What problems do gay or lesbian adolescents face when dating quizlet

In the previously mentioned study by McCabe and colleagues , no difference in heavy episodic drinking was found between self-identified bisexual and heterosexual females, but there were significantly higher rates of heavy episodic drinking among behaviorally bisexual than behaviorally heterosexual females. In contrast, self-identified and behaviorally bisexual males were significantly less likely than heterosexual males to engage in heavy episodic drinking McCabe et al.

Differences in drug use and abuse based on sex may exist among LGB youth. In the previously mentioned study by Ford and Jasinski , bisexual females were more likely than either heterosexual or homosexual students to have used marijuana and other illicit drugs. Other studies support this finding, with self-identified and behaviorally bisexual students, especially females, being more likely than any other group e. On the other hand, McCabe and colleagues did not find a significant difference in rates of illicit drug use among homosexual, bisexual, and heterosexual college males.

In a community-based sample of young men who have sex with men aged 16—24, methamphetamine use was identified as correlated with high-risk sexual behavior as well as with specific sexualized social contexts for example, the Internet, bathhouses Garofalo et al. The literature highlights a number of potential mediators of substance use in LGB youth. In a study of LGB youth aged 14—21, receiving a rejecting reaction to disclosure of sexual orientation was associated with use and abuse of alcohol, cigarettes, and marijuana Rosario et al.

Tucker and colleagues examined other psychosocial factors that may predict substance use among young women.

Results of a longitudinal survey of approximately 1, young women based on self-reported sexual orientation as either bisexual or heterosexual participants identifying as lesbian were not included in the analysis suggest that as adolescents, bisexual women were more likely to have been substance users. Self-identified bisexual participants were also more likely than self-identified heterosexual participants to report holding beliefs in support of drugs, greater perceived parental approval of substance use, increased exposure to peers who used substances, and poorer mental health.

By age 23, bisexual women in the study had higher rates of current substance use, greater quantity and frequency of use, and more problematic use Tucker et al. Almost no research has examined substance use among transgender youth. Although self-identified LGB youth engage in greater substance use and earlier initiation of use than heterosexual youth, sufficient evidence does not exist in the literature to determine whether this trend levels out with age.

The committee was unable to locate longitudinal or natural history studies examining issues of substance use in these populations. Such studies would be helpful in discerning how patterns of use change over time and whether greater use relative to heterosexual youth levels off as these young people age into adulthood.

There also has been little research on interventions specifically targeting substance use in LGBT youth. Lesbian , gay, and bisexual youth are disproportionately represented among the homeless youth population. Studies of homelessness using a variety of samples have reported that 22—35 percent of their samples comprise sexual-minority youth Cochran et al.

Studies specific to sexual minorities suggest that LGB youth are at increased risk of homelessness Cochran et al. Furthermore, Gwadz and colleagues report that, in their sample of young men who have sex with men, the probability of becoming homeless increased with age. Additionally, compared with young men who have sex with men who self-identified as homosexual or gay, the likelihood of homelessness was four times greater for those young men who have sex with men who identified as heterosexual, three times greater for those who identified as bisexual, and twice as likely for those who identified as transgender.

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The literature tends to define sexual orientation by behavior rather than by identity or attractions, thereby failing to account for the unique challenges faced by youth who engage in same-sex survival sex sex for money, food, etc. Therefore, these findings are especially useful in helping to identify how sexual identity as opposed to sexual behavior may impact risk. A review by Coker and colleagues highlights that the general risks associated with homelessness are exacerbated for LGB youth. In studies examining both sexual-minority and heterosexual homeless youth, the sexual-minority youth were shown to be at significantly greater risk for mental health issues Cochran et al.

And various studies have found that young men who have sex with men are significantly more likely than young heterosexual men to engage in survival sex after becoming homeless Gangamma et al.

DEVELOPMENT OF SEXUAL ORIENTATION AND GENDER IDENTITY

The literature also suggests that homeless young men who have sex with men are more likely than nonhomeless young men who have sex with men to use controlled substances Clatts et al. Therefore, it is apparent from the literature not only that LGB youth are at greater risk for homelessness than their heterosexual peers, but also that once homeless, LGB youth are more likely to experience multiple risk factors and significantly more negative outcomes. Research on LGB homelessness has utilized both cross-sectional and longitudinal designs, and most studies have occurred in large, urban settings.

The majority of samples have been recruited through venue-based convenience sampling and with the assistance of social service agencies. To the best of the committee's knowledge, there has been no published research on interventions directed at decreasing homelessness or alleviating negative outcomes among homeless LGB youth.

