Psychosocial Problems Associated With Homelessness in Sexual Minority Youths

Sexual minorities are overrepresented among homeless youths, and this is often related to reactions to their status as sexual minorities. While on the streets, they are at increased risk for victimization, substance and alcohol use, sexual risk behaviors, and mental health issues compared to homeless heterosexual youths. This article uses ecological systems theory to examine psychosocial problems associated with homelessness among sexual minority youths and reviews empirical literature examining outcomes related to homeless sexual minority youths including mental health, substance use, and sexual risk behavior. Implications for social work are discussed including practice, policy, and suggestions for future studies.     

Risk Factors for Homelessness Among Lesbian, Gay, and Bisexual Youths: A Developmental Milestone Approach

Lesbian, gay, and bisexual (LGB) youths are over-represented in the homeless population. To examine why some LGB youths become homeless, this report compares homeless and non-homeless LGB youths. Of the 156 LGB youths, 48% reported ever being homeless (i.e., running away or being evicted from home). Results indicate that sexual orientation awareness and the initiation of sexual behavior occurred earlier in homeless than in non-homeless LGB youths and predated the first homeless episode. Substance use was more frequent and first occurred at an earlier age in homeless as compared to non-homeless LGB youths; however, substance use occurred subsequent to first homelessness. Childhood sexual abuse was associated with homelessness; and, early sexual orientation development was related to homelessness among youths without a history of sexual abuse. Findings suggest that interventions should help youths cope with their unfolding sexual orientation and work to prevent or address the consequences of sexual abuse.     

Support,Discrimination, and Alcohol Use Among Racially/Ethnically Diverse Sexual Minority Youths

Rates of alcohol use for sexual minority youths are nearly twice that of their heterosexual peers, yet specific risk and protective factors associated with alcohol use among sexual minority youths remain unclear. Structural equation modeling is used to examine relations among alcohol use, peer and family support, and discrimination among 207 diverse sexual minority youths. Discrimination had no relationship to alcohol use; however, it was negatively associated with peer and family support. Peer support was associated with greater alcohol use among bisexual youths. This study adds to our understanding of the roles of discrimination, social support, and alcohol use among diverse sexual minority youths.     

Associations Between Social Support Network Characteristics and Receipt of Emotional and Material Support Among a Sample of Male Sexual Minority Youths

Few studies have examined how social support network characteristics are related to perceived receipt of social support among male sexual minority youths. Using egocentric network data collected from a study of male sexual minority youths (N = 592), multivariable logistic regression analyses examined distinct associations between individual and social network characteristics with receipt of (1) emotional and (2) material support. In multivariable models, frequent communication and having friends in one's network yielded a twofold increase in the likelihood of receiving emotional support whereas frequent communication was associated with an almost threefold higher likelihood of perceived material support. Finally, greater internalized homophobia and personal experiences of gay-related stigma were inversely associated with perceived receipt of emotional and material support, respectively. Understanding the evolving social context and social interactions of this new generation of male sexual minority youths is warranted in order to understand the broader, contextual factors associated with their overall health and well-being.     

Assessing Community Needs of Sexual Minority Youths: Modeling Concept Mapping for Service Planning

Research devoted to interventions and other attempts to buffer the negative experiences of gay, lesbian, bisexual, transgender, or questioning (GLBTQ) youths is lacking. This study used Concept Mapping to explore the psychosocial support needs of diverse sexual minority youths served in a GLBTQ youth-focused center and brings youth voice to currently limited literature on GLBTQ service planning. Conceptual maps generated represent the types of supports youths believe are needed to meet their needs. Three primary areas for service planning—developing protective supports, mental health-related supports, and culturally relevant services—were identified from the 58 statements and 5 clusters generated.     

