APPENDIX V: Research on Health Education Needs of LGBT Youth

Those trying to obtain health education which addresses the presently unmet needs of LGBT youth in the schools will find the results of our recent research literature search (below) very helpful. SOME education officials ARE aware of the needs of LGBT young people for education regarding suicide and HIV disease but even those officials still profess ignorance of the needs of LGBT youth for education SPECIFIC TO THEIR ISSUES around drug, alcohol, and tobacco use; around drop-out prevention; around family conflict resolution skills for healthy family dynamics, etc. We have done a comprehensive literature review to locate the very best and latest research on the health education needs of LGBT young people. Here we have provided a Table of Contents which includes synopses of each article so that you may a) use the statistics contained in the synopses in your current activist work and b) obtain copies for yourselves of the articles themselves by using the citations provided.

You will note that over and over and over again, the research shows that LGBT youth are at special risk for misuse of substances such as alcohol, tobacco, and drugs due to the stresses to which a hostile society and homophobic educational system subject them. Further, the studies prove that LGBT youth are at high risk of dropping out of school, running away from home, etc. Their needs for information and support clearly are NOT being met. This is powerful material to use in advocating for inclusive health texts and curricula NOW!

Special Note: Our review of the research literature was conducted by Katie Laird. She can be reached at claird1@cc.swarthmore.edu.

Table of Contents

Verbal and Physical Abuse as Stressors in the Lives of Lesbian, Gay Male and Bisexual Youths. Ritch C. Savin-Williams.Journal of Counseling and Clinical Psychology. April, 1994

-Most stressful aspect is coming out to others or being discovered by others because of classmates' homophobia.
-Previous research has a sampling bias because it has been mostly male, and mostly troubled youth who have sought help/social services.
-The most frequent abusers are fellow teens.
-Outcomes associated with harassment: school related problems, runaway and homelessness, conflict with law/substance abuse, prostitution, suicide.

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The Impact of Victimization on the Mental Health and Suicidality of Lesbian, Gay Male and Bisexual Youths. Scott L. Hershberger & Anthony R. D'Augelli. Developmental Psychology. Vol. 31, No.1

This study about the importance of family but of course also presents data on victimization.

-40% of sample experienced physical violence.
-Victimization compromises mental health.
-12% of mothers and 18% of fathers rejected their children because of their sexuality.
-41% had experienced strong negative reactions from friends.
-Family support and self-acceptance influence victimization and mental health.
-Support from other lesbians/gay men and nonjudgemental heterosexuals is critical for development and acceptance of identity.
-Participants obtained from gay and lesbian community centers
-Family support acts as a buffer against the deleterious effects of victimization.
-Low percentage of females in sample.
-SINGLE LARGEST PREDICTOR OF MENTAL HEALTH WAS SELF-ACCEPTANCE.

School Climate for Gay and Lesbian Students and Staff Members. John D. Anderson. Phi Delta Kappan. October, 1994

-Homophobia is about ignorance and myths.
-There are many prominent gay and lesbian people who should be used as role models.
-In 1991, the Connecticut Board of Education's "Equity Newsletter" published 9 suggestions on making a better school environment for gay and lesbian youth.
-Massachusetts created the Commission on Gay and Lesbian Youth, whose recommendations include: training for teachers about gay and lesbian issues, support groups, anti-discrimination clauses, and curriculum reform.
-This author offers 5 suggestions:

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The At-Risk Kids Schools Ignore. Del Stover. The Executive Educator. March, 1992

-Gay students are an at-risk population: they run away, are thrown out by parents, are at high risk for suicide
-40% of street youth in Seattle identified as gay or bisexual
-High risk for unprotected sexual experimentation
-Professionals aren't trained to deal with the issue
-Fear of tackling a controversial issue.
-A national task force does not address the individual principal or teacher who has to deal with the parents, the community and the day to day.
-Start by ensuring a safe space for gay and lesbian students--protect them from verbal and physical abuse.
-Look at Project 10 and the Harvey Milk School as examples.
-Provide counseling.

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Violence Against Lesbian and Gay Male Youths. Joyce Hunter. Journal of Interpersonal Violence. September, 1990

-Data collected from intake interviews at Hetrick-Martin Institute
-Interviews of 500 youths--mean age=17
-40% reported violent physical attacks
-Of those reporting violent physical attacks, 46% said is was gay-related.
-Many of the violent incidents happened at home.
-Suicide attempts frequent among this group.
-Data limited to physical (not verbal/emotional) attacks
-Schools must provide a safe environment

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A Developmental, Clinical Perspective on Lesbian, Gay Male and Bisexual Youths. Ritch Savin-Williams & Richard Rodriguez. (Chapter in book)

-Homosexuality in textbooks often fits right in between AIDS and self-stimulation--not afforded proper time/space.
-Assumptions of heterosexuality in Developmental Psychology Journals.
-Social science literature focuses on homosexual behavior as opposed to gay identity.

