The document summarizes research on health disparities faced by LGBT transition aged youth. It finds that LGBT youth experience higher rates of discrimination, rejection, bullying, mental health issues like depression and suicide attempts, drug use, and homelessness due to social stigma and lack of family and social support developing their sexual identities. The social determinants of health, including discrimination, access to healthcare, and social environment disproportionately impact the health of LGBT youth. Developing culturally competent healthcare professionals is key to addressing these issues and disparities.

1. John Arthur Jackson, III CMHS/OD, BA* (expected 12/14)
Bachelors of Arts in Sociology, Bethune-Cookman University, Daytona Beach, Florida
Army of One: LGBT Health Disparities in Transition Aged Youth
from Prevalent Social Determinants
There are many factors that contribute to a person’s state of
health. For the LGBT individual those factors are numerous.
These factors encompass the social environment and individual
behavior spectrum of the social determinants of health which
include: discrimination, gender, access to quality health care
etc.
Historically, in the United States there is a preponderance, of
intolerance, as with most socially constructed ‘problems’ that
foment a sense of discrimination against divergent social
groups, one in which happens to be focused on sexuality.
Transition aged youth are developing their sexual identities, and
for those exploring their sexual identities also face constant,
and negative messages about the perception of belonging to the
LGBT community.1
Homophobia, stigma, and discrimination serve as barriers to
physical and mental health, even if LGBT individuals seek and
are able to obtain health services, the quality of the services
they receive at best are inconsistent with their needs.
Homophobia, stigma and discrimination needs to be addressed
at different levels of society, such as health care services, in
addition to work places, and schools in order to increase
opportunities for improving the health of LGBT individuals,
more specifically LGBT Transition Aged Youth.
In the discourse of mental health and illnesses, there has been
so much language and data that is attempting to define
homosexuality as pathological, even with a rising tolerance and
acceptance for LGBT Youth. Through stigma, society discredits
and invalidates homosexuality relative to heterosexuality.
Institutions embodying stigma results in heterosexism, and
heterosexual individuals internalizing stigma results in
prejudice. 2
Transition aged LGBT youth are at an elevated risk of exposure
to stigma and discrimination aged youth and other sexual
minorities are at increased risk of being bullied in school, at
risk of being rejected by their families and as a result, are at
increased risk of behavioral health conditions.
LGBT youth are 2 to 3 times more likely to attempt suicide.3
LGBT youth are more likely to be homeless.4, 5
The purpose of this poster is to conduct a systematic
literature review on the effects contributing to health
disparities that disproportionately impact transition aged
LGBT youth.
Developing a culturally competent cohort of specialists specific
to this population is key. There are a myriad of issues that need
to be addressed within the vernacular of LGBT health, which
include a more culturally competent understanding of
sexual/gender identity among youth. There is a deficit of
research concerning LGBT youth that needs to be represented.
LGBT youth and individuals are victims to a higher incidence
of hate crimes, and discrimination. While, tolerance and
inclusion can mitigate the consequences to social exclusion it’s
not enough. Additionally, it is grievous to assume that LGBT
individuals are still not at a disadvantage.
LGBT health requires specific and timely attention from health
care and public health professionals who are culturally
competent and aware of the social determinants affecting the
health of LGBT transition aged youth.
According to a 2013 Pew Research poll on LGBT Americans,
Attitudes and Experiences and Values in Changing Times, there
was a aggregate of about 1,200 LGBT respondents who were asked
in what varying forms did they feel discriminated against. About
four in ten (39%) of the LGBT individuals say that at some point in
their lives they were rejected by a family member of friend because
of sexual orientation. (30%) have been physically attacked or
threatened, and (29%) have been made unwelcome at their place of
worship with (21%) being treated unfairly by an employer.
