Thursday, July 17, 2008

Homosexual youth struggle with many psychological issues and are at a high risk for suicide. How can therapists best support homosexual youth? Cite references.

Homosexual youth struggle with many external and psychological issues, the most severe of with can result in untimely and unnecessary deaths. Externally, homosexual youth may be rejected by family, friends and society. Because of these external effects, homosexual youth often suffer from anxiety, depression, substance abuse, sexual promiscuity, suicide attempts and completion. However, with the support of helpful resources an individual counselor, group therapy, and family members, homosexual youth can survive and thrive from the challenges of being both an adolescent and homosexual.

It is estimated that 10% of the population may be gay, lesbian or bisexual. This means that 1 in 5 families may have a gay, lesbian or bisexual child in it (Dahleimer & Feigal, 1991). Generally, awareness of same sex attraction occurs in childhood, self-labeling and sexual activity happen around puberty, and disclosure occurs in late adolescence or early adulthood (Floyd & Stein, 2002). It is already challenging to experience puberty, late adolescence and early adulthood, and the added stigma of a homosexual orientation can makes these life phases only that much harder.

In their external lives, homosexual youth experience harassment, being shunned by family and friends, getting kicked out of their homes and societal rejection (Tharinger & Wells, 2000). A research study was conducted using data from a 1988 national survey of 1,463 identified heterosexual male youth between the ages of 15 and 19. Participants rated their agreement with various statements about homosexuals. 89% of these males strongly agreed with the statement: “The thought of men having sex with each other is disgusting.” Only 12% of these males agreed with the quote: “I could be friends with a gay person” (Marsiglio, 1993). Because only 12% of straight males believe they could be friends with a homosexual male, it’s no wonder homosexual youth have difficult social lives and suffer psychologically.

Aside from the intolerance of peers and friends, homosexual youth struggle with being shunned by their families. Bass and Kaufman (1996) state,
Gay, lesbian and bisexual people have been portrayed as a threat to the family. But in reality, virtually all gay people care very much about their families- and when there is alienation, it is the straight relatives who are rejecting them, not vice versa. Fear, hatred and misinformation are the true threats to family unity.
Homosexual youth, after coming out to their families, may be rejected through unkind words, physically violent attacks, or even kicked out of their homes. About 30-40% of homeless youth are gay, lesbian or bisexual (Bass and Kaufman, 1996). Because homosexual youth know the potential for these occurrences, they often keep their sexual orientation hidden, and suffer the psychological effects of living in deep secrecy.

Psychologically, Muller and Hartman (1998) note that homosexual youth are more likely than other youth to suffer from depression and anxiety. These psychological problems lead them to substance abuse, promiscuity/STDs, and suicide attempts/suicide completion. A research study surveyed 1,725 9th graders from rural high schools. The students were asked about their attraction towards the same and opposite genders, and about their frequency of marijuana and alcohol use in the past three months. Students who reported same-sex attraction had significantly higher marijuana and alcohol use (Rostosky, Owens, Zimmerman, & Riggle, 2003).

A study from the National Longitudinal Study of Adolescent Health examined 12,000 adolescent students. This study asked about sexual orientation and suicidal thoughts and behaviors. The results show the connection between anxiety, depression, substance abuse and suicidality. 58% of gay and bisexuals meet the criteria for substance abuse (Remafedi, 1987).
“Higher levels of depression and alcohol abuse are reported by youths with same-sex sexual orientation… For gay and lesbian youths who are concealing their sexual identities, alcohol may be used to numb the related anxiety and depression. Research and prevention efforts with this population should focus on depression and substance abuse as precursors to suicidality” (Russell & Joyner, 2001).

Because homosexual youth may be too ashamed to speak to anyone about their sexual identity, they may use drugs and alcohol in an attempt to self medicate their depression and anxiety rather than seeking psychotropic medications. Although drugs and alcohol may temporarily medicate against anxiety and depression, they can also have an undesired negative effect of lowering inhibitions and good decision-making, possibly leading to dangerous outcomes.
Unprotected sexual encounters and suicide attempts increase with substance use, as cognitive skills are not at their peak when individuals are under the influence of drugs and/or alcohol (Rotheram-Borus et al, 1994). Homosexual adolescents are at high risk for STDs, the most deadly of which is HIV. In 2002, an estimated 112,000 to 250,000 American adolescents were HIV positive. About half of these adolescents were males who have sex with other males (Goodenow, Netherland & Szalacha, 2002). The high level of HIV in this population may be associated with a lack of education on how it is contracted. Homosexual youth may not seek education on STDs, for fear of having to coming out to others (Hunter and Schaecher, 1994). This shows that unprotected sexual encounters between homosexuals occur because of substance abuse, lack of proper sexual health education and the shame associated with possibly being outed to others.

