Tag Archives: LGBT Issues

How Can We Better Protect LGBTQ Students: Psychologists Take Action

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By Joshua R. Wolff, PhD (Adler University); H.L. “Lou” Himes, PsyD (QuIPP); and Theresa Stueland Kay, PhD (OUTReach Utah)

Over the last year, we have witnessed regular news media headlines coming out of Washington, D.C. with a state of shock, horror, and anger. Specifically, we have been alarmed by the rollback of protections for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth and students.

We know from first-hand experience that LGBTQ students face many forms of discrimination which contribute to health disparities, such as increased rates of suicide and homelessness. Specifically:

  • I (Lou) have been gender non-conforming my whole life and I have faced harassment in educational institutions from elementary school through my doctoral studies.
  • I (Theresa) work with LGBTQ youth at an organization called OUTreach Utah. All too often, the youth I see are marginalized and bullied at home and at school. When they suffer at school, personnel frequently fail to protect these students. Even worse, faculty, staff, and administration often blame the youth for the fact that they are bullied.
  • I (Joshua) came out as gay at a faith-based college, Biola University, where I risked academic expulsion based solely on my sexual orientation, and realized I did not have any legal protections.

Together, we have each dedicated our careers as clinical psychologists to helping support LGBTQ people in the face of discrimination, which we have done through research, clinical services, and volunteering.

LGBTQ children and youth face daily roadblocks to their education and threats to their safety. This is a systemic issue and requires a systemic response.

Like many Americans, we have at times felt powerless against what seems to be an overwhelming recent assault on many of the most marginalized groups of Americans, including (but certainly not limited to) LGBTQ students. Hence, we asked ourselves “what can we do to help”? We decided to visit Washington, D.C. to talk to Members of Congress, including some who may not share our views, about the importance of protecting LGBTQ students.

Our first step was to contact staff at the APA to help us get started. We felt particularly fortunate to receive wonderful assistance from staff in the Public Interest and Education Government Relations Offices.

Prior to meetings with congressional offices, we connected with leading LGBTQ advocacy groups in Washington to learn about their current federal priorities and strategies. We met with the Human Rights Campaign, GLSEN, and the Trevor Project, as well as APA staff from the Safe and Supportive Schools Project. As a result, we learned about several important priorities. These included:

  • re-instating Title IX protections for transgender youth;
  • the ‘Safe Schools Improvement Act’ which would require schools to create plans to combat bullying, specifically including LGBTQ students;
  • fully funding Title IV (school climate improvement grants) of ‘Every Student Succeeds Act’; and
  • ensuring that federal surveys and surveillance systems  collect sexual orientation and gender identity data.

Further, we were alarmed to learn that the Trevor Project has seen a dramatic increase in the number of transgender youth calling their suicide prevention crisis hotline following the announcement of President Trump’s military ban for transgender service members. This provided a sobering reminder of how our government’s words and decisions affect those most vulnerable in our society.

Our meetings with these groups affirmed two clear messages:

(1) LGBTQ students need critical legal protections, and

(2) we need data to tell us how we can help.

We lobbied staff from the National Governors Association and the offices of Rep. Rob Bishop (R-UT), Rep. Katherine Clark (D-MA), Sen. Orin Hatch (R-UT), and Sen. John McCain (R-AZ) on these important legal protections and data collection. Among the issues raised by the advocacy groups we met with the day before, we talked about:

  • the high rates of LGBTQ suicide attempts and homelessness, as well as
  • the lack of Title IX protections that could reduce bullying and victimization of transgender students
  • the need for greater legal protections and data collection to end these health disparities.

Each of us explained why these issues are important to us personally, how they impact our work as psychologists, and how they affect the Members’ constituents. Unsurprisingly, some offices did not agree on how to address the concerns. But others were eager to listen, and shared concerns about the high rates of suicide attempts among LGBTQ youth and other health disparities. All of the offices agreed that there should be ongoing Congressional oversight of the Department of Education to continue to protect students, and asked us to follow up and continue the conversation.

The experience reminded us that advocacy isn’t a one-time deal, and it’s not just happening in Washington. Advocacy can happen through a phone call or an email to our Members of Congress. Hence, we will follow up with the various offices we contacted to remind them about the critical protections that LGBTQ youth need.

We encourage you to get involved, too. Join the APA Federal Action Network or get involved at the local or community level. Psychologists have a lot to contribute to advocacy, and it’s vital to make your voice heard.



Joshua R. Wolff, PhD, is an Assistant Professor in the Department of Psychology at Adler University in Chicago, IL. Further, he was a contributor to the U.S. government’s (SAMHSA/HHS) report, “Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth”. His current research is directed at developing evidence-based public health strategies to reduce suicide rates and health risk behaviors for SGM people in non-affirming religious environments by building partnerships with clergy and faith leaders.

Theresa Stueland Kay, PhD, trained at Biola University, a faith-based institution, and is a licensed psychologist in Utah.  She is also an Associate Professor of Psychology at Weber State University.  Dr. Kay also serves as Board Chair at OUTreach Utah, a nonprofit organization that serves and supports LGBTQ youth.

H. L. “Lou” Himes, PsyD, is a licensed clinical psychologist and president at QuIPP, the Queer Identities Psychology Partnership—a group psychotherapy practice in Manhattan, NY that focuses on providing psychotherapy and transition-related support for trans/queer individuals.  Dr. Himes uses they/them/theirs pronouns.

Filed under: Children and Youth, Health Disparities, Human Rights and Social Justice, LGBT Issues, Public Policy Tagged: advocacy, Capitol Hill, data collection, Every Student Succeeds Act, gender identity, health disparities, LGBT, LGBT health, LGBT rights, LGBT students, LGBT youth, Safe Schools Improvement Act, sexual orientation, student health, suicide prevention, surveillance, Title IV, Title IX, transgender, transgender youth

A Fate Worse than Death? Being Transgender in Long-term Care

Serious transgender couple standing together


By Mark Brennan-Ing, PhD (Senior Research Scientist, Brookdale Center for Healthy Aging)


“I would kill myself.” This is what a 70 year-old transgender woman told me recently when I asked what she would do if she needed long-term care. While this sounds dramatic, it is a common sentiment among older transgender and gender nonconforming (TGNC) adults (Witten, 2014). Many TGNC older adults do not have family caregivers available to meet their needs for assistance in later life, having been rejected and ostracized by their families of origin according to a study by Grant and colleagues (2011), and long-term care services may be their only option.


Plans for concealing gender identities, suicide and euthanasia are one way for older TGNC adults to cope with the fears of entering long-term care (Bockting & Coleman, 2007; Ippolito & Witten, 2014). The National Senior Citizens Law Center (2011) reports that TGNC older adults, regardless of the degree of gender transitioning, are at risk for abuse, mistreatment, or violence in institutionalized settings, especially those needing assistance with activities of daily living such as showering, dressing, and toileting.


