Lesbian, gay, and bisexual students (LGB) and those questioning their sexual orientation are often at great risk for negative outcomes like depression, suicidality, drug use, and school difficulties (Elliot and Kilpatrick, How to Stop Bullying, A KIDSCAPE Guide to Training, 1994; Mufoz-Plaza et al., High Sch J 85:52-63, 2002; Treadway and Yoakam, J School Health 62(7):352-357, 1992). This study examined how school contextual factors such as homophobic victimization and school climate influence negative outcomes in LGB and questioning middle school students. Participants were 7,376 7th and 8th grade students from a large Midwestern county (50.7% Female, 72.7% White, 7.7% Biracial, 6.9% Black, 5.2% Asian, 3.7% Hispanic, and 2.2% reported "other"). LGB and sexually questioning youth were more likely to report high levels of bullying, homophobic victimization, and various negative outcomes than heterosexual youth. Students who were questioning their sexual orientation reported the most bullying, the most homophobic victimization, the most drug use, the most feelings of depression and suicidality, and more truancy than either heterosexual or LGB students. A positive school climate and a lack of homophobic victimization moderated the differences among sexual orientation status and outcomes. Results indicate that schools have the ability to lessen negative outcomes for LGB and sexually questioning students through creating positive climates and reducing homophobic teasing.

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Minority stress theory has widespread research support in explaining health disparities experienced by sexual and gender minorities. However, less is known about how minority stress impacts multiply marginalized groups, such as lesbian, gay, bisexual, and transgender people of color (LGBT POC). Also, although research has documented resilience in the face of minority stress at the individual level, research is needed that examines macro-level processes such as community resilience (Meyer, 2015). In the current study, we integrate minority stress theory and intersectionality theory to examine multiple minority stress (i.e., racial/ethnic stigma in LGBT spaces and LGBT stigma in one's neighborhood) and community resilience (i.e., connection to LGBT community) among sexual minority men of different racial/ethnic groups who use a geosocial networking application for meeting sexual partners. Results showed that Black sexual minority men reported the highest levels of racial/ethnic stigma in LGBT spaces and White sexual minority men reported the lowest levels, with Asian and Hispanic/Latino men falling in between. Consistent with minority stress theory, racial/ethnic stigma in LGBT spaces and LGBT stigma in one's neighborhood were associated with greater stress for sexual minority men of all racial/ethnic groups. However, connection to LGBT community played more central role in mediating the relationship between stigma and stress for White than POC sexual minority men. Results suggest that minority stress and community resilience processes may differ for White and POC sexual minority men. Potential processes driving these differences and implications for minority stress theory are discussed.

School climates that protect sexual minority students may reduce their risk of suicidal thoughts.

Purpose The mental health and victimization of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth have garnered media attention with the “It Gets Better Project.” Despite this popular interest, there is an absence of empirical evidence evaluating a possible developmental trajectory in LGBTQ distress and the factors that might influence distress over time. Methods This study used an accelerated longitudinal design and multilevel modeling to examine a racially/ethnically diverse analytic sample of 231 LGBTQ adolescents aged 16–20 years at baseline, across six time points, and over 3.5 years. Results Results indicated that both psychological distress and victimization decreased across adolescence and into early adulthood. Furthermore, time-lagged analyses and mediation analyses suggested that distress was related to prior experiences of victimization, with greater victimization leading to greater distress. Support received from parents, peers, and significant others was negatively correlated with psychological distress in the cross-sectional model but did not reach significance in the time-lagged model. Conclusions Analyses suggest that psychological distress might “get better” when adolescents encounter less victimization and adds to a growing literature indicating that early experiences of stress impact the mental health of LGBTQ youth.

Objectives To examine purging for weight control, diet pill use, and obesity across sexual orientation identity and ethnicity groups. Method Anonymous survey data were analyzed from 24,591 high school students of diverse ethnicities in the federal Youth Risk Behavioral Surveillance System Survey in 2005 and 2007. Self-report data were gathered on sexual orientation identity, height, weight, purging and diet pill use in the past 30 days, gender, and ethnicity. We used multivariable logistic regression to estimate odds of purging, diet pill use, and obesity associated with sexual orientation identity in gender stratified models and examined for the presence of interactions between ethnicity and sexual orientation. Results Lesbian, gay, and bisexual (LGB) identity was associated with substantially elevated odds of purging and diet pill use in both females and males (odds ratios [OR] range: 1.9 to 6.8). Bisexual females and males were also at elevated odds of obesity compared to same-gender heterosexuals (OR: 2.3 and 2.1, respectively). Conclusions Interventions to reduce eating disorders and obesity are urgently needed that are appropriate for LGB youth of diverse ethnicities.

Purpose: Lesbian, gay, bisexual, and transgender (LGBT) youth show increased risk for a number of negative mental health outcomes, which research has linked to minority stressors such as victimization. Further, social support promotes positive mental health outcomes for LGBT youth, and different sources of social support show differential relationships with mental health outcomes. However, little is known about how combinations of different sources of support impact mental health. Methods: In the present study, we identify clusters of family, peer, and significant other social support and then examine demographic and mental health differences by cluster in an analytic sample of 232 LGBT youth between the ages of 16 and 20 years. Results: Using k-means cluster analysis, three social support cluster types were identified: high support (44.0% of participants), low support (21.6%), and non-family support (34.5%). A series of chi-square tests were used to examine demographic differences between these clusters, which were found for socio-economic status (SES). Regression analyses indicated that, while controlling for victimization, individuals within the three clusters showed different relationships with multiple mental health outcomes: loneliness, hopelessness, depression, anxiety, somatization, general symptom severity, and symptoms of major depressive disorder (MDD). Conclusion: Findings suggest the combinations of sources of support LGBT youth receive are related to their mental health. Higher SES youth are more likely to receive support from family, peers, and significant others. For most mental health outcomes, family support appears to be an especially relevant and important source of support to target for LGBT youth.

Purpose Lesbian, gay, bisexual, and transgender (LGBT) adolescents are at greater risk for mental health problems than their heterosexual peers, in part due to victimization. Social support, particularly from families, has been identified as an important promotive factor. However, little is known about how LGBT youth experience multiple forms of support or how early support predicts mental health across adolescence and into young adulthood. Methods In an analytic sample of 232 LGBT youth aged 16–20 years at baseline across 5.5 years, we compared developmental trajectories of psychological distress between three empirically derived social support cluster types at baseline: those who reported uniformly low support, those who reported uniformly high support, and those who reported nonfamily support (i.e., high peer and significant other but low family support). Results Longitudinal multilevel modeling, controlling for age, victimization, and social support at each wave, indicated key differences between cluster types. Youth in the low and nonfamily support clusters reported greater distress across all time points relative to youth in the high support cluster; however, they also showed a sharper decline in distress. Youth in the nonfamily cluster gained family support across adolescence, such that they resembled youth in the high support cluster by early adulthood. Conclusions Findings underscore the importance of family support for LGBT youth. Youth who lack family support, but who have other forms of support, report a decrease in psychological distress and an increase in family support across adolescence. Youth who are low in all forms of support continue to exhibit high distress.