Fact Sheet on LGBT Youth Health Education Needs Fact Sheet on LGBT Youth Health Needs and Issues, which schools presently fail to address: SUICIDE LGBT youth are 2-3 times more likely to attempt suicide that heterosexual young people. It is estimated that up to 30% of the completed youth suicides are committed by LGBT youth annually. Gibson, Paul. LCSW, "Gay Male and Lesbian Suicide," Report of the Secretary's Task Force on Youth Suicide, U.S. Department of Health and Human Services, 1989. Typically, adolescent females are at far greater risk (10.3% attempt suicide) as compared to males (6.2% attempt suicide). In contrast to overall rates among adolescents in community-based studies, attempted suicide was reported by 39% of a consecutive series of 138 self-identified gay and bisexual males, ages 14 through 19, presenting at a social service agency for lesbian and gay adolescents in NYC. More than one-half of attempters had tried to kill themselves more than once, and suicide attempters were more likely to have dropped out of school, to be ejected from their homes, and to have friends or relatives who attempted suicide. Gay-related stressors were significantly more common among suicide attempters as compared to nonattempters, but general life stress was not higher. Rosario, M, Hunter, J., Rotheram-Borus, M.J. Journal of Adolescent Research, (Sage Publications) Vol. 9, No. 4, Oct. 1994, pp. 498-508. SCHOOL ENVIRONMENT 80% of LGB youth report severe problems due to cognitive, social and emotional isolation. Hetrick, E.S., Martin, A. D. "Developmental Issues and Their Resolution for Gay and Lesbian Adolescents." Journal of Homosexuality, 1987. 13(1/2): 2543. HOMELESSNESS: 26% of LGBT youth are forced to leave home because of conflicts with their families over their sexual orientation. NGLTF, "Anti-Gay/Lesbian Victimization," New York, 1984; and Remafedi, G. "Male Homosexuality: The Adolescent's Perspective," Pediatrics, 79:326-330, 1987. LGBT youth constitute up to 25% of all youth living on the streets in the U.S. U.S. Dept. of Health and Human Services, 1989. CHEMICAL ABUSE In a study of gay male adolescents, 68% reported alcohol use and 44% reported drug use. 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 Rosario, M, Hunter, J., Rotheram-Borus, M.J. Unpublished data on lesbian adolescents, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute, NY NY 10032, 1992. HIV/AIDS
The factors that place LGBT youth at very high risk for HIV transmission include: denial of sexual identity, unsafe sex, substance abuse and having to exchange sex for money. HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute, NY NY 10032, 1992 and an unpublished June 1995 paper by Joyce Hunter and Priscilla Alexander entitled "Women Who Sleep with Women." Additionally, while the personalizing of knowledge about AIDS is known to be crucial in successful prevention strategies, "For lesbian and gay adolescents, the barriers to personalizing knowledge about AIDS are further complicated by a host of issues not faced by their hetersexual peers," including fear of coming out, isolation, and lack of access to resources welcoming to them specifically. Hunter, J., Schaecher, R. "AIDS Prevention for LGB Adolescents," Families in Society: The Journal of Contemporary Human Services, 1994, pp. 346-354. Research on Health Education Needs of LGBT Youth Those trying to obtain health education in public schools which addresses the presently unmet needs of LGBT youth in the schools will find the results of The P.E.R.S.O.N. Project's 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.
== 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: o Professional development--we need to educate ourselves o Support staff and services-- i.e.- nurse, guidance counselors, psychologist--should be educated about gay and lesbian issues. o Sexuality in the health curriculum--not just in the context of AIDS o Library--should have information, booklists and positive media attention to gay and lesbian issues. o Curriculum--only demands education of staff. The critical word is inclusion.
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.
== 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
== 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 selfstimulation--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 selfesteem 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.
== 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.
== 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.
== Lesbian, Gay and Bisexual Youths in Community Settings. D'Augelli & 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 couldn't 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 selfesteem.
== 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.
== 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. They're 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.
== 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.
== >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.
"Substance abuse and suicide" (chapter 2). Klitzner, Blasinsky. o We have already established in earlier articles that substance abuse is high in the gay and lesbian population. If educators are concerned about suicide in gay youth, they should pay attention to substance abuse as well. o Though specific nature of relationship is unclear, it is very clear (from various sources of research) that there is a relationship between suicide and substance abuse. o Possible relationships: substance abuse causes suicide; depression as the root cause for both; both as maladaptive coping mechanisms (stress is a precursor)
"Evaluation of Suicide Risk" (Chapter 5). Rotheram-Borus, Bradley o Following are predictors of suicide, based on a variety of studies. o Depression--as many as 65% of attempters were depressed before attempting o Drug and Alcohol abuse--37% of suicide attempters abuse drugs. o Problems in school--social and academic o Family conflict o Poor peer relationships
== 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. == 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. 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 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."