More problematic is that there has been very little research focused directly on the specific needs of homeless youth who are LGBT. Given the magnitude of the risks to which sexual- and gender-minority homeless youth are exposed, the scholarship on this particular issue lacks the depth needed to fully assess the problem or to inform the development of interventions. For example, the majority of studies provide comparisons of homeless LGB and heterosexual youth, outlining the basic risks without examining the mechanisms of those risks in depth. Understanding the mechanisms of risks is critically important, as highlighted by the case study of HIV in Chapter 2.

In the case of HIV, the failure to examine mechanisms of risk among LGBT youth, specifically young men who have sex with men and young transgender women, has hindered the development of interventions for these high-risk groups. There is almost no literature examining the risks of homelessness faced by transgender youth. The limited research that has been done on transgender females using small convenience samples suggests that they are at significant risk for homelessness Garofalo et al.

There are hardly any data on homelessness among transgender males. Chapters 5 and 6 present some of that literature. However, in secondary analyses of data from seven population-based high school health surveys in the United States and Canada, Saewyc and colleagues found that the prevalence of sexual and physical abuse was significantly higher for sexual minorities than for their heterosexual peers in nearly all of the surveys. More research is needed to determine what impact childhood emotional, physical, and sexual abuse has on LGBT youth, including how disclosure or nondisclosure of sexual identity relates to this abuse; when the abuse is taking place; and what interventions might be appropriate.

While some may view the absence of risk factors as protective, there is, as noted earlier, a paucity of data on specific protective factors that affect the health of LGBT youth. When examining protective factors, it is important to focus on multiple levels: The few studies that have examined protective factors for LGBT youth have considered individual and interactional factors, such as self-esteem Savin-Williams, a , b , school support, and family relatedness Eisenberg and Resnick, Saewyc and colleagues , using data from six large-scale school-based surveys, compared family connectedness, school connectedness, and religious involvement among bisexual adolescents with the same protective factors among heterosexual, mostly heterosexual, and homosexual adolescents.

The results showed that in almost all of the cohorts, bisexual adolescent boys and girls tended to report lower levels of family and school connectedness compared with heterosexual adolescents. Similarly, Sheets and Mohr examined the relationship between social support and psychosocial functioning in self-identified bisexual college students aged 18—25 and found that the level of support of both family and friends predicted depression, life satisfaction, and internalized negative feelings about bisexuality. The researchers found that family connectedness, adult caring, and school safety were significantly protective against suicidal ideation and attempts.

The systemic exposure to stigma that LGBT children and adolescents experience from early ages calls for studying protective factors that are unique to LGBT youth in addition to those that can be found among heterosexual youth Russell, While little research has focused on protective factors unique to LGB youth, several studies may provide insight. These findings may warrant further research. Another potential protective factor may be disclosure of sexual identity. In one study of LGB youth participating in an HIV prevention program, youth who disclosed their sexual identity to more people in their support networks were less likely to have high levels of distress related to their sexual identity, which has been associated with mental health problems in LGB youth Wright and Perry, However, disclosure of identity is a multifaceted issue, and as noted in the above discussion of risk factors, may also lead to harassment and victimization D'Augelli, Ryan and colleagues found protective effects related to specific accepting family reactions to adolescents' LGBT identity—such as advocating for the youth when they were discriminated against or welcoming their LGBT friends and partners to family events and activities.

A small body of research has begun to evaluate the impact of school policies and procedures on the experiences of LGB students Szalacha, Goodenow and colleagues analyzed data from the Massachusetts Youth Risk Behavior Survey and a state survey of high school principals to examine the relationship among school supports, victimization, and suicidality among LGB youth.

They also found that sexual-minority youth in larger schools with more low-income and ethnically diverse students experienced lower rates of victimization and suicidality. In the previously mentioned study by O'Shaughnessy and colleagues , results showed that students at schools with antiharassment policies reported feeling safer and less likely to be harassed.

Similarly, students were less likely to report being harassed or feeling unsafe at schools with gay—straight alliance clubs and teachers who intervened to stop harassment. Another study comparing sexual minorities at colleges with and without LGB resources found that sexual-minority women were less likely to smoke at colleges with LGB resources, but sexual-minority men were more likely to binge drink at these same colleges Eisenberg and Wechsler, b. These conflicting findings indicate the need for further study to understand protective factors.

In addition to addressing specific needs related to sexual orientation and gender identity, primary care for LGBT adolescents, as for all adolescents, should be sensitive, comprehensive, and high-quality. Preventive health and health maintenance visits should include periodic, private, and confidential discussions of a range of health and health-related issues, including sexuality and sex Frankowski and American Academy of Pediatrics Committee on Adolescence, These discussions should address identity-related feelings and concerns, as well as behaviors and experiences that can affect health and development.