Accessing medically competent care may also be a problem for older TGNC adults in long-term care. Geriatric care for TGNC older adults requires special considerations. Due to potential drug interactions, contraindications, and polypharmacy, TGNC older adults using hormone therapy concurrent with other medications may require close monitoring (Grant et al., 2011; SAGE & NCTE, 2012; Witten & Eyler, 2015). Sometimes these problems may require stopping hormone therapy, which may be especially traumatic for those who have transitioned later in life and not yet achieved their goals for masculinizing or feminizing their appearance.


Since private rooms in long-term care facilities are not covered by insurance, older TGNC adults may be assigned shared rooms based on their birth sex instead of their gender identities, which is problematic for the TGNC person as well as their roommate. The Department of Veterans Affairs (2013) has issued a directive that rooms for TGNC veterans are assigned based upon self-identified gender without regard to physical presentation or surgical history. This policy should be a requirement in all long-term care facilities.


The Nursing Home Reform Act and the Fair Housing Act prohibit TGNC discrimination and mistreatment in long-term care. The Affordable Care Act (ACA) also prohibits discrimination on the basis of gender identity by health care organizations (NCTE, 2015), but this legal protection is at risk following the 2016 election with promises by those in power to repeal the ACA. If ACA repeal is successful, older TGNC people will lose safeguards around denial of services, access to facilities like restrooms that conform to their gender identities, isolation, deprivation, and harassment by staff.


For long-term care providers, there are a number of resources available for continuing education to better serve their TGNC clients. These include the National Resource Center on LGBT Aging, which offers a variety of in-person and on-line training options (http://www.lgbtagingcenter.org/training/index.cfm). Providers working with veterans can review training and education options in the VA system at http://www.patientcare.va.gov/LGBT/index.asp . And TRANSLINE provides on-line consultation for medical providers (http://project-health.org/transline/ ).


Sadly, we may soon witness a rollback of protections for TGNC individuals in long-term care. Therefore it is imperative that the TGNC community and their allies work harder than ever to insure that policies, legislation, and training programs are in place to guarantee that older TGNC people are treated with the dignity and respect they deserve in long-term care and other clinical settings.


Portions of this blog were drawn from “Providing competent and affirming services for transgender and gender nonconforming older adults” (Porter, Brennan-Ing et al., 2016), and “Guidelines for psychological practice with transgender and gender nonconforming people (American Psychological Association, 2015).



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

Bockting, W. O., & Coleman, E. (2007). Developmental stages of the transgender coming‐out process. In R. Ettner, S. Monstrey, & A. Eyler (Eds.), Principles of transgender medicine and surgery (pp. 185‐208). New York, NY: Haworth.

Department of Veterans Affairs (VA; 2013). Providing health care for transgender and intersex veterans (VHA Directive 2013–003). Retrieved from http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2863

Grant, J. M., Mottet, L. A., Tanis, J., Harrison, J., Herman, J. L., & Kiesling, M. (2011). Injustice at every turn: A report of the national transgender discrimination survey. Washington, DC: National Center for Transgender Equality & National Gay and Lesbian Task Force. Retrieved from http://endtransdiscrimination.org/PDFs/NTDS_Report.pdf

Ippolito, J., & Witten, T. M. (2014). Aging. In L. Erickson-Schroth (Ed.), Trans bodies, trans selves: A resource for the transgender community (pp. 476-497). New York, NY: Oxford University Press.

National Center for Transgender Equality (2015). Know your rights: Healthcare. Retrieved from http://www.transequality.org/know-your-rights/healthcare

National Senior Citizens Law Center (2011). LGBT Older Adults in Long-Term Care Facilities: Stories from the Field.  Washington, DC: National Senior Citizens Law Center.

Porter, K. E., Brennan-Ing, M., Chang, S. C., dickey, l. m., Singh, A. A., Bower, K. L., & Witten, T. M. (2016). Providing competent and affirming services for transgender and gender nonconforming older adults. Clinical Gerontologist. http://dx.doi.org/10.1080/07317115.2016.1203383

Services and Advocacy for GLBT Elders (SAGE) & National Center for Transgender Equality (NCTE; 2012). Improving the lives of transgender older adults. New York, NY: Authors. Retrieved from http://transequality.org/Resources/TransAgingPolicyReportFull.pdf

Witten, T.M. (2014). End of life, chronic illness and trans-identities. J. Social Work in End-of-Life and Palliative Care, 10(1), 1-26. doi:10.1080/15524256.2013.988864

Witten, T.M. & Eyler, A.E. (2015). Care of aging transgender and gender non-conforming patients. In. R. Ettner, S. Monstrey and A.E. Eyler (Eds.), Principles of transgender medicine and surgery. New York, NY: Routledge Press.



Mark Brennan-Ing, PhD is the Senior Research Scientist, Brookdale Center for Healthy Aging at Hunter College, City University of New York. He was the 2016 Chair of the APA Committee on Sexual Orientation and Gender Diversity.


Filed under: Aging, Health Disparities, LGBT Issues Tagged: health disparities, health equity, LGBT, long-term care, older adults, transgender

Is the Current Political Climate Hurting LGBTQ Youth? What Schools and Families Can Do


By Tyler Hatchel, MA (Counseling Psychology Doctoral Student, University of Florida, Espelage Lab)


How is the current sociopolitical climate impacting at-risk LGBTQ youth?


Although I believe that simply seeing or hearing about the diminished rights of diverse and oppressed folk is distressing for LGBTQ youth, Bandura’s seminal work on Social Learning Theory might suggest that the impact is more insidious. This theory posits that new behavior can be learned by simply watching and imitating others1. The likelihood of a new behavior occurring is potentially influenced by observed rewards or punishments (i.e., vicarious reinforcement).  It is then plausible that seeing aggression, discrimination, prejudice, and stigma being rewarded with monumental power could shape how all youth in the U.S. behave.


There is well established research showing that aggression in the sense of peer victimization and bullying is deleterious to the mental health of LGBTQ youth33,6,11,12,15,17. Although there are many different ways to frame aggression, Bandura (1973) has demonstrated that seeing aggressive behavior often predicts future aggression.  It follows then that the sociopolitical climate in the U. S. could predict more peer victimization directed at diverse youth like LGBTQ students.  However, there is not much school administrators and parents can do to easily change a nation’s political climate.  However, there are things one can do to change community or school climate.


What can schools do?


Create safe and supportive environments:



Accommodating the needs of LGBTQ youth are profound for improving school climate. School climate is vital when it comes to their well-being. Many studies have demonstrated that accepting and warm climates serve as protective factors whereas less accommodating climates have a negative impact on LGBTQ youth7,9,10,16.  Programs and policies play a large role in shaping school climate.


