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Working With Suicidal and Homeless LGBTQ+ Youth in the Context of Family Rejection

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Ream, G., Peters, A. Working With Suicidal and Homeless LGBTQ+ Youth in the Context of Family Rejection. J Health Serv Psychol 47, 41–50 (2021). https://doi.org/10.1007/s42843-021-00029-2

Abstract

LGBTQ+ individuals are at increased risk of suicide. Homelessness further increases the risk, as does family-of-origin rejection. A model that combines suicidal risk factors and minority stress theory is useful in clinical practice. An openness to “hearing” the lived experiences of LGBTQ+ individuals is essential to treatment. An LGBTQ+ affirming therapeutic approach is recommended. It is also frequently helpful to rebuild family relationships and support for the LGBTQ+ individual, particularly with younger youth. Principles of practice are described and illustrated.

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References

American Psychological Association. (2012). Guidelines for psychological practice with lesbian, gay, and bisexual clients. American Psychologist, 67(1), 10-42. https://doi.org/10.1037/a0024659

American Psychological Association. (2015). Guidelines for psychological practice with transgender and gender nonconforming people. American Psychologist, 70(9), 832-864. https://doi.org/10.1037/a0039906

Arnett, J. J. (2019). Conceptual foundations of emerging adulthood. In J. L. Murray & J. J. Arnett (Eds.), Emerging adulthood and higher education: A new student development paradigm (pp. 11-24). Routledge.

Blosnich, J. R., Henderson, E. R., Coulter, R. W. S., Goldbach, J. T., & Meyer, I. H. (2020). Sexual orientation change efforts, adverse childhood experiences, and suicide ideation and attempt among sexual minority adults, United States, 2016–2018. American Journal of Public Health, 110(7), 1024-1030. https://doi.org/10.2105/AJPH.2020.305637

Chowdhury, R. (2020). Transgender sex workers in New York City struggle to survive the pandemic. Retrieved October 10, 2020 from https://theappeal.org/transgender-sex-workers-new-york-city-coronavirus/

Clark, K. A., Blosnich, J. R., Haas, A. P., & Cochran, S. D. (2019). Estimate of lesbian, gay, bisexual, and transgender youth suicide is inflated. Journal of Adolescent Health, 64(6), 810. https://doi.org/10.1016/j.jadohealth.2019.03.003

Clark, K. A., Cochran, S. D., Maiolatesi, A. J., & Pachankis, J. E. (2020). Prevalence of bullying among youth classified as LGBTQ who died by suicide as reported in the National Violent Death Reporting System, 2003-2017. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2020.0940

Connell, C. (2016). Contesting racialized discourses of homophobia. Sociological Forum, 31(3), 599-618. https://doi.org/10.1111/socf.12265

Diamond, G. M., Diamond, G. S., Levy, S., Closs, C., Ladipo, T., & Siqueland, L. (2012). Attachment-based family therapy for suicidal lesbian, gay, and bisexual adolescents: A treatment development study and open trial with preliminary findings. Psychotherapy, 49(1), 62-71. https://doi.org/10.1037/a0026247

Dodd, S. J., Ruffins, J., & Arzola, D. (2018). Improving health while saving money: Lessons learned from a supportive housing program for young adults with HIV. Sexuality Research and Social Policy, 15(2), 163-171. https://doi.org/10.1007/s13178-017-0287-8

Elze, D. E. (2019). The lives of lesbian, gay, bisexual, and transgender people: A trauma-informed and human rights perspective. In L. Butler, F. Critelli, & J. Carello (Eds.), Trauma and Human Rights. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-16395-2_8

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245-258.

Forge, N. R. (2012). A longitudinal investigation of risk and resiliency among homeless LGBT youth residing in a Transitional Living Shelter [Doctoral dissertation, Fordham University]. New York.

Gysin-Maillart, A., Schwab, S., Soravia, L., Megert, M., & Michel, K. (2016). A novel brief therapy for patients who attempt suicide: A 24-months follow-up randomized controlled study of the Attempted Suicide Short Intervention Program (ASSIP). PLoS Med, 13(3), e1001968. https://doi.org/10.1371/journal.pmed.1001968

Haas, A. P., & Lane, A. (2015). Collecting sexual orientation and gender identity data in suicide and other violent deaths: A step towards identifying and addressing LGBT mortality disparities. LGBT Health, 2(1), 84-87. https://doi.org/10.1089/lgbt.2014.0083

Hill, R., Rooney, E., A Mooney, M., & Kaplow, J. (2017). Links between social support, thwarted belongingness, and suicide ideation among lesbian, gay, and bisexual college students. Journal of Family Strengths, 17(2). http://digitalcommons.library.tmc.edu/jfs/vol17/iss2/6

