Latent Class Analysis of Victimization Patterns and Associated Protective Factors among LGBTQ Youth

Youth victimization in schools remains a fervent public health issue, despite increased awareness of this issue, and this is especially true for marginalized populations like lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth. Youth violence has been studied widely, but less research has sought to understand factors protective of violence victimization, particularly protective factors shared across multiple forms of violence. In the current study, we utilized latent class analysis to test patterns of three types of victimization: peer victimization (PV), homophobic name-calling victimization (HNCV), and sexual harassment victimization (SHV). In addition, we tested protective factors associated with experiencing these types of violence. Our sample included 4778 9-11th graders in the United States, of which about 15% identified as LGBTQ. Three unique classes of victimization emerged, suggesting that concurrent forms of violence occur among some groups of adolescents. LGBTQ youth were more likely to be members of classes which demonstrated higher levels of victimization. Consistent with previous literature, medical access, counseling access, family support, peer support, and spirituality emerged as significant protective factors associated with a lower risk of victimization. We discuss the implications of our findings with specific attention to protecting the wellbeing of SGM youth.

LGBTQ Qualitative and Mixed Methods Research in Counseling Psychology: A Content Analysis

Given that qualitative and mixed methods have been used to address social justice issues, counseling psychologists have been drawn to these research designs to advance knowledge in the field. However, qualitative and mixed methods are rarely used in counseling psychology to examine the experiences of LGBTQ individuals. This content analysis reviewed all qualitative and mixed methods studies conducted with LGBTQ individuals between 2009 and 2019 in three leading counseling psychology journals. Results from 24 studies revealed: (a) an increase in LGBTQ-related topics; (b) an overreliance in grounded theory as a research design, diverse analytical approaches, overreliance on semi-structure interviews, and increased disclosure of reflexivity and trustworthiness; and (c) an overwhelming representation of White, cisgender, gay and lesbian, middle class, college educated, English-speaking, Christian, mainland United States residents. We pose a call to action for the next decade of qualitative and mixed methods research with LGBTQ individuals in counseling psychology.

LGBTQ Youth Homelessness: Why We Need to Protect Our LGBTQ Youth

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth are 120% more likely to be homeless than cisgender and heterosexual youth, yet current federal policies are insufficient and exclude LGBTQ youth. Youth homeless shelters are inadequately equipped to serve LGBTQ homeless youth due to poor funding, a focus on heterosexual or cisgender clients in their programs, and a lack of LGBTQ-friendly policies. Given the pervasiveness of this issue, public health and social policy interventions must be considered. In this perspective, the LGBTQ homeless youth epidemic is introduced and described, past policies are analyzed, and policy recommendations are made.

A Systematic Review of Recommendations for Behavioral Health Services for Transgender and Gender Diverse Adults: The Three-Legged Stool of Evidence-Based Practice is Unbalanced

There is a growing literature of clinical recommendations for transgender and gender diverse (TGD) affirming behavioral health care, yet it is unknown to what extent these recommendations are rooted in evidence-based practice (EBP). This systematic review included 65 articles published between 2009 and 2018 with recommendations for behavioral health services with TGD adults, emphasizing general clinical care. Coded variables included type of article, participant demographics, aspects of EBP, and whether care was informed by objective assessment. Most articles did not equally draw from all components of EBP. Recommendations for specific clinical problems are increasingly available and address diversity within TGD communities. More research, including clinical trials adapting established interventions, is needed to inform state-of-the-art TGD-affirmative behavioral health care.

Exploring transgender adolescents' body image concerns and disordered eating: Semi-structured interviews with nine gender minority youth

Transgender adolescents (TGAs) face many of the same sociocultural and biological influences on body dissatisfaction and disordered eating as cisgender peers. Additionally, TGAs experience unique body- and gender-related concerns. The purpose of this study is to explore the nuances of gender identity, gender transitioning, body image, and disordered eating among TGAs. Case summaries and a synthesis of key themes are presented from interviews with nine TGAs aged 16-20 (M_age = 17). All participants reported engaging in at least one behavior to change their weight or shape. Consistent with a theoretical biopsychosociocultural model we proposed, TGAs described body dissatisfaction and disordered eating related to transgender-specific factors (e.g., behaviors aimed at minimizing secondary sex characteristics) and broader developmental and sociocultural factors. Some participants reported improvements in body image and disordered eating following gender transition. The interviews highlight complex associations among gender identity, gender transitioning, body image, and disordered eating during adolescence, suggesting that disentangling transgender-specific factors from other individual factors is difficult. These findings may guide future research on the prevalence and functions of disordered eating among TGAs and point to a unique set of needs for effective detection and treatment of concurrent gender incongruence, body dissatisfaction, and disordered eating.