In terms of sexual health education, a qualitative research study was conducted on 72 men who identify as homosexual. These men were extensively interviewed to explore recommendations for the HIV risk prevention of homosexual adolescents. Those interviewed believe that HIV prevention programs should be fun, comfortable and accepting, and should address dating and intimacy, sexuality and arousal, drugs and alcohol, self-esteem and self-worth, abuse and coercion, sexual identity (Seal, Kelly & Bloom, 2000). Unfortunately, sexual education in schools is not currently this open-minded and savvy to the needs of homosexual youth. Individual and group counselors can, however, provide their clients with this type of information, which is, at least, a starting point.

Along with sexual promiscuity, the most dangerous expressions of the psychological pain experienced by homosexual youth are suicide attempts and suicide completion. Gay, lesbian and bisexual youth comprise 1,500 of the 5,000 completed youth suicides each year (McFarland, 1998). Hellquist says, “I certainly know more people in our [gay] community who have taken their own lives than I know who have died from AIDS” (Hellquist, 1993, as cited in Bagley & Tremblay, 1997). A research study was done on both homosexual (n = 394) and heterosexual (n = 336) junior high and high school students. They were surveyed on their suicidal intent and self-reported suicide attempts. Results found that suicide attempts were reported by 28.1% bisexual/homosexual males, 20.5% bisexual/homosexual females, 14.5% heterosexual females and 4.2% heterosexual males. There is a significant link between suicide risk and bisexuality/homosexuality in males, and not significant link between suicide risk and bisexual/homosexual females (Remafedi, French, Story, Resnick & Blum, 1998). This is obviously a highly serious issue that needs to be addressed by individual therapist, group therapists and family members.

Individual counseling can be highly beneficial for adolescents struggling with their sexual identities. Skilled counselors can help these clients deal specifically with their depression, anxiety, promiscuity, substance abuse and/or suicidality. However, these issues obviously do not exist in a vacuum, as homosexuality is stigmatized by society at large. This may be why person-centered therapy has been shown to be effective for helping GLBTQ youth. Person-centered therapy’s humanistic tenets (The Big Three: congruence, empathy and unconditional positive regard) present GLBT adolescent clients with self-exploration and self-understanding. The Big Three’s tenets can help normalize the adolescent’s same-sex feelings, which is imperative for self-disclosure and eventual acceptance (Lemoire & Chen, 2005).

Counselors of homosexual youth can help their clients feel comfortable by having resources available to them. Counselors can have written materials, waiting room posters, library resources, information on gay and lesbian community centers, support groups and websites (Fontaine and Hammond, 1996). As noted by Hunter and Schaecher (1994), homosexual youth may not seek information on sexual health because of the fear of having to come out to others. Solomon and Dejong (1986) believe it is the responsibility of all counselors to ensure that their adolescent clients have enough information to protect themselves from HIV. This information should be realistic, clear, nonjudgmental and culturally sensitive. Having information readily available can help prevent unnecessary STDs and even untimely deaths.

Before counselors work with questioning and homosexual youth, they must come to terms with their own attitudes and feelings about homosexuality to effectively help their clients (Fontaine & Hammond,1996). Counselors are obviously all human beings, most of which have been socialized by cultures that are intolerant of homosexual identities. Heterosexual counselors may have internalized cultural stereotypes about homosexuals. Similarly, homosexual counselors may experience negative self-perceptions about their own identities. In turn, it is important that both heterosexual and homosexual counselors examine their own belief systems and prejudices before they can positively impact their clients.

Group counseling can have a highly beneficial impact on sexual minority youth. This is because group counseling emphasizes universality, hope and interpersonal learning. (Muller & Hartman, 1998). Because homosexual youth are generally isolated from society at large, an environment of allies and likeminded individuals is essential. Also, this gives sexual minority youth the space to see that others struggle with the same issues as them. In a similar vein to person-centered therapy, group therapy helps homosexual youth feel supported, understood and connected to others.

Lastly, it can be highly beneficial if individual counselors can have access to the family members of sexual minority youth. It has been shown that adolescents who come from supportive families often come out sooner than those from unsupportive families. These youth have higher self esteem, greater feelings of security in terms of relationships with family members, a more positive attitude about their sexual orientation (Beaty,1999). If a homosexual youth is struggling and in therapy, the therapist can conduct family sessions and help the family become more supportive of their child’s sexual identity.

In conclusion, research shows that homosexual youth struggle with many potentially dangerous external and psychological issues. However, with proper education, the support of a therapist, a therapy group, and family members, a homosexual youth can feel more accepted, and will be less likely to abuse substances, engage in dangerous promiscuous behavior and attempt suicide.

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