Hottes, T. S., Bogaert, L., Rhodes, A. E., Brennan, D. J., & Gesink, D. (2016). Lifetime prevalence of suicide attempts among sexual minority adults by study sampling strategies: A systematic review and meta-analysis. American Journal of Public Health, 106(5), e1-12. https://doi.org/10.2105/ajph.2016.303088

Human Rights Campaign Foundation. (2018). A national epidemic: Fatal anti-transgender violence in America in 2018. Retrieved October 10, 2020 from https://assets2.hrc.org/files/assets/resources/AntiTransViolence-2018Report-Final.pdf

Jobes, D. A. (2016). Managing suicidal risk: A collaborative approach (2nd ed.). The Guilford Press. https://www.guilford.com/books/Managing-Suicidal-Risk/David-Jobes/9781462526901

Johns, M. M., Lowry, R., Andrzejewski, J., Barrios, L. C., Demissie, Z., McManus, T., Rasberry, C. N., Robin, L., & Underwood, M. (2019). Transgender identity and experiences of violence victimization, substance use, suicide risk, and sexual risk behaviors among high school students — 19 states and large urban school districts, 2017. Morbidity and Mortality Weekly Report, 68(3), 67-71. https://doi.org/10.15585/mmwr.mm6803a3

Johns, M. M., Lowry, R., Rasberry, C. N., Dunville, R., Robin, L., Pampati, S., Stone, D. M., & Kollar, L. M. M. (2018). Violence victimization, substance use, and suicide risk among sexual minority high school students — United States, 2015–2017. Morbidity and Mortality Weekly Report, 67(43), 1211–1215. 10.15585/mmwr.mm6743a4

Joiner Jr, T. E., Van Orden, K. A., Witte, T. K., & Rudd, M. D. (2009). The interpersonal theory of suicide: Guidance for working with suicidal clients  [doi:10.1037/11869-000]. American Psychological Association. https://doi.org/10.1037/11869-000

Joiner, T. E. (2005). Why people die by suicide. Harvard University Press.

Katz-Wise, S. L., Rosario, M., & Tsappis, M. (2016). Lesbian, gay, bisexual, and transgender youth and family acceptance. Pediatric Clinics of North America, 63(6), 1011-1025. https://doi.org/10.1016/j.pcl.2016.07.005

Mallon, G. P. (1998). We don’t exactly get the Welcome Wagon: The experiences of gay and lesbian adolescents in child welfare systems. Columbia University Press.

Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674-697. https://doi.org/10.1037/0033-2909.129.5.674

Pachankis, J. E. (2018). The scientific pursuit of sexual and gender minority mental health treatments: Toward evidence-based affirmative practice. American Psychologist, 73(9), 1207-1219. https://doi.org/10.1037/amp0000357

Paris, J. (2007). Half in love with death: Managing the chronically suicidal patient. Mahwah, NJ, US: Lawrence Erlbaum Associates Publishers.

Peñas Defago, M. A., Morán Faúndes, J. M., & Vaggione, J. M. (2018, November). Religious conservatism on the global stage: Threats and challenges for LGBTI rights. Retrieved January 9 from https://globalphilanthropyproject.org/2018/11/04/religious-conservatism-on-the-global-stage-threats-and-challenges-for-lgbti-rights/

Peters, A. J. (1997). Themes in group work with lesbian and gay adolescents. Social Work with Groups, 20(2), 51-69. https://doi.org/10.1300/J009v20n02_05

Pingel, E. S., & Bauermeister, J. A. (2018). ‘Church hurt can be the worst hurt’: community stakeholder perceptions of the role of Black churches in HIV prevention among young Black gay and bisexual men. Culture, Health & Sexuality, 20(2), 218-231. https://doi.org/10.1080/13691058.2017.1338756

Ream, G. L. (2016). The Interpersonal–Psychological Theory of Suicide in college student suicide screening. Suicide and Life-Threatening Behavior, 46(2), 239-247. https://doi.org/10.1111/sltb.12188

Ream, G. L. (2019b, October). The LGBTQ youth suicide disparity in emerging adulthood vs. adolescence: It gets less bad. 9th Society for the Study of Emerging Adulthood conference, Toronto.

Ream, G. L. (2019c). What’s unique about lesbian, gay, bisexual, and transgender (LGBT) youth and young adult suicides? Findings from the National Violent Death Reporting System. Journal of Adolescent Health, 64(5), 602-607. https://doi.org/10.1016/j.jadohealth.2018.10.303

Ream, G. L. (2020). An investigation of the LGBTQ+ youth suicide disparity using National Violent Death Reporting System narrative data. Journal of Adolescent Health, 66(4), 470-477. https://doi.org/10.1016/j.jadohealth.2019.10.027

Ream, G. L. (2021). Conceptualizing sexual orientation and gender identity. In E. M. Lund, C. Burgess, & A. J. Johnson (Eds.), Violence against LGBTQ+ persons: Research, practice, and advocacy. (pages 5-23). Springer. https://www.springer.com/us/book/9783030526115

Ream, G. L., & Barnhart, K. F. (2021). Homeless LGBTQ+ youth in New York City. In E. M. Lund, C. M. Burgess, & A. J. Johnson (Eds.), Violence against LGBTQ+ persons: Research, practice, and advocacy. (pages 275-281). Springer. https://www.springer.com/us/book/9783030526115

Ream, G. L., & Forge, N. R. (2014). Homeless lesbian, gay, bisexual, and transgender (LGBT) youth in New York City: Insights from the field. Child Welfare, 93(2), 7-22.

