Suicidality and depression disparities between sexual minority and heterosexual youth: a meta-analytic review.

PURPOSE: To examine disparities between sexual minority youth (SMY) and heterosexual youth in rates of suicidality and depression symptoms. METHODS: Separate meta-analyses were conducted to examine suicidality and depression disparities. Studies were included if the average age of the participants was <18 years, and if suicidality or depression symptoms were compared across SMY and heterosexual youth. RESULTS: SMY reported significantly higher rates of suicidality (odds ratio [OR] = 2.92) and depression symptoms (standardized mean difference, d = .33) as compared with the heterosexual youth. Disparities increased with the increase in the severity of suicidality (ideation [OR = 1.96], intent/plans [OR = 2.20], suicide attempts [OR = 3.18], suicide attempts requiring medical attention [OR = 4.17]). Effects did not vary across gender, recruitment source, and sexual orientation definition. CONCLUSIONS: Disparities in suicidality and depression may be influenced by negative experiences including discrimination and victimization. Clinicians should assess sexual orientation, analyze psychosocial histories to identify associated risk factors, and promote prevention and intervention opportunities for SMY and their families.

Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations.

Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these populations. This article is a culmination of a three-year effort by an expert panel to address the need for better understanding of suicidal behavior and suicide risk in sexual minority populations, and stimulate the development of needed prevention strategies, interventions and policy changes. This article summarizes existing research findings, and makes recommendations for addressing knowledge gaps and applying current knowledge to relevant areas of suicide prevention practice.

Relationship trajectories and psychological well-being among sexual minority youth.

Dating in adolescence plays an integral part in the development of sexual and social identities. This process is particularly salient for sexual minority youth who face additional obstacles to their identity formation due to their marginalized status. We investigated the influence of participating in a same-sex relationship (SSR) or an opposite-sex relationship (OSR) on sexual minority youths' psychological well-being (i.e., symptoms of depression, anxiety and internalized homophobia, and self-esteem) in an ethnically-diverse sample of 350 youth (55% male) between the ages of 15-19 years, recruited from three GLBT drop-in centers in the New York City area. Using longitudinal data, we examined youths' SSR and OSR over time. Multivariate regression analyses suggest that involvement in a SSR was positively associated with changes in self-esteem in males, and negatively correlated with changes in internalized homophobia in females. We discuss the implications for positive development in sexual minority adolescent populations.

Transgender youth and life-threatening behaviors.

Sexual minority status is a key risk factor for suicide among lesbian, gay, and bisexual youth; however, it has not been studied among transgender youth. Fifty-five transgender youth reported on their life-threatening behaviors. Nearly half of the sample reported having seriously thought about taking their lives and one quarter reported suicide attempts. Factors significantly related to having made a suicide attempt included suicidal ideation related to transgender identity; experiences of past parental verbal and physical abuse; and lower body esteem, especially weight satisfaction and thoughts of how others evaluate the youths' bodies. Sexual minority status is a key risk factor for life-threatening behaviors among transgender youth.

The relationship of stigma to the sexual risk behavior of rural men who have sex with men.

Most studies of risky sexual behaviors of men who have sex with men (MSM) have been conducted in cities. Few have documented risky sexual behavior of rural men despite increases in rural HIV. Fewer have addressed stigma and risk. This study explored the effects of stigma on sexual risk behavior among rural MSM. We hypothesized that stigma emanating from families, health care providers, and the communities of rural MSM would indirectly affect their sexual risk behavior through their mental health status, specifically self-esteem and internalized homophobia. A convenience sample of 414 rural MSM obtained through political, health service, and social organizations completed an anonymous self-administered questionnaire. Over half of the men reported high-risk sexual behavior. Sensation seeking directly affected levels of sexual risk while the effects of stigma on sexual risk behavior were mediated by mental health variables. Stigma related to respondents' low self-esteem, and low internalized homophobia increased risk behavior.

Childhood gender atypicality, victimization, and PTSD among lesbian, gay, and bisexual youth.

