Suicide Risk among Lesbian,Gay, Bisexual,and Transgender Military Personnel and Veterans: What Does the Literature Tell Us?

Research suggests that both the military and veteran and the lesbian, gay, bisexual, and transgender (LGBT) populations may be at increased risk for suicide. A literature review was conducted to identify research related to suicide risk in the LGBT military and veteran populations. Despite the paucity of research directly addressing this issue, themes are discussed evident in the literature on LGBT identity and suicide risk as well as LGBT military service members and veterans. Factors such as social support and victimization appear to be particularly relevant. Suggestions are made with respect to future research that is needed on this very important and timely topic.     

Safe and supportive schools for LGBT youth: Addressing educational inequities through inclusive policies and practices

Inclusive policies that attend to sexual orientation and gender identity (SOGI) are associated with more supportive school environments for lesbian, gay, bisexual, and transgender (LGBT) youth. We use the 2013–2015 California Healthy Kids Survey (n = 113,148) matched with principal reports of school policies from the 2014 California School Health Profiles to examine differential effects of SOGI-focused policies for LGB and transgender youth. SOGI-focused policies had a direct association with less truancy, and moderated the association between sexual orientation/gender identity and other school outcomes. SOGI-focused policies were associated with more positive experiences and perceptions of school climate for LGB youth and, to a lesser extent, transgender youth. Findings underscore the importance of inclusive policies, especially those that address the unique needs of transgender students.     

Applying Person‐Centered Counseling to Sexual Minority Adolescents

Drawing attention to the very unique and complex needs of stigmatized sexual minority youth, the authors explore the therapeutic potential of person‐centered counseling in helping lesbian, gay, bisexual, transgender/sexual (LGBT) adolescents who are working toward the acceptance and disclosure of their sexual identity. They suggest that person‐centered counseling embodies 6 aspects that are particularly helpful to LGBT adolescent clients and propose 3 additional methods that compensate for the limitations of the person‐centered approach in this particular helping context.     

Transgender youth and life-threatening behaviors

Sexual minority status is a key risk factor for suicide among lesbian, gay, and bisexual youth; however, it has not been studied among transgender youth. Fifty-five transgender youth reported on their life-threatening behaviors. Nearly half of the sample reported having seriously thought about taking their lives and one quarter reported suicide attempts. Factors significantly related to having made a suicide attempt included suicidal ideation related to transgender identity; experiences of past parental verbal and physical abuse; and lower body esteem, especially weight satisfaction and thoughts of how others evaluate the youths' bodies. Sexual minority status is a key risk factor for life-threatening behaviors among transgender youth.     

Sexual orientation and gender identity in schools: A call for more research in school psychology—No more excuses

Research focused on sexual orientation and gender identity among youth is scarce in school psychology journals. Graybill and Proctor (2016; this issue) found that across a sample of eight school support personnel journals only .3 to 3.0% of the articles since 2000 included lesbian, gay, bisexual, transgender (LGBT)-related research. It appears that special issues are a mechanism for publishing LGBT-related scholarship. This commentary includes a call for more research in school psychology and other related disciplines that intentionally addresses experiences of LGBT youth and their families. Two articles in this special section are summarized and critiqued with clear directions for future scholarship. Researchers and practitioners are ethically responsible for engaging in social justice oriented research and that includes assessing gender identity and sexual orientation in their studies and prevention program evaluations.     

Lesbian,gay, bisexual,and transgender youth: Limited representation in school support personnel journals

Many lesbian, gay, bisexual, and transgender (LGBT) youth experience harassment and discrimination in schools and these experiences lead to increased negative social-emotional outcomes. Youth who can identify at least one supportive adult at school report better outcomes than youth who cannot identify a safe adult. Yet, many educators report feeling uncomfortable or unprepared to support LGBT youth. One reason for educators' discomfort may be that content related to issues unique to LGBT youth is sometimes missing or covered minimally in university training programs. We hypothesized that LGBT content may be covered minimally in school support personnel journals, as well. This study analyzed eight school support personnel journals across the disciplines of school counseling, school nursing, school psychology, and school social work for LGBT content published between 2000 and 2014 to gain a better understanding of the visibility of LGBT issues in the research. Results suggested that there has been a lack of presence of LGBT issues in journals across disciplines. These results also suggest a need for an intentional focus on issues relevant to LGBT youth in school support personnel journals. Thus, the article concludes with an introduction to two articles in this special topic section, including Russell, Day, Ioverno, and Toomey's (in this issue) study on teacher perceptions of bullying in the context of enumerated school policies and other supportive sexual orientation and gender identity related practices and Poteat and Vecho's (in this issue) study on characteristics of bystanders in homophobic bullying situations. The broad goal of these three studies is to increase visibility of critical LGBT issues in school support personnel journals.     

