LGBTQ Inclusion in Youth Program Environments

Practice Matters, June 2013

A publication of the ACT for Youth Center of Excellence

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by L. Maurer, MS

L. Maurer, MS is the founding Director of the Center for Lesbian, Gay, Bisexual & Transgender Education, Outreach, and Services at Ithaca College.

Introduction

Young people are deciding to come out as lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) at earlier ages than ever before. Research shows that LGBTQ youth commonly experience harassment and can feel alienated from peers, family, and school and youth program environments. This can have striking and long-lasting effects, such as lower grades and less interest in pursuing college than their heterosexual peers (Kosciw, Diaz, & Greytak, 2008), and can also put youth at risk for a variety of negative health outcomes. People who work with youth have a very real opportunity -- and a responsibility -- to address the needs of LGBTQ young people. These youth have the right to expect that they will be understood and respected. By making program environments more inclusive, those who work with youth can begin to address some of the disparities LGBTQ adolescents face, and can equip youth with knowledge and skills to be more successful and resilient as they reach adulthood.

Disparities

In order to make inclusion efforts effective, it's important to understand how the experiences and lives of youth who are LGBTQ may differ from non-LGBTQ youth. Because of continuing homophobia and misinformation, LGBTQ youth are more vulnerable to a variety of negative outcomes. But simply being LGBTQ doesn't put someone at risk (Garofalo et al., 1998). These youth are at increased risk not because of their sexual orientation or gender identity, but because of societal stigma and its continuing effects. LGBTQ youth are more likely than heterosexual youth to experience:

• Feelings of isolation (Garofalo et al., 1998)
  
• Stress (Hart & Heimberg, 2001)
  
• Violence (D'Augelli, 2002)
  
• Depression (Hart & Heimberg, 2001)
  
• Alcohol (Garofalo et al., 1998; Marshal et al., 2008), tobacco (Garofalo et al., 1998; Ryan et al., 2001), and substance use (Garofalo et al., 1998; Marshal et al., 2008)
  
• Suicidality (Garofalo et al., 1998; Hart & Heimberg, 2001; Russell, 2003)
  
• Estrangement from family and friends (D'Augelli, 2002)
  
• Homelessness (Ray, 2006)

Other types of discrimination can also play a significant role early in the lives of LGBTQ adolescents -- they are 40% more likely to be stopped or arrested by police, and more likely to be expelled from school or convicted by courts than their heterosexual peers who have engaged in the same level of misconduct (Himmelstein & Brückner, 2010).

Young people who are LGBTQ have also been found to experience significant disparities in risk-taking behaviors (Busseri, Willoughby, Chalmers, & Bogaert, 2008) and unintended teen pregnancy (Saewyc, Poon, Homma, & Skay, 2008).

Lesbian, Gay, and Bisexual Youth and Unintended Pregnancy

Several factors may contribute to the rather unexpected higher risk of pregnancy involvement among LGBTQ teens. This research strengthens the case for making youth programs more responsive to the needs of LGBTQ youth.

• LGB youth use contraception less frequently than their heterosexual peers when engaging in sexual behaviors that can lead to pregnancy (Goodenow, Netherland, & Szalacha, 2002; Robin et al., 2002). For some youth, the "camouflage" of heterosexual dating may be an attempt to avoid discrimination and stigma (Saewyc, Bearinger, Blum, & Resnick, 1999).
  
• Connectedness to family or school have been linked to lower rates of teen pregnancy. Many LGBTQ youth feel less connected to family and school than their heterosexual peers. LGB young people who experience rejection by their families are about three and a half times more likely to have engaged in unprotected sex (Ryan, Huebner, Diaz, & Sanchez, 2009).
  
• Youth programs that address sexual risk taking and unplanned pregnancy -- most of which are designed for heterosexual teens -- have not been effective for LGB youth (Saewyc, Pettingel, & Skay, 2004). More effective strategies that actively name and address the needs of LGB youth may be seen as more relevant to their lives (Saewyc et al., 2008).
  
• In one study, LGB youth reported more sexual partners than heterosexual youth, and higher rates of alcohol use before last sex (Blake, et.al., 2001). However, the same study found that LGB youth in schools with LGBT-inclusive sex ed curricula reported fewer sexual partners, less recent sex, and less substance use before last sex than did LGB youth in schools without this instruction.
  

