Lecture 3a – LGBT, sexual minority and gender nonconforming youth
Historical context
1973: until then the APA classified homosexuality as a mental disorder, from now on in the DSM-V
not included
Kinsey in 1940-1950s: homosexuality is a normal variant of human sexuality
Evelyn Hooker: 1970s common to use kind of tests with ink pictures, results blind to psychiatrics to
ask what diagnosis was, no differences in hetero and gay men.
Although homosexuality wasn’t classified as a disorder, it didn’t mean that those people did not have
psychological health problems critique on those studies because convenience samples (versus
including questions about sexual identity in large national samples, as done in the
Netherlands/Utrecht now).
outcome: men and women who belong to a sexual minority based on behavior, attraction and/or
identification report more psychological (for example: depressive feelings) and psychiatric problems
(for example men in particular mood and anxiety disorders and women more substance use
dependence) compared to heterosexual people
Studies generally found that transgender non-conforming adults show poorer mental health (e.g.,
anxiety, depression, suicidality) and that gender affirmation treatment was associated with
improvements in mental health and wellbeing
In general, youth who reported gender-variant experiences more likely to show poor mental health,
Mental health, including gender dysphoria, depression and suicidality generally improved following
gender affirmation treatment
General studies about health and health outcomes among adult population
General studies about health and school outcomes in school surveys
Intersectionality
“ (…) previous research has frequently (…) failed to use approaches that account for intersectionality.
(…) It is critical to take intersecting minority identities (i.e., sexual minority, gender, race/ethnicity)
into account when examining physical health disparities.”
“Given the dearth of research using an intersectional perspective to examine physical health
disparities as well as evidence suggesting both increased risk and resilience, further examinations of
how physical health disparities differ by race/ethnicity are required.” (2018)
Minority stress is the predominant explanation for sexual and gender minority (SGM) health
inequities:
• Chronic stressful events (e.g., stigma, discrimination, violence)
• Expectation of such events and the vigilance this requires
• Rejection sensitivity-often leading to concealment of SGM status
• Internalization of negative societal attitudes
Structural stigma: societal-level conditions, cultural norms, and institutional policies that constrain
opportunities, resources, well-being, and health.
Research has shown that SGM people who live in countries or cities that have low levels of structural
stigma are less likely to experience poor health than those who live in high stigma locations.
There are country differences: Researchers in California did a study on almost all countries: Social
acceptance of LGBT people in 174 countries (1981-2017) overall the social acceptance increased
(Iceland, Sweden, Canada, Netherlands, Norway), however in some countries there was a decrease
(Moldova, Ethiopia, Mauritania, Azerbaijan, Zimbabwe).
, The situation in the Netherlands is complex: there is a limited acceptance. There is a very strong
equal treatment act, and in the first article of the constitution sexuality is explicitly mentioned. It is
the first country in which gay marriage was accepted.
In research, 4% are ashamed that a family member is gay, 94% find that homosexuals must be able to
live their lives the way they would like. The 4% is not going to decrease in the future most likely.
16% disgusting two women kissing in public. 25% two men, 9% man and woman.
Similar percentages about homosexual couples should be able to adopt child and a child needs a
home with father and a mother for healthy development.
When we talk about gender identity, there is a much higher percentage not as free thinking at with
sexuality.
In a study (Huijnk, 2022) in groep 8: One-third of the students agreed with the statement that the
gender non-conforming peer should not participate. Forty percent found that the gender non-
conforming peer had to change the behavior in order to be allowed to participate in the future.
Actual events, risk factors and stressors
Kuyper (2018): SGM youth are being bullied more often (not studied if it was because of sexuality)
Rutgers (2017): boys get bullied more often than girls within SGM youth group (called names,
excluded, bullied, threatened, kicked/beaten)
Kooiman & Keuzemkamp (2012): expectation rejection adjust behaviour because of thinking they
will be rejected
Rutgers (2017): the strongest stressor is internalizing homonegativity 22% of boys would rather
not be gay, 12% of girls.
