Kevin R. Gogin, director of the sexual minority services office for the San Francisco Unified School District, remembers the day he asked a newly arrived Chinese student how long he'd thought he might be gay.
"I'm not gay," the student responded to Gogin's surprise. "I want to be a doctor."
"He honestly believed that if one was gay, one could not be a doctor," says Gogin, explaining the apparent non-sequitur.
That example not only illustrates that stereotypes and misinformation still exist among youth, but that psychologists need to think carefully about how to approach sexual orientation with youth of color.
"These young people are dealing with multiple identity issues at the same time," says DePaul University psychologist Gary Harper, PhD, who works with Project VIDA, a Chicago community center assisting Latino and African-American young gay men. "This is a very difficult process, and they often don't have the support necessary to really engage in a healthy exploration of their identities."
Psychologists working with youth of color who identify as lesbian, gay or bisexual (LGB)--as well as those who question their orientation or engage in same-sex sexual behavior--need to recognize the variety of socioeconomic, family and cultural factors that influence their sexual behaviors and actions, say behavioral researchers in the field.
"Any psychologist who works with an LGB youth should make sure that they're educated about the ethnic group that person is from and that group's perceptions about being gay," says Harper.
A long way to go
Unfortunately, there is little research on how culture, socioeconomic class and sexual orientation intersect in young people's lives.
Even when it comes to the critical area of HIV prevention, "we essentially don't know anything about minority youth except that there is a higher prevalence of HIV infection among minority young men who have sex with men," says Margaret Rosario, PhD, a professor and researcher at The City University of New York--City College and Graduate Center.
What causes young African-American men who have sex with men to be nearly five times as likely as their white counterparts to contract HIV? Some psychologists theorize that it's the stress due to the extra pressures that minority LGB youth face, from coming out, to educating their families about their sexual orientation, to coping with harassment.
Harper recounts the story of one young gay man's explanation for not practicing safe sex: "He was saying, 'Well, HIV isn't really a big issue for me right now because I'm just worried about getting down the street without getting shot,'" he says. "We really have to understand the environmental factors that are going on."
In the absence of hard data to guide their work, psychologists who've developed an expertise in the area recommend that psychologists who work with LGB youth should:
Understand the impact of family. In his work with incarcerated gay youth, Terry Sai-Wah Gock, PhD, director of the Asian Pacific Family Center in Los Angeles, has found that many of them came from families that had problems accepting the youth for who they are. Being shunned by the family was often the first step toward trouble with the law, says Gock. The reasons behind a family's negative reaction vary. While some parents may feel that being gay is morally wrong, others may worry more about the possibility that there will not be future generations of the family.
Be educated about the youth's ethnic group and that group's perceptions of LGB people. Make sure assessments, interventions and research questionnaires take into account cultural values. For example, with some Asian youth, Gock suggests approaching HIV prevention from the angle of "By honoring my body, I am honoring my family and community."
Don't avoid religion. Many youth feel torn between their sexual orientation and their religion. Rosario suggests that psychologists link youth with local religious leaders who might be able to help them work through their religious beliefs instead of foreclosing on something the youth might be interested in or sensitive about.
Find resources and know when to use them. Because some families may not be able to provide all of the support a minority LGB youth needs, community agencies can play a key role in their lives. However, it's important to make sure the agency has programs targeted for young people and to consider whether a young person would do better at a neighborhood agency or one across town as well as whether a LGB-focused or culturally focused group would be best.
Talk about sexual health. Psychologists should address the risks of sexual activity, including HIV and other sexually transmitted diseases. However, it's important to do so in a positive way, experts say. At Project VIDA, says Harper, "the message is that your sexuality is normal" and there are things you can do to stay healthy (see Making a safe school environment for all students).
Make youth comfortable. Have magazines or pamphlets on hand that address LGB issues, advises Gogin. In addition, be aware that some youth can feel pressure to "come out" before they are sure they are lesbian or gay. "You have to be clear that whatever identity they choose is acceptable to you," says private practitioner and St. John's University psychology professor Beverly Greene, PhD. "You can support them in their journey without pushing them one way or the other."
Capitalize on strengths. "These are young people who have a lot of resilience and strengths," says Harper. "Too often we look at the negatives without really looking at it from a strengths perspective. These young people have lived through a lot, and we need to learn from their knowledge and work with them in a more collaborative manner to help them develop ways to live happier and healthier lives."
Bass, E. & Kaufman, K. (1996). Free Your Mind: The Book for Gay, Lesbian, and Bisexual Youth--and Their Allies. New York: HarperPerennial.
D'Augelli, A.R. & Patterson, C.J. (Eds.). (2001). Lesbian, gay, and bisexual identities and youth: Psychological perspectives. New York: Oxford University Press.
Ryan, C. & Futterman, D. (1998). Lesbian and gay youth: Care and counseling. New York: Columbia University Press.