Use teachers and staff to reduce discrimination:



Teachers and staff are essential to creating welcoming environments for LGBTQ youth as well. If students hear prejudice from their teachers or do not observe an appreciation for diversity, then it is reasonable to posit that this would diminish the quality of climate and even predict student discrimination. I trust schools can protect their LGBTQ youth by hiring teachers and staff who are diverse themselves and allies for diverse youth. Watching role models be allies for LGBTQ youth could cultivate a sense of belonging for LGBTQ students.  I suspect some schools are not ready to remodel their entire staff.  If hiring is not a strategy available, training is another approach.  Cultivate an appreciation and understanding of diversity in your teachers.  Make it a point to incorporate LGBTQ-specific curriculum in your classes.


Foster school connectedness:



Feeling connected is another critical part of LGBTQ youth well-being4,5. Some research has suggested that peer victimization diminishes belonging which then predicts associated mental health issues like suicidality8. Although belonging and connectedness can be specific to an LGBTQ community, they do not have to be. LGBTQ youth can find belonging in theatre club or marching band if these programs are accepting or even appreciative of diversity.  I know I would feel connected to a band or club if the teacher was committed to social justice issues, an ally, and/or identified as LGBTQ.


But what can parents do, you ask?


You can be models for all youth by appreciating diversity in your homes and communities. Furthermore, you can advocate for the inclusion of anti-bullying programs, trans-inclusive policies, and other options like Gay Straight Alliances.  You can also push for the inclusion of diverse teachers/staff in your children’s schools.  Finally, please be an understanding and proud parent of your LGBTQ children as that is clearly another protective factor for LGBTQ youth13.


Essentials for LGBTQ youth well-being:


  • Less exposure to peer victimization
  • Warm and accommodating school climates
  • A sense of belonging and connectedness
  • Supportive families
  • Positive role models who appreciate diversity



LGBTQ youth are an incredibly important and valuable part of our society. Although these youth are clearly resilient, it is their right to be treated as equals by our schools, communities, and families.  This is especially true when dire sociopolitical climates are disheartening.


Resources for LGBTQ youth, parents, and schools:






1Bandura, A., (1971). Social learning theory. General Learning Corporation.

2Bandura, A. (1973). Aggression: A social learning analysis. Oxford, England: Prentice-Hall.

3Birkett, M., Espelage, D.L., & Koenig, B. (2009). LGB and questioning students in schools: The moderating effects of homophobic bullying and school climate on negative outcomes. Journal of Youth and Adolescence, 38, 989 – 1000. doi: 10.1007/s10964-008-9389-1

4Eisenberg, M. E., Neumark‐Sztainer, D., & Perry, C. L. (2003). Peer harassment, school connectedness, and academic achievement. Journal of School Health, 73, 311-316. doi: 10.1111/j.1746-1561.2003.tb06588.x

5Eisenberg, M. E., & Resnick, M. D. (2006). Suicidality among gay, lesbian and bisexual youth: The role of protective factors. Journal of Adolescent Health, 39, 662-668. http://doi.org/10.1016/j.jadohealth.2006.04.024

6Espelage, D. L., Merrin, G. J., & Hatchel, T. (2016). Peer Victimization and Dating Violence Among LGBTQ Youth: The Impact of School Violence and Crime on Mental Health Outcomes. Youth Violence and Juvenile Justice, 1-18. doi: 10.1177/1541204016680408

7Goodenow, C., Szalacha, L., & Westheimer, K. (2006). School support groups, other school factors, and the safety of sexual minority adolescents. Psychology in the Schools, 43(5), 573-589. DOI: 10.1002/pits.20173

8 Hatchel, T., Espelage, D. L., & Huang, Y. (in press). Sexual harassment victimization, school belonging, and depressive symptoms among LGBTQ adolescents: Temporal insights. Journal of Orthopsychiatry.

9Hatzenbuehler, M. L., Birkett, M., Van Wagenen, A., & Meyer, I. H. (2014). Protective school climates and reduced risk for suicide ideation in sexual minority youths. American Journal of Public Health, 104(2), 279-286. doi: 10.2105/AJPH.2013.301508

10Hatzenbuehler, M. L., & Keyes, K. M. (2013). Inclusive anti-bullying policies and reduced risk of suicide attempts in lesbian and gay youth. Journal of Adolescent Health, 53(1), S21-S26. http://dx.doi.org/10.1016/j.jadohealth.2012.08.010

11 Huebner, D. M., Thoma, B. C., & Neilands, T. B. (2015). School victimization and substance use among lesbian, gay, bisexual, and transgender adolescents. Prevention Science, 16(5), 734-743. DOI: 10.1007/s11121-014-0507-x

12Kosciw, J. G., Greytak, E. A., Bartkiewicz, M. J., Boesen, M. J., & Palmer, N. A. (2012). The 2011 national school climate survey. New York, NY: GLSEN.

13Poteat, V. P., Mereish, E. H., DiGiovanni, C. D., & Koenig, B. W. (2011). The effects of general and homophobic victimization on adolescents’ psychosocial and educational concerns: the importance of intersecting identities and parent support. Journal of Counseling Psychology, 58, 597. http://dx.doi.org/10.1037/a0025095

14Robinson, J.P., & Espelage, D.L. (2011). Inequities in educational and psychological outcomes between LGBTQ and straight students in middle and high school. Educational Researcher, 40, 315-330. doi: 10.3102/0013189X11422112

15 Toomey, R. B., Ryan, C., Diaz, R. M., Card, N. A., & Russell, S. T. (2010). Gender-nonconforming lesbian, gay, bisexual, and transgender youth: school victimization and young adult psychosocial adjustment. Developmental psychology, 46(6), 1580. http://dx.doi.org/10.1037/a0020705

16Ueno, K. (2005). Sexual orientation and psychological distress in adolescence: Examining interpersonal stressors and social support processes. Social Psychology Quarterly, 68, 258-277.

17Ybarra, M. L., Mitchell, K. J., Kosciw, J. G., & Korchmaros, J. D. (2015). Understanding linkages between bullying and suicidal ideation in a national sample of LGB and heterosexual youth in the United States. Prevention Science, 16, 451-462. doi: 10.1007/s11121-014-0510-2




Tyler James Hatchel, MA is a doctoral student in Counseling Psychology at the University of Florida, Department of Psychology. Tyler graduated from California State University, Los Angeles with a BA and MA in psychology. His research interests broadly include developmental psychology, prevention science, aggression, and mental health. He is particularly interested in examining the well-being of at risk and stigmatized youth. More specifically, he has completed a number of studies that explored the various risk and protective factors that shape the relations between peer victimization and poor outcomes for LGBTQ youth. He is also interested in digital media, suicidality, and tele-health. He is currently appointed as a research assistant for Dr. Espelage’s lab which focuses on understanding and preventing bullying, peer aggression, and sexual assault. Tyler has both been the recipient of a number of awards and published a few studies. He has worked with at The Trevor Project, with number of public school administrators, and served as a counselor at the University of Florida. He would like to become appointed as a professor and continue completing translational research that proves beneficial for at risk and stigmatized youth.

