The American Journal of Psychiatry, 158:154, January 2001
ROCHELLE L. KLINGER, M.D.
This comprehensive review of clinical care of lesbian and gay youth grew out of a conference in 1994 designed to identify primary care (including mental health) needs of this underserved population. The authors’ goal was to integrate a large database of research information into a format that could be used by clinicians, educators, parents, and advocates for sexual minority youth. They have more than succeeded in this daunting task. This volume is concise, readable, and scholarly. The coherence of this book reflects the increasingly rare phenomenon of a volume written by one or two authors rather than multiple experts. The emphasis throughout is on practical clinical application of research knowledge. To this end, the authors employ a variety of helpful tables and figures as well as seven appendixes of resources and protocols.
The book is divided into three sections. Part 1 is a thorough overview of pertinent background information about gay, lesbian, and bisexual adolescents. Complex definitions of sexual orientation, behavior, and identity development are explained as clinically applicable. For example, because of the vicissitudes of identity development, gay and lesbian youth are not likely to present initially as such to a primary care or mental health practitioner. In one study, 5% of surveyed youth reported homosexual behavior but only 1% identified themselves as homosexual. Clinicians who treat adolescents need to be particularly conscious of not making assumptions about heterosexuality.
Multiple stressors faced by sexual minority youth in learning to live with external and internal stigma are documented by the authors. In addition, they identify the primary developmental task for these adolescents, which is learning to adapt to and manage a stigmatized identity. A great deal of information is also provided on family adaptation to an adolescent’s coming out and therapeutic work with families of lesbian and gay youth…
Lesbian and Gay Youth: Care and Counseling
By Caitlin Ryan and Donna Futterman
Family Acceptance Project™
Although there is an increasing amount of information about the risks and challenges facing LGB youth (with very little information about transgender youth), we know little about their strengths and resiliency, including the strengths of families in supporting their children's health and well-being. Even though the family is the primary support for children and youth, and family involvement helps reduce adolescent risk, there have been no previous studies of how families affect their LGBT children’s risk and resiliency. Prior to this study, little information was available to show how families respond to an adolescent's coming out and how family and caregiver reactions affect adolescent health, mental health and development for LGBT young people.
Attention to family reactions is critical since increasingly, youth are coming out at younger ages which significantly increases risk for victimization and abuse in family, school and community settings, and provides opportunities for helping to support and strengthen families. Victimization has long-term consequences for health and development, and impacts families as well as the targeted individuals. Early intervention can help families and caregivers build on strengths and use evidence-based materials to understand the impact of acceptance and rejection on their child’s well-being.
The Family Acceptance Project™ (FAP) is directed by Caitlin Ryan at the Marian Wright Edelman Institute at San Francisco State University, and was developed by Caitlin Ryan and Rafael Dìaz in 2002. It includes the first major study of the families of lesbian, gay, bisexual and transgender youth.
Read complete overview:
The Family Acceptance Project™
Project Director, Caitlin Ryan, Senior Quantitative Researcher, Rafael Dìaz and Project Coordinator, Jorge Sanchez. Teresa Betancourt worked on the first two phases of the project.
Caitlin Ryan is the Director of the Family Acceptance Project.™ Caitlin is a clinical social worker who has worked on LGBT health and mental health since the 1970s, and AIDS since 1982. She received her clinical training with children and adolescents at Smith College School for Social Work in inpatient and community mental health programs, and began her social work career in school-based psychoeducational settings. Caitlin pioneered community-based AIDS services at the beginning of the epidemic; initiated the first major study to identify lesbian health needs in the early 1980s; and has worked to implement quality care for LGBT youth since the early 1990s. She developed the Family Acceptance Project™ with Rafael Diaz in 2002 to promote family support, decrease risk and improve well-being for LGBT youth…
Study: Tolerance Can Lower Gay Kids' Suicide Risk –
All Things Considered - NPR
December 29, 2008
Gay, lesbian and bisexual teens and young adults have one of the highest rates of suicide attempts — and some other health and mental health problems, including substance abuse. A new study suggests that parental acceptance, and even neutrality, with regard to a child's sexual orientation could have a big impact in reducing this rate.
The study, published in the journal Pediatrics, found that the gay, lesbian and bisexual young adults and teens at the highest risk of attempting suicide and having some other health problems are ones who reported a high level of rejection by their families as a result of their sexual orientation.
"A little bit of change in rejecting behavior, being a little bit more accepting," says lead researcher Caitlin Ryan, "can make a significant difference in the child's health and mental health."
Ryan, director of Adolescent Health Initiatives at the Cesar Chavez Institute at San Francisco State University, and her researchers conducted lengthy interviews with more than 200 gay, lesbian and bisexual young adults. Ryan tried to judge whether, as adolescents, they had faced low, moderate or high levels of rejection from their families.
They found that kids who, by Ryan's measure, experienced high levels of rejection were nearly 8.5 times more likely to have attempted suicide. They were nearly six times more likely to report high levels of depression and almost 3.5 times more likely to use illegal drugs or engage in unprotected sex. That was compared with adolescents whose families may have felt uncomfortable with a gay kid, but were neutral or only mildly rejecting.
Acceptance Can Go A Long Way
Because the level of rejection is hard to measure, Ryan looked at things like whether the parents tried to get their children to change their sexual orientation, or tried to stop them from being with other gay kids…
Dr. Caitlin Ryan:
Reducing Risk and Promoting Well-Being
for LGBT Youth:
The Critical Role of Family Support
November 16, 2009