Is there an emotional cost of completing high school? Ecological factors and psychological distress among LGBT homeless youth

Understanding Homelessness Among Young People to Improve Outcomes

In the United States, an estimated 4.2 million young people experience homelessness during critical stages in their development-adolescence and emerging adulthood. While research on youth homelessness often emphasizes risk and vulnerability, the field must situate these issues within the developmental trajectories of adolescence and emerging adulthood to effectively prevent and end youth homelessness. This review uses the Risk Amplification and Abatement Model (RAAM) as a conceptual framework for contextualizing the landscape of youth homelessness research in the United States since 2010. An extension of ecological models of risk-taking, RAAM emphasizes both risk and resilience, positing that negative as well as positive socialization processes across interactions with family, peers, social services, and formal institutions affect key housing, health, and behavioral outcomes for youth experiencing homelessness. This review applies RAAM to our understanding of the causes and consequences of youth homelessness, recent interventions, and recommendations for future directions.

Homelessness Among Sexual Minority Youth

OBJECTIVES

This study examines the prevalence and types of homelessness experienced by sexual minority and heterosexual youth. Then, we examine whether state-level nondiscrimination policies and/or public attitudes on sexual diversity are associated with reduced homelessness among sexual minority youth. Finally, we investigate the differences in health risk behaviors at the intersections of sexual minority and homelessness status.

METHODS

We conducted a secondary data analysis using a large population-based sample from 21 states collected in the 2017 and 2019 Youth Risk Behavior Surveys. Self-reported data were obtained from sexual minority (n = 28 405) and heterosexual (n = 136 232) youth through a survey administered in high schools. We assessed the prevalence of homelessness and the types of homelessness. Sexual minority-stratified bivariate and multivariable analyses assessed associations between homelessness, state-level policy and cultural environments, and health-risk behaviors.

RESULTS

Sexual minority youth were significantly more likely (12%) to be homeless compared with heterosexual youth (4.1%). Greater acceptance of sexual diversity at the state-level was associated with reduced homelessness among both sexual minority and heterosexual youth. Finally, homeless sexual minority youth experienced a broad array of health risk behaviors in excess of both nonhomeless sexual minority youth and homeless heterosexual youth.

CONCLUSIONS

Sexual minority high school students were more likely to experience homelessness than their heterosexual peers. Public attitudes and greater acceptance of sexual diversity were associated with lower levels of sexual minority homelessness. More research and public health programs are needed to prevent and address homelessness among sexual minority youth.

Measuring the prevalence and impact of adverse childhood experiences in the lives of LGBTQ individuals: A much-needed expansion

BACKGROUND

Numerous studies indicate that LGBTQ people have extensive experiences with adverse childhood experiences (ACEs), more so than their heterosexual and cisgender counterparts. Research also shows that LGBTQ youth endure traumatic experiences with victimization, including bullying, harassment, and violence, based on their non-hetero-cis-normative genders and/or sexual identities. Yet, most ACE measurement strategies fail to: (1) explicitly link the risk of ACE exposure to the discrimination and stigmatization of LGBTQ people, and (2) account for the breadth of potential ACE exposure in LGBTQ populations.

OBJECTIVE

In the current article, we develop and present a more comprehensive ACE measurement strategy for understanding the cumulative and deleterious impacts of ACEs in the lives of LGBTQ individuals.

METHODS

Here, we offer three expansions to the current ACE framework: (1) the inclusion of an LGBTQ-specific ACE in addition to the standard ACE measures, (2) the addition of LGBTQ qualifiers for current ACE items (when applicable), and (3) the expansion of ACE measures to capture the unique ACE experiences of LGBTQ individuals in family life, schools, and faith communities.

CONCLUSIONS

The implementation of a more comprehensive ACE measurement strategy will assist scholars and policymakers in better understanding the impacts of ACEs in the lives of LGBTQ individuals. In all, ACE measurement strategies that capture the breath of exposure of ACEs in the lives of LGBTQ individuals will assist in ACE screening, public health policy, and clinical intervention efforts.

'Bending' against straightening devices: queer lived experiences of sexuality and sexual health in Bangladesh

BACKGROUND

Despite global data around increased health risks among sexual and gender diverse populations, lived experiences of young lesbian, gay, bisexual, transgender, queer or questioning, and others (LGBTQ+) people are often ignored in mainstream health research. This is particularly evident in countries such as Bangladesh where the rights of sexual minorities are not recognised. This article looks at queer lived experiences of sexuality and sexual health within such a context. We use the phenomenological framework of heteronormative 'straightening devices' - mechanisms working to direct people towards heterosexuality, gender conformity, and procreative marriage - to identify 'invisible' structures upholding normative sexual behaviours and see how young people in Bangladesh navigate these in their everyday lives.