Filed under: Children and Youth, Human Rights and Social Justice, LGBT Issues Tagged: bullying, bullying prevention, Education, homophobia, LGBT allies, LGBT students, LGBT youth, politics, safe and supportive schools, safe schools, school climate, school connectedness, transphobia

How Black Boys Turn Blue: The Effects of Masculine Ideology on Same-Gender Loving Men


By Courtland Douglas (Psychology Graduate Student, Texas Southern University) & Erlanger Turner, PhD (Assistant Professor of Psychology, University of Houston-Downtown)


What Do We Mean by the Term “Same-Gender Loving”?


They say, “Black boys turn blue in the moonlight”. In the Oscar winning movie Moonlight, the story follows character Chiron as he develops into a man. What’s interesting about Chiron’s story is that it mirrors that of countless other African American men. Chiron is simply not allowed to “be” – he’s bullied for being “Little,” beaten because of his demeanor, and denied the opportunity to safely and freely explore his sexuality. It is indeed under this distress that Black boys turn blue.

Chiron is a same-gender loving man. “Same-gender loving” (SGL) was first coined by Dr. Cleo Manago to describe African Americans with same gender attractions1. It encompasses African Americans who experience exclusively homosexual or bisexual attractions and sexual interactions. Same-gender loving has been used to redefine the terms gay, lesbian, and bisexual. In doing this, Manago challenges the assumed link between sexual minority identities and the stereotypes that accompany them.


Masculinity and SGL

Pascoe (2003), in his study of heterosexual masculinity, called for greater examination of the complex ways that young men negotiate masculinity, rather than discussion of how to categorize the types of masculinity (e.g., jock, player, effeminate). According to various scholars2,3, in traditional masculine ideology, men exemplify certain characteristics and behaviors:

  • Men are aggressive and physically strong
  • Men are self-reliant and responsible heads of the household
  • Men are emotionally restricted
  • Men have non-relational attitudes towards sex
  • Men avoid femininity, which includes concealing their emotions
  • Men view heterosexuality as the normative sexual orientation
  • Men aspire to success and achievement

According to Levant and Majors (1997), African American men embrace traditional masculine ideology to a greater extent compared to other ethnic groups in the United States. Therefore, the heterosexism – negative attitudes toward homosexuality and gender non-conforming expression – pervades the African American community. A recent study4 in the Journal of Black Psychology notes that in the Black community, gender norms portrayed in popular music may increase ideals of hegemonic masculinity which is defined to include traits such as competitiveness, emotional restraint, risk taking, dominance, non-relational attitudes toward sexuality.

Research identifies the disdain of homosexuality and avoidance of femininity as beliefs of traditional masculine ideology. This influences the ability of SGL men to meet masculine standards. For some, their identity and gender non-conforming expression contradict traditional masculine ideology. SGL men who don’t conform to traditional masculinity may have their manhood questioned by their ethnic peers. Subsequent persecution may prompt some SGL men to forego exploration of their sexuality and gender expression. Pleck (1995) identified these patterns of persecution and trauma as trauma strain, which negatively affect the psychological well-being of SGL men.

Similarly, being able to perform masculinity successfully can harm the mental health of SGL men. Pleck asserts that the fulfillment of certain male gender role norms can have negative consequences such as being inherently dysfunctional—dysfunction strain. For example, SGL men who internalize traditional masculinity may have a reluctance to express emotions, which may prevent the development of intimate relationships. However, for some SGL men, adhering to traditional masculine norms may serve a protective function. Traditional masculine ideology has helped mold the expectation for how African American men should behave. So, adhering to male gender role norms increases their chances of successfully navigating social environments (e.g., work and school) without persecution.

Additionally, research finds that African American men are more likely to self-identify as bisexual than other ethnic minorities5. Identifying as bisexual may serve a dual protective function for African American SGL men. The identification arguably allows them to validate their same gender attractions, protecting them psychologically, while grounding themselves in their masculinity protects them socially. This further complicates our understanding of how individuals navigate social contexts as a result of their intersecting identities.


Mental Health and SGL Men

The literature often finds that attempts to adhere to traditional masculine ideologies are associated with decreased mental health functioning6,7. Ethnic minorities who identify as SGL frequently experience a sense of never being part of any group, which may leave them at greater risk for isolation, feelings of estrangement, and increased psychological vulnerability8.

In 2013, a meta-analysis of 25 studies5 revealed that the lifetime prevalence of depression and anxiety disorders was at least 1.5 times higher among lesbians, gays, and bisexuals. Furthermore, African American men who experienced homophobia from the heterosexual community and their friends reported more negative psychological effects5. Choi and colleagues reported that perceived homophobic disapproval and rejection by an immediate circle of heterosexual friends harmed psychological well-being for sexual minority men of color more than harassment related to sexual orientation.


What Helps with Coping for SGL Men?


  • Engage in healthy personal habits (e.g., eating, exercise).
  • Identify a safe space to discuss your identity and seek supportive relationships.
  • Avoid engaging in risky sexual behaviors (e.g., unprotected sex).
  • Avoid using substances to cope with negative thoughts as it could lead to more negative psychological and health outcomes.

Psychological interventions:

  • According to Greene (1994), individuals learn about negative stereotypes and homophobia before they know they are attracted to the same-sex. Therapy can help explore sexual identity and self-acceptance.
  • Group therapy for SGL men: Group therapy can provide a safe space to explore issues surrounding SLG men’s intersecting identities while fostering solidarity among group members. Here, members can negotiate their identities as African American and same-gender loving men.
  • Therapy goals to overcome internalized homonegativity: Homonegativity has been defined as negative societal attitudes about non-heterosexual attractions, behaviors, and identities that are internalized by homosexuals.10 Homonegative messages can be internalized, causing a decreased sense of self-worth. Therapy can deconstruct internalized homonegativity and expose its origin as the external attitudes of society. SGL men are then able to use their own values to shape their views of themselves and reframe their sexuality as a positive or neutral aspect of their identity rather than a negative one.




1Lassiter, J. (2016). Effective strategies used by African American same gender loving men in promoting health and well-being. In L. D. Follins & J. M. Lassiter (Eds.), Black LGBT Health in the United States: The Intersection of Race, Gender, and Sexual Orientation (pp. 169-184). Lanham, MD: Lexington Books.


2Levant, R. F., Hirsch, L., Celentano, E., Cozza, T., Hill, S., MacEachern, et al. (1992). The male role: An investigation of norms and stereotypes. Journal of Mental Health Counseling, 14(3), 325-337.


3Pascoe, C. J. (2003). Multiple masculinities? Teenage boys talk about jocks and gender. American Behavioral Scientist46(10), 1423-1438.


