Working With Suicidal and Homeless LGBTQ+ Youth in the Context of Family Rejection

Abstract

LGBTQ+ individuals are at increased risk of suicide. Homelessness further increases the risk, as does family-of-origin rejection. A model that combines suicidal risk factors and minority stress theory is useful in clinical practice. An openness to “hearing” the lived experiences of LGBTQ+ individuals is essential to treatment. An LGBTQ+ affirming therapeutic approach is recommended. It is also frequently helpful to rebuild family relationships and support for the LGBTQ+ individual, particularly with younger youth. Principles of practice are described and illustrated.

Differences in suicidality and psychological symptoms between sexual and gender minority youth compared to heterosexual and cisgender youth in a psychiatric hospital

“…In particular, this theoretical model posits that the high prevalence of mental health problems among SGMY is caused by the chronic stress of SGMY having to manage societal stigma and mistreatment because of their sexuality and/or gender identity. 9,10 For instance, SGMY experience higher rates of harassment and bullying 5,11 , homelessness 12,13 , sexual and physical violence 5,14 , parental rejection 15,13 , and social isolation 8 than HCY. These recurring negative experiences coupled with a relative lack of social support place SGMY at substantial risk for depression 4,5,16 , anxiety 16 , hopelessness 5,17 , traumatic stress 18 , substance use 5,19,20 non-suicidal self-injury (NSSI) 21,22 , and suicidality.…”

“…These recurring negative experiences coupled with a relative lack of social support place SGMY at substantial risk for depression 4,5,16 , anxiety 16 , hopelessness 5,17 , traumatic stress 18 , substance use 5,19,20 non-suicidal self-injury (NSSI) 21,22 , and suicidality. 1,2,13,14,15,16 Overall, sexual minority youth have nearly four times (OR=3.50; 95% CI,2.98-4.12) and gender minority youth have nearly six times (OR=5.87; 95% CI,3.51-9.82) the odds of attempting suicide compared to heterosexual youth. 23…”

“It kinda breaks my heart”: LGBTQ young adults' responses to family rejection

“…Existing research suggests that many families' discomfort and rejection of their children's LGBTQ identity comes from a place of fear and concern, rather than hatred (Ryan et al, 2010). Although not all families may be open to reconsidering their heterosexist and cisgenderist views and behaviors, clinical interventions may be able to help young adults and families navigate family rejection before it becomes a crisis impacting the young adults' ability to live at home (Ream & Peters, 2021). Practitioners working with LGBTQ young adults experiencing homelessness may also consider developing outreach efforts to connect with young people who are still living at home but fear that their families' heterosexism and cisgenderist attitudes and behaviors may threaten their housing.…”

Tending to the Flock: The Experiences of LDS Clergy with LGBTQ Congregants

“…These stressors include experiences of discrimination and marginalization (Meyer, 2003; Williams & Serpas, 2021). For example, homelessness, family rejection, and bullying among LGBTQ+ youth increase the risk of poor mental health, and discrimination in the workplace negatively affects LGBTQ+ adults (Holman, 2018; Mittleman, 2019; Ream & Peters, 2021).…”