No Place Called Home: Life Quality and Purpose of Homeless Youths

Subjective quality of life (SQOL) has been reported to display remarkable resilience to objective circumstances. This is thought to derive from the capacity to interpret experience in positive ways, but is defeated by very adverse circumstances. This raises the question of whether such positive mental devices are able to adequately protect the SQOL of homeless youths, who typically face substantial objective trials. This study compares youths who are homeless or at risk of homelessness with youths living consistently with their families (control group). It was found that both the homeless and “at risk” youths reported significantly lower SQOL. These youths also reported lower levels of personal meaning than the control group, and higher existential vacuum. Of the variables measured, personal meaning provided the strongest prediction of SQOL, challenging theories that would predict choice/responsibleness to provide the predominant contribution. Lack of differences in response between homeless and “at risk” youths suggests that subjective difficulties may precede homelessness rather than stem from it. A model is proposed to describe the possible factors involved in the maintenance and erosion of SQOL.     

Where Risks and Protective Factors Operate Differently: Homeless Sexual Minority Youth and Suicide Attempts

Using a sample of 628 homeless youth and young adults from eight US cities, this study examines whether the relationship between having been in custody of social services and suicide attempts, and the relationship between engaging in survival sex and suicide attempts differ based on sexual orientation. Findings suggest that being in custody of social services is associated with a significant increase in likelihood of suicide attempts for heterosexual youth, it does not, however, significantly change the already increased risk of suicide attempts for sexual minority youth. Engaging in survival sex appears to be associated with increased risks of suicide attempts for both heterosexual and sexual minority youth, but the increase in likelihood is much stronger for heterosexual youth than for sexual minority youth. Implications for practice and future research are discussed.

Social networks and sexual risk factor differences between cisgender heterosexual and cisgender LGBQ homeless youths

ABSTRACT

Cisgender lesbian, gay, bisexual, and queer/questioning (LGBQ) homeless youths are more likely to engage in sexual risk behaviors relative to cisgender heterosexual homeless youths. Homeless youths (N = 1,046) were recruited and surveyed from three drop-in centers in Los Angeles, California. This study assessed differences in demographics, background experiences, and perceived social network norms in order to understand the disparities in rates of unprotected sex and concurrent sex between these two subgroups. Results indicate significant differences in engagement in risk factors as well as social network norms. Findings provide support for tailored sexual risk-reduction interventions that cater specifically to LGBQ homeless youths.     

Strengths First: An Empowering Case Management Model for Multiethnic Sexual Minority Youth

This article (1) describes the development of a strengths-based case management (SBCM) model for multiethnic sexual minority youths; (2) provides a profile of participant risks and strengths; and (3) discusses critical considerations for implementation with this population. Participants (N = 162) reported complex risks such as family rejection as well as personal strengths. SBCM is a promising intervention that provides opportunities to bridge the unique gaps in service for this vulnerable population. Strategies to incorporate strengths into program assessments and address issues such as family engagement and service delivery challenges are offered.     

Sexual‐Minority and Heterosexual Youths' Peer Relationships: Experiences,Expectations, and Implications for Well‐Being

The current study compared the peer relationships and well‐being of 60 sexual‐minority (i.e., nonheterosexual) and 65 heterosexual youths between the ages of 15 and 23. Sexual‐minority youths had comparable self‐esteem, mastery, and perceived stress as did heterosexuals, but greater negative affect. Younger sexual‐minority male adolescents had smaller overall peer networks than did young male heterosexuals, whereas older male and female sexual minorities had larger numbers of extremely close friends within their networks than did heterosexuals. Younger sexual‐minority adolescents had lost or drifted away from more friends than did heterosexuals. Regardless of age, sexual‐minority youths reported disproportionately high worries about losing friends, low feelings of control in their romantic relationships, and fears of never finding the type of romantic relationship they wanted. Sexual‐minority youths that were “out” to more heterosexual peers had larger peer networks but more friendship loss and friendship worries. Youths' relationship experiences and concerns mediated sexual identity differences in negative affect.     