Historical context
1973: until then the APA classified homosexuality as a mental disorder, from now on in the DSM-V
not included
Kinsey in 1940-1950s: homosexuality is a normal variant of human sexuality
Evelyn Hooker: 1970s common to use kind of tests with ink pictures, results blind to psychiatrics to
ask what diagnosis was, no differences in hetero and gay men.
Although homosexuality wasn’t classified as a disorder, it didn’t mean that those people did not have
psychological health problems critique on those studies because convenience samples (versus
including questions about sexual identity in large national samples, as done in the
Netherlands/Utrecht now).
outcome: men and women who belong to a sexual minority based on behavior, attraction and/or
identification report more psychological (for example: depressive feelings) and psychiatric problems
(for example men in particular mood and anxiety disorders and women more substance use
dependence) compared to heterosexual people
Studies generally found that transgender non-conforming adults show poorer mental health (e.g.,
anxiety, depression, suicidality) and that gender affirmation treatment was associated with
improvements in mental health and wellbeing
In general, youth who reported gender-variant experiences more likely to show poor mental health,
Mental health, including gender dysphoria, depression and suicidality generally improved following
gender affirmation treatment
General studies about health and health outcomes among adult population
General studies about health and school outcomes in school surveys
Intersectionality
“ (…) previous research has frequently (…) failed to use approaches that account for intersectionality.
(…) It is critical to take intersecting minority identities (i.e., sexual minority, gender, race/ethnicity)
into account when examining physical health disparities.”
“Given the dearth of research using an intersectional perspective to examine physical health
disparities as well as evidence suggesting both increased risk and resilience, further examinations of
how physical health disparities differ by race/ethnicity are required.” (2018)
Minority stress is the predominant explanation for sexual and gender minority (SGM) health
inequities:
• Chronic stressful events (e.g., stigma, discrimination, violence)
• Expectation of such events and the vigilance this requires
• Rejection sensitivity-often leading to concealment of SGM status
• Internalization of negative societal attitudes
Structural stigma: societal-level conditions, cultural norms, and institutional policies that constrain
opportunities, resources, well-being, and health.
Research has shown that SGM people who live in countries or cities that have low levels of structural
stigma are less likely to experience poor health than those who live in high stigma locations.
There are country differences: Researchers in California did a study on almost all countries: Social
acceptance of LGBT people in 174 countries (1981-2017) overall the social acceptance increased
(Iceland, Sweden, Canada, Netherlands, Norway), however in some countries there was a decrease
(Moldova, Ethiopia, Mauritania, Azerbaijan, Zimbabwe).
, The situation in the Netherlands is complex: there is a limited acceptance. There is a very strong
equal treatment act, and in the first article of the constitution sexuality is explicitly mentioned. It is
the first country in which gay marriage was accepted.
In research, 4% are ashamed that a family member is gay, 94% find that homosexuals must be able to
live their lives the way they would like. The 4% is not going to decrease in the future most likely.
16% disgusting two women kissing in public. 25% two men, 9% man and woman.
Similar percentages about homosexual couples should be able to adopt child and a child needs a
home with father and a mother for healthy development.
When we talk about gender identity, there is a much higher percentage not as free thinking at with
sexuality.
In a study (Huijnk, 2022) in groep 8: One-third of the students agreed with the statement that the
gender non-conforming peer should not participate. Forty percent found that the gender non-
conforming peer had to change the behavior in order to be allowed to participate in the future.
Actual events, risk factors and stressors
Kuyper (2018): SGM youth are being bullied more often (not studied if it was because of sexuality)
Rutgers (2017): boys get bullied more often than girls within SGM youth group (called names,
excluded, bullied, threatened, kicked/beaten)
Kooiman & Keuzemkamp (2012): expectation rejection adjust behaviour because of thinking they
will be rejected
Rutgers (2017): the strongest stressor is internalizing homonegativity 22% of boys would rather
not be gay, 12% of girls.
