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Gay, lesbian and bisexual teens: Facing challenges and building resilience

by Andrew Roffman, LCSW, Virginia Hooper and Staff of the NYU Child Study Center

gay, lesbian and bisexual teens

Recent news stories have brought attention to the devastating effects anti-gay and lesbian bullying can have on teens and adolescents. In September 2010, 18-year-old Rutgers University freshman Tyler Clementi jumped from the George Washington Bridge days after he had been secretly filmed during an intimate encounter with another man that was broadcast over the Internet. Within the same three weeks, Seth Walsh, 13, of Tehachapi California; Billy Lucas, 15, of Greensburg, Indiana; and Asher Brown, 13, of Houston, Texas, all turned to suicide to escape the taunting, bullying and other abuse they faced because of their sexual orientation.

According to a recent survey conducted by the Gay, Lesbian, and Straight Education Network, nearly 9 out of 10 gay, lesbian, transgender or bisexual middle and high school students suffered physical or verbal harassment in 2009, ranging from taunts to outright beatings.

It is with young people like Tyler, Seth, Billy, and Asher in mind that we highlight the following article about building resilience and promoting coping skills in the face of adversity for gay, lesbian and bisexual adolescents. The piece addresses some of the following common questions:

What makes someone gay? | Separating myth from fact | Are GLB kids different from other kids? | What does sexual orientation mean? | Are there special developmental milestones? | What is "coming out" all about? | Are there special mental and physical health concerns? | How can parents help? | Addtional Resources

Introduction

Gay, lesbian, and bisexual (GLB) adolescents face the same developmental tasks as their heterosexual peers. They also face additional challenges that may negatively affect their development - such as the need to develop an identity with few role models - that are different from their peers. But we live in changing times. Openly gay people are prominent in diverse fields - business, finance, entertainment, sports, science. Family-oriented television shows feature gay characters and themes. The Internet offers a new world. The prospects for GLB youth today are more promising than ever before.

But not everything has changed. Despite progress, GLB youth must still cope with a culture that is often hostile. Stigma still surrounds homosexuality. GLB kids face many of the same obstacles as earlier generations: poor self-esteem, family rejection, stigma, social isolation, self-harm, and risky behavior. In school, where kids should feel safe, GLB youth are often taunted and bullied. In many cases, a kid will not seek help, suffering in silence, due to shame. As these social stressors accumulate, GLB adolescents have a greater risk for mental and physical health complications, compared with their peers.

Parents, teachers, and others can help GLB kids negotiate the challenging passage through adolescence into healthy adulthood by showing support, helping reduce social isolation and promoting coping skills. The term "resilience" is used to describe the healthy ability to adapt to adversity and bounce back. Most GLB youth are naturally resilient and, over time, develop coping skills and a positive self-identity. But some are more vulnerable and may need help.

What makes someone gay?

We don't really know. But mental health and other experts agree that sexual preference is not a conscious choice that a person can change. As researchers learn more, we are discovering that biology, including genetic or inborn hormonal factors, may influence a person's sexuality. Most experts today believe that a complex interaction of environmental, cognitive, and biological factors shape a person's sexual orientation. There may be different reasons for different people. But unlike a century ago, we no longer blame poor parenting or regard a person's sexuality as a "character flaw."

A few facts about kids and homosexuality

Approximately one in four families has an immediate GLB family member. Studies suggest that 2 to 4.5% of high school youth self-identify as gay, lesbian, or bisexual; these figures do not reflect others who may be struggling with coming to an understanding of their sexual orientation. Many myths surround homosexuality. Here are a few facts.

Separating myth from fact

Myth: Homosexuality is a mental disorder.
Fact: Mental health professionals agree that homosexuality is not a mental disorder or an emotional problem; GLB youth do, however, face greater risks as a result of social stigma, isolation, and poor self-esteem.

Myth: Kids are young and can still choose to be either gay or straight.
Fact: According to mental health professionals, sexual orientation is not a choice; regardless of age, a person does not choose to be gay or straight.

Myth: Poor parenting causes homosexuality, particularly a domineering mother or a passive father.
Fact: Parenting does not affect a child's sexual orientation, and it's no one's "fault;" parents can, however, positively or negatively influence a GLB child's self-esteem.

Myth: A therapist or religious counselor can make a GLB youth straight.
Fact: Researchers believe that therapy cannot change a person's sexual orientation; it can, however, promote coping skills and help kids resolve questions surrounding their sexual orientation.

Myth: If a kid has a "crush" on someone of the same sex, it's a sure sign he is gay.
Fact: Many kids, gay or not, experience same-sex attractions, and sexual experimentation is a normal part of adolescence. Only time and patience can reveal a person's true sexual orientation.

