In recent years, much of the country has become more accepting of those with sexual- and gender-nonconforming identities. But according to a yearly survey from the media-monitoring organization GLAAD, 2017 marked the first time that their Accelerating Acceptance report showed a decline in its four-year history — not surprising given the “attacks, bias, and erasure by the Trump administration,” as the report states. Many in the LGBTQ community still face pressure, hostility and discrimination from a variety of sources, including their own families. As a result, these individuals, especially youth, are at a much higher risk of mental illness, substance abuse and risky behaviors.
According to the National Alliance on Mental Illness:
— LGBTQ youth are nearly three times more likely than others to experience a mental health condition, such as major depression or generalized anxiety disorder.
— For LGBTQ individuals ages 10 to 24, suicide is one of the leading causes of death.
— LGBTQ youth are four times more likely, and questioning youth are three times more likely, to attempt suicide or engage in self-harm compared to heterosexual youth.
— An estimated 20 to 30 percent of LGBTQ individuals abuse substances, compared to about 9 percent of the general population.
[See: How to Find the Best Mental Health Professional for You.]
In a large national survey conducted by the National Center for Transgender Equality in 2015, 40 percent of respondents reported at least one suicide attempt during their lifetime. The vast majority of reported attempts — 92 percent — occurred before age 25.
“Transgender youth also face high rates of homelessness and physical violence,” says Dr. Natalia Ramos, an assistant clinical professor at the David Geffen School of Medicine at UCLA and a child, adolescent and adult psychiatrist at UCLA Health.
LGBTQ children often run away, explains Dr. Yolanda Graham, chief medical officer for Devereux Advanced Behavioral Health, a national nonprofit organization devoted to behavioral health care. As a result, “They are at higher risk for sexual exploitation,” says Graham, an expert in the treatment of sexually exploited children.
The Risks Are High
“LGBTQ individuals are more likely to experience harassment, discrimination and emotional, physical and sexual trauma,” Ramos says. “They are also much more likely to face family rejection.”
Graham says that they are most commonly diagnosed with depression, anxiety, post-traumatic stress disorder and substance abuse, which are often linked to violence, bullying, lack of support and homelessness. “This population suffers multiple stigmas, around their sexuality and also around mental health,” she says.
Access to mental health care is problematic. “When kids have issues they rely on their parents to find support. But if the parents don’t recognize symptoms or validate their child, they won’t seek support,” she says. “Their illnesses might be addressed quicker, but care is not available to this population.”
[Read: How to Come Out to Your Doctor as an LGBT Patient.]
And the care they do receive may seem unsupportive. The gender-identity language on forms they fill out, visual displays in offices and questions related to aggression and discrimination might be different from other youth who come in for treatment. “We need to send the message we are affirming with our treatment,” Graham says.
The reality is LGBTQ youth often suffer in silence. “They already feel stigmatized, so they are much more reluctant to discuss mental health issues,” Graham says. “Many have been coping with feeling outside the norm for so long, they have developed strategies to mask their symptoms. You don’t see the sudden changes in behavior we might expect in non-LGBTQ children.”
What Can Be Done to Help?
It is critical that parents have “open and affirming conversations” with their children, she says. “Family communication is important with all youth, especially those starting to explore different aspects of their identities.”
Parents can help their LGBTQ children build resilience and mitigate stress in many ways, Ramos says. “We know that expressing affection towards your child and acceptance of your child’s identity is very important. Parents can also encourage safe exploration of gender expression by providing access to age-appropriate toys, clothes, books and media.”
All adults should advocate for children who are mistreated because of their identity and limit exposure to intolerant individuals or environments. “Parents can also help children by connecting them to positive and affirming activities and groups. And seeking professional help for mental health symptoms or stressful events can help youth develop positive coping skills, explore identities and manage negative emotions,” Ramos explains.
[Read: How Hospitals Are Stepping Up Efforts to Best Accommodate LGBTQ Patients.]
Safety is of utmost importance. “A child no matter what age has to determine the safe environment and the safe individuals to discuss their sexuality,” Graham says. “Families are not always supportive. We recommend all youth are aware of hotlines, especially suicide hotlines, as a safe place to feel heard and validated.”
There are many LGBTQ organizations available for teens and young adults to find helpful resources. “Devereux has partnered with the Human Rights Campaign to help educate, empower and support LGBTQ individuals and parents,” Graham says. Ramos recently launched the EMPWR (“empower”) Program at UCLA, which is designed to promote well-being and resilience in LGBTQ youth and young adults through individual therapy, family interventions and group sessions.
Schools and community centers can create welcoming, safe spaces for LGBTQ individuals to both learn and explore their identities, Ramos says. “They can foster a culture that is supportive of all students and does not tolerate discrimination or bullying.” The Human Rights Campaign Foundation’s Welcoming Schools, a professional development program that offers training and resources to elementary school educators to create LGBTQ and gender-inclusive schools, prevent bullying and support transgender and non-binary students, is a great resource, she says.
More from U.S. News
How to Find the Best Mental Health Professional for You
How to Come Out to Your Doctor as an LGBT Patient
How Hospitals Are Stepping Up Efforts to Best Accommodate LGBTQ Patients
How to Reduce the Mental Health Risk for Gender-Nonconforming Kids originally appeared on usnews.com
