A 2017 Youth Survey conducted by the Human Rights Campaign Foundation and the University of Connecticut of more than 12,000 LGBTQ+ young people shed light on the factors that contribute to higher rates of substance use, depression and anxiety in this population.[1]

Another study showed Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) teens may be two times as likely to be bullied, excluded or assaulted at school. And they are nearly 40 percent less likely to have an adult in their family to whom they can turn. So, it’s no surprise that they may be twice as likely to experiment with drugs and alcohol.[2]

Adolescents are receiving messages at light speed in regards to sex, sexuality and gender. Many may believe that in 2019, LGBTQ+ adolescents “have it easier” than years ago. We have been making strides in the world for the betterment of LGBTQ+ people, however having this bias can do a disservice for young people that may be seeking our counsel.

Young LGBTQ+ people are struggling with the same issues as their peers as well as the issues of being in a marginalized population. While cisgender / straight young people are focusing on school, grades, and future careers, many LGBTQ+ young people are trying to concentrate on success as well as coming out, acceptance, and the need for safety. It is important for us as clinicians to be aware of these dynamics so we do not pathologize their identities into diagnoses.

Young LGBTQ+ people do use alcohol and drugs at higher rates than their peers, much of this use is adaptive to the environment that they are navigating. Drugs and alcohol are the easiest and most convenient way to escape from reality. It is important for clinicians to understand that if they are not talking about gender and sexuality in sessions, they are missing out on reasons why their client may be using. Young people are forced to figure out their gender and sexual identities basically on their own, leading many get their information from the internet. Many young people may enter your office or facility with misinformation, and it is up to us as providers to address this misleading information. If it is not addressed we could be setting up our young people to fail and even causing them harm.

In the age of social media, there are pros and cons for LGBTQ+ young people online. Many LGBTQ+ individuals connect online. They connect online not only because they are adolescents, but because that is where they find community. If a young person cannot be their authentic self in the reality that surrounds them, then they will find it online. LGBTQ+ youth can play with gender online, they can get to know others who may have similar feelings or situations. There is info about sex and sexuality that a young person may not be receiving in school. Many sex education courses in school do not teach students about LGBTQ+ sex and bodies, therefore young people turn to the internet.

There are vast topics surrounding gender identity that one can research. As a clinician you may feel behind the times when a young person comes to your office speaking about a gender or sexual identity that you have never heard of and that is okay. The best way to get informed is by asking (and continuing your education). The best way to ask a young person who is talking about a gender or sexuality that you have never heard of is, “I have never heard that term before, would you like me to google it, or do you want to share with me what it is?” More often than not, a young person loves to share their identity in their own words. This also produces a space of vulnerability and being real with a young person. When engaging with young LGBTQ+ people it is important to be transparent and honest. There is no shame is not knowing, however it is our duty to put the emotional and educational labor on our shoulders rather than that of the young person. Throughout their day to day life they most likely have had to explain themselves numerous times over and over again, so having to do it in your office is tedious.

When working with young LGBTQ+ people you may be the first person to explore gender and sexuality with them.

In a recent study the Trevor Project reported that with only one supportive adult, it can cut the chances of suicide of a LGBTQI+ youth by 40%.[3] This statistic alone gives purpose to what we as therapists can do for young people. We may be the only person this young person can be honest with. We must hold that space very sacred and close to our hearts.

LGBTQ+ youth are resilient, strong, and have the ability to thrive as long as they are given the ample space to do so. We have the ability to affirm and give them the opportunities to live in their authenticity. With affirming therapeutic connection, LGBTQ+ youth will flourish.