4Mahalik, J. R., Good, G. E., & Englar-Carlson, M. (2003). Masculinity scripts, presenting concerns, and help seeking: Implications for practice and training. Professional Psychology: Research and Practice34(2), 123-131.


5Levant, R. F., & Majors, R. G. (1997). An investigation into variations in the construction of the male gender role among young African American and European American women and men. Journal of Gender, Culture, and Health, 2(1), 33-43.


6Avery, L. R., Ward, L.M., Moss, L., & Uskup, D. (2017). Tuning gender: Representations of femininity, and masculinity in popular music by Black artists. Journal of Black Psychology, 43(2), 159-191.


7Choi, K. H., Paul, J., Ayala, G., Boylan, R., & Gregorich, S. E. (2013). Experiences of discrimination and their impact on the mental health among African American, Asian and Pacific Islander, and Latino men who have sex with men. American Journal of Public Health103(5), 868-874.


8Pleck, J. H. (1995). The gender role strain paradigm: An update. In R. F. Levant & W. S. Pollack (Eds.), A new psychology of men (pp. 11-32). New York: Basic Books.


9Wilson, B. D., Harper, G. W., Hidalgo, M. A., Jamil, O. B., Torres, R. S., Fernandez, M. I., & Adolescent Medicine Trials Network for HIV/AIDS Interventions. (2010). Negotiating dominant masculinity ideology: Strategies used by gay, bisexual and questioning male adolescents. American Journal of Community Psychology, 45(1-2), 169-185.


10Greene, B. (1994). Ethnic-minority lesbians and gay men: mental health and treatment issues. Journal of Consulting and Clinical Psychology62(2), 243.



Courtland Douglas earned his Bachelor of Science degree in Psychology from Louisiana State University. He is currently pursuing a Masters of Art in Psychology at Texas Southern University. His interests include Black masculinity, LGBTQ issues, and mental health.

Erlanger A. Turner, PhD, is a Clinical Psychologist and an Assistant Professor of Psychology at the University of Houston-Downtown (UHD). Dr. Turner’s research focuses on access to child mental health services, health inequity, help-seeking attitudes and behaviors, and cultural competency in clinical practice. He is the Director of the UHD Race, Culture, and Mental Health Research Lab and is also a blogger for The Race to Good Health. Dr. Turner has served in numerous leadership positions throughout APA and APA Divisions. He currently serves as Chair of the APA Board for the Advancement of Psychology in the Public Interest (2017-2018) and as a member of the Behavioral Health National Project Advisory Committee for the U.S. Department of Health and Human Services, Office of Minority Health. He is a member of the American Psychological Association and the Association of Black Psychologists.

Image source: iStockPhoto.com

Filed under: Children and Youth, Culture, Ethnicity and Race, LGBT Issues, Men and Masculinity Tagged: african american, African American men, bisexuality, boys and men, gender norms, gender roles, homophobia, homosexuality, identity, identity development, masculine ideology, masculine norms, masculinity, same gender loving men

How the Federal Government Can Better Protect LGBTQ Students in Religious Universities & Colleges

Urban lesbian couple enjoy

This is a cross-post from Adler University’s “The Socially Responsible Practitioner” blog.  Joshua Wolff, PhD (Assistant Professor of Psychology, Adler University) describes his recommendations to the Office of Civil Rights at the U.S. Department of Education on how best to protect the wellbeing of LGBTQ students attending religious institutions of higher education where their identities are not supported. Growing social and legal acceptance of LGBTQ individuals has resulted in many of these institutions applying for exemptions from Title IX (which prohibits sex discrimination in education) due to religious convictions. In short, these institutions are able to discriminate against LGBTQ college students while still receiving taxpayer funds. The risks posed to LGBTQ students by this are great cause for concern. An excerpt is posted below. You can read the full post here.

This September, I met with staff members in the Office of Civil Rights, at the U.S. Department of Education (DOEd) in Washington, D.C. to talk about the risks posed to lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) students by disaffirming religious universities/colleges (DRUs). Last year, the DOEd published a list of religious colleges and universities which have applied for exemption to Title IX, which includes federal regulations against sex discrimination in colleges. These are institutions of higher education seeking to discriminate against LGBTQ students on the basis of the institutions’ religious convictions—while still collecting taxpayer dollars.

Currently, Title IX allows schools who are “controlled by a religious entity” to request exemptions to Title IX on the basis of religious beliefs which may be in conflict with federal regulations. Since Title IX was passed in 1972, requests for exemptions were generally limited to contraception concerns at Catholic schools. However, there has been a dramatic increase in Title IX exemption requests over the past 2 years in response to growing social and legal acceptance of LGBTQ people. As it currently stands, universities with Title IX exemption are allowed to:

  • Refuse to admit or retain students based on their sexual orientation or gender identity
  • Refuse gender-affirming housing or restrooms to transgender students
  • Discriminate on the basis of sexual orientation or gender identity in employment

Read the rest of the post here.

Image source: iStockPhoto.com

Filed under: Children and Youth, Human Rights and Social Justice, LGBT Issues Tagged: higher education, LGBT, LGBT rights, LGBT youth

How the Federal Government Can Better Protect LGBTQ Students in Religious Universities & Colleges

Urban lesbian couple enjoy

This is a cross-post from Adler University’s “The Socially Responsible Practitioner” blog.  Joshua Wolff, PhD (Assistant Professor of Psychology, Adler University) describes his recommendations to the Office of Civil Rights at the U.S. Department of Education on how best to protect the wellbeing of LGBTQ students attending religious institutions of higher education where their identities are not supported. Growing social and legal acceptance of LGBTQ individuals has resulted in many of these institutions applying for exemptions from Title IX (which prohibits sex discrimination in education) due to religious convictions. In short, these institutions are able to discriminate against LGBTQ college students while still receiving taxpayer funds. The risks posed to LGBTQ students by this are great cause for concern. An excerpt is posted below. You can read the full post here.

This September, I met with staff members in the Office of Civil Rights, at the U.S. Department of Education (DOEd) in Washington, D.C. to talk about the risks posed to lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) students by disaffirming religious universities/colleges (DRUs). Last year, the DOEd published a list of religious colleges and universities which have applied for exemption to Title IX, which includes federal regulations against sex discrimination in colleges. These are institutions of higher education seeking to discriminate against LGBTQ students on the basis of the institutions’ religious convictions—while still collecting taxpayer dollars.

Currently, Title IX allows schools who are “controlled by a religious entity” to request exemptions to Title IX on the basis of religious beliefs which may be in conflict with federal regulations. Since Title IX was passed in 1972, requests for exemptions were generally limited to contraception concerns at Catholic schools. However, there has been a dramatic increase in Title IX exemption requests over the past 2 years in response to growing social and legal acceptance of LGBTQ people. As it currently stands, universities with Title IX exemption are allowed to:

  • Refuse to admit or retain students based on their sexual orientation or gender identity
  • Refuse gender-affirming housing or restrooms to transgender students
  • Discriminate on the basis of sexual orientation or gender identity in employment

Read the rest of the post here.

