Psychodynamics of Suicide in Lesbian,Gay, Bisexual,or Transgender Youth

Lesbian, gay, bisexual, and transgender (LGBT) youth are a vulnerable population at high risk of suicide and, as such, benefit from an informed psychotherapeutic approach to treatment. While it is clear that sexual orientation and gender identity are independent dimensions from psychopathology, LGBT youth are frequently marginalized and may face unique challenges with self-acceptance and identification with peers, family, and society, increasing risk of social isolation, which in turn increases vulnerability to anxiety, mood disorders, substance use, and suicide. We elaborate on the common phenomenon of ambivalent repression of the sexual self in adolescents associated with intertwined themes frequently expressed in suicidal lesbian, gay, transgender, bisexual, and queer patients on the inpatient adolescent unit: anger directed toward internal and external objects; desire for self-punishment, atonement, and possibly rebirth; and desperation and desire to escape psychic pain. We enhance our discussion with case examples and practical therapeutic considerations that emerge from these themes that can be harnessed across treatment settings.     

Heterosexuals’ Attitudes Toward Transgender People: Findings from a National Probability Sample of U.S. Adults

Using data from a national probability sample of heterosexual U.S. adults (N?=?2,281), the present study describes the distribution and correlates of men’s and women’s attitudes toward transgender people. Feeling thermometer ratings of transgender people were strongly correlated with attitudes toward gay men, lesbians, and bisexuals, but were significantly less favorable. Attitudes toward transgender people were more negative among heterosexual men than women. Negative attitudes were associated with endorsement of a binary conception of gender; higher levels of psychological authoritarianism, political conservatism, and anti-egalitarianism, and (for women) religiosity; and lack of personal contact with sexual minorities. In regression analysis, sexual prejudice accounted for much of the variance in transgender attitudes, but respondent gender, educational level, authoritarianism, anti-egalitarianism, and (for women) religiosity remained significant predictors with sexual prejudice statistically controlled. Implications and directions for future research on attitudes toward transgender people are discussed.     

Straight Allies: What Predicts Heterosexuals' Alliance With the LGBT Community?1

Despite their prominence in civil rights movements, out‐group allies have been understudied. The current research examined out‐group alliance, focusing on predictors of heterosexuals' advocacy for lesbian, gay, bisexual, and transgender (LGBT) rights. Heterosexuals who were recruited through an online panel of research participants completed a survey containing measures of empathy, out‐group contact, gender, education, and attitudes toward gays and lesbians. Additionally, participants indicated whether they had engaged in several allied behaviors (e.g., donating money for LGBT causes). Women, educated individuals, and those with gay and lesbian friends were more likely to be allies. Additionally, alliance was greatest among individuals lower in prejudice and simultaneously higher in positivity toward gays and lesbians. Implications regarding intergroup relations and future research are discussed.     

Using Intergroup Contact Theory to Reduce Stigma Against Transgender Individuals: Impact of a Transgender Speaker Panel Presentation

Sexual minorities experience significant stigma and prejudice. Much research has examined sexual stigma and prejudice impacting gay and lesbian individuals, but limited research has examined other sexual minorities, such as transgender persons or individuals whose gender identity or expression is incongruent with their assigned gender or anatomical sex. Research has found that interpersonal contact with sexual minorities is associated with lower sexual stigma and prejudice. Intergroup contact theory predicts that interaction between groups can reduce stereotyping and improve intergroup relationships. Using a randomized crossover design, this study compared the impact of exposure to a transgender speaker panel vs. a traditional transgender lecture presentation on transphobia. Results indicated greater immediate reductions of transphobia following the transgender speaker panel than traditional lecture.     

