2018 LGBTQ Youth Report

The Human Rights Campaign, in partnership with the University of Connecticut, conducted a survey of over 12,000 LGBTQ-identified youth ages 13 to 17 in the United States. QSPACES is here to breakdown some healthcare highlights.

Following a 2017 survey in partnership with the University of Connecticut, the Human Rights Campaign (HRC) just released one of the largest comprehensive reports on the state of LGBTQ youth in the United States. The survey, consisting of over 150 questions, follows the HRC’s 2012 work, which was a ‘first-of-its-kind’ national approach to understanding LGBTQ youth health and social needs, struggles, and experiences. While the recent report was not exclusively focused on healthcare, there is a lot of critical information embedded for mental health and medical professionals.

For one, the survey builds on a growing body of literature that highlights a few LGBTQ-specific drivers of positive mental and physical health in LGBTQ youth:

• Supportive and accepting families can positively impact LGBTQ youth health and have been shown to improve youth self-esteem and resilience and reduce rates of depression, distress, hopelessness and substance use.
• Outness is also positively associated with higher self-esteem and lower rates of anxiety and depression; being out and experiencing continual affirmation is shown to improve overall health and well-being.

Patient and family-centered healthcare approaches, as well as practitioner skill development, can help LGBTQ youth navigate experiences like coming out, transitioning, expressing gender and sexuality, and more. Specific trainings and ongoing workshopping are feasible considerations for healthcare improvement.

Transgender and gender-expansive youth face many serious challenges in the school system. In addition to more overt forms of discrimination such as verbal and physical harassment, they also commonly report being barred from using locker rooms or bathroom facilities that match their gender identity and not being addressed by the appropriate pronouns or their chosen names.

The report also highlights that in cases of disclosure of sexual orientation and gender identity, healthcare providers are missing critical connections to their LGBTQ youth patients. Nearly two-thirds of LGBTQ youth are not out to their healthcare providers, which is less disclosure than that seen to teachers, parents and coaches.

LGBTQ youth are out at varying levels. Many LGBTQ youth continue to manage to whom and in what contexts they are out regarding their sexual orientation or gender identity. The term “manage” is used to describe a scenario in which LGBTQ youth are not out to everyone in their life and therefore must constantly evaluate and decide in which environments and scenarios they are safe to selectively share information about their LGBTQ identity.

Healthcare providers are in a unique position to help LGBTQ youth experiencing some of the challenges that burden their community today, including disproportionate levels of mental health distress, homelessness, substance use, HIV and STIs, adverse childhood experiences and trauma, and more. However, practitioners must work more closely with the LGBTQ community and its allies to build safe, affirming relationships and environments for their LGBTQ youth patients.

In moving forward, the HRC plans to analyze the survey data with a greater focus on intersectional experiences, particularly for LGBTQ youth of color. Practitioners should engage with this information to broaden their perspectives and improve quality of care for their most vulnerable patients, including LGBTQ youth, youth of color and those experiencing homelessness, chronic illness, poverty and lack of social acceptance.

For more on the HRC and University of Connecticut’s LGBTQ Youth report, click here. All images are adapted from the HRC 2018 LGBTQ Youth Report.