Understanding Sexual Minority Health Disparities in Rural Areas

This article reviews research from several disciplines including sociology, psychology, and public health to examine recent inconsistencies in findings of rural/urban health disparities among sexual minority populations. Previous work has found that sexual minorities (lesbian, gay, and bisexual individuals) report worse health than their heterosexual counterparts on many physical and mental health measures. To understand this occurrence, scholars have situated these findings most often within either minority stress or fundamental cause frameworks. These theories attribute health differences to unique stressors and stigmatization experienced by sexual minorities within a heteronormative social climate. This review provides an overview of specific health disparities by gender and sexual orientation, critically examines research on rural/urban health differences among sexual minorities, and offers three avenues for future research to help remedy the inconsistent results of previous rural/urban sexual minority health disparities research. Discussions of the ‘rural effect,’ rural social support resources, and the importance of geographic region for health are included as opportunities to further social scientific research on sexual minority health disparities.     

After Breast Cancer: Sexual Functioning of Sexual Minority Survivors

Research on sexual difficulties after cancer has neglected sexual minority women (SMW); for example, lesbian and bisexual women. Clinicians treating these women are therefore at a disadvantage as they lack information about sexual problems in this population. This study tested the hypothesis that SMW with breast cancer have poorer sexual function than SMW without breast cancer, distinguishing partnered from unpartnered women. Using convenience sample recruitment, we conducted a case-control study to compare survivors of breast cancers who are SMW, in other words, cases to controls, that is, SMW without cancer. Anonymous survey data were collected from 85 cases after they had completed active cancer treatment and 85 age- and partner-status matched controls with no history of any cancer. Participants' self-reported sexual frequency and sexual function measured by the Female Sexual Function Index were evaluated. Cases and controls did not differ in risk of sexual dysfunction or the level of overall sexual functioning; however, cases had lower sexual frequency and scored lower on desire and ability to reach orgasm, and higher on pain compared to controls. Results inform clinicians about sexual minority survivors' sexual domains affected by cancer. When discussing sexual problems and therapeutic options, sexual orientation should be ascertained.     

No Place Called Home: Life Quality and Purpose of Homeless Youths

Subjective quality of life (SQOL) has been reported to display remarkable resilience to objective circumstances. This is thought to derive from the capacity to interpret experience in positive ways, but is defeated by very adverse circumstances. This raises the question of whether such positive mental devices are able to adequately protect the SQOL of homeless youths, who typically face substantial objective trials. This study compares youths who are homeless or at risk of homelessness with youths living consistently with their families (control group). It was found that both the homeless and at risk youths reported significantly lower SQOL. These youths also reported lower levels of personal meaning than the control group, and higher existential vacuum. Of the variables measured, personal meaning provided the strongest prediction of SQOL, challenging theories that would predict choice/responsibleness to provide the predominant contribution. Lack of differences in response between homeless and at risk youths suggests that subjective difficulties may precede homelessness rather than stem from it. A model is proposed to describe the possible factors involved in the maintenance and erosion of SQOL.     

The Impact of Childhood Sexual Abuse on Later Sexual Victimization among Runaway Youth

Path analysis was used to investigate the impact of childhood sexual abuse on later sexual victimization among 372 homeless and runaway youth in Seattle. Young people were interviewed directly on the streets and in shelters by outreach workers in youth service agencies. High rates of both childhood sexual abuse and street sexual victimization were reported, with females experiencing much greater rates compared with their male counterparts. Early sexual abuse in the home increased the likelihood of later sexual victimization on the streets indirectly by increasing the amount of time at risk, deviant peer affiliations, participating in deviant subsistence strategies, and engaging in survival sex. These findings suggest that exposure to dysfunctional and disorganized homes place youth on trajectories for early independence. Subsequently, street life and participation in high‐risk behaviors increases their probability of sexual victimization.     

Risk and Protective Factors Associated with Personal Mastery Among Sexual Minority African-American Female Sex Workers

Research among sexual minorities has traditionally examined problems such as substance use, HIV risk, mental health problems, and victimization. Among sexual minority street-based female sex workers, these vulnerabilities can be magnified. Grounded in theories of resilience, this study examines risk and protective factors associated with a high level of personal mastery among a vulnerable population of women. Data are drawn from baseline interviews from street-based African-American female sex workers enrolled in a randomized intervention trial in Miami, Florida. We compare sexual minority (N = 197) and heterosexual (N = 365) women on measures of risk and protective factors; among sexual minority women we present logistic regression analyses which reveal that severe mental distress and HIV transmission risk are associated with low levels of personal mastery, while protective factors of transportation access and social support are associated with high levels of personal mastery. These findings suggest that these protective factors may potentially facilitate the development of personal mastery and represent beneficial avenues for intervention efforts.     