Image source: iStockPhoto.com

Filed under: Children and Youth, Human Rights and Social Justice, LGBT Issues Tagged: higher education, LGBT, LGBT rights, LGBT youth

“I’m Not Just Black!”: Exploring Intersections of Identity

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By Faye Z. Belgrave, PhD (Professor, Virginia Commonwealth University) and Sarah J. Javier, MS (Doctoral Candidate, Virginia Commonwealth University)

Through a very complete body of research, the field of psychology has established that a person’s identity is composed of several different parts. However, psychological research projects often only focus on one or two aspects of identity. As we move towards a more complete picture of human behavior, we must remember to keep in mind that the intersections of identity are a vital piece of that picture.

“Intersectionality” is a term that is coming to the forefront in psychological research. It encompasses race, ethnicity, gender, socioeconomic status, sexual orientation, and other intersecting, categorical dimensions that describe groups of people. For example, think about different parts of your identity. You may describe yourself as a single, older, African American female who makes a modest income. Or perhaps you are a young, White male who identifies as gay. These different parts of our identities make us who we are, and professionals interested in intersectionality have come to understand that these different components of identity are integral to why individuals do the things they do.

Intersectionality in National Data Sets

Data collection on the intersections of identity and how they affect health is of utmost importance. By examining combinations of identities (e.g. Gender X Race, Race X Sexual Orientation, etc.), researchers can more completely understand why some groups do better on certain health outcomes than others.

For instance, research on the intersecting identities of Race X Gender yields findings that there are different outcomes among African American males compared to, not only White males, but also African American females, including lower levels of academic achievement and higher levels of incarceration. These data can then be used to create culturally and identity-appropriate programs to decrease disparities and promote wellness among African American males.

But data aren’t perfect. And often, these identities get lost, even in well-known national data sets. For example, because it is politically charged, sexual orientation may be omitted completely from national data sets, based on the idea that children and adolescents should be protected from this information. However, research indicates that sexual orientation may develop anywhere between middle childhood and early adolescence, and being a sexual minority is associated with a host of worsened physical and mental health disparities (e.g., higher levels of suicidality, depression, substance use, risk for sexually transmitted infections, etc.). What’s more, not asking these questions limits the amount of research that can be done in exploring how sexual orientation intersects with other identities.

Youth Risk Behavioral Surveillance Survey

On August 11, 2016 the Centers for Disease Control and Prevention released sexual minority youth data from the Youth Risk Behavioral Surveillance Survey (YRBSS). The YRBSS is a survey collected from millions of 9th through 12th grade students in the continental U.S. bi-annually. The survey asks questions about a diverse array of health behaviors, including violence, sexual activity, sexually transmitted infections including HIV infection, alcohol, tobacco, and other drug use, and physical activity.

One key feature of the YRBSS is its inclusion of identities in asking these questions. For instance, the survey asks items on race, gender, grade, and includes the following items on sexual orientation:

  1. “During your life with whom have you had sexual contact?” with response items being I have not had sexual contact, females, males, or females and males; and
  2. “Which of the following describes you?” with response items being heterosexual (straight), gay or lesbian, bisexual, or not sure.

The 2015 report yielded startling findings, including that more than 40% of LGB students seriously considered suicide, while 30% attempted suicide in the past year. According to the 2015 report, LGB students were more than five times more likely than individuals identifying as heterosexual to report using multiple illegal drugs.

Research that can come from this report includes how the intersection of sexual orientation and other identities (i.e., race/ethnicity) affect these outcomes, if at all. Individuals at intersections of identity in adolescence are especially at high risk for mental and physical consequences, and intersecting identities may be a vital component to risk for these consequences. Thus, the YRBSS is setting a precedent as one can now explore different aspects of identity and their relation to health outcomes in an adolescent population.

Data from the YRBSS may also help us understand whether certain intersections of identity act as protective factors that will help to combat negative health outcomes. Potential data analyses may in fact find that being at the intersection of a marginalized group may be correlated with being less likely to engage in certain negative health behaviors. For instance, African American adult females on the whole have been shown to smoke cigarettes at lower rates compared with both African men and White women. With the YRBSS, researchers can determine if this is true at a younger age, and whether this varies by grade, gender, sexual orientation, or any combination of these identities. 

What We Can Do

  • Acknowledge different parts of individuals’ identities. Too often, we make assumptions about individuals based on surface-level interactions. It is important to acknowledge that new individuals you may meet may have different parts of their identity that can’t just be seen on the surface.
  • Use existing resources from APA. APA recently released a Resolution on Data about Sexual Orientation and Gender Identity that speaks to the importance of collecting data from diverse groups in national surveys. Behavioral health professionals can use these tools, as well as others, to make the case for conducting research on underserved populations.
  • Fill in the gaps. One major limitation of the YRBSS is that it does not ask questions on gender identity. Researchers should examine these kinds of gaps in data collection so that yet another aspect of identity can be used in studies to improve the outcomes of people of different gender identities.
  • Be an advocate. Parents of underserved children, teachers, and allies of the LGBT community can help to advocate for these individuals and push their members of Congress to pass legislation that helps to improve the lives of the LGBT population.



American Psychological Association, Task Force on Resilience and Strength in Black Children and Adolescents. (2008). Resilience in African American children and adolescents: A vision for optimal development. Washington, DC: Author. Retrieved from http://www.apa.org/pi/cyf/resilience.html

American Psychological Association. (2008). Answers to your questions: For a better understanding of sexual orientation and homosexuality. Washington, DC: Author. Retrieved from www.apa.org/topics/lgbt/orientation.pdf

American Psychological Association, Presidential Task Force on Educational Disparities.(2012). Ethnic and racial disparities in education: Psychology’s contributions to understanding and reducing disparities. Retrieved from http://www.apa.org/ed/resources/racial-disparities.aspx

Centers for Disease Control and Prevention. (2011). Sexual identity, sex of sexual contacts, and health-risk behaviors among students in grades 9–12 — youth risk behavior surveillance, selected sites, United States, 2001–2009. MMWR, 60. Retrieved from http://www.cdc.gov/mmwr/pdf/ss/ss60e0606.pdf

Cole, E. R. (2009). Intersectionality and research in psychology. American Psychologist, 64(3), 170-180. Retrieved from: http://psycnet.apa.org/journals/amp/64/3/170.html

Jamal, A., Homa, D. M., O’Connor, E., Babb, S. D., Caraballo, R. S., …, & King, B. A. (2015). Current cigarette smoking among young adults – United States, 2005-2014. MMWR, 64(44), 1233-1240. Retrieved from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6444a2.htm

Kann, L., Olsen, E. O., McManus, T., et al. (2016). Sexual identity, sex of sexual contacts, and health-related behaviors among students in grades 9–12 — United States and selected sites, 2015. MMWR Surveillance Summaries, 65(No. SS-9):1–202. DOI: http://dx.doi.org/10.15585/mmwr.ss6509a1

Neal, D., & Rick, A. (2014). The prison boom and the lack of Black progress after Smith and Welch. National Bureau of Economic Research. NBER Working Paper No. 20283. Retrieved from http://www.nber.org/papers/w20283



Faye Belgrave, PhD, is a professor in the Department of Psychology at Virginia Commonwealth University. Her work is focused on cultural factors (gender, ethnicity, age) that affect the health and wellbeing of African American youth and young adults.