This study examined childhood gender atypicality, lifetime victimization based on sexual orientation, and current mental health, including trauma symptoms and posttraumatic stress disorder (PTSD), among 528 lesbian, gay, and bisexual youth. Nearly 80% reported verbal victimization, 11% physical, and 9% sexual, with males reporting significantly more victimization. Victimization began, on average, at age 13. Verbal attacks occurred as early as age 6, physical attacks at 8, and sexual attacks at 9. Youth who were considered gender atypical in childhood reported more victimization and more current mental health symptoms. PTSD was found in 9% of youth and was associated with past physical victimization.

Transgender youth: invisible and vulnerable.

This study used three focus groups to explore factors that affect the experiences of youth (ages 15 to 21) who identify as transgender. The focus groups were designed to probe transgender youths' experiences of vulnerability in the areas of health and mental health. This involved their exposure to risks, discrimination, marginalization, and their access to supportive resources. Three themes emerged from an analysis of the groups' conversations. The themes centered on gender identity and gender presentation, sexuality and sexual orientation, and vulnerability and health issues. Most youth reported feeling they were transgender at puberty, and they experienced negative reactions to their gender atypical behaviors, as well as confusion between their gender identity and sexual orientation. Youth noted four problems related to their vulnerability in health-related areas: the lack of safe environments, poor access to physical health services, inadequate resources to address their mental health concerns, and a lack of continuity of caregiving by their families and communities.

Coming out, visibility, and creating change: empowering lesbian, gay, and bisexual people in a rural university community.

Personal and professional challenges faced in encouraging the development of a gay community in a rural university setting are described. Community psychologists who are lesbian, gay, or bisexual (LGB) must assess their willingness to be open and the roles they can play in developing helping resources. These issues concern how to encourage the empowerment of others while maintaining a collaborative role in a situation of major personal investment. Two specific challenges-developing informal helping resources for local LGB people and fostering institutional and policy changes to make the university a safer place for LGB faculty, staff, and students-are described. Community psychologists must consider personal risk when they become involved in empowerment efforts with this population.

The evaluation of homophobia in an Italian sample.

Homophobia has not been systematically studied by Italian social scientists. This study was an initial investigation of the nature of homophobia among Italians, using an Italian version of a scale measuring the construct, and investigated personality and other factors related to homophobia. We examined (1) whether a male military personnel group had more homophobic attitudes than a group of comparably aged male university students; (2) whether personal characteristics and personality factors were correlated with homophobia; and (3) whether there were gender differences in homophobia between male and female university students. Male officers of the Italian Marine Corps were compared to male university students of the same age with respect to homophobia and personality characteristics. In addition, a sample of male university students was compared to female students. The instruments used were the Italian versions of the Modern Homophobia Scale (MHS) and the 16 Personality Factor Inventory (16 PF). Results showed significantly higher homophobia among the military personnel than among male students. Consistent with previous research, male university students demonstrated more negative attitudes towards gay and lesbian people than female students.

Predicting the suicide attempts of lesbian, gay, and bisexual youth.

In this study predictors of serious suicide attempts among lesbian, gay, and bisexual (LGB) youth were examined. Three groups were compared: youth who reported no attempts, youth who reported attempts unrelated to their sexual orientation, and youth whose attempts were considered related to their sexual orientation. About one third of respondents reported at least one suicide attempt; however, only half of the attempts were judged serious based on potential lethality. About half of all attempts were related to youths' sexual orientation. Factors that differentiated youth reporting suicide attempts and those not reporting attempts were greater childhood parental psychological abuse and more childhood gender-atypical behavior. Gay-related suicide attempts were associated with identifiability as LGB, especially by parents. Early openness about sexual orientation, being considered gender atypical in childhood by parents, and parental efforts to discourage gender atypical behavior were associated with gay-related suicide attempts, especially for males. Assessment of past parental psychological abuse, parental reactions to childhood gender atypical behavior, youths' openness about sexual orientation with family members, and lifetime gay-related verbal abuse can assist in the prediction of suicide attempts in this population.