Attitudes Toward and Beliefs about Transgender Youth: A Cross-Cultural Comparison Between the United States and India

Using an internet-based survey, we examined attitudes toward transgender youth in the United States and India, two cultures with differences in conceptualizations of gender and treatment of transgender individuals in society, law, and religion. We found generally positive attitudes toward transgender youth in our U.S. (n = 218), but moderately negative ones in our Indian (n = 217), sample. Consistent with the literature on prejudice against transgender adults in many Western societies, general social conservatism in the form of religious beliefs and political ideology, gender-specific conservatism in the form of gender binary belief, and endorsement of environmental rather than biological causes of transgender identity were the best predictors of U.S. participants’ attitudes, although personal contact with gender and sexual minorities also played a role at the bivariate level. These findings suggest that the processes underlying prejudice against transgender youth are similar to those that foster adult-directed transphobia in that cultural context. In contrast, religion-based disapproval and environmental causal attributions were the best predictors of Indian respondents’ attitudes, whereas gender binary belief played only a minor role, and political conservatism and personal contact no role at all. Our regression analyses accounted for considerably more of the variability in U.S. than in Indian participants’ attitudes, highlighting the need for additional (qualitative) work to identify the factors that promote transprejudice in India. We discuss these findings in light of cross-cultural differences between the two countries in terms of our predictors and consider implications for efforts to reduce prejudice against 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, and bisexual victimization in the military: an unintended consequence of "Don't Ask, Don't Tell"?

The integration of lesbian, gay, and bisexual (LGB) individuals into the U.S. military is a long-standing and politically and socially divisive issue. Exclusionary and pseudo-inclusionary policies that restrict openly LGB individuals from military service are also of long duration. Yet LGB servicemembers have continued to serve covertly in the military for many decades. Moreover, political issues and social conventions associated with "Don't Ask, Don't Tell" (DADT) have diverted focus from imperative research issues, such as LGB servicemembers and incidents of victimization in the military. Research is reviewed to evaluate such victimization, which is conceptualized as resulting from a convergence of sexual stigma, conservative gender role beliefs, and sexual prejudice. DADT, in combination with overarching difficulties intrinsic to sexual orientation research, serves to augment LGB victimization and reduce victim reports and help seeking. Consequently, there is a deficient evidence base for assisting LGB servicemembers and for advancing research, prevention efforts, and policy changes. Implications of repealing DADT are discussed, as are future directions for LGB military research.     

The Psychology of Sexual Prejudice

Sexual prejudice refers to negative attitudes toward an individual because of her or his sexual orientation. In this article, the term is used to characterize heterosexuals' negative attitudes toward (a) homosexual behavior, (b) people with a homosexual or bisexual orientation, and (c) communities of gay, lesbian, and bisexual people. Sexual prejudice is a preferable term to homophobia because it conveys no assumptions about the motivations underlying negative attitudes, locates the study of attitudes concerning sexual orientation within the broader context of social psychological research on prejudice, and avoids value judgments about such attitudes. Sexual prejudice remains widespread in the United States, although moral condemnation has decreased in the 1990s and opposition to antigay discrimination has increased. The article reviews current knowledge about the prevalence of sexual prejudice, its psychological correlates, its underlying motivations, and its relationship to hate crimes and other antigay behaviors.     

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.     

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.     

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.     

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.     

Religious Queer People Beyond Identity Conflict: Lessons from Orthodox LGBT Jews in Israel

A key thread of research on how lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons of faith navigate and make sense of gender and sexual identities and desires that defy their religious traditions’ teachings focuses on identity conflict, management, negotiation, and reconciliation. Drawing on interviews with 64 Orthodox Jewish same-sex attracted persons in Israel, supplemented by physical and digital ethnographic data, I argue that the conflict frame is empirically imprecise and conceptually flawed. I demonstrate fluidity and ambivalence vis-à-vis religiosity and sexual identity and argue that ambivalence is generative: In the process of making sense of their sexual and religious selves, my respondents challenge what it means to be Orthodox and what it means to be same-sex attracted, thereby challenging the conflict frame's categorical schema. I then make the case for a more contextualized and dynamic framework for theorizing LGBT negotiations of religious and sexual identities. I also observe that the limitations of the conflict lens are symptomatic of broader tendencies in the sociology of religion to rely on U.S. and Christian cases and a pattern of limited engagement with work in other disciplines and subdisciplines.     