Sarah Javier is a doctoral candidate in Health Psychology at Virginia Commonwealth University. Her research interests include developing culturally tailored prevention programs for underserved populations.

 Image source: iStockphoto.com


Filed under: Culture, Ethnicity and Race, Health Disparities, LGBT Issues Tagged: data collection, gender, health disparities, identity, intersectionality, race, research, sexual orientation, YRBS

New CDC Survey Data Confirm the Severe Health Risks LGB Youth Face


By Clinton Anderson, PhD (Director, APA Office on Lesbian, Gay, Bisexual and Transgender Concerns) & Lacey Rosenbaum, MEd (Director, APA Safe and Supportive Schools Project)


On August 11, 2016, the Centers for Disease Control and Prevention released the results of the first national study of sexual minority high school students: “Sexual Identity, Sex of Sexual Contacts, and Health-Related Behaviors Among Students in Grades 9-12 – United States and Selected Sites, 2015.”

This is the first nationally representative data on a wide range of risks among lesbian, gay, and bisexual (LGB) students, and it was made possible by CDC adding questions to the 2015 national Youth Risk Behavior Survey (YRBS), which is conducted biannually among students in grades 9-12 in high schools.


What does this new research tell us?


LGB students experience much higher levels of physical and sexual violence and bullying compared to their heterosexual peers:

  • LGB high school students are more likely to report being forced to have sex (18% vs. 5%),
  • to experience sexual dating violence (23% vs. 9%),
  • to experience physical dating violence (18% vs. 8%),
  • and to be bullied at school or online (at school: 34% vs. 19%; online: 28% vs. 14%).

LGB students are at increased risk for suicide:

  • More than 40% of LGB students reported seriously considering and roughly 30% reported attempting suicide in the last year.

60% of LGB youth reported having been so sad or hopeless they stopped doing some usual activities.

More than 10% reported having missed school because of safety concerns.

LGB students were up to 5 times more likely than other students to report using several illegal drugs.

These results confirm the need for school-based interventions that APA called for in its Resolution on Sexual Orientation and Gender Diversity in Children and Adolescents in Schools.


What about transgender students? 


The 2015 results include no findings on transgender students. To date, federal officials have not been able to devise scientifically sound gender identity questions for inclusion in the YRBS. The Department of Health and Human Services recognizes this research challenge and seeks to address it in its federal sexual orientation and gender identity data collection plans. APA in its Resolution supports the validation of gender identity measures to better understand the experiences of transgender and gender diverse students and calls for schools to create supportive environments for these students.


What does other research on LGB youth say?


Other research points to a number of shared risk factors for violence, which may affect LGB youth:

  • Social isolation and lack of social support;
  • Poor parent-child relationships (lack of parental caring and support);
  • History of violent victimization (violence makes one vulnerable to more violence);
  • Perceived by others as not masculine or feminine enough.


So, what works to protect LGB youth?


There is no simple solution to these dangerous intersections of risks, but research has identified shared protective factors that can help young people at the individual, family, and community levels.

  • Individual-level protective factors include helping young people develop problem-solving and coping skills and encouraging bystander interventions.
  • Family-level protective factors include family support and connectedness, connection to other caring adults, connection to and commitment to school and peers.
  • Community-level protective factors include community support and connectedness and access to mental health and substance abuse services.

All of us, including parents, schools and communities, can and must take action to ensure gay, lesbian, and bisexual youth survive and thrive. APA’s Respect Workshop, developed with CDC support, provides school counselors, nurses, psychologists, and social workers with the knowledge, attitudes, and skills to make schools safe and supportive for LGB students.


What can we all do?


Professionals and parents can:

  • Work with schools to ensure comprehensive, community-wide support systems that reduce risk and promote protective factors for LGB youth.

Schools can:

  • Work to support and encourage parents to foster resiliency in their children by providing strong family support and teaching all children nonviolent problem solving skills.
  • Build environments that provide safety and connectedness for all students, including gay, lesbian, and bisexual youth.

Communities can:

  • Adopt policies and practices to reduce discrimination and forms of victimization that contribute to vulnerability and thereby reduce stressors for LGB youth.


Connectedness is key


At the end of the day, making sure that LGB youth feel connected – to parents, to peers, to teachers, and to schools and other community organizations – is key to protecting their health. Students are more likely to thrive in their schools and communities if they know they matter – if they know the adults, teachers, and friends in their lives care about their safety and success.

For more info, check out APA’s Safe and Supportive Schools Project.

Image source: Flickr user ankxt via Creative Commons

Filed under: Children and Youth, LGBT Issues Tagged: bullying, CDC Youth Risk Behavior Survey, health disparities, health risks, LGB youth, online bullying, safe schools, school bullying, school connectedness, school safety, sexual assault, sexual minorities, sexual minority youth, sexual violence, suicide, violence, YRBS

Why Did the FDA Prevent Gay and Bisexual Men from Donating Blood in the Aftermath of Orlando?

Blood donation bag syringe needle

By Leo Rennie (Senior Legislative and Federal Affairs Officer, APA Public Interest Government Relations Office) 


Understanding the Controversy


After the horrific shooting on June 12, 2016 at Pulse, a popular gay bar in Orlando, Florida, many of the victims were in extreme need of blood transfusions. Driven by empathy and solidarity with the victims, gay and bisexual men rushed to area hospitals and blood donation centers to help, along with scores of their Orlando neighbors. Sadly, hundreds identifying as men who have sex with men (MSM) were turned away because current FDA regulations prohibit gay and bisexual men from donating blood unless they abstain from sex with other men for a full year before donating blood.


HIV risk depends on several factors including condom use, number of sex partners and type of sexual activity, with unprotected anal sex being the most risky. While gay men and bisexual men make up more than half of the number of persons living with HIV/AIDS in Orlando, it is individual behavior, not sexual orientation, that puts someone at risk of acquiring or transmitting HIV.

The FDA 12-month MSM deferral policy prevents healthy gay and bisexual men from donating blood solely based on their sexual orientation rather than actual risk to the blood supply. The tragic Orlando shootings have brought attention to an outdated, discriminatory and stigmatizing policy and sparked renewed calls for the FDA to end it once and for all.