The Influences of Career Support and Sexual Identity on Sexual Minority Women's Career Aspirations

The authors examined the relationship between sexual identity, family/friend career support, and career aspirations in a sample of 381 sexual minority women. The results indicated that family career support and friend career support were positively related to career aspirations of sexual minority women. The results also indicated that the relationship between family career support and career aspirations depended on the level of negative sexual identity. The findings demonstrate the utility of social cognitive career theory (Lent, Brown, & Hackett, 1994, 2002) with this particular population. Limitations and implications for further research and practice are discussed.     

Masculine Gender-Role Congruence among Sexual Minority Men

Sexual minority men’s sexual identity may be vulnerable to feelings of masculine gender-role incongruence within heteronormative dominant cultural contexts. This study explored associations between masculine gender-role congruence/incongruence and various aspects of sexual identity development in a sample of 106 nonheterosexual men between ages 18 and 74?years (M?=?34.86, SD?=?14.32). The majority of the sample identified as gay (79%), with the rest of the sample identifying as bisexual (10%), and nonexclusively same-sex-attracted sexual identity labels (e.g., pansexual, queer; 10%). Slightly more than half of the men reported congruence between their actual self-perception of masculinity and their ideal masculine presentation. However, men who experienced greater masculine gender-role incongruence, specifically presenting with lower masculine appearance and behavior than they desired, reported higher levels of identity distress and self-consciousness. Thus, though masculine gender roles are being challenged and gender nonconformity is becoming more widely accepted, masculine gender roles are still relevant to the lives of sexual minority men. Future research and clinical implications are discussed.     

Minority Stress Theory: An Examination of Factors Surrounding Sexual Risk Behavior Among Gay and Bisexual Men Who Use Club Drugs

Background: Few studies have examined the impact of minority stress theory (MST) upon sexual risk behavior among gay and bisexual men using club drugs. Similar studies have focused on ethnic minorities and women; however, gay and bisexual men demonstrate greater likelihood for risk behaviors leading to HIV/AIDS. Objective: This study examines sexual risk behavior from the perspective of minority stress theory upon substance-using gay and bisexual men and their partners. Methods: Multivariable logistic regression analysis examined minority stress associations with participant sexual risk behaviors, drug use, and partner type, controlling for demographics. Results: 396 gay and 54 bisexual respondents, ages 18–67, reported at least one-time drug use while engaging in sexual risk behavior. In the adjusted model, expectations of rejection associated with lower odds of sexual risk behavior, while older age approached significance. Conclusions: Theoretical origins for examining risk behavior among gay and bisexual men may underscore risk and protective factors, while ultimately holding implications for prevention and treatment interventions.     

Differences in Adolescent Experiences of Polyvictimization and Suicide Risk by Sexual Minority Status

Sexual minority adolescents (SMA) report more suicide risk behaviors than heterosexual adolescents. Polyvictimization (co‐occurrence of multiple types of victimization) may be an important, underresearched correlate of this disparity. With the 2017 national Youth Risk Behavior Survey (N = 13,179), national estimates of polyvictimization and suicide risk were assessed among high school students by sexual minority status (SM vs. heterosexual), and multivariate relationships between sexual minority status, polyvictimization, and suicide risk were tested. Additionally, risk profiles of those who experienced polyvictimization (2 + types of victimization; n = 1,932) were compared across sexual minority status. Results confirm that SMA are more likely to experience polyvictimization than heterosexual adolescents (31.8% v. 12.9%, respectively); however, also indicate that polyvictimization does not fully explain elevated suicide risk among SMA.