METHODS

This article is based on qualitative data collected in Dhaka, Bangladesh over nine months in 2019 as part of the first author's doctoral research. Using thematic analysis, we draw on experiences of normative sexual expectations from biographical in-depth interviews with 14 purposively sampled LGBTQ + individuals aged 18 to 24.

RESULTS

Respondents identified heteronormative expectations around gender norms of traditional behaviour and presentation for men and women as well as parental expectations of compulsory heterosexuality through marriage. These straightening devices existed at multiple levels, including individual, interpersonal, community, and societal. The four main themes around straightening devices include marriage norms for women; harassment of feminine-presenting bodies in public spaces; heteronormative healthcare; and consequences of not embodying heteronormativity.

CONCLUSION

Our study highlighted young people's everyday experiences of having to 'bend' to - and against - heteronormative straightening devices at home, in public spaces, and within institutions such as healthcare in Bangladesh. The exploration of queer experiences provides new insights into context-specific ways in which sexual and gender diverse people understand themselves. Further research using the framework of straightening devices can help public health professionals to identify more 'barriers' confronted by sexual and gender diverse young people.

Victimization and Resilience: Experiences of Rural LGBTQ+ Youth Across Multiple Contexts

LGBTQ+ youth experience higher rates of interpersonal violence, such as peer-based bullying and identity-based harassment, than their counterparts. Experiences of victimization can occur across different social contexts including family, school, peers, and community. LGBTQ+ youth in rural communities may be at increased risk for identity-based victimization due in part to geographic isolation and an often conservative value system that may create a hostile environment to LGBTQ+ individuals. However, few studies have examined the experiences of rural LGBTQ+ youth from their perspectives, and how the rural context may affect their experiences with victimization and social support. This qualitative study explores the victimization experiences of rural LGBTQ+ youth, the supports available to them, and ways they show resilience. We conducted qualitative interviews with a sample of 11 young people ages 12-21, recruited in partnership with a local LGBTQ+ agency across a rural five county region in the Southeastern United States. Four themes emerged related to how rural youth navigate bullying, harassment, and victimization across different social contexts and the support that is available to them: (1) conflicting family messages, (2) navigating personal safety at school, (3) connecting through technology, and (4) confronting negative religious sentiment. A fifth theme captures the strengths of young people in the mid of victimization: (5) demonstrating individual and collective resilience. Although rural LGBTQ+ youth experience victimization in similar ways to urban and suburban youth, rural youth may have less access to social supports that buffer effects of victimization. This study highlights the strengths in rural LGBTQ+ young people as well as their commitment to supporting one another and seeing change in their communities. Findings illustrate a need for greater support for LGBTQ+ youth in rural areas while leveraging existing strength of the youth and their community for sustainable support and resources.

Differences in the age-varying association of school belonging with socioemotional flourishing among minority and non-minority college and university students

Objective: This study aimed to assess the age-varying prevalence of and association between school belonging and flourishing among sexual or gender minority (SGM) and racial or ethnic minority (REM) students compared with non-minority students in the U.S. college setting. Participants: Data were drawn from a 2017-2018 national survey of U.S. college and university students ages 18-26. Method: Data were examined using varying-coefficients models to estimate the relation of school belonging and flourishing across ages 18-26. Results: SGM students (n = 6,718) and REM students (n = 10,539) reported significantly lower belonging and flourishing than cisgender heterosexual students (n = 19,492) and white students (n = 16,444), respectively, at several age points. The association of belonging with flourishing was significantly greater for SGM students than for cisgender heterosexual students across all ages. Conclusions: Findings of this study underline the important role of school belonging in socioemotional flourishing for SGM young adults.

Social support in schools and related outcomes for LGBTQ youth: a scoping review

Recent research has increasingly focused on positive factors and supports for LGBTQ youth. This scoping review explores existing social support for LGBTQ youth in schools through the Ecological Systems Theory to respond to the following four objectives: (1) define social support systems in schools, (2) identify current research on outcomes for LGBTQ youth, (3) identify barriers to support LGBTQ youth in schools, and (4) identify areas for future research for LGBTQ youth and social support in schools. A systematic search (Arksey and O'Malley in Int J Soc Res Methodol 8(1):19-32, 2005) between 2007 through 2021 resulted in 94 articles. This review gave rise to an organizational framework to consolidate various systems of social support for LGBTQ youth in schools. Social support consisted of seven social support systems (family, curriculum, family, peers, school policies, GSAs and programs, and school climate) that are positively associated with the promotion of positive socioemotional, behavioural, and educational outcomes for LGBTQ youth. Though the literature has been clear surrounding the risks associated with LGBTQ youth, this scoping review provides a positive outlook on LGBTQ youth's school experiences and how these systems of social support allow for LGBTQ youth to act as active participants to foster a positive school climate and sense of safety.