Resiliency

It's important to recognize that many LGBTQ people experience stressful situations related to sexual orientation and gender identity throughout their lives. Yet most survive and thrive, demonstrating resilience -- perhaps due to having had to acquire many developmental assets as a result of navigating the significant number of risks they may face. Resilience in LGBTQ youth is an area that investigators are just beginning to explore (Russell, 2005; Hunter, 1999).

Research has also looked into the impact of homophobia on children of LGBTQ parents, but only a few studies examine factors that promote resilience. Attending a school that provides curricula inclusive of LGBT issues is one factor that has been demonstrated to increase resilience (Van Gelderen, Gartrell, Bos, & Hermanns, 2009). Making program environments more inclusive can make an important positive difference in the lives of the children of LGBTQ parents as well as youth who are LGBTQ themselves.

Strategies for Inclusion

The needs of LGBTQ youth are increasingly the subject of conversation and research. This is an area of great promise but still rather limited understanding. By including the needs and strengths of LGBTQ adolescents, youth programs and educators may potentially impact many more people than previously understood, including LGBTQ youth, their families, friends, and peers, and children of LGBTQ parents, among others. Practitioners have an exciting opportunity to make a positive difference by creating program environments that address the specific needs of LGBTQ youth.

Some inclusion strategies involve simple program adaptations such as changes in language or terminology. Others will take a bit more time. Each will result in a more accessible learning environment for LGBTQ youth, which in turn will increase knowledge and engagement. Inclusion will also broaden the understanding of non-LGBTQ youth so they will be better equipped to assist LGBTQ peers and better prepared for today's diverse world.

Here are some tips as you retool and re-envision your program for inclusion:

Know general definitions and terminology.

There are many resources to help you get up to speed on LGBTQ words and terms, and the diverse and creative ways youth are using them today. Know how to locate key resources. Even seasoned professionals will want to keep up with changing research, trends, and terminology. Young people are expanding boundaries, challenging assumptions, and constructing identity and community in exciting, new, and different ways.

Use inclusive language.

For instance, instead of using gender-specific words in teaching scenarios and handouts, use terms like "parents" to replace "mother and father," and "boyfriend or girlfriend" rather than just one gender-specific word. This approach can also be taken when designing forms where demographic information is requested. Use inclusive pronouns or gender non-specific names in program activities. This can be a simple but powerful reminder to participants about sexual and gender diversity. You can leave it up to your participants to discuss whether "Chris" or "Pat" in a role-play scenario is male or female -- and if it matters. Many non-LGBTQ people also appreciate the use of inclusive language because they have an LGBTQ parent, sibling, or child.

Try to avoid assumptions.

Not everyone is heterosexual. Not all LGBTQ youth are struggling. LGBTQ youth come in all sizes, abilities, ages, religions, and backgrounds. In what ways can your lessons, activities, or programs reflect this?
Keep in mind that identity and behavior are separate and not always aligned. Some youth may engage in sexual behavior with people of the same sex but not identify as LGBTQ. And (just like some heterosexual youth who are not yet sexually active) some LGBTQ youth are not sexually active and may not yet have had a same-sex relationship even though they have a full understanding and acceptance of their sexual orientation.
Finally, don't assume an LGBTQ staff person should be responsible for all LGBTQ inclusion efforts, or delegate this role to an LGBTQ person without a clear reason for doing so.

Conduct an inclusion audit.

An inclusion audit explores barriers and supports within a program when it comes to serving LGBTQ youth. Are LGBTQ youth and experiences reflected in agency materials and forms? Are resources, services, and referrals inclusive and sensitive? Imagine an LGBTQ young person or family in the classroom, office, or waiting room, reading pamphlets or handouts, or accessing services. Do you provide books and magazines that are inclusive of LGBTQ experiences, or comfortable items, furniture, and materials for LGBTQ youth (perhaps in the "rainbow" palette or with recognizable LGBTQ signs and symbols) that can communicate a sense of belonging? Evaluate whether agency settings and services are congruent with messages of pluralism, diversity, and respect for LGBTQ youth and families. You can find one example of an inclusion audit at: www.outforhealth.org/files/all/out_for_health_lgbt_inclusion_audit.pdf

Involve LGBTQ people at all levels.

