Studies take closer look at mental health challenges for LGBTQ youth

(Reuters Health) - Lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth may be more likely than their heterosexual and gender-conforming peers to experience abuse, bullying and mental health problems, three U.S. studies suggest.

While plenty of previous research has documented a variety of psychological issues that can be more common among LGBTQ children and teens, these new studies published in Pediatrics offer fresh insight into the types of challenges these youth encounter that may negatively impact their mental and physical health.

One of the studies done in California and Georgia examined medical records for 1,333 transgender and gender-nonconforming children and teens and for more than 13,000 youth whose outward gender presentation matched their sex assigned at birth.

“In nearly all instances, mental health diagnoses were more common for transgender and gender-nonconforming youth than for youth who identify with the gender assigned at birth, also known as cisgender youth,” said lead study author Tracy Becerra-Culqui of the Kaiser Permanente Southern California Department of Research & Evaluation in Pasadena.

Transgender and gender-nonconforming children and teens were three to 13 times more likely to be diagnosed with conditions like depression, anxiety and attention deficit disorders than cisgender youth, the study found. They also had a much higher risk of suicidal thoughts and self-inflicted injuries than cisgender children and teens.

A second study examined survey data from almost 82,000 high school students in Minnesota and found LGBTQ adolescents were more likely to experience abuse and victimization than heterosexual teens.

While the majority of youth didn’t experience any abuse, bullying or victimization, LGBTQ youth in the study were still more likely to be victims of these behaviors and more apt to experience multiple forms of bullying, abuse, victimization or mistreatment, the study found. LGBTQ teens also tended to experience more severe forms of torment than heterosexual adolescents.

“The more gender nonconformity an adolescent reports, the higher their risk of experiencing abuse,” study author Laura Baams of the University of Groningen in the Netherlands said by email.

For the third study, researchers examined survey data from 2,396 teens and young adults and found lesbian, gay, bisexual and questioning youth were more likely to experience depression than their heterosexual peers.

The increased risk of depression may be explained in part by lower satisfaction with family relationships, greater exposure to cyberbullying and peer victimization, and more unmet medical needs, the study found.

“We know that LGBQ teens face discrimination because of their sexual orientation. In addition they may experience problems with family acceptance and more frequent bullying from peers,” said lead author Jeremy Luk of the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Rockville, Maryland.

“All of these factors are known risks for mental health problems,” Luk said by email. “Our study identified two additional sources of risk - victimization in cyberspace and unmet medical needs.”

None of the studies were controlled experiments designed to prove whether or how sexual orientation or gender identity might directly impact physical or mental health.

Taken together, however, the studies add to a large and growing body of evidence suggesting that LGBTQ youth are at higher risk for problems such as depression, anxiety, suicide, homelessness and substance abuse, said Dr. Stanley Ray Vance of the Child and Adolescent Gender Center at the University of California, San Francisco.

Parents can be part of the problem, Vance, coauthor of an accompanying editorial, said by email. Some parents may reject their child’s sexuality or gender identity and this may increase the chance of abuse, and other parents may try to change their child out of concern that life might be easier if a kid was heterosexual and gender conforming.

“It should be emphasized that LGBTQ youth are incredibly resilient, but they unfortunately face poor mental health outcomes and adversity,” Vance added. “Their childhood environment and experiences matter and reducing rejection, abuse and other adverse events could potentially make a difference.”

SOURCE: , , and Pediatrics, online April 16, 2018.