Supplementary Information

The online version contains supplementary material available at 10.1007/s44217-022-00016-9.

Hierarchical Analysis of Disparities in Suicidal Outcomes With Intersection of Sexual Minority and Gender Among U.S. Youth, 2017

Sexual minority youth have a higher risk of suicidal behaviors than their straight peers. Despite this alarming trend, there is limited information on how health-risk factors are systematically associated with suicidal outcomes in relation to the intersection of sex and sexual orientation identity. Data from the 2017 Youth Risk Behavior Survey (Grades 9-12, N = 14,108) were analyzed to examine three distinct suicidal outcomes (i.e., suicidal ideation, suicide planning, and suicide attempt). Separate hierarchical logistic regression models were performed to gradually adjust for influencing factors in examining the association between suicidal outcomes and sexual orientation identity (i.e., heterosexual, gay/lesbian, bisexual, and unsure), stratified by self-reported sex. There exist significant differences in youth suicidal behaviors based on sexual orientation identity and sex: lesbians (adjusted odds ratio [AOR] = 2.7, 95% CI [1.5, 5.0]), bisexual girls (AOR = 1.9, 95% CI [1.3, 2.6]) and bisexual boys (AOR = 2.6, 95% CI [1.3, 5.2]) had higher odds of suicide attempts than their straight peers. Unsure boys and girls also reported higher risks of suicidal ideation and suicide plan as compared with their straight peers. Having a very short sleep duration, reporting ever use of illicit drugs, being bullied, and feeling sad/hopeless were associated with elevated risks of suicidality across males and females. This study identified potential disparities in suicidal outcomes by sexual orientation identity as well as factors that attenuate or strengthen this relationship in a representative sample of adolescents across the United States. An improved understanding of the differences in suicidal outcomes will serve as an opportunity to ameliorate any potential inequalities and improve sexual minority youth' health outcomes.

Bullying at School and on the Street: Risk Factors and Outcomes Among Homeless Youth

Though rates of bullying among general population youth are high, there is elevated prevalence among certain subgroups, in particular sexual minority homeless youth. Enduring bullying can have devastating consequences, including poor mental health, revictimization, and substance abuse. The current study compares risk factors (i.e., sexual orientation, gender, and child abuse) for being bullied both at school and on the street among homeless youth. We also examine the associations of both contexts of bullying (i.e., at school and on the street) with physical and sexual victimization while on the street, with illicit drug use. From July 2014 to October 2015, we interviewed 150 homeless youth aged 16 to 22 years in shelters and on the streets from two Midwestern cities. Our sample was 51% female and 22% identified as lesbian, gay, or bisexual (LGB). Results revealed that LGB youth experienced more frequent bullying at school and were more likely to have ever used one or more illicit drugs at least a few times compared with heterosexual youth. Moreover, youth who experienced more child abuse prior to leaving home were also victimized more often at school (school bullying) and on the street (street bullying). Young people who experienced more sexual and physical street victimization were more likely to report illicit drug use compared with those who had fewer street victimization experiences. Overall, youth who experience victimization in one context (i.e., home) are at heightened risk for being bullied in additional contexts (i.e., school). These findings have important policy and service intervention implications, such that service providers should attend to homeless youth's multiple social contexts of victimization and the potential for youth's illicit drug use as a coping mechanism.

Pathways Into Homelessness Among LGBTQ2S Adults

This article examines entries into homelessness among adults who identify as LGBTQ2S (lesbian, gay, bisexual, transgender, queer, two-spirit). Twenty LGBTQ2S adults who were currently or formerly homeless participated in one qualitative interview. The interview protocol included questions on the participants' history of homelessness, causes of homelessness, and relationship of their gender and/or sexual identity to their homelessness. Data were analyzed using an iterative coding process. Results demonstrated that the participants listed both structural (i.e., discrimination) and intrapersonal (i.e., substance use) variables related to their homelessness. In particular, substance abuse was a common antecedent of their homelessness, and some participants linked their homeless experiences to discrimination and victimization based on their sexual and/or gender identity. The results are discussed in terms of interventions to prevent homelessness among LGBTQ2S adults and support their exits out of homelessness.