What is the FDA MSM deferral policy?


According to the FDA Blood Products Advisory Committee recommendations, blood centers must follow guidelines that inherently discriminate against and stigmatize gay and bisexual men. While the guidelines prior to 2015 included a lifetime ban on all donations from MSM, the 2015 guidelines are not much better. They require that blood donors must not be a man who has had sex with a man for the past 12 months, or a woman who has had sex with an MSM in the past 12 months.


What’s Wrong with Current FDA Regulations on Blood Donations?


Beyond being discriminatory and stigmatizing towards gay and bisexual men, they perpetuate stereotypes that HIV is a “gay disease” and that gay and bisexual men are the primary carriers of communicable diseases. This type of stigma and discrimination has no scientific basis and is particularly damaging to the psyche of gay and bisexual men.


The policy is also obsolete. The FDA implemented the MSM deferral policy in the early days of the HIV epidemic before blood donations could be screened for HIV. HIV tests weren’t developed before 1985, putting those receiving blood transfusions at risk of HIV infection. However, modern HIV and other sexually transmitted infection testing methods are incredibly rapid.


Compared with older testing methods, recent testing methods can detect positive results within days of exposure, or at most, a few weeks. Today, the nation’s blood supply is incredibly safe. The risk of HIV infection via blood transfusion is low. As of December 2015, the rate of HIV infection via blood transmission was miniscule at one out of 1.47 million donation cases.


What Can Policymakers Do?


We know that the current FDA deferral policy singles out gay and bisexual men based on criteria unlikely to put those receiving blood transfusions at risk of HIV infection. The FDA should change its 2015 blood donation guidelines to end the 12-month deferral policy for gay and bisexual men once and for all, replacing it with one based on assessment of individual risk behaviors.


One day after the shooting, Rep. Mike Quigley (D-IL), Vice President of the Congressional LGBT Equality Caucus, led a bipartisan group of more than 1,000 members of the House of Representatives in calling on the FDA to end its discriminatory blood ban. Senators Tammy Baldwin (D-MN) and Elizabeth Warren (D-MA) led a similar charge in their chamber. Lawmakers stopped short of taking legislative action, but they strongly urged the FDA commissioner to revise the 12-month MSM deferral policy to more closely align with current science and blood screening technologies.


FDA should promptly report back to congressional oversight committees and, in coordination with the Department of Health and Human Services Secretary’s Office, engage public health and LGBT stakeholders in devising a policy that may defer high-risk gay and bisexual men, while permitting low-risk gay and bisexual men to donate blood.


We urge federal agency heads and Members of Congress to consider the impact of stigmatizing and discriminatory laws and health policies on the LGBT community, and to take steps to correct them. For example, lawmakers can support the Equality Act of 2016, a bill to prohibit discrimination based on sex, sexual orientation and gender identity. APA supports policies that decrease stigmatization and marginalization of LGBT individuals. To learn more about APA’s advocacy efforts on this topic and others, please visit the Public Interest Government Relations Office website.



AIDS.gov – Blood Transfusions and Organ/Tissue Transplants

FDA – Revised Recommendations for Reducing the Risk of Human Immunodeficiency Virus Transmission by Blood and Blood Products – Questions and Answers

GMHC – MSM Blood Ban

WHO – Blood Safety and Availability

Filed under: AIDS, LGBT Issues Tagged: aids, discrimination, FDA MSM deferral policy, HIV, HIV testing, LGBT, MSM, MSM blood ban, Orlando shootings

Why HIV Providers Should Care About the Orlando Shooting


By David J. Martin, PhD, ABPP (Senior Director, APA Office on AIDS)

In the aftermath of the mass shooting of LGBT people in an Orlando nightclub on June 12, 2016, there was a great deal of discussion concerning the shooter’s motives. Was it a hate crime? An act of terrorism? Members and allies of the LGBT community have come together to express their support for the victims and to denounce violence against LGBT people.

Although the solid links between the LGBT community and the HIV prevention and treatment communities resulted in a strong show of solidarity, there is another reason HIV care providers and educators should be concerned about the shooting and its aftermath: It is an instance of the stigma that can increase the risk of HIV transmission and reduce the ability of people with HIV to fight their disease.

Although most LGBT community members demonstrate resilience in the face of these psychosocial factors, they do take a toll. These factors have been associated with poor mental health (increased depression, anxiety, loneliness, suicide ideation/attempt), diminished self-esteem, and drug and alcohol use/misuse.  

Just as important, they can increase the risk of HIV transmission in the LGBT community. And for those living with HIV, they may diminish the body’s ability to fight HIV beyond the damage done by the virus itself:

  • In an early study, Steve Cole and his colleagues reported that gay men with HIV who concealed their sexual orientation demonstrated faster disease progression than gay men with HIV who did not conceal their sexuality.
  • In a later study, Dr. Cole and his colleagues reported that gay men with high levels of autonomic nervous system activity (ANS: a measure of stress) experienced impaired response to anti-HIV medication—their viral loads prior to starting anti-HIV medication did not drop nearly as much as those with low ANS levels.
  • In 2003, Ron Stall and his colleagues reported on the impact of psychosocial health problems (polydrug use, depression, childhood sexual abuse) on high-risk sexual behavior among gay men; they found that the more of these health problems gay men had, the higher their sexual risk. Similarly, in 2007, Brian Mustanski and his colleagues demonstrated the role of psychosocial health problems (binge drinking, street drug use, regular marijuana use, psychological distress, sexual assault, partner violence) in increasing high-risk sex, and in 2012, Ann O’Leary and her colleagues also reported similar findings. They suggested that the overall constellation of findings suggests that “cumulative adverse psychosocial health conditions of any sort seem to exert their negative effects on HIV risk and infection.” Dr. O’Leary and her colleagues also found that optimism and education lessened (but did not eliminate) these effects.

The Orlando mass shooting is another manifestation of the multiple psychosocial insults that still confront the LGBT community. The recent findings cited here (and others) suggest that, in addition to their impact on the mental health of the LGBT community, these insults contribute to increased risk for HIV and diminished physical health among people with HIV.  For these reasons, HIV providers need to continue partnering with their LGBT allies in confronting anti-LGBT bias and discrimination.

You can visit the American Psychological Association’s Office on AIDS website for information on psychology and HIV.  While there, you can also read the Resolution Opposing HIV Criminalization recently passed by the APA Council of Representatives. The Psychology and AIDS Exchange is a topical newsletter on emerging HIV-related issues.

Image source: Flickr user Ashley Van Haeften via Creative Commons

Filed under: AIDS, LGBT Issues Tagged: aids, discrimination, HIV, hiv prevention, HIV risk, HIV/AIDS research, homophobia, LGBT, Orlando shootings, prejudice, stigma