A growing body of research demonstrates that LGBTQ youth face a number of increased social, mental health, educational and physical health concerns. It is not being LGBTQ that increases these risks. Rather, it is the lived experience of stigma, discrimination, isolation and prejudice that result in these challenges.
- Attempt suicide,
- Experience high levels of depression (Ryan, 2009),
- Use illegal drugs (Gaetz, 2004),
- Have high risk sexual encounters,
- Be involved in an unintended pregnancy (US Department of Health & Human Services, Office of Adolescent Health, 2012),
- Contract HIV and sexually transmitted infections (STIs) (Ryan, 2009),
- Experience assault,
- Experience dating violence,
- Have been sexually assaulted,
- Experience bullying (Centers for Disease Control and Prevention, 2014), and/or
- Be street involved or homeless (National Coalition for the Homeless, 2009).
I thought I was getting it together and now this. I was close to telling my friends I’m gay, but then I hooked-up with some girl at a party, and now I’m as confused as ever. I was sure that I was gay and that I like guys, but I’ve never had sex with a guy yet. When I told my aunt I was gay, she wasn’t surprised and even said that it’s all in the genes- I probably caught being gay from my uncle. Is it OK to like both guys and girls? What’s wrong with me?
A date beat me up last night. Gotta make some money you know. How else am I going to get my own place? Funny, they pay extra to get a girl like me, but then they get pissed off about it, like they’re worried that they’re gay or something. Maybe I deserve it, you know? Still better than my own dad being the one to punch me and call me lady-boy while my mom just stands by and watches him throw me out. She could have said something. I’d rather be here on the street than there…what kind of parents are they? I’m just sick of all of this.
- Sex: categories (male, female) to which people are typically assigned at birth. Sex assigned at birth typically appears on proof of identity documents, unless a person has documentation changed.
- Sexual orientation: a person’s emotional and sexual attraction to others. It can be fluid and may or may not reflect sexual behaviors.
- Gender/gender identity: a person’s internal sense of identity as female, male, both, or neither, regardless of sex assigned at birth.
- Gender expression: how a person presents their gender. This can include appearance, name, and pronoun. A cisgender person’s identity conforms to the cultural expectations of the sex assigned at birth.
Language is fluid. Some terms may have a negative meaning for some people and other terms go out of favor. Terms change and new terms become more accepted. Some words, like “queer” have been reclaimed by some members of the LGBTQ community; others find these words hurtful and offensive. Some words that were once commonly used, like “homosexual” or “hermaphrodite” are now generally considered offensive.
(Alberta Health Services, Sexual & Reproductive Health, Calgary Zone, 2015)
The gender identity, behaviors and appearance of a person moves along a gender spectrum and/or challenges gender restrictions and norms. Related terms can include gender queer, gender non-conforming, gender neutral, pangender, tri-gender, agender, non-binary gender, or gender independent.
A person whose gender identity, outward appearance, expression and/or anatomy do not fit conventional expectations of male or female. Sometimes used as an umbrella term for transsexual, cross-dressing and drag individuals, such as:
• FTM: Female to male transgender person.
• MTF: Male to female transgender person.
- Active listening,
- Having encouraging and positive body language,
- Talking about and supporting a youth’s LGBT identity,
- Advocating for a youth when they are mistreated,
- Bringing youth to LGBT organizations or events,
- Connecting youth with an LGBT role model,
- Working to make a faith community supportive of LGBT members or find a supportive faith community that welcomes LGBT youth and their families,
- Welcoming a youth’s LGBT friends and partner,
- Supporting a youth’s gender expression, and
- Believing youth can have a happy future as LGBT adults (Ryan et al., 2010).
- Expressing disappointment when youth come out,
- Discounting or ignoring LGBT youth,
- Physical or verbal abuse,
- Excluding youth,
- Blocking access to LGBT friends, events and resources,
- Blaming youth if they are discriminated against,
- Pressuring youth to be more or less masculine or feminine,
- Telling youth that God will punish them because they are LGBT, and
- Telling youth to keep LGBT identity a secret and not letting them talk about it (Ryan, 2009).
People are usually aware of their gender identity in early childhood (American Academy of Pediatrics, 2015), but gender expression and understanding of gender identity may shift over time.
