WebMD Medical News
Daniel J. DeNoon
Laura J. Martin, MD
Dec. 6, 2010 -- Lesbian, gay, and bisexual (LGB) teens and young adults -- particularly females -- are more often punished by school and criminal authorities than are straight youths, a new study suggests.
The increased punishment can't be explained by more rule-breaking or law-breaking behavior, find Yale researchers Kathryn Himmelstein and Hanna Bruckner.
"LGB kids are being punished more often than heterosexual kids by police, courts, and school officials -- and that is not because they are misbehaving more," Himmelstein tells WebMD. "We controlled for what kids were doing to elicit punishment, and we found that LGB youth were excessively punished."
Himmelstein and Bruckner analyzed data from a nationally representative sample of teens in grades 7 through 12 in 1994 to 1995. More than 15,000 participants were interviewed again in 2001-2002, when they were 18 to 26 years old.
The youths were asked whether they were ever expelled from school, stopped by police, arrested before or after turning 18, or convicted in juvenile or adult court. They answered a battery of questions about their own rule- and law-breaking behavior.
They also were asked whether they were attracted to members of the same sex, whether they had a same-sex relationship, and whether they identified themselves as anything other than 100% heterosexual (in which case they were counted as LGB).
The result: Overall, non-heterosexual teens were between 25% and 300% more likely than their heterosexual peers to have experienced punishment.
"The differences are most striking for non-heterosexual girls, who are about two to three times more likely to be punished," Himmelstein says. "We don't have a clear idea of why, but the juvenile justice system has historically played a role in policing girls' sexuality."
"This study adds to our understanding of the increased risks to their health and well-being that LGB youths face," Tumaini Coker, MD, assistant professor of pediatrics at the University of California, Los Angeles, tells WebMD. Coker has studied the special health challenges of LGB teens. She was not involved in the Himmelstein study.
LGB health researcher Caitlin Ryan, PhD, LCSW, director of the Family Acceptance Project at San Francisco State University, notes that the Himmelstein study mixes together youths who are questioning their sexuality with those who are fully LGB-identified.
"Probably what is happening in this study is they pick up young people who are experienced as different from others, and that may be because of their gender nonconforming behaviors," Ryan tells WebMD. "One way a person responds to that is by acting out. This may bring that child to the attention of authorities."
Harassment by schoolmates and being singled out for punishment by school authorities can have powerful harmful effects on LGB youths' future health, Coker notes. But in a series of new studies, Ryan finds that the biggest health issues for LGB teens lie inside their families.
For nearly a decade, Ryan's Family Acceptance Project has been conducting extensive interviews with the entire families of ethnically diverse LGB youth and their families. They identified more than 100 ways in which families express acceptance or rejection of an LGB family member.
Regardless of how it is expressed, family acceptance and rejection each have powerful effects on an LGB youth's health.
"In our  paper we looked at specific rejecting behaviors and got dramatic findings," Ryan says. "With high family rejection the teens were more than eight times more likely to try suicide, six times more likely to be depressed, and more than three times more likely to use illegal drugs or to put themselves at risk of HIV infection."
But rejection isn't a family's only reaction to an LGB teen. In a new study, Ryan and colleagues find that family acceptance during the teen years protects LGB youth against suicide, depression, and substance abuse and gives youths' significantly higher levels of self-esteem, social support, and general health.
Perhaps the best news is that supportive families don't always start out that way. Even families initially hostile to homosexuality due to religious beliefs or prejudice can become supportive of their LGB loved ones.
"The moral is that families can grow and change and can support LGB youth and can integrate this with their faith," Ryan says. "We work with families of all traditions. Underneath all these attitudes toward nonconforming sexual identity, they love their children and want them to have a good life. Our aim is not to make them do anything against their beliefs, but to do things for their family to protect their child's health."
In consultation with the families they studied, the Family Acceptance Project has developed educational brochures, videos, and other materials for other families. These materials are freely available at the familyproject.sfsu.edu web site.
The Himmelstein study appears in the January 2011 issue of Pediatrics. The Ryan study appears in the November issue of the Journal of Child and Adolescent Psychiatric Nursing.
SOURCES:Himmelstein, K.E.W. and Bruckner, H. Pediatrics, January 2011; vol 127, manuscript received ahead of print.Ryan, C. Journal of Child and Adolescent Psychiatric Nursing, November 2010; vol 23: pp 205-213.News release, San Francisco State University.Ryan, C. Pediatrics, January 2009; vol 123: pp 346-352.Toomey, R.B. Developmental Psychology, 2010.
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