Riggs, D. W., & Sion, R. (2017). Gender differences in cisgender psychologists’ and trainees’ attitudes toward transgender people. Psychology of Men & Masculinity, 18(2), 187-190. https://doi.org/10.1037/men0000047

Rosenkrantz, D. E., Rostosky, S. S., Toland, M. D., & Dueber, D. M. (2020). Cognitive-affective and religious values associated with parental acceptance of an LGBT child. Psychology of Sexual Orientation and Gender Diversity, 7(1), 55-65. https://doi.org/10.1037/sgd0000355

Russell, S. T., Pollitt, A. M., Li, G., & Grossman, A. H. (2018). Chosen name use is linked to reduced depressive symptoms, suicidal ideation, and suicidal behavior among transgender youth. Journal of Adolescent Health, Advance online publication. https://doi.org/10.1016/j.jadohealth.2018.02.003

Ruud, M. (2018). Cultural humility in the care of individuals who are lesbian, gay, bisexual, transgender, or queer. Nursing for Women’s Health, 22(3), 255-263. https://doi.org/10.1016/j.nwh.2018.03.009

Ryan, C., Russell, S. T., Huebner, D., Diaz, R. M., & Sanchez, J. (2010). Family acceptance in adolescence and the health of LGBT young adults. Journal of Child and Adolescent Psychiatric Nursing, 23(4), 205-213. https://doi.org/10.1111/j.1744-6171.2010.00246.x

Savin-Williams, R. C. (1994). Dating those you can’t love and loving those you can’t date. In R. Montemayor & G. R. Adams (Eds.), Personal relationships during adolescence (pp. 196-215).

Savin-Williams, R. C. (2001). Mom, dad. I’m gay. How families negotiate coming out. American Psychological Association.

Savin-Williams, R. C., & Ream, G. L. (2003). Sex variations in the disclosure to parents of same-sex attractions. Journal of Family Psychology, 17(3), 429-438. https://doi.org/10.1037/0893-3200.17.3.429

Savin-Williams, R. C., & Ream, G. L. (2007). Prevalence and stability of sexual orientation components during adolescence and young adulthood. Archives of Sexual Behavior, 36(3), 385-394. https://doi.org/10.1007/s10508-006-9088-5

Sommers-Flanagan, J. (2018). Conversations about suicide: Strategies for detecting and assessing suicide risk. Journal of Health Service Psychology, 44(1), 33-45. https://doi.org/10.1007/BF03544661

Stanford, A. (2013). Homophobia in the Black church: How faith, politics, and fear divide the Black community. Praeger.

Stanley, I. H., Boffa, J. W., & Joiner, T. E. (2019). PTSD from a suicide attempt: Phenomenological and diagnostic considerations. Psychiatry, 82(1), 57-71. https://doi.org/10.1080/00332747.2018.1485373

Taliaferro, L. A., & Muehlenkamp, J. J. (2017). Nonsuicidal self-injury and suicidality among sexual minority youth: Risk factors and protective connectedness factors. Academic Pediatrics, 17(7), 715-722. https://doi.org/10.1016/j.acap.2016.11.002

The Trevor Project. (2016, November 7). Nov. 7, 2016 letter. Retrieved December 4 from https://www.apa.org/advocacy/civil-rights/sexual-diversity/national-violent-death-letter.pdf

Tobkes, J. L., & Davidson, W. C. (2017). When a child comes out, parents may want to go in the closet. Psychology Today. https://www.psychologytoday.com/us/blog/when-your-child-is-gay/201704/when-child-comes-out-parents-may-want-go-in-the-closet

Turban, J. L., Beckwith, N., Reisner, S. L., & Keuroghlian, A. S. (2020). Association between recalled exposure to gender identity conversion efforts and psychological distress and suicide attempts among transgender adults. JAMA Psychiatry, 77(1), 68-76. https://doi.org/10.1001/jamapsychiatry.2019.2285

Waidzunas, T. (2011). Young, gay, and suicidal: Dynamic nominalism and the process of defining a social problem with statistics. Science, Technology, & Human Values, 37(2), 199-225. https://doi.org/10.1177/0162243911402363

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