Adolescence is tough. But for teens who are lesbian, gay or bisexual (LGB)--or think they might be--research has found that growing up can be even tougher. In fact, LGB youth report higher levels of emotional distress, greater use of marijuana and earlier sexual debut, according to a 1997 Journal of the American Medical Association article (Vol. 278, No. 10) that studied data from the National Longitudinal Study on Adolescent Health.
Other studies have found LGB youth at high risk for eating disorders, unintended pregnancy and trauma/sexual assault.
"Clearly there's a need to think about how we as professionals can more effectively serve these students," says Karen Anderson, PhD, director of APA's Center for Psychology in Schools and Education and assistant executive director of APA's Education Directorate.
To address the special needs of this population, APA is collaborating with six professional associations on a group effort called the Healthy Lesbian, Gay and Bisexual Students Project.
Now in its third year, the project's focus is on giving school counselors, social workers, nurses and psychologists the tools they need to assist students with health and mental concerns, stop harassment and positively affect their school climate. Working with APA on the initiative are the American Counseling Association, American School Counselor Association, National Association of School Nurses, National Association of School Psychologists, National Association of Social Workers and the School Social Work Association of America.
"We know that many LGB youth are not receiving salient information on health risks," explains J. Davidson Porter, PhD, project manager in APA's Education Directorate.
That's especially troubling, he says, since HIV-infection rates among young men who have sex with men continue to be alarmingly high. Particularly at risk are young men of color who have sex with other men (see chart), as well as young women of color, who are at risk through sexual activity with bisexual young men.
"We believe these professionals, through their contact with students, may have the chance to engage in a conversation with an LGB youth around health and mental health," explains Porter.
Survey identifies needs
The project, co-directed by Karen Anderson and APA's Lesbian, Gay and Bisexual Concerns Officer Clinton W. Anderson, has five years of funding from the Centers for Disease Control and Prevention and has divided its work into three phases.
In the first year, the staff built relationships between the collaborating associations and with schools, teachers, parents and others. This outreach included giving presentations about the needs of LGB youth at meetings across the country. During the second and third years, the project has focused on assessing what professionals need to serve LGB youth and developing materials to address those needs. The project has just analyzed results of a survey of about 1,000 high school-based counselors, psychologists, social workers and nurses, which pinpointed the realities these professionals face when dealing with LGB youth:
Most believe that LGB students are at a greater risk than heterosexual students for health and mental health concerns, including low self-esteem, anxiety, depression, attempting suicide, substance abuse and harassment.
Sixty-three percent have counseled an LGB student (defined as one who identifies as LGB, is questioning his or her sexual orientation, engages in same-sex behaviors or appears to be attracted to members of his or her own sex) because of peer harassment. However, only 39 percent have intervened with the harasser.
Most have not counseled a student on sexual orientation, sexual risks, safer sex or HIV testing, but most agree that their role should include these things.
Half agreed that there is a lack of administrative support for LGB youth, and 89 percent say that school staff have negative attitudes about LGB people.
More than four out of five professionals agreed that a lack of training, knowledge, skills and materials, along with negative staff attitudes and students' fears of disclosure, are barriers in their schools to providing services for LGB youth.
Few received training in college preparing them to provide services for LGB students, and of those who did, few found it adequate. Slightly more report receiving on-the-job training or education, and about half of those who did found the training useful.
The project will use the results of the survey to develop tool kits on LGB youth for each profession. The school counselor kit, for example, will include information on legal and ethical concerns, resources to use with LGB youth and their families, information on providing interventions and resources to help counselors improve their school climate. The kits should be available next spring.
The third phase of the project, which comprises years four and five, will focus on providing training activities at national and regional conferences as well as conducting two pilot projects in a local and a state school system to create healthier environments for LGB students.
This spring, the staff will begin to establish relationships with the professionals of Philadelphia city schools and Connecticut public schools. Over the next two years, the project will provide the counselors, psychologists, nurses and social workers with information on LGB youth and training to work with other school officials on the endeavor.
"We will create a training plan tailored to the school systems," says Porter. "Unlike at a national conference, the pilot projects can reflect the current state of practice, local laws, state statues and use community-based organizations for referrals."
The project hopes the end result will be that more LGB youth get the information they need to reduce the risk of HIV-infection and other health problems and to create an improved school climate. If successful, the project plans to make this kind of intervention the focus of its future efforts.
"When you work with individual schools or organizations of schools, there's a better chance for them to work on concrete steps, to build alliances and think about what's happening with LGB youth than if they just heard our presentation at a convention," explains Porter.
For more information about the Healthy Lesbian, Gay and Bisexual Students Project, contact Dusty Porter at (202) 336-5977 or e-mail: HLGB.