The influence of stigma on the sexual risk behavior of rural men who have sex with men.

Research investigating predictors of risky sexual behavior of rural MSM is sparse, even though the prevalence of HIV in rural areas has increased. This study explored two sets of predictors of 93 rural MSM's levels of risky sexual behavior: mental health variables and stigma emanating from men's family members, health care professionals, and people in the rural communities in which they live. Over 47% of the men were found to be at modified high to high risk. Logistic regression using a continuation logit model was used to test the relationship of the predictor variables and the four levels of risk. Findings indicate that self-esteem was predictive of the highest sexual risk behavior but not lower levels of risk. Stigma was predictive of modified high sexual risk when compared to low and no risk categories. No variables differentiated men at low risk from men at no risk.

How lonely are gay and lesbian youth?

UCLA Loneliness Scale (8-item version) scores in a sample of 384 gay and lesbian adolescents support the hypothesis that such youths are especially vulnerable to loneliness.

Coming out in community psychology: personal narrative and disciplinary change.

Community psychology as a discipline has not focused its attention on the lives of lesbians, gay men, and bisexual (LGB) people, despite the field's potential to collaborate with this population in dealing with the many psychosocial challenges they face. Professional and personal barriers that community psychologists must confront conducting research and developing interventions with the LGB community are described. Community psychology work with LGB communities is often a "coming out" experience for LGB community psychologists, and a questioning of sexual orientation for heterosexual community psychologists. Conceptual analyses and empirical reports are presented that exemplify how community psychologist can contribute to decreasing the pervasive stigma LGB people face. The use of an ecological model, a focus on the development and evaluation of preventive interventions, and a recognition of the diversity within the LGB population are core perspectives that can direct future work by community psychologists. Issues ranging from testing ways to empower young LGB people to analyses of the impact of the sociopolitical climate on LGB lives demonstrate the rich range of contributions community psychologists can make.

Lesbian and bisexual female youths aged 14 to 21: developmental challenges and victimization experiences.

SUMMARY Two hundred six lesbian and bisexual female youth aged 14 to 21 were sampled from social and recreational settings. Most were aware of their same-sex attractions in adolescence, but disclosure to others lagged by five years. Youth on average spent 30% of their lives aware of their orientation without disclosure to others. According to youths' reports, three-quarters of their mothers and half of their fathers knew of their sexual orientation. Half had experienced repetitive verbal abuse, 12% reported several threats, and 7% had been assaulted multiple times. Youths who had self-identified as lesbian or bisexual or had told others of their sexual orientation reported more lifetime sexual orientation victimization. Fewer mental health symptoms were associated with having support from parents and with having not lost friends due to their sexual orientation. Less past sexual orientation victimization and fewer fears about future attacks were significant predictors of having less mental health symptoms. To decrease the victimization young lesbians and bisexual females experience, efforts need to be made to help families become more supportive and to make schools safer.

Effects of at-school victimization and sexual orientation on lesbian, gay, or bisexual youths' health risk behavior.

PURPOSE: To examine the link between victimization at school and health risk behaviors using representative data comparing lesbian, gay, and bisexual (LGB) youths and heterosexual youths. METHODS: Data from the 1995 Youth Risk Behavior Survey taken in Massachusetts and Vermont were examined. This sample included 9188 9th through 12th grade students; 315 of these students were identified as LGB. Analyses of variance were used to examine health risk behaviors by sexual orientation by gender by victimization level. RESULTS: The combined effect of LGB status and high levels of at-school victimization was associated with the highest levels of health risk behaviors. LGB youths reporting high levels of at-school victimization reported higher levels of substance use, suicidality, and sexual risk behaviors than heterosexual peers reporting high levels of at-school victimization. Also, LGB youths reporting low levels of at-school victimization reported levels of substance use, suicidality, and sexual-risk behaviors that were similar to heterosexual peers who reported low at-school victimization. CONCLUSIONS: The findings provide evidence that differences in health risks among LGB youth are mediated by victimization at school. Such victimization of LGB youth is associated with health risk behaviors.