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Research Finds Black LGB Youth at Greater Risk for Poor Mental Health Outcomes

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American University researchers have found that black lesbian, gay and bisexual youth are at greater risk for poor mental health outcomes compared with black heterosexual youth. This can, in part, be explained by the higher rates of online bullying and bias-based victimization black LGB youth experience in the United States, the researchers contend. The study is believed to be the first to document sexual orientation disparities in depression, suicidal thoughts and substance use in a large sample of black youth.

The findings raise questions about how to help black LGB youth, which the researchers also discuss in a paper published in the journal Culture, Health and Sexuality. Ethan Mereish, assistant professor of health studies at AU, and his colleagues examined self-reported data for 1,129 black/African-American youth, a sample size that they isolated from the 2014 Youth Development Survey, a comprehensive survey of youth from a school district in a large county in North Carolina. The survey asked questions of youth 10 to 18 about relationships, bullying, substance use and health. 

Findings highlight health disparities

The researchers' analysis indicates the health disparities black LGB youth face: Researchers found 56 percent of black LGB youth at risk for depression, followed by 39 percent for those identified as mostly heterosexual, and 28 percent for heterosexual youth. Thoughts of suicide also were highest for black LGB youth, with 38 percent having suicidal thoughts in the past year, followed by 15 percent of mostly heterosexual youth, and 11 percent of heterosexual youth.  

“Our findings document high rates of depression and suicidal thoughts among all young people in the sample, but for black LGB youth, these are alarmingly high rates,” said Mereish, a psychologist and director of AU’s Lavender Lab for research on the psychological, social, and cultural factors of health for LGBTQ individuals and racial/ethnic minorities.

Mereish’s research involves studying experiences people have with multiple forms of oppression such as racism, sexism or homophobia. Specifically, Mereish researches minority stressors, which are unique stressors associated with one’s identity, including real or perceived discrimination, harassment, violence, microaggressions, and internalized stigma.  

The role of cyberbulling and identity targeting

Another key piece of the study involved trying to explain the factors influencing black LGB youth and poor mental health outcomes. As youth spend significant time online and with each other online, Mereish felt it was important to examine the role of cyberbullying. In many nationally representative surveys, LGB youth report higher rates of verbal and physical harassment specific to their sexual orientation. Studies also show that cyberbullied youth engage in substance use.

Using statistical analysis, Mereish and his colleagues found a correlation between bias victimization and cyberbullying and black LGB youth’s depression, suicidal thoughts, and to some extent, their substance use. Bias victimization is targeting due to one’s race, sexuality, gender or other marginalized identity.

“The main takeaway is that black LGB youth are at greater risk for poor mental health outcomes than black heterosexual adolescents, and this difference can potentially be explained by higher rates of cyber and bias-based bullying that black LGB youth experience,” he explained.

Given the high rates of depression, suicidal thoughts and substance use, it is important to develop culturally informed interventions and clinical care, the researchers write. This can be achieved, Mereish said, when clinicians assess the multiple forms of oppression that black LGB youth experience and help them understand the impact on their mental health and to develop coping skills and ways to advocate for themselves.

“I think some clinicians are not considering these experiences because they don't have the training or knowledge to do so, and some might have implicit biases that impact their cultural competence and work,” Mereish said. “However, there are some well-trained clinicians that know how to do what I described and do it well.”

Moreover, Mereish and his co-authors add, given the role of cyberbullying in the lives of young people, future research and interventions should target cyberbullying and generate digital interventions to help those affected.