Loss of Religious or Spiritual Identities Among the LGBT Population

Lesbian, gay, bisexual, and transgender (LGBT) individuals are at risk of having negative experiences with religion because of mainstream religions’ non‐LGBT‐affirming stance. Negative religious experiences can lead to religious or spiritual (R/S) struggles and loss of R/S identity to maintain sexual identity. The authors describe R/S abuse, R/S struggle, and how these can result in loss of R/S identity in LGBT individuals. They provide a case study and discuss counseling implications and areas for future research.     

Minority stress and health: Implications for lesbian,gay, bisexual,transgender, and questioning (LGBTQ) young people

Historically, the pathologization of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) orientations shaped research and professional practice, while the impact of stigma was not considered. Within a minority stress conceptualization however, stigma-related prejudice and discrimination experienced by LGBTQ people constitute chronically stressful events that can lead to negative health outcomes. Minority stress has been linked to psychological distress among gay men and lesbians and may contribute to elevated rates of distress frequently observed among LGBTQ youth. This study explored the impact of minority stress on psychological distress among LGBTQ youth in Ireland. Measures assessing three components of minority stress (sexual identity distress, stigma consciousness, and heterosexist experiences) were administered online to LGBTQ youth aged 16–24 years (N = 301). Each minority stressor had a significant independent association with distress. Stepwise regression analyses identified the linear combination of minority stressors as significantly predictive of distress [F(3,201) = 30.80, p ≤ 0.001]. Results suggest that the oppressive social environment created through sexual/transgender identity-related stigma negatively impacts on the well-being of LGBTQ youth. These findings have implications for health professionals and policy makers interested in the concerns of LGBTQ youth experiencing difficulties related to minority status and will facilitate the development and tailoring of interventions aimed at reaching those most at risk.     

Reflecting Resiliency: Openness About Sexual Orientation and/or Gender Identity and Its Relationship to Well-Being and Educational Outcomes for LGBT Students

For lesbian, gay, bisexual, and transgender (LGBT) youth, coming out (i.e., disclosure of LGBT identity to others) can be a key developmental milestone, one that is associated with better psychological well‐being. However, this greater visibility may come with increased risk of peer victimization. Being out, therefore, may reflect resilience and may unfold differently depending on ecological context as some spaces may be more or less supportive of LGBT youth than others. This article explores a model of risk and resilience for outness among LGBT youth, including whether it varies by community context. We tested our hypothesized model with a national dataset of 7,816 LGBT secondary school students using multi‐group structural equation modeling. Consistent with our hypotheses, outness was related to higher victimization but also to higher self‐esteem and lower depression. Greater victimization was related to negative academic outcomes directly and indirectly via diminished well‐being. The increases in victimization associated with outness were larger for rural youth, and benefits to well‐being partly compensated for their lower well‐being overall. This article suggests that being out reflects resilience in the face of higher risk of victimization, in addition to promoting well‐being in other ways. Nonetheless, contextual factors influence how this model operates among LGBT youth.     

Facilitating Mental Health Support for LGBT Forced Migrants: A Qualitative Inquiry

Evidence suggests that lesbian, gay, bisexual, and transgender (LGBT) individuals who flee their countries of origin may arrive in host countries with persecution‐related mental health problems. This qualitative study explored facilitators and barriers to mental health care in Canada for forced migrants who are LGBT through the perspectives of 22 service providers and 7 migrants. Using thematic analysis, the authors identified 4 themes: recognizing stigma and shame, accessing competent mental health providers, managing distress/manifesting resilience, and healing through community connections. The authors discuss implications for counseling.     