Myth: If a kid is exposed to other GLB people and/or information, she has a greater risk of "being recruited."
Fact: Positive role models and accurate information can lighten the burden of shame and isolation for a questioning youth, making the adjustment process easier. No one can influence another person to become GLB.

Myth: GLB parents pose a risk of influencing their children to become homosexual.
Fact: No research indicates a parent's sexual orientation determines that of his or her child. GLB youth are as likely to have heterosexual parents as not.

Are GLB kids different from other kids?

GLB youth share with all adolescents these basic developmental tasks:

  • Developing independence from parents
  • Exploring new social roles, as preparation - or rehearsal - for their roles as adults.
  • Recognizing and managing their emerging sexuality, a natural result of the hormonal and body changes associated with puberty.

GLB youth, however, have unique burdens that may overwhelm an otherwise healthy GLB teen:

Greater social trauma. For GLB youth, social adversity makes negotiating adolescent developmental tasks more difficult. Their families and religious communities may not accept them. In school, they may face rejection and harassment from peers - including bullying or violence - and school officials may not provide support or protection. Moreover, kids who do not conform to gender stereotypes face greater harassment.

Fewer role models. GLB youth have fewer opportunities to explore social roles and socialize with their peers. Their "rehearsal for adulthood" becomes more difficult. Further, kids may internalize negative social attitudes; the result may be self-hatred. Their emerging sexuality may be clouded in shame. To cope with stigma, some adolescents learn to conceal their identity, aware of the risk for exposure, which increases isolation.

What does sexual orientation mean?

Sexual orientation is a person's enduring pattern of attraction to other people. The attraction may be emotional, romantic, or sexual, and the feelings persist over time rather than being a phase. Sexuality spans a continuum, ranging from heterosexuality to homosexuality. Over a lifetime, a person may move along the continuum until they discover what feels right. Also, feelings may change, or a person may need time to "label" their feelings. For many GLB youth, the process of evolving a secure identity can be a long, difficult process.

Sexual orientation is an important part of who we are. During adolescence, kids begin to establish an adult identity. This developmental task involves integrating cognitive, emotional, and social factors that form our sense of self. Personality, gender, sex roles, and sexual orientation all play a role. But individual timetables may vary. Many GLB youth first become aware of their sexual orientation during adolescence; others may begin to question but do not resolve their orientation until adulthood.

Normal experimentation. Sexual curiosity is a normal, healthy part of adolescence. Many kids dabble or briefly question their orientation, but these early experiments do not necessarily predict sexual orientation. That's because sexual activity is a form of behavior, while sexual orientation is part of identity. And there are no "gold standards" for distinguishing a passing phase from an enduring sexual identity. For example, heterosexual youth may have same-sex sexual experiences, and gay youth may experiment with the opposite sex. Some youth identify as GLB without any previous sexual experience.

Unfolding identity. If a youth is questioning his/her sexuality, it may take time for the issues to resolve. Some challenges complicate the process, making it harder. Some teens recognize their feelings early, openly acknowledging their sexual orientation. For others, self-discovery naturally extends into adulthood, often resolving in the twenties. But for some, negative experiences and social isolation may delay or complicate a positive resolution; they may need help.

Are there special developmental milestones?

The development of GLB sexual identity, according to most experts, progresses through a series of milestones. There are several theories, but they share these characteristics: the burden of shame, an unfolding identity, self-acceptance, and the role of disclosure ("coming out"). Most of what we know describes boys; lesbian development is less well understood. The few studies of lesbians indicate that females generally have their first sexual experiences later and come out later, compared to males.

Recent studies suggest that adolescents today are coming out and having their first sexual experiences earlier than previous generations. We are also learning that the process may differ for various groups, based on variety of factors, such as socio-economic status, education, and ethnicity. Remember that there is no single "right way," except for what each person feels is right for him. Following is a four-stage model.

Milestones for gay and lesbian development

  1. Feeling different: I'm not like other girls/boys. Many GLB people say they've felt different from a young age. As kids begin to explore gender roles (ages 9 - 12), this feeling may intensify. A girl may feel embarrassed by her technology interests; a boy may dislike team sports. Hopefully, as gender roles become more flexible, the impact of these restrictive stereotypes will lessen.
  2. Identity confusion: Something doesn't feel right. During early adolescence, as the body matures, kids become aware of their sexual feelings. Friendships become more intimate, and same-sex attractions may cause confusion or shame. When dating begins, teens may question their sexual orientation for the first time.
  3. Identity resolution: I know who I am. Gradually, a person moves beyond questioning toward acceptance of their sexual orientation. Information, support, and role models help facilitate the process. A transitional period of bisexual identity is common. Some people are relieved to finally put a "label" on their feelings.
  4. Identity integration: I want to share my life. Eventually, a person wants to share his or her identity and pursue healthy relationships. But each person has his own way, with differences in the degree and timing of disclosure - often with good reason, as cultural, religious, family, and regional pressures may be harmful.