LGBTIQ+ Homelessness: A Review of the Literature

Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer (LGBTIQ+) people’s experiences of homelessness is an under-explored area of housing and homelessness studies, despite this group making up 20–40% of homeless populations. Despite this, much of the existing literature focuses on specific elements of LGBTIQ+ homelessness, and often does not consider the intersections of these elements, instead placing them into individual siloes. Our approach is an intersectional one; this paper identifies the key themes in the existing research, and analyses how these themes interact to reinforce the discrimination and stigma faced by LGBTIQ+ people who experience homelessness. This intersectional-systems thinking approach to LGBTIQ+ homelessness can be used to develop well-informed, culturally sensitive support programmes.

Homelessness among youth who identify as LGBTQ+: A systematic review

AIMS AND OBJECTIVES

To explore homelessness among lesbian, gay, bisexual, transgender, queer/questioning plus (LGBTQ+) youth and to identify their support and care requirements.

BACKGROUND

LGBTQ+ youth face many health and societal challenges including issues related to homelessness.

DESIGN

A systematic review of qualitative, quantitative and mixed methods studies.

METHODS

A search of relevant electronic databases was carried out and included the dates August 2008-August 2018 and limited to academic journals and peer-reviewed empirical studies written in English. Included studies specifically addressed the homeless experiences of youth aged 13-24 years old who identified as LGBTQ+. The PRISMA checklist was used in the review. A quality assessment instrument was used to review all of the selected papers and narrative methods utilised in the synthesis of the research evidence.

RESULTS

The search resulted in 319 papers, and after applying distinct inclusion criteria, a total of 14 papers were considered suitable for the systematic review. Following analysis, the four main themes identified were stigma, discrimination and exclusion; mental health issues and substance use; sexual risks and vulnerability; and interventions and supports.

CONCLUSION

LGBTQ+ homeless youth is a major public health concern that has significant consequences for a young person's physical and psychosocial well-being.

RELEVANCE TO CLINICAL PRACTICE

Practitioners need to be aware of the specific health and support requirements of LGBTQ+ youth in relation to homelessness. Inclusive and holistic care plans should exist that are fully responsive to the distinct needs of this group guided by definitive policies and sound clinical research. The implications for future nursing practice are presented and discussed.

Queer Youth in Educational Psychology Research

Despite greater social acceptance of individuals with diverse sexual identities across the world, queer students still experience greater bullying, poorer academic motivation, and lower school attendance than heterosexual students. Educational psychology could provide additional insight toward these experiences for queer students in school, but the field of educational psychology is often absent from research on queer students. To partially address this concern, the current article examines why researching queer students is important, reviews extant research on queer youth in predominant educational psychology journals, and provides potential avenues of future research. Further, the article explores protective factors that help queer students succeed in school.

Homelessness, Mental Health and Suicidality Among LGBTQ Youth Accessing Crisis Services

LGBTQ youth experience increased risks of homelessness, mental health disorder symptoms, and suicidality. Utilizing data from LGBTQ youth contacting a suicide crisis services organization, this study examined: (a) rates of homelessness among crisis services users, (b) the relationship between disclosure of LGBTQ identity to parents and parental rejection and homelessness, and (c) the relationship between homelessness and mental health disorder outcomes and suicidality. A nationwide sample of LGBTQ youth was recruited for a confidential online survey from an LGBTQ-focused crisis services hotline. Overall, nearly one-third of youth contacting the crisis services hotline had experienced lifetime homelessness, and those who had disclosed their LGBTQ identity to parents or experienced parental rejection because of LGBTQ status experienced higher rates of homelessness. Youth with homelessness experiences reported more symptoms of several mental health disorders and higher rates of suicidality. Suggestions for service providers are discussed.

A comparison of risk factors for various forms of trauma in the lives of lesbian, gay, bisexual and heterosexual homeless youth

Numerous homeless youth experience trauma prior to leaving home and while on the street. Bullying and trading sex (i.e. exchanging sexual favors for survival items such as food) are additional forms of trauma experienced by many homeless youth. Although lesbian, gay, and bisexual (LGB) homeless youth experience higher rates of child abuse compared to their heterosexual counterparts, there is a paucity of research comparing these two groups. As such, we compare whether difficulties finding items of necessity (e.g. food) and different forms of trauma including child sexual abuse, being bullied, trading sex, and street sexual victimization significantly differ for LGB and heterosexual homeless youth. Bivariate results reveal that LGB youth have more trouble finding shelter and are more likely to trade sex compared to heterosexual youth. Logistic regression results show that trading sex is correlated with street sexual victimization. In the second model, we find that being female, experiencing more child sexual abuse, and ever having traded sex are all positively linked with street sexual victimization. LGB youth are over-represented among homeless youth populations and are also more likely to trade sex; therefore, these young people need services that are widely accessible and specific to their needs.