevalence of sexual abuse
  in hetero girls ranges from 10-25)
• Among boys, 1 in 4 bisexual boys 1 in 5 gay
  boys reported sexual abuse (Prevalence of sexual
  abuse in hetero boys is well under 10)

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Physical Abuse by Family Members

• Girls in all orientation groups report higher
  prevalence of physical abuse than male peers
• Bisexual lesbian girls report a higher
  prevalence of physical abuse then hetero girls
  (Prevalence among hetero girls is 1 in 4 or 5)
• Gay bisexual boys also report a higher
  prevalence of physical abuse, nearly 1 in 5 or
  1 in 3 reporting abuse (Prevalence among hetero
  boys is 1 in 8)

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Risk Factors Violence

• LGB youth are at higher risk for violence in
  their homes
• Gender atypicality, even if not disclosed,
  creates risk for victimization.
• Bisexual youth higher risk for victimization
  than lesbian or gay
• Higher level of stigma and violence toward LGB
  youth ?higher risk-taking behaviors

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Risk Factors for Suicide in Queer Youth

• Having a mental disorder
• Lack of social support
• Sense of isolation
• Stigma assoc. w/ seeking help
• Loss of relationship
• Access to lethal means
• Physical/verbal abuse by parents

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Suicidal Trans Youth

• Very little research
• 45 had SI ½ of these say it was related to
  their transgender status
• Youth who had made suicidal attempts reprted
  increased rates of physical and verbal abuse by
  parents.
• Grossman DAngelli, 2007

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Impact of Families on GLB Youth

• Looked at 9 negative health indicators including
  mental health, substance abuse sexual risk
• Sample 245 LGB Latino and non-Latino White
  young adults ages 21 to 25 years
• Criteria open about SO to at least 1 parent or
  primary caregiver during adolescence
• LGB young adults who reported high levels of
  family rejection during adolescence were
• -8.4x more likely to report suicide attempt
• -5.9x more likely to report high levels of
  depression
• -3.4x more likely to use illegal drugs
• -3.4x more likely to engage in unprotected
  sexual intercourse
• compared with peers from families that reported
  no or low levels of family rejection.
• C. Ryan Study in Pediatrics, 2009

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Gender Variance in Schools

• 26.1 of students have experienced physical
  harrassment at school due to their gender
  expression/variance
• 11.8 have been physically assaulted
• LGBT students are 5 times more likely to have
  skipped school in the last month due to safety
  concerns
• The avg. GPA for gender variant students feeling
  physically harrassed was ½ grade lower (2.6 vs.
  3.1) than students experiencing less harrassment
• GLSEN 2005 survey 1732 students, ages 13-20yrs
  from 50 states from Trans Youth Family Allies

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Gender Variance in Schools contd

• LGBT students were 2x more likely as the general
  population of students to report they are NOT
  planning post-secondary education
• States with inclusive anti-bullying laws and
  policies that have specific categories for sexual
  identity and gender identity have significantly
  lower rates of verbal harrassment (31.6 vs.
  40.8)
• GLSEN 2005 survey 1732 students, ages 13-20yrs
  from 50 states from Trans Youth Family Allies

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Families - What to do?

• What do families need to move from rejection to
  ambivalence to acceptance?
• How can clinicians/counselors support this
  process?
• Identification of those at risk most critical
  element
• Education Advise parents that negative
  reactions to their adolescents may adversely
  affect their childs physical and mental health
• Encouragement resources to decrease rejection

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How Can Families Nurture Queerness?

• Encourage all family members to express negative
  feelings worries lose steam when voiced
• Develop new appreciation for queer youth
• Embrace the gifts their child has to offer with
  their queerness
• (StoneFish Harvey, 2005)

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Four Competencies to dealing with GLB and GV Youth

• Individualizing identifying and responding to
  each youth as an individual, separate from their
  sexual identity
• Strength finding Highlight strengths in youth
  to balance the negative elements in their life
• Affirming Affirm youths internal experiences
  and struggles as important.
• Normalizing Youths need to understand that
  their feelings and concerns are normal/typical,
  even when their feelings are inconsistent with
  the views of others.
• Child Welfare League

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Queer Affirmative Therapy

• Understanding and Combating Heterosexism
  Heterosexual Privelege
• Understanding and Moving Beyond Gender Binary
  Model
• Learning to Affirm vs. Alienate

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Therapeutic Considerations

• Not disclosing your sexual orientation when asked
• Denying your own homo/trans phobia heterosexism
• Not offering resources for clients
• Sexual preference Alternative lifestyle
• Heterosexist paperwork/intake ????
• Tabla rasa as therapeutic style
• No queer literature in waiting room
• (Kort, 2008)

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Therapeutic Recommendations

• We need to be non-judgmental
• We do not have all the answers so dont pretend
  like we do.
• Keep our Gaydar and Transdar in check
• Accept client as total person sexuality and
  gender part but not whole person
• Hear their voice

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Schools

• In most cases where LGB GV youth reported that
  their school experience has been positive, they
  attributed that fact to the presence of
  supportive teachers.
• Confidentiality Establish and implement
  policies providing confidentiality in discussions
  between counselors and students.
• Develop and implement policies that prohibit
  discrimination, harrasment, and abuse of students
  based on actual or perceived SO or GV.
• Ensure that all existing and model complaint
  mechanisms at the school and district level
  include provisions for trans/gender variant
  youth.
• Allow GV youth to define themselves in the manner
  most appropriate for them.