Comparing implicit and explicit attitudes of gay,straight, and non-monosexual groups toward transmen and transwomen

Background: Transphobia studies have typically relied on self-report measures from heterosexual samples. However, there is evidence suggesting the need to use indirect measures and to explore transphobia among other populations. Aims: This study examined how explicit and implicit attitudes toward transwomen and transmen differ between people of different sexual orientations. Methods: Cisgender participants (N = 265) completed measures of explicit feelings toward transmen and transwomen, as well as Implicit Association Tests (IAT) for each group. Comparisons were made between 54 gay, 79 straight, and 132 non-monosexual (asexual, bisexual, pansexual) individuals. Results: An interaction was found between measurement type (explicit, implicit) and sexual orientation (straight, gay, non-monosexual). With regard to transmen, gay respondents’ explicit and implicit scores diverged such that they explicitly reported lower bias than their straight counterparts, but their Transmen-IAT showed an implicit preference for biological men over transmen. For attitudes toward transwomen, implicit measurement scores were consistently negative and did not differ by group. Gay participants also reported positive explicit attitudes toward transwomen, similar to non-monosexual people. Discussion: Overall, findings show that gay people tend to report positive attitudes toward transgender people explicitly, but tend to have implicit bias against both transmen and transwomen. Future studies need to explore the origins of these biases and how they relate to the complex interplay of sex, gender, and sexual orientation.     

A Preliminary Investigation of Body Dissatisfaction and Eating Disorder Symptomatology with Bisexual Individuals

Body dissatisfaction and eating disorder symptomatology were examined in bisexual individuals (n?=?139 women, n?=?37 men) and compared to lesbian/gay (n?=?51 women, n?=?96 men) and heterosexual individuals (n?=?82 women, n?=?34 men) in a U.S. online sample. Age, body mass index (BMI), income, and exercise frequency served as covariates. MANCOVA results showed a significant gender by sexual orientation interaction and significant main effects of gender and sexuality. Univariate tests were used to explore multivariate results. ANCOVA results for body dissatisfaction showed a significant gender by sexual orientation interaction. Post-hoc comparisons revealed higher levels of body dissatisfaction among all groups compared to heterosexual men. ANCOVA results for eating disorder symptomatology showed a significant main effect of sexual orientation. Post-hoc comparisons revealed higher levels of eating disorder symptoms among bisexual compared to heterosexual individuals. For bisexual men, gay community involvement, maladaptive social comparison, drive for muscularity, self-esteem, gender role orientation, and body dissatisfaction were explored as predictors of eating disorder symptomatology while controlling for age, BMI, exercise frequency, and income in a hierarchical regression analysis. The same factors, minus body dissatisfaction, were explored as predictors of body dissatisfaction in bisexual men. For bisexual women, similar factors, with the exception of drive for muscularity, were explored. Drive for muscularity predicted body dissatisfaction and exercise frequency predicted eating disorder symptomatology in bisexual men. BMI and self-esteem predicted body dissatisfaction in bisexual women; gay community involvement and body dissatisfaction predicted eating disorder symptomatology.     

Intake Interviewing with Lesbian, Gay, Bisexual, and Transgender Clients: Starting from a Place of Affirmation

Initial interactions between lesbian, gay, bisexual, or transgender (LGBT) clients and psychotherapists can reveal existing biases from both parties. LGBT clients may have previous experiences with the mental health establishment and legitimate concerns about being pathologized. Psychotherapists may approach clients with openness and acceptance, but are likely to have little training in working with LGBT individuals. In this article, we discuss affirmative practices as a framework for clinicians beginning the intake process with LGBT clients. Through a brief history and overview of LGBT mental health, we provide mental health professionals with an appreciation of the multiple influences on LGBT individuals’ well-being. We then discuss the intake interview process in relation to each subgroup of the LGBT acronym, as each of these four populations face different (yet inter-related) challenges. While there is clearly no “formula” for working with LGBT individuals, in keeping with the principles of multicultural competency (Sue, The Counseling Psychologist, 29:790–821, 2001), our goal is to encourage therapists to reflect on their existing biases and to gain knowledge and skills for working with this diverse population. Overall, we hope this article demonstrates to therapists how to conduct an affirmative intake interview that minimizes heterosexual and dualistic gender assumptions that remain so pervasive in our society and in therapeutic practice.     

