Gathering prevalence information is fraught with difficulty; however, many behavioral health and healthcare professionals in the United States, knowingly or unknowingly, have or are likely to encounter LGB youth and their families in their practice. These professionals are in a unique position to help these youth and their families through the various transitions and other issues that they may encounter. Indeed, research suggests that the more these families accept their children, the better off the children will be in their health and well-being (Ryan & Diaz, 2011). This basic-level course begins its exploration of this youth population with a definition of terms, a model of identity development, and a focus on diversity considerations. The course then discusses four major areas that affect LGB youth in their development as adolescents. Because issues facing any adolescent are commonly also family issues, particular focus is paid to interventions from a family systems perspective, including an in-depth exploration of three models of family Understanding youth sexual orientation Although lesbian, gay, and bisexual (LGB) youth have always existed in the population, in the past few decades there has been a significant increase in the visibility of LGB adolescents. Counting the number of LGB youth in the United States is a particular challenge because responses to survey questions on sexual orientation tend to underreport LGB identity and the populations surveyed tend not to be nationally representative; moreover, youth may indeed not come out with LGB identification in adolescence. However, it is helpful to have some “ballpark” statistics to know that the chance of a professional working with an LGB youth is not only quite possible but also very probable. According to the American Academy of Pediatrics (AAP), up to 10% of the population may be lesbian, gay, or bisexual (AAP, 2014). It is very likely that there are many more youth who will question their identification and ultimately “come out” who are also not counted in surveys. Given this reality, it is vital that families provide stability and support for these youth as they develop their sexual orientation. Indeed, it is essential that practitioners help families identify supportive measures that optimize outcomes, as well as reject behaviors that can result in poor health and mental health outcomes for the youth (Ryan & Diaz, 2011). Origins of sexual orientation A common question is why someone is lesbian or gay. Of course, asking this question illuminates a larger question as to why someone is interested in the origins of a homosexual or bisexual orientation – after all, individuals tend not to ask about why someone is heterosexual. Nonetheless, the latest research suggests that a number of factors may be responsible for determining sexual orientation. The American Academy of Pediatrics believes sexual orientation is fixed and is created by a combination of factors, including genetic predisposition (AAP, 2014). Summing up the research, the American Psychological Association (APA; 2008) states: There is no consensus among scientists about the exact reasons that an individual develops a heterosexual, bisexual, gay, or lesbian orientation. Although much research has examined the possible genetic, hormonal, developmental, social, and cultural influences on sexual orientation, no findings have emerged that permit scientists to conclude that sexual orientation is determined by any particular factor or factors. Many think that nature and nurture both play complex roles; most people experience little or no sense of choice about their sexual orientation (APA, 2008, p. 2). In summary, it is important to recognize that there are probably many reasons for a person’s sexual orientation, and research in this area continues. It is also important to emphasize that an LGB sexual orientation is not pathological but, instead, is reflective of human variance. It is vital for practitioners to know that focusing
therapy (structural, solution-focused, and narrative) that can be applied to work with LGB youth and their families. The purpose of this course is to provide current information on issues and dynamics that affect LGB youth and their families, as well as best practices for working with this population. The target audience for this course is behavioral health and healthcare professionals, including psychiatric-mental health nurses, social workers, mental health counselors, marriage and family therapists, and psychologists; however, other professionals who interact with LGB youth will find this course useful. After successfully completing this course, the learner will have an increased knowledge and understanding of the LGB youth population, the issues that LGB youth face, and specific models of family and other interventions that may be used in working with these youth and their families. It is hoped that this course inspires practitioners to pursue advanced knowledge and skills that will strengthen their interventions with this population.
LGB YOUTH DEVELOPMENT
on why youth (and adults) are LGB might be interesting, but distracts from the larger goal of assisting them with normative development. Definitions It is important to begin with a clear understanding of definitions, which have caused confusion among professionals. Sexual orientation is the romantic/emotional and sexual attraction and affiliation that an individual experiences toward another. Heterosexual orientation (attraction to the opposite sex) has historically been perceived to be the only “normal” sexual orientation; however, as norms have changed and the American Psychological Association removed “homosexuality” from its Diagnostic and Statistical Manual of Mental Disorders, Second Revision (DSM-II) , list of psychological disorders in 1973 (and other mental health and medical associations followed suit), homosexual and bisexual sexual orientations have increasingly been seen as legitimate and genuine alternatives. As the terms associated with sexual orientation are reviewed, it is important for clinicians to keep in mind that as youth begin, and continue, their process of self-realization with respect to sexual orientation, the youth’s self- identification may develop in ways that are more flexible or fluid, and less rigid, than some of these terms indicate. Therefore, sexual minority is an umbrella term that can apply to this population of youth who are in the process of exploring and defining their sexual orientation that is outside of heterosexuality. Clinicians should be aware of this fluid self-identification process and be mindful of not being too rigid when helping youth and families work with the following labels. It is also important for clinicians to be mindful and think beyond the word “sexual” (which is part of the common terminology of sexual orientation and sexual minority ) when working with this population. This means that a youth’s attraction and behavior toward another person has emotional and romantic components as well, which are very important dynamics to assess and address in the clinical setting. Lesbian is a term some females use to describe their sexual orientation and attraction to other females, while gay is a term used by many males and some women to describe their same-sex sexual orientation and attraction. Bisexual is a term used by some individuals to describe their sexual orientation and attraction to both sexes. Bisexuality for some may be a step in the process on the way to recognizing her or his sexual orientation, or it may be the final recognition of identity itself for a person whose sexual orientation extends to individuals of both sexes. Heterosexism is a term that refers to the social belief that the world is and should be heterosexual. Heterosexism in the United States is presented in various forms, from the current federal restriction on the definition of “marriage” as between
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