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Schools contd

• Integrate age appropriate discussion about gay
  issues into relevant core curriculum subject
  areas such as literature, history and current
  affairs
• Include information specific to the needs of LGB
  GV youth in health education on sexuality and
  sexually transmitted diseased. Such info should
  NOT be presented that being LGB or GV is itself a
  health problem.

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Interventions

• Me You
• Responsive and responsible adults
• School counselor as first responders,
  supportive administration, curriculum issues
• DCF workers worker turnover and multiple
  placements inhibit development of a stable and
  supportive environment for LGB youth
• Community education critical component
• Pediatric providers Ask LGB adolescents about
  family reactions to SO GV and refer to
  community support programs

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The Gifts of Queerness

• We have a different way of looking at the world
  to offer our families
• We have provided opportunity for closeness due to
  sharing our intimate selves
• We have recruited our parents to be appropriately
  involved w/ us in a developmental trajector
  toward independence
• (StoneFish Harvey, 2005)

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Check your heterosexist/homophobic
countertransference

• Do I question the origins of my clients gayness?
• Do I assume that same-sex attractions have a
  pathological origin?
• Do I allign w/ my clients reluctance to admit
  being LGBT?
• How do I feel about LGBT people having children?
• Do I think LGBT should not tell others they are
  LGBT unless they are asked?

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Protective Factors for Suicidal Queer Youth

• Access to effective,sensitive,affirming MH/SA
  treatment (PRIDE Institute)
• Restricted access to lethal means
• Community supports
• Increased coping skills
• Strong family connections
• Spiritual connectedness

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Community Efforts

• Houses
• Your Turf/Rainbow Room
• True Colors mentoring foster parents, etc.
• GLSEN
• PFLAG
• GSAs

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The Houses

• Freedom
• Nations
• Everlasting Empire
• Pleasure
• Q
• Trailer Park Trash
• Sappho
• Bushfire

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Queer Cultural Competency Needed Supports

• Attending TC each year
• Rebekah Jacksons dissertation Increasing
  Competency A Sexuality and Gender Diversity
  Training Program for Mental Health Professionals
  (2008), University of Hartford
• GSAs in LMHAs Substance Abuse facilities of
  DMHAS
• DCF, Corrections, DMR supports for Queer Youth
• Queer Youth Shelter(s)

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Resources

• Hatred in the Hallways Violence
  Discrimination Against Lesbian, Gay, Bisexual,
  and Transgender Students in U.S. Schools Human
  Rights Watch
• Child Welfare League of America, 2006 series of
  articles on GLBT youth from a public health,
  youth in out-of-home care, homeless youth
  retrospective review of literature.
• Mom, I need to be a girl. 2007 By Just
  Evelyn
• TransYouth Family Allies, Inc. (TYFA)
  www.imatyfa.org
• Our Trans Children. A publication of the PFLAG
  Transgender Network.

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Other Resources

• CT Clearinghouse booth/ publication/ website
• CPA Task Force on Sexuality and Gender Diversity
  website
• CTAC website w/ State-wide Queer Affirming
  Therapists
• Rainbow Heights Club GLBT MI psycho-social
• www.rainbowheights.org
• Trevor Project
• www.thetrevorproject.org 866-4-U-TREVOR

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Sexual Orientation - Sammy

• 15 y.o. male admitted to inpatient unit for
  suicide attempt longstanding depression family
  history of depression superficial cutting
  behavior some paranoia
• Experiencing harassment in school for being
  effeminate and gay
• Conservative religious family want him to be
  normal trying to be supportive
• How to modify his school program to help him
  succeed?
• Additional clinical resources

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Gender Variance - Jack

• 9 year old boy has a 5 y.o. sister
• Referred for therapy at age 7 for gender
  dysphoria
• Pediatrician told parents to steer him toward boy
  toys, boy clothes and activities
• Loves dressing up in female clothingdresses,
  tutus, wigs, tiara, dolls begged for a Barbie or
  Hannah Montanna doll loves mermaids
• Mother wanted to be supportive and looked for
  advice father was punitive and pushed son toward
  sports creates conflict in the marriage

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Final Comments

• I think (Harvey Milk) would want me to say to
  all the gay and lesbian kids out there tonight
  that you are beautiful, wonderful creatures of
  value, and that no matter what anyone tells you,
  God does love you and that very soon, I promise
  you, you will have equal rights, federally,
  across this great nation of ours.
• Dustin Lance Black, Oscar winner for original
  screenplay for Milk at the Oscars on 2/29/2009

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