Sexual Orientation, Gender Identity And Adolescent Health 10.6.07


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Presentation for Wayne State University Health Focus Conference 2007

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  • brought up lots of great points also had lots of great health info! thank you!
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Sexual Orientation, Gender Identity And Adolescent Health 10.6.07

  1. 1. Sexual Orientation, Gender Identity and Adolescent Health Laura Sorensen, Youth Services Coordinator Knoll Larkin, Health Services Coordinator
  2. 2. Overview <ul><li>Terms and Definitions (Understanding Sexual Orientation and Gender Identity) </li></ul><ul><li>The coming out process </li></ul><ul><li>LGBT youth health issues </li></ul><ul><li>Barriers to care </li></ul><ul><li>LGBT Youth-Diverse and Resilient </li></ul><ul><li>Taking Action </li></ul><ul><li>Resources for Providers and Parents </li></ul>
  3. 3. Sexual Orientation <ul><li>Gay </li></ul><ul><li>Lesbian </li></ul><ul><li>Bisexual </li></ul><ul><li>Queer </li></ul><ul><li>Questioning </li></ul>
  4. 4. Sexual Behavior Versus Sexual Identity <ul><li>Health concerns of LGBT youth are impacted by both identity and behavior. </li></ul><ul><li>Identity- the “label” one applies to oneself and one’s community of affiliation. </li></ul><ul><li>Behavior- the specific activities a person engages in. </li></ul>
  5. 5. Gender Identity/Gender Expression <ul><li>Gender identity is distinct from sexual orientation. </li></ul><ul><li>Gender Identity May be: </li></ul><ul><ul><li>Feminine / Femme </li></ul></ul><ul><ul><li>Androgynous </li></ul></ul><ul><ul><li>Masculine / Butch </li></ul></ul><ul><ul><li>Transgender </li></ul></ul>
  6. 6. Gender Identity (cont.) <ul><li>Transgender: Individuals who do not conform to gender stereotypes, roles, and expectations. This is referred to as the “umbrella definition” as it covers everyone. </li></ul><ul><ul><li>Some groups under the transgender umbrella: </li></ul></ul><ul><ul><li>Drag kings/queens, </li></ul></ul><ul><ul><li>Androgynous folks </li></ul></ul><ul><ul><li>Crossdressers </li></ul></ul><ul><ul><li>Genderqueer, </li></ul></ul><ul><ul><li>Gender-non conformists, </li></ul></ul><ul><ul><li>Transsexuals, </li></ul></ul><ul><ul><li>MTF (male to female) / FTM (female to male) </li></ul></ul>
  7. 7. Gender Expression <ul><li>The way in which someone conveys gender attributes. </li></ul>
  8. 8. Language Makes A Difference <ul><li>Preferred vs. Other Terms </li></ul><ul><ul><ul><li>Lesbian, Gay, Bisexual Homosexual </li></ul></ul></ul><ul><ul><ul><li>Partner Lover/Roommate </li></ul></ul></ul><ul><ul><ul><li>Sexual orientation Sexual preference </li></ul></ul></ul><ul><ul><ul><li>Crossdresser Transvestite </li></ul></ul></ul><ul><ul><ul><li>Transgender Transsexual </li></ul></ul></ul><ul><ul><ul><li>Intersex Hermaphrodite </li></ul></ul></ul><ul><li>WHEN IN DOUBT… ASK! </li></ul><ul><li>Words/Phrases Often Used “Within” the Community </li></ul><ul><li>Dyke, Queer, Family, Same Gender Loving </li></ul>
  9. 9. Coming Out: <ul><li>Refers to the experiences of some, but not all, LGBT people as they work through and accept a stigmatized identity. </li></ul><ul><li>Transforming a negative self identity into a positive one </li></ul><ul><li>Often described as a process of self-actualization. Transgender youth may face far more barriers (legal & medical). </li></ul>
  10. 10. Coming Out (cont) <ul><li>There is no correct way to come out </li></ul><ul><li>Some people may decide they do not want to take on a LGBT identity and may choose not to disclose their feelings and experiences to anyone. </li></ul>
  11. 11. Cass Model of Identity Development <ul><li>Stage 1: Identity Confusion </li></ul><ul><li>Stage 2: Identity Comparison </li></ul><ul><li>Stage 3: Identity Tolerance </li></ul><ul><li>Stage 4: Identity Acceptance </li></ul><ul><li>Stage 5: Identity Pride </li></ul><ul><li>Stage 6: Identity Synthesis </li></ul>