SEXUAL BEHAVIOR AND SEXUAL IDENTITY:
-it is becoming easier to identify as gay
-because of that, though, it is more difficult to ignore homoerotic inclinations
-age of coming out is falling
-survey of high school juniors and seniors found less than 1% with a gay, lesbian or bisexual identity, but up to 6.4% reported homosexual attractions or behavior.
-less than 30% of those engaging in homosexual acts identified as homosexual.

COMING OUT TO SELF:
-difficult research dilemma--would need a large longitudinal study
-initial awareness is about being different, feeling isolated
-process may span 10-11 years.

SELF-DEVALUATION AND STIGMATIZATION OF HOMOSEXUALITY:
-incorporating society's negative emotions/homophobia
-passing--hiding one's sexual identity
-SELF-DEVALUATION MAY LEAD TO INCREASED RISK FOR DRUG ABUSE, SUICIDE, PREGNANCY AND HIV INFECTION

SEXUAL IDENTITY AND PSYCHOLOGICAL HEALTH:
-revealing one's identity only to "safe" others may prevent the painful ridicule.
-all researchers argue for change in cultural attitudes and policies, but few have optimism about change.
-retrospective research shows positive association between coming out and feelings of self-worth -acknowledgment of sexual orientation at an early age correlated with high self-esteem for lesbians (not necessarily same for gay/bisexual men).

MULTICULTURALISM AND GAY YOUTHS:
-gay youths of color may be in a perplexing position, but also have two sources of support--gay and ethnic community.
-may experience conflict of allegiance
-gay and ethnic identities may be incongruous.

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Counseling Gay Men and Lesbians with Alcohol Problems. Herbert, Hunt & Dell. Journal of Rehabilitation. April/May/June, 1994

This is not directly related to youths, but about the problem in general

-Gays are the hidden minority
-Alcoholism affects the gay community at a rate of 20-33%, which far exceed the general population (10%).
-Drinking is a means of coping with internalized homophobia
-Social stigmatization leads to depression/low self-esteem/powerlessness
-Mental health professionals aren't getting special training on gay and lesbian issues.
-Counselors must address own homophobia/stereotypes/assumptions.
-Gay and Lesbian clients end up trying to 'pass' and only talk about alcoholism
-Treatment must look at gay lifestyle/community
-Intake forms should ask about sexual orientation
-Be aware of community resources for gays and lesbians
-Lack of proper training will alienate gay and lesbian clients.

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Gay and Lesbian Homeless/Street Youth. Gabe Kruks. Journal of Adolescent Health. Vol. 12, No. 7.

-Data from intake information at Youth Services Department (YSD) of LA Gay and Lesbian Community Service Center.
-Generally more information on gay males because women are still seen as nonsexual beings and are invisible.
-72% of males engaging in survival sex identify as gay or bisexual.
-LA found 25-35% of street youth gay
-Seattle found 40% of street youth gay
-80% of gay and lesbian youth receiving services at YSD report homophobia and victimization as main reason for leaving home.
-53% of gay identified street youth attempted suicide.
-Feelings of isolation--find peer support in the streets.

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Lesbian, Gay and Bisexual Youths in Community Settings. DAugelli & Hershberger. American Journal of Community Psychology. Vol 21, No. 4

-41% of gay male sample had lost at least one friend because of sexual orientation.
-73% male/27% female. Ages 17-21
-21% often worried so much that they couldnt get stuff done.
-This was significantly correlated with depression.
-42% had made a past attempt of suicide.
-Male attempters had lower self-esteem
-Over 60% reported feeling overwhelmed in last year.
-Attempters were more 'out', had more worries about alcoholism, lower self-esteem.

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Male Homosexuality--The Adolescent's Perspective. Gary Remafedi. Pediatrics. March, 1987.

-Subjects recruited from gay news publication, gay radio show and health department
-subjects--29 males aged 15-19--white, middle class, Christian
-69% had become aware of feelings in adolescence
-93% had told friends
-55% reported regular verbal physical abuse from classmates
-50% lost friends over sexual orientation.

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Teaching About Sexual Orientation by Secondary Health Teachers. Telljohann, Price, Poureslami & Easton. Journal of School Health. January, 1995.

-Homosexual youth at risk for self-hatred and emotional isolation
-Prevalence rates are 50% higher for alcohol use and three times higher for marijuana use for gays than straights.
-Up to 48% have run away from home.
-Theyre more likely to drop out of school.
-60% believed gay students feel more isolated and rejected.
-Teachers were unclear about or believed in stereotypes.
-55% said a gay and lesbian support group would not be supported by the administration
-Less than half formally taught homosexuality
-Leading source of information for those who taught was mass media.
-FEW TEACHERS SEE HOMOSEXUALS AT HIGHER RISK, SO THEY'RE NOT LOOKING FOR SYMPTOMS.
-Public schools should offer in-service training on gay issues.

