Destroying the Monster: How We Can Protect LGBTQIA+ Youth Mental Health

“Looking in the mirror, I’m haunted by the monster staring back at me — the reflection of an ugly, disgusting, less-than monster. As my eyes lock in with the monster, I question, ‘am I unlovable? Am I enough? Is this my fault? Will anyone ever accept me? Do I accept me? Am I safe?’”

Through shaking voices and pained eyes, these are just a few common-themed questions I hear daily from children and adolescents in my clinical practice as a pediatric psychologist: youth feeling as if they are carrying the weight of the world on their shoulders, coupled with the unknown of these questions can seem too much to bear at times. Some may feel flawed, broken, or scared, and yet they resemble astounding fortitude.

What You Need to Know About LGBTQIA+ Youth

LGBTQIA+ youth are not predisposed to increased suicidality or mental health disorders because of their sexual or gender identities, rather their experiences of stigmatization, familial rejection, and unsafe or non-affirming environments place them at increased risk; they are not inherently born to feel like monsters. Perpetual and chronic victimization, prejudice, and discrimination experienced by LGBTQIA+ youth encapsulate minority stress theory. Envision the degree of disapproval, hate, and exclusion a child must experience to internalize themselves as a disgusting monster unworthy of love. Consequently, depression, anxiety, trauma, and homelessness occur at significantly higher rates for LGBTQIA+ youth. And sadly, LGBTQIA+ are more than four times as likely to attempt suicide than their peers, with one LGBTQIA+ young person attempting suicide every 45 seconds in the United States. 

As a pediatric psychologist, one of the most indigestible statements is: “Please don’t tell my parents I’m gay, they’ll kill me.” In that moment, I contemplate the content and language used by parents, family members, friends, or teachers that may render such fear and terror at the thought of simply talking to their parents. Instinctively, I aim to protect and validate every child in an attempt to relinquish some of their distress and instill hope; however, this work truly must begin at home.  

Current LGBTQIA+ youth mental health statistics, along with a record-high number of anti-LGBTQIA+ legislative bills sweeping across the United States, paint a dismal picture. Luckily, data has also shown that we can mitigate negative mental health outcomes for youth with easily applicable strategies by parents, teachers, and friends.

For starters, research has shown that family acceptance protects LGBTQIA+ adolescents from suicidal behavior, depression, and substance abuse. Youth with accepting families report higher self-esteem, social support, and overall health. Having just one accepting adult reduces suicide by 40% for an LGBTQIA+ young person. Imagine for a moment how much you can truly change the outcome of a child’s life by simply accepting them for who they are. Similarly, LGBTQIA+ youth who find their school and home to be affirming report lower rates of attempting suicide. 

So, you may ask, what is an affirming environment?

How You Can Help LGBTQIA+ Youth

Kids are innately curious and ask questions to understand the world around them and the context in which they are living. Cultivating an affirming and accepting environment for children begins early on with language they can understand about family and love. For example, talk to your child about diversity among families by explaining that families all look different – some kids may have one parent or two parents, like two moms, two dads, or one mom and one dad. “What is important is that families love one another and keep each other safe!” This simple language launches the narrative of openness and acceptance toward all people. 

Self-expression and exploration are critical and normative aspects of childhood development. Allowing kids opportunities to explore interests and activities cultivates creativity, growth, and self-identity. Parents and adults can enhance this process by ensuring interests and activities are labeled for all children. For example, if a child states, “dolls are for girls” or “baseball is for boys,” parents can quickly explain that toys and activities are for all kids! 

Fast-forward to when your child or teen may come to you with questions or declarations about their gender identity or sexual orientation, unconditional love and support are paramount. Be present with your child, listen, validate, ask about their experiences, and demonstrate to them that as their parent you will always love and protect them. For parents who may struggle with grasping aspects of their child’s identities, recognize your emotions and seek out your own support. 

Parents can also be catalysts for peer connection and support by connecting their youth with LGBTQIA+ resources and events to increase belongingness and community. Such resources and communities serve as invaluable resources also for parents who may need additional support for their child’s emerging gender identity or sexual orientation. 

When to Seek Additional Support With LGBTQIA+ Youth

If you notice your child is struggling with an aspect of their identity, seek out mental health support from affirming providers who can provide evidence-based guidance. Transgender and gender-diverse youth exhibit even higher rates of negative mental health outcomes and may need a specialty gender care team. Such a team of physicians, psychologists, and social workers specialize in supporting transgender youth and their parents. This does not simply imply medical interventions but rather affirming care for parents and children to better understand themselves. 

For youth who undergo gender-affirming care, multiple studies have shown improved mental health outcomes for transgender and gender-diverse youth, including reduced suicidality, after receiving gender-affirming care (i.e., social transition, pubertal suppression, and/or hormone treatment). Even social transitions, such as chosen name use and respected pronouns are linked to reduced depressive symptoms, suicidal ideation, and suicidal behavior among transgender adolescents. 

In the end, discrimination, prejudice, and bullying are the actual monsters, the monsters in the forms of political attacks, shaming, fearmongering, and denying access to support, resources, and care for all children. Our society has created, fueled, and fed these monsters that continue to haunt numerous LGBTQIA+ youth and families; we must destroy these monsters. Findings regarding current LGBTQIA+ youth mental health and strategies to improve outcomes overwhelming show the need for acceptance and inclusion of gender and sexual diversity. We owe it to all children and adolescents in our lives to accept and support them as they are.

To all LGBTQIA+ youth and families, please know that you belong, you are worthy of all the love and acceptance, and you are more than enough.

Dr. Poulopoulos is a pediatric psychologist in Miami and advocates for sexual and gender diversity to establish a safe and inclusive community for LGBTQIA+ individuals. She teaches seminars and trainings regarding gender and sexual diversity and an affirming care approach across medical departments. Dr. Poulopoulos is a member of the Society of Pediatric Psychology and has co-authored several peer-reviewed publications and presentations.

Resources for LGBTQIA+ Youth

The Trevor Project: (866-488-7386) or Text ‘Start’ to 978678
LGBT National Youth Talk line: (800-246-7743)
LGBT National Center: (888-843-4564)
PFLAG.ORG
ITGETSBETTER.ORG