LGBTQ+ youth: Careers threats and interventions

In an era of rapid development, the world is showing greater openness towards diversity and inclusiveness. There is also an increasing amount of career-related research that has shed light on the LGBTQ+ population. Still, the literature reports many career issues that concern young LGBTQ+ individuals. The current article aimed to highlight the contributing issues that might impact young LGBTQ+ groups’ career development, mental health, and well-being – in particular, the issues of workplace hostility, the costs of self-identity disclosure, self-identity confusion, and inadequate career counselling and guidance services. These issues are discussed through the lens of three major career theories: Super’s life-span, life-space theory, Gottfredson’s circumscription and compromise theory, and Krumboltz’s social learning theory. The aim was to equip career counsellors with a better understanding of the challenges facing LGBTQ+ youth and to suggest potentially useful interventions.

Which Methodological Practice(s) for Psychotherapy Science? A Systematic Review and a Proposal

Three main methodological practices have been employed in psychotherapy science: the empirical-quantitative, empirical-qualitative, and theoretical one. Some scholars have argued for a monopoly of the empirical-quantitative methodological practice, sustained by scientific monism. This systematic review aims at exploring the contribution of each methodological practice to the field. Fifteen journals were searched from 2003 to 2013. A total of 9796 publications and 9915 studies met inclusion criteria and were coded for the methodological practice employed. Empirical-quantitative studies were the most published overall, over time, and in most of the journals considered. This overwhelming prevalence increased when considering the citation rates of the publications. We argue that these results are indicative of a quantitative monopoly, which in turn is due to a lack of critical thinking sustaining scientific monism. We call for disciplinary critical thinking and the consequent scientific pluralism valuing the plurality, diversity, and multiplicity of all the existing methodological practices.

Risking It Anyway: An Adolescent Case Study of Trauma, Sexual and Gender Identities, and Relationality

This article presents the case of a Chinese-American adolescent with a significant trauma history who was questioning her sexual and gender identities. The implications of the client's intersecting identities for case conceptualization and treatment are considered within the framework of affirmative practices for sexual and gender minority (SGM) clients. The impacts of stress and trauma on this client's experiences-and SGM clients more broadly-are also considered, particularly with respect to how this client understood and negotiated her experiences of relational trauma. This case is intended to illustrate some best practices with SGM clients within an intersectional framework which underscores the importance of multiple salient cultural identities.

Charting the Center and the Margins: Addressing Identity, Marginalization, and Privilege in Counseling

In order to address the inequities experienced by individuals who experience multiple forms of marginalization, counselors must be able to make linkages between identity, marginalization, and privilege. Equally important is the need to balance individual counseling with advocacy. This perspective requires counselors to understand how identities intersect and the ways in which a counselor's and client's statuses as members of privileged and marginalized groups influence the therapeutic relationship. These expectations are based on the new Multicultural and Social Justice Counseling Competencies (MSJCC), which were recently endorsed by the American Counseling Association. To address these challenges, and to operationalize the MSJCC, the Multicultural and Social Justice Counseling Competencies—Assessment Form (MSJCC-AF) is introduced. This form incorporates intersectionalities and advocacy with counseling.

Patterns of Mental Health Care Utilization Among Sexual Orientation Minority Groups

Prior studies of the utilization of mental health professionals by sexual minority populations have relied on data that are now dated or not nationally representative. These studies have also provided mixed findings regarding gender differences in the utilization of mental health professionals among sexual minority individuals. Using data from the 2013-2015 National Health Interview Surveys, this study investigates (1) how sexual minority individuals compare to heterosexual participants in their utilization of mental health professionals; and (2) gender differences in that utilization. The results indicate sexual minority individuals utilize mental health care professionals at higher rates than heterosexual individuals even after controlling for measures of mental health and other demographic characteristics; this is true for both men and women. However, gender moderates the sexual minority effect on utilization rates. Sexual minority men utilize mental health professionals at a high rate, such that their utilization rates are similar to sexual minority women, contrary to the gender gap seen among heterosexuals.