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School Counselors' Perceptions of Adolescent Homosexuals. Price, Telljohann. Journal of School Health. Vol. 61, No.10.
-Study gave a questionnaire to high school counselors
-Cites Remafedi study that: of gay male youths studied, 48% ran away, 34% attempted suicide, 43% felt negative attitudes from friends, 41% felt negative attitudes from family, 55% experienced verbal abuse, 30% experienced physical assault.
-Most school counselors (92%) erroneously did not believe that gay and lesbian youth were at greater risk for substance abuse.

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From Planning to Live: Evaluating and Treating Suicidal Teens in Community Settings. Rotheram-Borus, Bradley, Obolensky (eds). National Resource Center for Youth Services. University of Oklahoma. (1990).
This book does not directly address the needs of gay and lesbian youth (except for in a separate chapter), but given the above information, it is apparent that what follow as predictors of suicide are traits that many gay and lesbian youth are prone to.

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Making Schools Safe for Gay and Lesbian Youth: Breaking the Silence in Schools and in Families. Education Report, The Governor's Commission on Gay and Lesbian Youth, State House, Room 111, Boston MA 02133; 617-727-3600 x312; 1993, pp. 17-23.

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Prevention of Health Problems Among Gay and Lesbian Youth: Making Health and Human Services Accessible and Effective for Gay and Lesbian Youth. Health and Human Services Report, The Governor's Commission on Gay and Lesbian Youth, State House, Room 111, Boston MA 02133; 617-727-3600 x312; 1994, pp. 26-50.

Tremblay's paper "The Homosexality Factor in the Youth Suicide Problem" is available at this URL:

http://www.qrd.org/qrd/www/youth/tremblay/
This is the abstract: Suicidology has a history of not recognizing the homosexuality factor in suicide problems, but a suicide problem has existed in gay communities for the last 150 years. Non-random samples of GLB (gay, lesbian, and bisexual) youth have produced 20% to 50% attempted suicide rates. Their predictable over-representation in the attempted suicide problem, at least for GB males, has now been confirmed by Dr. C. Bagley's study of 750 randomly sampled young adult males. Homosexually active males accounted for 37.5% of suicide attempters, and the actual percentage may be higher. Study results and the related literature suggest that GLB youth of colour are at the highest risk for suicide attempts. Professionals working with youth generally lack the knowledge and understanding needed to help these "at risk" adolescents, and their socially induced interrelated problems may be exacerbated when they access often inappropriate services. Important changes in the youth problem prevention/intervention fields are mandatory. The Bagley study reveals that 87.5% of male youth suicide attempters were either sexually abused as children and/or are homosexually oriented. Data confirming a postulated GLB over-representation in worsening youth suicide statistics is lacking due to the poor quality of the research work.

Other important facts: - "In a study of gay male adolescents, 68% reported alcohol use (with 26% using alcohol once or more per week), and 44% reported drug use (with 8% considering themselves drug-dependent). Among young lesbians, 83% had used alcohol, 56% had used drugs, and 11% had used crack/cocaine in the three months preceding the study." --Rosario, M; Hunter, J; Rotheham-Borus, MJ. Unpublished data.

-A REPORT ON DROPOUTS IN CALIFORNIA states that, "family stress can also occur when children are older and can disrupt the lives of high school students who previously did well in school." In this report, family stress is one of the main reasons for dropping out. --CALIFORNIA DROPOUTS: A STATUS REPORT. CALIFORNIA STATE DEPARTMENT OF EDUCATION, 1986. We know from other studies mentioned here that being gay often creates a great deal of family stress when gay and lesbian youth confront their parents with their sexuality.

Other useful citations:

Alcohol, Tobacco, and Other Drugs Resource Guide--Lesbians, Gay Men, and Bisexuals; Dept. Health and Human Services Pub. No. (SMA) 94-2097. Contact: National Clearinghouse for Alcohol and Drug Information (NCADI), P.O. Box 2345, Rockville MD 20847-2345; 1-800-729-6686.

The New York State AIDS Institute for HIV prevention among gay youth funds a COFFEEHOUSE so that LGBT can gather in an alcohol-free, drug-free environment to reduce their crushing sense of isolation and hopelessness and boost their self-esteem.

A book due out in September from Doubleday/Anchor entitled Joining the Tribe features in-depth interviews with 15 young LGBT people. The author, Linnea Due, of the San Francisco Bay Area, found a very high dropout rate among these youth, despite their being highly intelligent.

The National Network of Runaway and Youth Services, 1-202-783-7949, 1319 F St. NW Suite 401, Washington DC 20004, has statistics about LGBT youth. They state "National Network members are increasingly aware of the large numbers of lesbian, gay and bisexual youth they serve, with some agencies reporting that these adolescents represent as many as 35 percent of their clients."

The federal government's Substance Abuse and Mental Health Services Administration (SAMHSA) has an LGBT resource at URL: http://www.health.org/features/lgbt/index.htm

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Last updated 10/16/2000 by Jean Richter, richter@eecs.Berkeley.EDU