Children often experiment with gender roles. This is typical child development. Children who are transgender have consistent mild to severe discomfort with the sex they were born with and this can include confusion or stress about their genitals and expressing unhappiness at being the gender they have been assigned (Children’s Hospital of Eastern Ontario [CHEO] & Fedoroff, 2014).
- Focus on the client and their needs not their sexual orientation or gender identity.
- Avoid making assumptions about gender, sexual orientation, sexual behaviors/practices, family structures, or relationships.
- Use inclusive language and be aware of non-verbal communication such as facial expression, body language and tone of voice.
- Communicate as respectfully about people as you do to people. People recognize when these are not consistent.
- Express willingness to learn about individual needs. Listen to what the client is saying, both in their words and in non-verbal communication.
- Acknowledge and apologize for mistakes and slip-ups without dwelling on the issue.
- Protect the confidentiality of all information. This includes not revealing gender identity or sexual orientation to others, even those who may be present at an appointment or session between the client and service providers.
- Provide all-gender bathrooms and change rooms.
- When possible, avoid separating people according to sex. When separation is required, consideration needs to be given to the client’s gender identity.
- Include images of sexually and gender diverse people and families in posters, literature, and resources.
- Create a non-discriminatory policy and code of conduct outlining the expectations and responsibilities of staff and clients.
- Post a non-discriminatory statement that equal service will be provided to all clients regardless of age, sex, race, gender identity, gender expression, sexual orientation and religion.
- Consider displaying LGBTQ welcoming symbols such as the rainbow flag.
- Take the time to learn more about LGBTQ inclusive practice. It is important for all staff (e.g., clerical, administrative, security, custodial, technical, executive, volunteer, and front line workers). For more information, see the resources below.
- Teachers calling their classes to attention by saying “OK boys and girls;” or
- Admission forms asking to identify as either female or male.
- Joking or teasing about biological sex, gender identity or sexual orientation (such as, “you throw like a girl” or “that’s so gay”), or
- Using derogatory slang (such as, homo or tranny).
- Crisis phone numbers
- Peer chat or phone support
- Social support
- Mental health services and resources
- Addiction treatment
- STI testing and treatment
- Sexual health clinical services
- Anti-bullying information and advocacy
- Victims of violence support
- Domestic, dating and intimate partner violence education, prevention and safety planning
- Housing first initiatives
In addition to using the tips provided above, service providers can offer support by referring LGBTQ youth to these community services:
Crisis phone numbers
To learn more about support, resources, inclusive practice and sexual diversity, see here:
Alberta Health Services. (2011). E-SYS. Enhanced street youth surveillance Edmonton site results (1999-2010). Edmonton AB: Communicable Disease Control, Alberta Health Services.
Alberta Health Services, Sexual & Reproductive Health, Calgary Zone. (2015). Sexual and gender diversity: Patient experience pilot project final report. Calgary: Author.
American Academy of Pediatrics. (2015). Gender non-conforming and transgender children. Retrieved from https://www.healthychildren.org/English/ages-stages/gradeschool/Pages/Gender-Non-Conforming-Transgender-Children.aspx
Centers for Disease Control and Prevention. (2014). Lesbian, gay, bisexual and transgender: LGBT Youth. Retrieved from http://www.cdc.gov/lgbthealth/youth.htm
Children’s Hospital of Eastern Ontario [CHEO], & Fedoroff, P. (2014). Gender identity and diversity. Retrieved from http://www.cheo.on.ca/en/genderidentity
Gaetz, S. (2004). Safe Streets for Whom? Homeless youth, social exclusion and criminal victimization. Canadian Journal of Criminology and Criminal Justice, 423-455.
National Coalition for the Homeless. (2009). LGBT homelessness. Retrieved http://www.nationalhomeless.org/factsheets/lgbtq.html
Ryan, C. (2009). Supportive families, healthy children: Helping families with lesbian, gay, bisexual and transgender children. San Francisco: San Francisco State University.
Ryan, C., Russell, S. T., Huebner, D., Diaz, R., & Sanchez, J. (2010). Family acceptance in adolescence and the health of LGBT young adults. Journal of Child and Adolescent Psychiatric Nursing, 23(4), 205-213.
US Department of Health & Human Services, Office of Adolescent Health. (2012). LGB Youth: Challenges, risks and protective factors. Retrieved from http://www.hhs.gov/ash/oah/oah-initiatives/teen_pregnancy/training/tip_sheets/lgb-youth-508.pdf