Create an LGBTQ youth advisory board and partner with local LGBTQ organizations to create program linkages. Be aware, though, that you don't have to be an LGBTQ person yourself to do good work on these themes. Seek help, ask for input, and know that even just one person can make a difference. Identify other community resources for collaboration and referral. Many cities have a community-based LGBTQ organization, a campus-based LGBTQ resource center, or other well-informed people with whom you can collaborate and network.

Establish confidential, supportive "safe space" for LGBTQ youth.

LGBTQ youth might not feel safe to fully participate because of fear of being "outed" to parents or friends or concern that the presenter or organization may not be welcoming and inclusive of LGBTQ youth. Demonstrate your inclusiveness in your teaching materials, through your words and actions, and by displaying your organization's non-discrimination statement. Using symbols like the pride flag, or including LGBTQ terminology or well-known "out" figures in posters or program materials are other ways to signal to LGBTQ youth and their allied peers that yours is a safe and welcoming space.

Respond to bias and misinformation in participants
and colleagues.

In some instances, a simple reminder about the group's ground rules (or agency nondiscrimination policy, in the case of colleagues) may suffice. In other situations, it may be necessary to gently but firmly point out inappropriate or disrespectful behavior, and insist it stop. Doing so will also model for others ways that allies can intervene quickly and effectively.

Create policies and processes that are inclusive of LGBTQ participants and employees.

Review your organization's nondiscrimination policy as well as other policies that impact all program participants or all employees. Are participants and employees of varying sexual orientations and gender identities treated equally under these policies and procedures? If not, what changes can be made to address disparities?

Include LGBTQ-themed information in all settings and sessions.

Include content about sexual orientation and gender identity not as a separate, stand-alone topic but as another important aspect woven into every programmatic topic.

Create new programs and curricula when current offerings do not meet the needs of LGBTQ youth.

Sometimes, very simple adaptations will make a huge difference. At other times, it may be necessary to take a more in-depth look. Always aim toward ways all youth can feel included and valued in your program. Since teen pregnancy and parenting is much more common among LGBTQ youth than previously believed, programs that address the needs of teen parents should also be carefully examined in order to provide the information LGBTQ pregnant or parenting youth need.

All youth deserve to be treated with dignity and respect. Making your program environment more inclusive of LGBTQ youth can benefit all youth by providing facts, resources, and skills they will need to make informed decisions about their lives.

Resources

Definitions and Terminology

GLAAD: Media Reference Guide
www.glaad.org/reference

MAP: An Ally's Guide to Terminology
www.lgbtmap.org/effective-messaging/allys-guide-to-terminology

PFLAG: What Does It All Mean?
http://community.pflag.org/page.aspx?pid=316

ACT for Youth: Understanding the OBI: Sexual Orientation, Behavior, and Identity
www.actforyouth.net/resources/n/n_obi/

Responding to Bias

Ready, Set, Respect: GLSEN's Elementary School Toolkit
www.glsen.org/binary-data/GLSEN_ATTACHMENTS/file/000/002/2028-4.pdf

GLSEN: Think B4 You Speak Educator's Guide
www.thinkb4youspeak.com/foreducators/GLSEN-EducatorsGuide.pdf

GLSEN and PFLAG: Responding to Anti-LGBT Bias
www.pflagwestchester.org/Responding_To_Anti-LGBT_Bias.pdf

PFLAG: Cultivating Respect
http://community.pflag.org/page.aspx?pid=1011

Additional Resources for LGBTQ Inclusion

LGBT History Month offers free handouts and videos for use in youth programs, classrooms, and other educational settings. Each October, 31 LGBT "icons" are featured, and an archive of those featured in previous years is maintained on the site.
http://lgbthistorymonth.com/

GLSEN provides lesson plans, tools, tips, research, and much more for educators, students, and parents.
www.glsen.org

GLAAD offers a wide variety of educational resource kits and other information.
www.glaad.org

PFLAG NYC has posted tips for professionals who work with LGBT youth
www.pflagnyc.org/safeschools/tips

StopBullying.gov, a U.S. government site, includes resources to create safe environments for LGBT youth.
www.stopbullying.gov/at-risk/groups/lgbt/

The Family Acceptance Project provides pamphlets, videos, and research about family acceptance/rejection and health outcomes for LGBTQ youth.
http://familyproject.sfsu.edu/

CenterLink LGBT Community Center Member Directory allows users to find local resources throughout the U.S.
www.lgbtcenters.org/Centers/LGBT-Centers.aspx

References

• Blake, S., Ledsky, R., Lehman, T., Goodenow, C., Sawyer, R., & Hack, T. (2001). Preventing sexual risk behaviors among gay, lesbian, and bisexual adolescents: The benefits of gay sensitive HIV instruction in schools. American Journal of Public Health, 91(6), 940-946.
  