What is "coming out" all about?

Coming out to family and friends can be one of the most stressful experiences GLB youth face. There are risks and benefits. A youth may risk family and peer rejection, which can be devastating. Selective disclosure, however, may offer mental health benefits. For a long time, a youth may conceal her sexual orientation, becoming socially withdrawn, anxious, and insecure. Many GLB adolescents may delay exploring their sexual identity fully (e.g., coming out) until they have a greater degree of safety and support.

For example, some kids wait until they are away at school; others move to an urban environment with greater opportunities or create a network of tolerant friends.

A vulnerable period. During a coming out phase, a youth may be more vulnerable to mood disorders, substance abuse, or risky behaviors, such as unprotected sex. The risk for suicidal behavior is greater. Parental rejection is the greatest fear kids face; a positive parent-child bond is an important aspect of normal adolescent development. If a parent can accept a child, her chances for maintaining self-esteem are greater, which is associated with improved mental health.

A few guidelines. GLB youth should be selective in sharing information about their sexual identity. Emotional and physical safety considerations are primary. Parents may have their own concerns. As a general guide, parent and child together should decide whom to tell. Issues to consider include the following.

  • Personal decision: A youth should decide when and with whom to share her sexual orientation.
  • Family dynamics: Will one parent drive a youth away from home or become emotionally and/or physically abusive?
  • School safety: Is there a risk for harassment, violence, or bullying? Will teachers remain supportive and unbiased?
  • Religious affiliation: Will their place of worship convey the message that they are "wrong"?

Are there special mental and physical health concerns?

The obstacles GLB youth face increase their risk for a range of mental and physical health complications, compared with their peers. Today, experts agree that the psychological problems unique to GLB adolescents result primarily from cultural stigma, poor self-concept, and social isolation. The chronic stress of secrecy and an adverse social environment - including shame and harassment - may lead to depression, anxiety, fear, low self-esteem, self-blame, Post Traumatic Stress Disorder, as well as a range of somatic symptoms.

Studies report that academic career development difficulties, linked to self-concept and identity, may also be affected; when resilience fails, some kids may abandon their career and education goals.

Suicide risk. GLB youth appear to have a greater risk for suicide attempts, compared with their peers. Controversy has surrounded the issue of measuring suicide risk among GLB adolescents primarily due to research limitations. When we consider suicide risk, we refer to three different indicators: suicidal thoughts (ideation), attempted suicide, and completed suicide (death). While our knowledge of completed suicide is limited, studies of GLB adolescents have consistently found that they have a greater risk for suicidal thoughts and attempts, compared with their peers. Suicide risk for all youth, GLB or heterosexual, is associated with a common set of factors, such as depression, substance abuse, and social isolation; but for GLB youth, additional risk factors include:

  • Disclosure of sexual orientation (coming out) to friends and family
  • Exposure to homophobia and harassment
  • Gender nonconformity (effeminate males or masculine females)

When assessing the motive of a youth who has successfully completed a suicide (known as a psychological autopsy), it may be difficult or impossible to know the person's sexual orientation. For attempted suicide, our knowledge is based on surveys of youth who self-report their suicide behavior; these studies may not always be reliable indicators of sexual orientation, since use of GLB labels varies among adolescents.

Violence and victimization. Antigay comments are the most common "put-downs" in middle and high schools. For some youth, running away from home is a self-protective response to violence at home; for others, family rejection drives them away. Homelessness leads to other problems, such as risky sexual practices and substance abuse. For GLB youth, victimization has been associated with abandonment of education goals.

Drug and alcohol abuse. GLB youth have a greater incidence of substance abuse, compared with their peers. Some experts suggest this may be an attempt to self-medicate depression or relieve loneliness. Among all teenagers, substance abuse is associated with other destructive behaviors, including more lethal suicide attempts and unprotected sex.

Sexually transmitted infections and HIV. Youth who engage in high-risk behaviors (e.g., unprotected sex and substance abuse) have an increased risk for sexually transmitted diseases and HIV (AIDS). Lesbian youth may experiment with opposite-gender partners, increasing their risk for unintended pregnancy as well as sexually transmitted disease.

How can parents help?

Parents play a crucial role. Adolescents who have been rejected by the family or are unsuccessful socially or academically are most vulnerable. Having one's identity rejected by one's family can be devastating. Parents of GLB kids, like their children, may also need self-esteem enhancement, education, and acceptance.