The Meanings and Manifestations of Religion and Spirituality among Lesbian, Gay, Bisexual, and Transgender Adults

The present study employed a mixed method approach in the effort to explore religious and spiritual practices among lesbian, gay, bisexual, and transgender (LGBT) individuals, as well as the meanings ascribed to the terms religiosity and spirituality by LGBT adults. Data were collected via a cross-sectional survey consisting of open- and close-ended items among 498 LGBT (lesbian, gay, bisexual, transgender) identified individuals attending an annual Pride event in a large northeastern city. Both quantitative and qualitative findings suggested that consistent with other studies, spirituality was defined largely in relational terms (e.g., in terms of one’s relationship with God and with self). Religion, in contrast, was defined largely in terms of communal worship and in terms of its negative influences in the lives of individuals and communities. For this sample of LGBT persons, spiritual identities were more pronounced than religious ones, and this pattern may be explained by their understanding of the spiritual self in relation to prosocial engagement and interconnectedness with others, the world around them, and the universe. Further, religious affiliation and practices were explained, in part, by the religion in which the individual was raised, level of educational attainment, as well as the developmental stage in which the person is currently situated. The findings highlight the reality that a substantial number of LGBT individuals may remain committed to religious and spiritual life, which may be related to a motivation to make sense of one’s place in the world especially in light of societal misunderstandings and intolerance to LGBT individuals.     

Addressing disparities: The impact of a lesbian,gay, bisexual,and transgender graduate counselling course

Background: Lesbian, gay, bisexual and transgender (LGBT) individuals experience serious mental health disparities and treatment inequities. Counsellor education has been identified as both a contributing factor to these problems as well as an ameliorating mechanism to address these inequalities. Aim: The purpose of the current study was to evaluate the impact of an LGBT‐affirmative counselling course. Method: A total of 23 students enrolled in a graduate LGBT counselling course were administered the Sexual Orientation Counselor Competency Scale (SOCCS, Bidell, 2005) and the Lesbian, Gay, and Bisexual Affirmative Counseling Self‐Efficacy Inventory (LGB‐CSI, Dillon & Worthington, 2003) pre‐ and post‐course. In addition, a comparison group of 23 matched counselling students was obtained from an existing data source in order to make further assessments of the course's effectiveness. Those in the comparison group were not enrolled in the LGBT course, but were administered the SOCCS at analogous time intervals. Results: After completing the LGBT course, enrolled students demonstrated significant improvements regarding their sexual orientation counsellor competency and self‐efficacy. In addition, these students showed significant gains in SOCCS scores versus those in the comparison group. Implications: Results from this study show the positive effect a full‐credit LGBT psychotherapy course can have on graduate counselling students' sexual orientation counsellor competency and self‐efficacy. The findings also indicate that such a course can significantly impact counselling skills, a facet of LGBT cultural competency found to be the most attenuated. Findings are discussed in conjunction with LGBT‐affirmative counsellor training and clinical practice.     

Addressing multiple relationships between clients and therapists in lesbian, gay, bisexual, transgender communities

Therapists working in lesbian, gay, bisexual, and transgender (LGBT) communities are likely to experience the potential to engage in multiple relationships with their clients. Currently, the American Psychological Association's (2002) ethics code and the related literature base offer minimal direct guidance to therapists practicing in LGBT communities. In this article, the authors review current literature regarding multiple relationships in psychotherapy, considering how this literature addresses issues specific to practitioners working within LGBT communities, present a case study highlighting the negotiation of a multiple relationship between a client and therapist who both identify as lesbian, and offer recommendations for practitioners working within LGBT communities.     

Predicting the suicide attempts of lesbian, gay, and bisexual youth

In this study predictors of serious suicide attempts among lesbian, gay, and bisexual (LGB) youth were examined. Three groups were compared: youth who reported no attempts, youth who reported attempts unrelated to their sexual orientation, and youth whose attempts were considered related to their sexual orientation. About one third of respondents reported at least one suicide attempt; however, only half of the attempts were judged serious based on potential lethality. About half of all attempts were related to youths' sexual orientation. Factors that differentiated youth reporting suicide attempts and those not reporting attempts were greater childhood parental psychological abuse and more childhood gender-atypical behavior. Gay-related suicide attempts were associated with identifiability as LGB, especially by parents. Early openness about sexual orientation, being considered gender atypical in childhood by parents, and parental efforts to discourage gender atypical behavior were associated with gay-related suicide attempts, especially for males. Assessment of past parental psychological abuse, parental reactions to childhood gender atypical behavior, youths' openness about sexual orientation with family members, and lifetime gay-related verbal abuse can assist in the prediction of suicide attempts in this population.     