Additionally, the poll revealed that about six in ten (58%) LGBT
individuals say that they have been the target of slurs or jokes, and
that 12 is the median age in which LGBT individuals felt that they
may be something other than heterosexual. Those individuals who
know now that they are LGBT came to that realization at the
median age of 17. 7
The Centers for Disease Control and Prevention collected data
displaying a comparison between LGBT individuals who
experienced strong rejection from their families than their peers
who had more supportive families. The researcher found that those
who experienced stronger rejection were: (8.4 times more likely to
have tried to commit suicide, 5.9 times more likely to report high
levels of depression and 3.4 times more likely to use illegal drugs
and engage in risky sexual acts)
The U.S. Department of Health and Human Services (HHS),
conducted research on Healthy People and lifestyle habits with a
focal point on LGBT individuals and from that research it
suggested that these individuals face health disparities linked to
societal stigma, discrimination, and denial of their civil and human
rights. Discrimination against LGBT persons have been associated
with high rates of psychiatric disorders, substance abuse and
suicide. 3
When gays, lesbians and bisexuals internalize society’s
homophobic attitudes and beliefs, the results can be
devastating. This is especially true when assessing those
individuals who are youth. In the discourse of health we must
be especially attentive and cognizant of the prevalent health
disparities not only in LGBT adults but youth as well. 8
Society’s hatred becomes self-hatred. As a minority group;
gays, lesbians and bisexuals are victims of systemic and
ongoing oppression. It can lead to feelings of alienation,
despair, low self-esteem, self-destructive behavior, and drug
addiction. 8 This is patterned with the individual behaviour
social determinant of health such as an intake of alcohol, and
substance abuse.
Some gays, lesbians and bisexuals resort to drug abuse or
alcohol abuse as a means to numb the feelings of being
different, to relieve emotional pain or to reduce inhibitions
about their sexual feelings. 1,2,3,7
Drug abuse or alcohol abuse often begins in early adolescence
when youth first begin to struggle with their sexual orientation.
2,6
The divergent social group of the LGBT community are at
disproportionate disadvantage when it comes to the prevalence
of health disparities that plagues them. Higher incidences of
suicide ideation, drug use and depression reflected the many
studies that show the correlation between sexuality, the various
social determinants of health and the resulting health
disparities.
Agencies should educate and implement culturally responsive
health professionals in addressing and serving the needs of this
population specifically. Programs developed for mental illness
should include both preventive, therapeutic, and trauma-
informed components and provide the supports and services
people need for recovery and healing.
An influx of culturally competent health care professionals
that are specific to this population is vital. One must engender
a social climate that is non-exclusionary.
[1] Morrow, D. F. (2004). Social work practice with gay, lesbian, bisexual, and transgender
adolescents. Families in Society, 85(1), 91-99.
[2] Herek, G., Chopp, R., & Strohl, D. (2007). Sexual stigma: Putting sexual minority health
issues in context. In I. Meyer and M. Northridge (Eds.), The health of sexual minorities: Public
health perspectives on lesbian, gay, bisexual, and transgender populations (pp. 171-208). New
York: Springer.
[3] US Department of Health and Human Services. Healthy People 2010. [Internet]. Available
from: http://www.hhs.gov
[4] Conron KJ, Mimiaga MJ, Landers SJ. A population-based study of sexual orientation
identity and gender differences in adult health. Am J Public Health. 2010 Oct;100(10):1953-60.
[5] Kruks, G. Gay and lesbian homeless/street youth: Special issues and concerns. J Adolescent
Health. 2010;12(7):515-8.
[6]Van Leeuwen JM, Boyle S, Salomonsen-Sautel S, et al. Lesbian, gay, and bisexual homeless
youth: An eight-city public health perspective. Child Welfare. 2006 Mar–Apr;85(2):151-70.
[7] Pew Research Center, Social and Demographic Trends . A Survey of LGBT Americans .
Attitudes, Experiences and Values in Changing Times
[8] Nicoloff, L. K., & Stiglitz, E. A. (1987). Lesbian alcoholism: Etiology, treatment, and
recovery. In the Boston Lesbian Psychologies Collective (Eds.), Lesbian psychologies:
Explorations and challenges (pp. 283-293). Chicago: University of Illinois Press.
Introduction
Method
Implications for the Future
Conclusion
References
A systematic review of electronic bibliographic databases (e.g.
CDC, NSDUH, APA, HHS and Google Scholar) utilizing the
search: “LGBT”; “stigma”; “heteronormativity”; mental
health”; “social determinants”; “shelters”; “Affordable Care
Act”; “social exclusion”. Articles selected were full text,
qualitative semi-structured interviews, cross-sectional
assessment/research, systematic reviews and peer reviewed
articles published between 2001-2014.
Summary of Research
Intern to the Center for Mental Health
Services/Office of the Director