With the recent implementation of health care reform, access to health services has increased for many youth since they can now be covered under their parents' insurance until age However, this increased access may be less relevant for those LGBT youth who are not cared for by their families. In some U. In addition to primary care services, these centers provide other services, such as case management, counseling, and support groups.

Organizations such as the Gay and Lesbian Medical Association have websites that offer listings of health care professionals who are able to provide appropriate care to LGB patients. However, not all LGB youth have access to such centers or health care professionals; most receive health care from providers in their own community who also provide care to non-LGB youth. Nationally, family physicians are the primary care providers for the majority of youth aged 15—24, and overall they are insufficiently trained to provide care to LGBT youth IOM, As with LGB youth, while centers exist that specialize in providing care to transgender patients, not all transgender youth have access to these centers.

Studies utilizing convenience samples of LGBT youth show that they value the same health provider characteristics as other youth. Specifically, they wish to receive private and confidential services, to be treated with respect and honesty, and to be seen by providers who are well trained and have good listening and communication skills Ginsburg et al. Whether LGB or straight, adolescents often are uncomfortable with initiating discussions about sex including sexual orientation with their providers; thus, it is incumbent on those who provide health services to youth to initiate such discussions.

Studies of LGB youth using small convenience samples show that substantial percentages have not disclosed their sexual orientation to their physician; these include youth who describe themselves as being out to almost everyone in their lives Allen et al. In a sample of 60 pediatricians and adolescent medicine specialists responding to a mailed survey, more than half reported that they do not usually include sexual orientation in their sexual histories, and a large majority had some reservations about broaching the issue with patients East and El Rayess, In a more recent self-administered survey, most physicians reported that they did not discuss sexual orientation, sexual attraction, or gender identity with their adolescent patients.

What problems do gay or lesbian adolescents face when dating quizlet • Choochoo-ca-Chew

A majority of respondents indicated they would not address sexual orientation even if their patient were depressed, had suicidal thoughts, or had attempted suicide. Physicians reported that they did not feel they could adequately address sexual orientation issues with their patients Kitts, In a similar study, 70 percent of physicians reported that they did not discuss sexual orientation with their adolescent patients.

Many of those physicians reported a fear of offending patients and a lack of knowledge about the treatment needs of sexual-minority patients Lena et al. Furthermore, data from a variety of samples suggest that many clinicians may have negative attitudes toward LGBT individuals. These attitudes may affect clinicians' ability to provide appropriate care to these populations Kaiser Family Foundation, ; Klamen et al. The health of LGBT children and adolescents is shaped by contextual influences such as sociodemographic and familial factors. Limited research exploring these factors has been conducted.

Few recent population-based studies have published substantive sociodemographic findings on LGBT youth. However, studies with smaller samples suggest that sociodemographic factors play a role in the lives of LGBT youth. For example, in a community-based sample of sexual-minority youth aged 14—21, Rosario and colleagues found racial and ethnic differences in the timing of the coming out process.

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Similarly, a recent retrospective study of a community-based sample of LGBT young adults on family acceptance during their adolescence found an association between family acceptance and parental job status, with highly accepting families having higher parental job status Ryan et al. The same study also explored religion as a factor in family acceptance and found that participants who reported a religious affiliation in childhood also reported lower family acceptance compared with participants with no childhood religious affiliation Ryan et al.

Drawing on population-based data obtained from students in 7th through 12th grades in British Columbia, Poon and Saewyc compared adolescents from rural and urban areas. They found differences between the groups on some health outcomes for example, rural sexual-minority youth were more likely than their urban peers to binge drink and further noted that the interaction between gender and location produced different outcomes.

Rural boys were more likely to have considered or attempted suicide in the past year than rural girls or urban boys, and rural girls were more likely than urban girls or rural boys to have been physically assaulted at school. More community-based and population-based research on the lives of LGBT adolescents is needed to document the role of sociodemographic factors and their impact on health. Community-based research can help inform the questions in this area for population-based surveys. Although connections to family have been shown to be protective against major health risk behaviors, the literature on LGB youth and families has been very limited in scope and quantity, and has focused mainly on negative aspects of the relationships between LGB youth and their parents.

Little research has examined the family experiences of transgender youth.

Exceptions include research conducted by Grossman and colleagues Grossman and D'Augelli, ; Grossman et al. Family-related research has been based on reports of LGBT youth themselves and rarely on reports of parents or other family members, especially among ethnically diverse groups. Research has continued to document fear of coming out to parents D'Augelli et al.