Risk factors that increase the vulnerability of gay and lesbian youth to emotional and behavioral difficulties

June 2004

Q: Are there risk factors that increase the vulnerability of gay and lesbian youth to emotional and behavioral difficulties?

A: Numerous studies document that gay and lesbian youth self-report higher levels of emotional and behavioral difficulties than heterosexual youth. These challenges include: anxiety, depression, substance abuse, conduct problems, and suicidal ideation and attempts. Gay and lesbian youth are often at increased risk of medical and psychosocial problems not primarily because of their sexual orientation, but because of the negative reaction—or their fear of the negative reaction—of their families, peers, and significant adults. The term “gay” is often used to describe males and females who are homosexual (i.e., people whose sexual and romantic feelings are mostly for people of the same sex). “Gay,” however, is increasingly used to describe male homosexuals while “lesbian” is the term used for females. The major risk factors experienced by these youth include:

-Verbal and physical aggression at school, home, and in the community

-Rejection or fear of rejection from family and peers

-Alcohol and other drug use

-Limited coping skills because of youth and inexperience

-Identity conflicts around acceptance of homosexual identity (especially true for African American males)

What Can Parents Do?

Examine your own beliefs system and values. If they conflict with your child's sexual orientation, find a safe place (i.e., Parents and Friends of Lesbian and Gays [P-FLAG)]) where you can talk about your feelings.
Try to talk with your child in an open and honest manner. You don't have to be comfortable with homosexuality to let your child know that he or she is still loved.
Obtain as much information as possible from workshops, movies, organizations, and books (i.e., Reinventing the Family by L. Benkov; My Son Eric by M.V. Borhec; Now That You Know: What Every Parent Should Know about Homosexuality by B. Fairchild and N. Hayward).
Advocate for your child at school and in the community, and refuse to allow verbal and physical aggressiveness to go unchallenged.

What Can Mental Health Professionals Do?

Examine your own beliefs system and values. If they conflict with your client's sexual orientation, seek peer and/or hierarchical supervision where you can talk about your feelings.
Attend workshops and courses on working with gay youth.
Read and use books that are focused on providing services to gay youth (i.e., Lesbian & Gay Youth : Care &Counseling by Caitlin Ryan and Donna Futterman; Gay & Lesbian Students: Understanding Their Needs by Hilda F. Besner and Charlotte I. Spungin).
Do a thorough assessment for suicide ideation and substance abuse as well as depression and posttraumatic stress.
Talk with our client about his or her perception of homosexuality as one dimension of life, not all of it.
Use cognitive behavioral techniques (i.e., assertiveness, relaxation training, or role play).

Information about Effective/Evidence-based interventions can be found:

- FOR PARENTS

The Effective Black Parenting Program, by Dr. Kerby T. Alvy

A Parents' Guide to Attention Deficit Disorders, by Lisa J. Barn

Your Defiant Child , by Russell A. Barkley, Ph.D.

- FOR CLINICIANS

Children of Color: Psychological Interventions with Culturally Diverse Youth, edited by Jewelle Taylor Gibbs, Ph.D., and Larke Nahme Huang, Ph.D.

Outcomes for Children and Youth with Behavioral and Emotional Disorders and Their Families: Programs and Evaluation Best Practices , edited by Michael H. Epstein, Ed.D., Krista Kutash, Ph.D., and Albert Duchnowski, Ph.D.

What Works with Children and Adolescents? A Critical Review of Psychological Interventions with Children, Adolescents and Their Families , edited by Alan Carr

Community Treatment For Youth: Evidence-Based Interventions for Severe Emotional and Behavioral Disorders, edited by Barbara J. Burns and Kimberly Hoagwood

- FOR EVERYONE

Mental Health: A report of the Surgeon General (1999). U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.

Technical Assistance Partnership for Child and Family Mental Health

Mental Health and Systems of Care Frequently Asked Questions

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	June 2004 Q: Are there risk factors that increase the vulnerability of gay and lesbian youth to emotional and behavioral difficulties? A: Numerous studies document that gay and lesbian youth self-report higher levels of emotional and behavioral difficulties than heterosexual youth. These challenges include: anxiety, depression, substance abuse, conduct problems, and suicidal ideation and attempts. Gay and lesbian youth are often at increased risk of medical and psychosocial problems not primarily because of their sexual orientation, but because of the negative reaction—or their fear of the negative reaction—of their families, peers, and significant adults. The term “gay” is often used to describe males and females who are homosexual (i.e., people whose sexual and romantic feelings are mostly for people of the same sex). “Gay,” however, is increasingly used to describe male homosexuals while “lesbian” is the term used for females. The major risk factors experienced by these youth include: -Verbal and physical aggression at school, home, and in the community -Rejection or fear of rejection from family and peers -Alcohol and other drug use -Limited coping skills because of youth and inexperience -Identity conflicts around acceptance of homosexual identity (especially true for African American males) What Can Parents Do? Examine your own beliefs system and values. If they conflict with your child's sexual orientation, find a safe place (i.e., Parents and Friends of Lesbian and Gays [P-FLAG)]) where you can talk about your feelings. Try to talk with your child in an open and honest manner. You don't have to be comfortable with homosexuality to let your child know that he or she is still loved. Obtain as much information as possible from workshops, movies, organizations, and books (i.e., Reinventing the Family by L. Benkov; My Son Eric by M.V. Borhec; Now That You Know: What Every Parent Should Know about Homosexuality by B. Fairchild and N. Hayward). Advocate for your child at school and in the community, and refuse to allow verbal and physical aggressiveness to go unchallenged. What Can Mental Health Professionals Do? Examine your own beliefs system and values. If they conflict with your client's sexual orientation, seek peer and/or hierarchical supervision where you can talk about your feelings. Attend workshops and courses on working with gay youth. Read and use books that are focused on providing services to gay youth (i.e., Lesbian & Gay Youth : Care &Counseling by Caitlin Ryan and Donna Futterman; Gay & Lesbian Students: Understanding Their Needs by Hilda F. Besner and Charlotte I. Spungin). Do a thorough assessment for suicide ideation and substance abuse as well as depression and posttraumatic stress. Talk with our client about his or her perception of homosexuality as one dimension of life, not all of it. Use cognitive behavioral techniques (i.e., assertiveness, relaxation training, or role play). Information about Effective/Evidence-based interventions can be found: - FOR PARENTS The Effective Black Parenting Program, by Dr. Kerby T. Alvy A Parents' Guide to Attention Deficit Disorders, by Lisa J. Barn Your Defiant Child , by Russell A. Barkley, Ph.D. - FOR TEACHERS Skillstreaming: Teaching Prosocial Skills, by Arnold P. Goldstein, Ph.D. Building Dreams: Elementary School Edition, by Mychal Wynn and Dee Blassie - FOR CLINICIANS Children of Color: Psychological Interventions with Culturally Diverse Youth, edited by Jewelle Taylor Gibbs, Ph.D., and Larke Nahme Huang, Ph.D. Outcomes for Children and Youth with Behavioral and Emotional Disorders and Their Families: Programs and Evaluation Best Practices , edited by Michael H. Epstein, Ed.D., Krista Kutash, Ph.D., and Albert Duchnowski, Ph.D. What Works with Children and Adolescents? A Critical Review of Psychological Interventions with Children, Adolescents and Their Families , edited by Alan Carr Community Treatment For Youth: Evidence-Based Interventions for Severe Emotional and Behavioral Disorders, edited by Barbara J. Burns and Kimberly Hoagwood - FOR EVERYONE Mental Health: A report of the Surgeon General (1999). U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.