An Argument for Separate Analyses of Attitudes Toward Lesbian, Gay, Bisexual Men, Bisexual Women, MtF and FtM Transgender Individuals

While past research has certainly investigated a variety of correlates of U.S. attitudes toward lesbians, gays, bisexual men, bisexual women, male-to-female (MtF) and female-to-male (FtM) transgender (LGBT) individuals, there are no U.S. quantitative studies that could be located that examined attitudes toward each of these groups separately. This is especially important because efforts to combat prejudices are likely to be most successful if they are based in research that explores how attitudes are both similar and different across specified targets of prejudice. Toward that goal, this essay underscores the significance of examining U.S. attitudes toward LGBT individuals as separate constructs. Both the gender and sexual orientation of the target of prejudice and the gender and sexual orientation of the respondent are highlighted as important constructs that should be considered when investigating U.S. attitudes toward LGBT individuals. First, I review previous U.S. studies that have examined attitudes toward LGBT individuals. Second, I offer arguments for how the intersections of gender and sexual orientation may affect attitudes toward LGBT individuals. Third, I discuss future considerations in studies of attitudes toward LGBT individuals in the context of multiple intersectionalities. I suggest that U.S. initiatives to reduce sexual stigma, gender nonconformity stigma, and transgender stigma should be grounded in research that highlights prejudicial attitudes as they vary by the target of prejudice and the respondents’ characteristics.     

Sexual Orientation Disclosure,Concealment, Harassment,and Military Cohesion: Perceptions of LGBT Military Veterans

From the perspective of 445 lesbian, gay, bisexual, and transgender (LGBT) U.S. military veterans, the present study examined hypothesized relations of sexual orientation disclosure, concealment, and harassment with unit social and task cohesion. Findings indicated that sexual orientation disclosure was related positively, whereas sexual orientation concealment and harassment were related negatively to social cohesion. Also, through their links with social cohesion, each of these variables was related indirectly to task cohesion. When the set of predictors was examined together, sexual orientation disclosure had a positive direct relation with social cohesion and a positive indirect relation with task cohesion, whereas sexual orientation–based harassment had a negative direct relation with social cohesion and a negative indirect relation with task cohesion. These data provide useful groundwork for evaluating military policies and practices regarding sexual orientation.     

Religion and Suicide Risk in Lesbian,Gay and Bisexual Austrians

Religion is known to be a protective factor against suicide. However, religiously affiliated sexual minority individuals often report a conflict between religion and sexual identity. Therefore, the protective role of religion against suicide in sexual minority people is unclear. We investigated the effect of religion on suicide risk in a sample of 358 lesbian, gay and bisexual Austrians. Religion was associated with higher scores of internalized homophobia, but with fewer suicide attempts. Our data indicate that religion might be both a risk and a protective factor against suicidality in religiously affiliated sexual minority individuals.     

Reconciling Counselors’ Christian Beliefs and Lesbian,Gay, Bisexual,and Transgender Affirmation: A Grounded Theory

The purpose of this qualitative grounded theory study was to learn how 15 Christian heterosexual counselors successfully reconciled a perceived conflict between lesbian, gay, bisexual, and transgender (LGBT) affirmation and their religious beliefs. Obstacles to reconciliation, helpful factors, states, and participant characteristics were integrated into a grounded theory (the Relational Equilibrium Model) of religious‐based value conflict reconciliation to guide counselor educators and supervisors working with nonaffirming or conflicted Christian trainees to develop LGBT‐affirming dispositions and practices.     

Long‐Term Outcomes of Lesbian,Gay, Bisexual,and Transgender Recalled School Victimization

The authors examined relationships among recalled and current bullying, shame‐focused coping, and fear of negative evaluation in an adult lesbian, gay, bisexual, and transgender (LGBT) sample. Findings indicated that attack self, withdrawal, and attack other shame‐focused coping fully mediated the relationship between recalled bullying and fear of negative evaluation. Fear of negative evaluation and current bullying victimization were predicted by shame‐focused coping. Findings suggested the importance of addressing histories of school‐related bullying and shame‐focused coping when counseling LGBT persons.