Unless otherwise specified, the definition of LGB or sexual minority youth as used in this paper will specifically reference adolescents who self-identify as lesbian, gay, or bisexual, and will not include transgender youth. Transgender youth are often confronted with a very different experience from cissexual minority youth, and cannot be grouped together with LGB youth for the purposes of this paper, but rather necessitate further need for research specific to the transgender experience. Research on LGBT adolescents is difficult for a number of reasons, including those found in non-LGBT adolescents like high attrition rates, self-selection, and response bias. Research on LGBT adolescents, however, has additional barriers that include the difficulty in establishing definitions for how to define LGBT and to include those who might self-identify any number of different ways in orientation and gender.
For example, pansexuality can be broadly defined as attraction not limited to gender, attraction to all genders, or attraction with no regard to gender. Bisexuality can be defined as the attraction to more than one gender, attraction to those of both your own and other genders, or attraction to both males and females (despite gender being non-binary and on a spectrum). Different people or groups of people within the LGBT community will look at these definitions of pansexuality and bisexuality in one of a number of different ways. Some consider bisexuality to be attraction to men and women, and some include trans individuals in that while others do not. Some consider pansexuality to fall under the umbrella term of bisexuality, others use the two terms synonymously, and still others consider them two distinct and separate orientations. Some will choose to self-identify by a particular term or more than one term that they feel best fits them, and which may not necessarily match the same definitions used by a broader LGBT community.
In addition, many LGBT adolescents will identify differently in different settings and contexts, or change their identity throughout their adolescent life, as sexual orientation is quite fluid. Historically, academic literature has too frequently grouped bisexuals with either heterosexual or homosexuals, often based on their partner at the time. We can only assume that pansexuals and those of other identities have also slipped through the cracks and been grouped in an overgeneralized way that does not capture the nuances of sexual orientation identity and the differences between them.
This represents a significant limitation to research on LGBT adolescents, and to this end, one must evaluate the best way to posit the question of sexual orientation identity. Researchers should consider, particularly with adolescents, who may only have limited romantic or sexual experience, wording questions in a way that asks adolescents to evaluate their identity, their attraction, or their behavior, based on what fits researchers’ interest best. Many adolescents may not yet know how they identify for sure, but have experimented with or experienced attraction to members of the same sex. Other adolescents may be sure of their identity or attraction, but have yet to explore or experience it, based on age or access to same-sex partners.
Moreover, researchers should consider what response options they present for adolescents to choose from, whether they limit those to heterosexual, gay/lesbian, and bisexual as is standard in the current academic literature, or they provide more options, the ability to select other, or the option to compose a freeform response in an attempt to capture the nuances of sexual identity. While this may make tracking patterns or forming strictly distinct groups more difficult for researchers, it would be more accurate to the great variability that exists in human sexuality, which even Alfred Kinsey alluded to in his 1948 Sexual Behavior of the Human Male. The Kinsey scale, or Heterosexual-Homosexual Rating Scale, is a seven point Likert scale that demonstrates that human sexuality is not limited to strictly heterosexual, strictly homosexual, or bisexual with equal levels of attraction; it even has what could be considered an option for asexuality.
The minority stress model has been in the makings for the past several decades, but was first termed such by Ilan Meyer in a 1999 paper, and expounded upon in his 2003 paper Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. The minority stress model hypothesizes that chronic stress faced by members of stigmatized minority groups leads to poor mental and physical health outcomes in minority individuals. These stresses can include implicit and explicit prejudice and discrimination, victimization, microaggressions, lack of social support, and low socioeconomic status, all of which are distal stressors. Distal stressors can lead to proximal stressors like fear of rejection, internalized prejudice against one’s own minority group, feelings of lack of belonging, and rumination (Baams, Dubas, Russell, Buikema, & van Aken, 2018). These stressors, experienced repeatedly and over an extended period of time, cause physical stress responses like high blood pressure and anxiety, and can lead to more severe negative mental and physical health outcomes, such as increased rates of suicidality, depression, anxiety, substance abuse, diabetes, cardiovascular disease, and some cancers.
Despite increasing acceptance of LGBT individuals in Western cultures, which this paper focuses on, sexual minority youth continue to experience sexual orientation-based prejudice, discrimination, violence, and microaggressions, which pose a significant threat to their overall well-being. This in turn has sexual minority adolescents experiencing depression, suicidal ideation, and self-harm at elevated rates (Oginni, Robinson, Jones, Ralman, & Rimes, 2018). One factor contributing to this could be that with same-sex-attracted identities becoming more accepted, children and adolescents are able to begin exploring their sexual identities and coming out to others at younger ages, leaving them open to more familial stigma and peer victimization.
Adolescence overall is a period of identity instability, exhibiting in particular significant mobility in sexual identity. Adolescents who change their sexual identity may do so to reduce cognitive dissonance caused by an identity they have defined themselves by; sexual identities, particularly within the larger LGBT community, have normative expectations associated with them, creating an identity standard. Adolescents evaluate their performance of this standard, and may change their identity to one they fit better as they undergo further sexual exploration (Everett, 2015). A change in identity may reduce cognitive dissonance and improve well-being, but it also disrupts an adolescent’s conception of self and causes them to lose social networks, support, and resources particular to that identity.
Social identities organize individuals’ social lives, validate in-group norms, buffer external stigma, and provide individuals with a sense of meaning and purpose in a larger heteronormative social and cultural context that otherwise invalidates their identities (Harper, Brodsky, & Bruce, 2012; Everett, 2015). They may also then be exposed to increased discrimination due to a change towards a more stigmatized identity. Everett’s research (2015) found that the negative impacts of identity change are concentrated among individuals who were originally heterosexual, and that increases in depressive symptomology was isolated to changes towards being more same-sex oriented.
Stigma against sexual minority adolescents takes a variety of forms. Microaggressions are brief, often unintentional, commonplace slights. They are socially legitimized, and although they lack the intensity of more familiar forms of discrimination, they are far more repetitive, often experienced on a daily basis. These indignities are verbal, behavioral, or environmental hidden messages that communicate hostile, derogative, or negative feelings, intolerance, and exclusion about sexual minorities (Kaufman, Baams, & Dubas, 2017). Physical forms of discriminatory aggression may take the forms of hitting and punching, sexual assault, and mock or corrective rape.
LGBT individuals have significantly higher rates of sexual victimization than their heterosexual peers (Langederfer-Magruder, Walls, Kattari, Whitfield, & Ramos, 2016). Verbal harassment takes the forms of teasing, name-calling, taunting, insults, slurs, gossip, and malicious rumors. Another reason rates of depression may be increasing in sexual minority adolescents is the greater role technology is playing in harassment, in the form of cyberbullying. This can include harassing, threatening, blackmail, or sharing images and messages with peers (Beckerman & Auerbach, 2014).