A Content Analysis of Literature on Trans People and Issues

This study provides a content analysis of more than a decade (2002–2012) of academic scholarship about trans people and issues. A total of 960 trans-focused publications were coded; there was a close balance of nonempirical (54%) and empirical (46%) publications. The analyses revealed that the literature on trans people and issues is growing, although many publications include trans people and issues nominally without substantive attention. The analyses also pointed to underutilized research designs and methodologies, the need for more clear assessment and more consistent reporting of demographic characteristics, and topics that warrant further attention. Specifically, literature on trans people and issues continues to be needed on the topics of focus thus far, such as psychological and identity-related distress. Scholarship is also needed to address important topics that have been understudied, including self-harm and suicide, positive functioning and mental health promoting factors, developmental issues across the life span, school and workplace experiences, and the training and competencies of health care providers to ensure affirmative and effective services for trans people.

Enhancing Scholarship Focused on Trans People and Issues

Scholarship about lesbian, gay, bisexual, and transgender (LGBT) people and issues has been growing. However, trans issues are often overlooked or addressed only nominally in this literature, leading to calls for further focused attention to trans people and issues. In a series of articles, this Major Contribution addresses such calls by (a) providing a content analysis of scholarship about trans people and issues, (b) discussing methodological considerations and strategies for conducting research with trans populations, and (c) presenting an empirical study that addresses how intersecting identities (e.g., ethnicity/race, sexual orientation, socioeconomic status) combine in relation to trans people’s mental health. This article provides a context for the Major Contribution and offers an overview of each of the component articles.

Lesbian, gay, bisexual, and transgender youth: Limited representation in school support personnel journals

Many lesbian, gay, bisexual, and transgender (LGBT) youth experience harassment and discrimination in schools and these experiences lead to increased negative social-emotional outcomes. Youth who can identify at least one supportive adult at school report better outcomes than youth who cannot identify a safe adult. Yet, many educators report feeling uncomfortable or unprepared to support LGBT youth. One reason for educators' discomfort may be that content related to issues unique to LGBT youth is sometimes missing or covered minimally in university training programs. We hypothesized that LGBT content may be covered minimally in school support personnel journals, as well. This study analyzed eight school support personnel journals across the disciplines of school counseling, school nursing, school psychology, and school social work for LGBT content published between 2000 and 2014 to gain a better understanding of the visibility of LGBT issues in the research. Results suggested that there has been a lack of presence of LGBT issues in journals across disciplines. These results also suggest a need for an intentional focus on issues relevant to LGBT youth in school support personnel journals. Thus, the article concludes with an introduction to two articles in this special topic section, including Russell, Day, Ioverno, and Toomey's (in this issue) study on teacher perceptions of bullying in the context of enumerated school policies and other supportive sexual orientation and gender identity related practices and Poteat and Vecho's (in this issue) study on characteristics of bystanders in homophobic bullying situations. The broad goal of these three studies is to increase visibility of critical LGBT issues in school support personnel journals.

Class at the Intersection of Race and Gender

Consistent with psychology’s call to action for an inclusive and intentional focus on social class, we conducted a content analysis examining class variables relative to race and gender variables in articles over a 15-year period in The Counseling Psychologist and the Journal of Counseling Psychology. Articles were classified by degree of inclusion of these variables, resulting in three categories: mentioned, integrated, and primary. Despite the recent trend toward class inclusion, only 560 of 1,440 studies (39%) included all three variables at any level. Articles where all variables were “Primary” comprised only 1.9% ( n = 28) of the articles we reviewed. Using a qualitative content analysis and intersectionality lens, only 15 of the 28 studies thoroughly integrated class, race, and gender variables. Results highlight a recent, significant increase in attention to class issues, as well as the continued need to place class analysis on par with other important diversity variables. Implications are discussed.