The Relationship Between Religious Orientation,Right-Wing Authoritarianism,and Implicit Sexual Prejudice

The relationship between intrinsic, extrinsic, and quest religious orientations, right-wing authoritarianism (RWA), and implicit and explicit attitudes toward homosexual individuals were examined within a sample of predominantly Protestant college students in the United States. Implicit attitudes were measured with the Implicit Association Test, a computer program that recorded reaction times as participants categorized symbols (of heterosexual and homosexual individuals) and adjectives (good or bad words). Participants displayed fairly negative implicit and explicit attitudes toward homosexual individuals (i.e., sexual prejudice). Intrinsic religious orientation uniquely predicted increased explicit sexual prejudice (when extrinsic, quest, and impression management were statistically controlled), and RWA appeared to mediate this effect. In contrast, the positive relationship between intrinsic religion and implicit sexual prejudice did not disappear when controlling for RWA. Although RWA seemed to be related to self-reports of prejudice, intrinsic religious orientation was uniquely related to automatic negative attitudes toward homosexual individuals.     

Effect of perceived public stigma on internalized homophobia,anticipated stigma,shame, and guilt: Outness as a moderator

Although previous studies found that distal minority stress contributes to proximal minority stress and shame/guilt among the lesbian, gay, and bisexual (LGB) population, it is unclear whether the extent to which LGB individuals' open display and discussion their sexual orientation moderates these relationships. A total of 1,452 Chinese LGB adults provided demographic information and completed measures of outness, perceived public stigma, internalized homophobia, anticipated stigma, shame, and guilt. Structural equation modelling was conducted to test the hypothesized moderation analyses. Perceived public stigma had positive associations with internalized homophobia, anticipated stigma, shame, and guilt. Outness played a moderating role in the associations of perceived public stigma with internalized homophobia, anticipated stigma, shame, and guilt. Specifically, when LGB individuals had higher levels of outness, the effects of perceived public stigma on internalized homophobia, anticipated stigma, shame, and guilt were lower. Moreover, such moderating effect did not differ by sexual orientation. The degree to which sexual minority individuals' sexual orientation is known by and openly discussed with others may lower the extent to which LGB individuals internalize sexual stigma, expect rejection after coming out, and develop shame and guilt as a result of perceived social prejudice and discrimination.     

Ideology,Prejudice, and Attitudes Toward Sexual Minority Social Policies and Organizations

This study tested the effects of multiple ideologies on support for restrictive policies against gay and lesbian individuals and organizations and if these effects were mediated by sexual prejudice. Social dominance orientation (SDO), conservatism, and right‐wing authoritarianism (RWA) each had significant direct and indirect effects. SDO had the most consistent direct effects in addition to its effects through sexual prejudice. The direct effects of conservatism were smaller and similar in size to its indirect effects through prejudice. Although the direct effect of RWA was significant for policy attitudes, its effect was entirely mediated through sexual prejudice for organization opposition. Results suggest that high‐RWA individuals adopt their positions largely because of prejudice toward sexual minorities, while high‐SDO individuals adopt their positions partly out of prejudice and partly because these positions perpetuate hierarchies between heterosexuals and sexual minorities. Results also diminish the principled conservatism argument that conservative positions on these policies and organizations are absent of prejudice. As policies continue to be enacted that affect the sexual minority community, research is needed to identify the underlying motivations for individuals' positions toward these policies.