• Busseri, M., Willoughby, T., Chalmers, H., & Bogaert, A. (2008). On the association between sexual attraction and adolescent risk behavior involvement: Examining mediation and moderation. Developmental Psychology, 44(1), 69-80.
  
• D'Augelli, A. (2002). Mental health problems among lesbian, gay, and bisexual youths ages 14 to 21. Clinical Child Psychology and Psychiatry, 7, 433-456.
  
• Garofalo, R., Wolf, R., Kessel, S., Palfrey, J., & DuRant, R. (1998). The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics, 101(5), 895-902.
  
• Goodenow, C., Netherland, J., & Szalacha, L. (2002). AIDS-related risk among adolescent males who have sex with males, females, or both: Evidence from a statewide survey. American Journal of Public Health, 92, 203-210.
  
• Hart, T., & Heimberg, R. (2001). Presenting problems among treatment-seeking gay, lesbian, and bisexual youth. Journal of Clinical Psychology, 57, 615-627.
  
• Himmelstein, K., & Brückner, H. (2010). Criminal-justice and school sanctions against nonheterosexual youth: A national longitudinal study. Pediatrics, 127(1), 49-57.
  
• Hunter, J. (1999). Beyond risk: Refocus research on coping. Journal of the Gay & Lesbian Medical Association, 3(3), 75-76.
  
• Kosciw, J., Diaz, E., & Greytak, E. (2008). 2007 National school climate survey: The experiences of lesbian, gay, bisexual and transgender youth in our nation's schools. New York, NY: Gay, Lesbian, and Straight Education Network.
  
• Marshal, M. P., Friedman, M. S., Stall, R., King, K. M., Miles, J., Gold, M. A., Bukstein, O. G., & Morse, J. Q. (2008). Sexual orientation and adolescent substance use: A meta-analysis and methodological review. Addiction, 103, 546-556.
  
• Ray, N. (2006). Lesbian, gay, bisexual and transgender youth: An epidemic of homelessness. New York, NY: National Gay and Lesbian Task Force Policy Institute and the National Coalition for the Homeless.
  
• Robin, L., Brener, N., Donahue, S., Hack, T., Haie, K., & Goodenow, C. (2002). Associations between health risk behaviors and opposite-, same-, and both sex sexual partners in representative samples of Vermont and Massachusetts high school students. Archives of Pediatric and Adolescent Medicine, 156, 349-355.
  
• Russell, S. (2005). Beyond risk: Resilience in the lives of sexual minority youth. Journal of Gay & Lesbian Studies in Education, 2(3), 5-18.
  
• Russell, S. (2003). Sexual minority youth and suicide risk. American Behavioral Scientist, 46, 1241-1257.
  Ryan, C., Huebner, D., Diaz, R., & Sanchez, J. (2009). Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics, 123, 346-352.
  
• Ryan, H., Wortley, P., Easton, A., Pederson, L., & Greenwood, G. (2001). Smoking among lesbians, gays, and bisexuals: a review of the literature. American Journal of Preventive Medicine, 21(2) 142-149.
  
• Saewyc, E., Bearinger, L., Blum, R., & Resnick, M. (1999). Sexual intercourse, abuse and pregnancy among adolescent women: Does sexual orientation make a difference? Family Planning Perspectives, 31, 127-131.
  
• Saewyc, E., Pettingel, S., & Skay, C. (2004). Teen pregnancy among sexual minority youth in population based surveys of the 1990s: Countertrends in a population at risk. Journal of Adolescent Health, 34, 125-126.
  
• Saewyc, E., Poon, C., Homma, Y., & Skay, C. (2008) Stigma management? The links between enacted stigma and teen pregnancy trends among gay, lesbian, and bisexual students in British Columbia. The Canadian Journal of Human Sexuality, 17(3), 123-139.
  
• Van Gelderen, L., Gartrell, N., Bos, H., & Hermanns, J. (2009). Stigmatization and resilience in adolescent children of lesbian mothers. Journal of GLBT Family Studies, 5(3), 268-279.