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More youth are coming out as LGBTQ+ than ever before (Worthen, 2023). However, anti-LGBTQ+ stigma places LGBTQ+ youth at increased risk for mental health problems compared to cisgender and heterosexual youth (Chodzen et al., 2019; Plöderl & Tremblay, 2015). Growing research in the past two decades shows that these disparities can be attributed to anti-LGBTQ+ experiences (Guz et al., 2021). These minority stressors include anti-LGBTQ+ discrimination at the institutional and interpersonal levels, such as anti-LGBTQ+ bullying from peers (Cyrus, 2017) and environments rejecting of LGBTQ+ identities (e.g., laws blocking access to gender-affirming care; Kline et al., 2022), as well as internalized anti-LGBTQ+ stigma (Williams et al., 2023). These effects may also be particularly heightened in the face of multiple minoritization; increasing work suggests that LGBTQ+ youth, particularly youth of color, are at increased risk for reduced healthcare access, alienation from peers, homelessness, school dropout, and greater rates of involvement in the juvenile justice system (Dank et al., 2015). Affirmative care, which asserts that all sexual and gender identities are valid and acknowledges the impact of anti-LGBTQ+ stigma, is imperative to reduce these health disparities, and aligns with guidelines for pediatric care (Rafferty et al., 2018) and American Psychological Association (APA) guidelines (APA, 2015; APA Task Force on Psychological Practice with Sexual Minority Persons, 2021). Clinicians may feel anxious about working with LGBTQ+ youth and their families given the complex issues they face, like legislative efforts to ban gender-affirming healthcare and threaten families seeking these services with prosecution (Gordon, 2022), and those limiting classroom discussions on sexual orientation and gender (e.g., House Bill 1557). However, clinicians can be trained to implement LGBTQ+ affirming therapies (Pachankis et al., 2022). Thus, this chapter offers guidance on delivering affirmative mental healthcare for LGBTQ+ youth and their families.

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Doing Affirmative Cognitive Behavioral Therapy with LGBTQ+ Youth and Their Families

  • 章节

  • 发表日期：

    2025年

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  • Jenny Shen,
  • Ilana Seager van Dyk,
  • Jeffrey M. Cohen

摘要

More youth are coming out as LGBTQ+ than ever before (Worthen, 2023). However, anti-LGBTQ+ stigma places LGBTQ+ youth at increased risk for mental health problems compared to cisgender and heterosexual youth (Chodzen et al., 2019; Plöderl & Tremblay, 2015). Growing research in the past two decades shows that these disparities can be attributed to anti-LGBTQ+ experiences (Guz et al., 2021). These minority stressors include anti-LGBTQ+ discrimination at the institutional and interpersonal levels, such as anti-LGBTQ+ bullying from peers (Cyrus, 2017) and environments rejecting of LGBTQ+ identities (e.g., laws blocking access to gender-affirming care; Kline et al., 2022), as well as internalized anti-LGBTQ+ stigma (Williams et al., 2023). These effects may also be particularly heightened in the face of multiple minoritization; increasing work suggests that LGBTQ+ youth, particularly youth of color, are at increased risk for reduced healthcare access, alienation from peers, homelessness, school dropout, and greater rates of involvement in the juvenile justice system (Dank et al., 2015). Affirmative care, which asserts that all sexual and gender identities are valid and acknowledges the impact of anti-LGBTQ+ stigma, is imperative to reduce these health disparities, and aligns with guidelines for pediatric care (Rafferty et al., 2018) and American Psychological Association (APA) guidelines (APA, 2015; APA Task Force on Psychological Practice with Sexual Minority Persons, 2021). Clinicians may feel anxious about working with LGBTQ+ youth and their families given the complex issues they face, like legislative efforts to ban gender-affirming healthcare and threaten families seeking these services with prosecution (Gordon, 2022), and those limiting classroom discussions on sexual orientation and gender (e.g., House Bill 1557). However, clinicians can be trained to implement LGBTQ+ affirming therapies (Pachankis et al., 2022). Thus, this chapter offers guidance on delivering affirmative mental healthcare for LGBTQ+ youth and their families.