  12. 12. What are the challenges that LGBT youth face? <ul><li>In School </li></ul><ul><li>At Home </li></ul><ul><li>Religious/Cultural </li></ul><ul><li>Developmental/Dating </li></ul><ul><li>Jobs/Employment </li></ul><ul><li>Accessing Health Care </li></ul>
  13. 13. School <ul><li>Majority of LGBT students do not feel safe at school. </li></ul><ul><li>LGBT youth are more than five times as likely to miss school than heterosexual youth. </li></ul><ul><li>Over a third experience harrassment based on their sexual orientation. </li></ul><ul><li>75% heard fellow classmates call someone “dyke” or “faggot” in a school hallway. </li></ul><ul><li>Only 16% of students witnessed a school staff member intervene when hearing slurs. </li></ul>
  14. 14. Home <ul><li>Studies have found that families have a range of reactions to their children’s LGBT identity and express their reactions through behaviors that affect their children’s health and mental health outcomes. Research linked family responses with risk and protective factors for key concerns including sexual health, HIV infection, substance use, mental health and wellness. (Family Accecptance Project USFC) </li></ul><ul><li>Rejection </li></ul><ul><li>Homelessness </li></ul><ul><li>Runaway </li></ul><ul><li>Abuse/violence </li></ul>
  15. 15. Dating/Developmental <ul><li>LGBT Youth may be denied the “Rites of Passage” characteristic of adolescence. </li></ul><ul><li>“ Rites of Passage” unique to adolescence such as: </li></ul><ul><ul><li>Classroom romances, first date, first kiss, Senior Prom </li></ul></ul><ul><ul><li>No role models or relationship models to look up to </li></ul></ul><ul><ul><li>No healthy outlets for sexual exploration </li></ul></ul><ul><li>Failure to experience these activities stifles the normal social development of LGBT Youth, even if they pass as heterosexual. </li></ul>
  16. 16. Jobs/Employment <ul><li>No legal protection for discrimination based on sexual orientation/gender identity </li></ul><ul><li>Transgender youth may face documentation issues (drivers liscence, legal name changes) and gender expression/presentation issues. </li></ul>
  17. 17. Most importantly…in Health Care Settings <ul><li>Bias/ignorance/fear/phobia of provider </li></ul><ul><li>Exclusion of partner in health care decisions </li></ul><ul><li>Heterosexist assumptions on forms/interviews </li></ul><ul><li>Lack of insurance coverage under partner’s health plan </li></ul><ul><li>Fear of being “outed” to employers, insurers, etc. (for youth—fear of being outed to parents) </li></ul><ul><li>Lack of provider knowledge about health care risks and issues for LGBT people </li></ul><ul><li>Patient’s own internalized homophobia or transphobia </li></ul>
  18. 18. Health Concerns…. <ul><li>Teen substance abuse, weapon-related violence, suicide attempts and unprotected sexual behavior are certainly among the predominant public health concerns in our nation.. However, these same concerns for lesbian, gay and bisexual (LGBT) youth are particularly alarming. As a group, LGBT adolescents appear to be at increased risk for a large number of health and mental health outcomes when compared to their heterosexual peers. </li></ul>
  19. 19. Health Concerns…. <ul><li>Sex work </li></ul><ul><li>Gay and bisexual male youth are also at risk for a variety of sexually transmitted diseases, as are bisexual females and lesbian youth who have sex with male partners (Ryan & Futterman, 1998). </li></ul><ul><li>Violence </li></ul><ul><li>Other studies have found that these youth experience higher rates of suicide attempts, victimization due to harassment, and violence (Remafedi, French, Story, Resnick & Blum, 1998). </li></ul><ul><li>HIV infection (YMSM) </li></ul><ul><ul><li>Recent data released by the Centers for Disease Control and Prevention found that young men who have sex with men accounted for 34% of all new AIDS cases among 13 to 24-year-olds. Black and Latino sexually active young men are at particular risk for HIV infection ( Centers for Disease Control and Prevention , 2000). </li></ul></ul>