Parental acceptance helps kids build resilience. Begin with communication and education. Parents often have their own complicated feelings, but non-judgmental support is essential and many parents say this is an opportunity to have a more open, honest relationship with their child. Consider how difficult it may have been for a child to share this information.

Nurture positive self-identity. Show support and reassure your child that you love and accept her regardless of sexual orientation. Parental support can help offset GLB health risks.

Be patient. Offer reassurance that a questioning period is normal, and there is no need to rush toward a label. But be careful not to minimize same-sex attractions as merely a "passing phase." With time and patience, a person will answer that question for himself.

Normalize the teen years. Enjoy this time together. Show an interest in your child's friends, and if possible, make your home a welcome sanctuary for other GLB kids. Providing a safe place to socialize with adult supervision can help reduce their risk for high-risk behaviors, such as substance abuse and sexual promiscuity.

Ensure safe schools. Children are legally entitled to a harassment-free education, which is not always a reality. Ask about teasing, bullying, or harassment; due to guilt and shame, kids may not volunteer this information. Confirm that school authorities provide appropriate support/ intervention. If necessary, legally advocate for your child's safety.

Educate about sexual practices. Discuss the need for sexual abstinence and/or protection against sexually transmitted diseases, such as HIV (AIDS). Provide information on birth control; contrary to expectation, it is not uncommon for a GLB youth to experiment with heterosexual sex, placing her at risk for unintended pregnancy.

Recognize when kids need extra help. If a youth is unhappy or struggling, seek out an unbiased therapist with experience in youth issues and sexual orientation. Sometimes kids just need an impartial listener; other times, they may be dealing with issues beyond what a parent can handle, such as depression, substance abuse, or suicidal feelings.

Build a support base and reduce social isolation

Although GLB youth face obstacles - stigma, hostility, and isolation - we can help modify these risk factors. Focus on reducing a child's sense of isolation, primarily through self-esteem enhancement, education, and acceptance. Help kids locate support and build social-connectedness, which nurture positive self-concept. Studies show that GLB individuals with a positive self-identity experience better psychological adjustment, higher self-esteem, and lower depression or stress. Many qualified support resources are available. The Internet is a great place to start.

Online resources. Rely on qualified sources with adult supervision. Reliable online resources offer education, coping tips, and listings for "offline" support services in your geographical area. Additionally, many feature adult-supervised discussion boards and chat rooms for GLB or "questioning" youth. These venues provide GLB kids with a relatively safe, anonymous way to share experiences and receive - or offer - peer support. Although online socializing is not a substitute for "real life," it can help reduce isolation and "normalize" feelings. For kids in rural areas, who face greater stigma and fewer social resources, online support may be particularly valuable.

Community resources. Many cities have community centers that offer supervised support meetings for GLB teens, as well as recreational opportunities. These activities provide safe opportunities for GLB teens to meet and socialize. School-based gay-straight alliances are another option.

When to consult a mental health professional

Homosexuality is not a mental disorder, but for a variety of reasons, a therapist may be helpful for both GLB youth and their families. Therapy cannot change a person's sexual orientation - which is not a choice - but therapy can ease confusion and promote positive coping skills. While most GLB kids negotiate the adolescent years without serious problems, others are more vulnerable and need help.

Counseling can help kids who are confused about their sexual orientation or those having trouble accepting their feelings. Over time, with support and accurate information, confusion about sexual identity will resolve. Even kids comfortable with their sexuality may face social stigma and isolation, which can increase their vulnerability. Keep in mind that help-seeking is a healthy response to social stressors; GLB youth who seek care may have more effective coping skills than those who do not.

Teach respect to all kids

Teach respect early before kids are exposed to prejudice. Children learn about homosexuality from the media, the playground, and their friends. But these sources may convey mixed messages and confuse kids. Gay name-calling hurts all children. Kids may be called gay or lesbian as a put-down, regardless of their sexual orientation. You can use simple terms, with age-adjusted language, such as: Everyone has a need for companionship, and there are different types of families, just like there are people with different skin colors. Even if you don't understand homosexuality, say mental health experts, it's important to provide accurate information.

Additional Resources:

Gay, Lesbian and Straight Education Network (GLSEN)
122 West 26th Street, Suite 1100
New York, NY 10001
Phone: (212) 727-0135
www.glsen.org

Parents, Families, and Friends of Lesbians and Gays (PFLAG)
1101 14th Street, NW, Suite 1030
Washington, DC 20005
Phone: (202) 638-4200
www.pflag.org

It Gets Better Project
www.itgetsbetter.org

The Trevor Project
www.thetrevorproject.org

Updated: November 2010