  20. 20. Health Concerns… <ul><li>Accessing hormones </li></ul><ul><li>Pumping (silicone injection) </li></ul><ul><li>Mental Health </li></ul><ul><ul><li>Data released from the National Longitudinal Study on Adolescent Health showed that youth who report same-sex attraction or behaviors also reported higher levels of emotional distress, greater use of alcohol and marijuana, and earlier sexual debut (Resnick et al., 1997) </li></ul></ul><ul><li>Substance Abuse </li></ul><ul><li>Suicide </li></ul><ul><li>Tobacco Use </li></ul><ul><ul><li>LGBT youth smoke at rates 11-50% higher than their non LGBT peers. </li></ul></ul>
  21. 21. Standards of Care for LGBT Youth <ul><li>“ Pediatritians should create a clinical environment where adolescents feel safe to discuss sensitive personal issuses, including sexuality and sexual orientation. The overall goal in caring for all youth, including those who are gay, lesbian, or bisexual, is the same: to promote normal adolescent development, social and emotional well being, and physical health.” </li></ul><ul><ul><li>American Academy of Pediatrics </li></ul></ul>
  22. 22. Standards of Care Cont. <ul><li>“People of diverse gender expression should be afforded the same respect and rights as those whose gender identity and expression conform to societal expectations” </li></ul><ul><ul><li>American Psychological Association </li></ul></ul>
  23. 23. LGBT Youth: A Strength in our Communities <ul><li>Leadership </li></ul><ul><li>Activism </li></ul><ul><li>Challenging binaries and status quo </li></ul>
  24. 24. Creating an LGBT Friendly Environment in Health Settings <ul><li>Forms </li></ul><ul><li>Language </li></ul><ul><li>Outreach & Materials </li></ul><ul><li>Training & Development </li></ul><ul><li>Policies & Hiring Practices </li></ul>
  25. 25. If a young person comes out to you, DO: <ul><li>Remember that sexual orientation or gender identity is just one dimension of your client. </li></ul><ul><li>Be yourself. </li></ul><ul><li>Recognize your limitations. </li></ul><ul><li>Remember that the person may be nervous or afraid. </li></ul><ul><li>Use the vocabulary they use. </li></ul>
  26. 26. <ul><li>Do your homework: find out more about sexuality, gender identity & local resources. </li></ul><ul><li>Remember that it doesn’t take a gay social to help a gay client. </li></ul><ul><li>If the client seems nervous, you can assure him or her that the information is confidential. </li></ul><ul><li>Remember that you have an obligation to respect the person’s right to privacy and confidentiality. </li></ul>If A Young Person Comes Out to You (CONT)
  27. 27. If a young person comes out to you, DON’T SAY: <ul><li>How do you know? Are you sure? </li></ul><ul><li>You will probably get over it when the right man/woman comes along. </li></ul><ul><li>I don’t agree with (being gay), but I can still work with you. </li></ul><ul><li>Have you tried dating the opposite sex? </li></ul><ul><li>You will grow out if it. It’s just a phase. </li></ul><ul><li>Any phrase that includes the term “lifestyle”, “preference” or “homosexual”. </li></ul>
  28. 28. Affirmations Community Center <ul><li>Programs for youth, adults, older adults </li></ul><ul><li>Support groups & helpline (800-398-GAYS) </li></ul><ul><li>Social events and special events </li></ul><ul><li>Health & mental health programs </li></ul><ul><li> </li></ul>
  29. 29. Other Resources <ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul>
  30. 30. Quickie Evaluation <ul><li>1. On a scale of 1-10, how useful was this presentation? (10 being the most useful) </li></ul><ul><li>2. One new thing I learned was: </li></ul><ul><li>3. Questions I still have are: </li></ul>