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March 2016Vol. 17, No. 1Endorsing Appropriate Therapeutic Practices for LGBTQ Youth

A recent report from the Substance Abuse and Mental Health Services Administration (SAMHSA) delivers a research-based, expert-endorsed overview of health community efforts to provide supportive, encouraging, positive environments for lesbian, gay, bisexual, transgender, and queer and questioning youth. Its findings focus on the harms of conversion therapy—the practice of attempting to change someone's sexual orientation, gender identity, or gender expression. The report's recommendations are based on specific consensus statements by experts in the field.

Three key findings from the group's consensus statements are highlighted in the report summary:

  • Same-gender sexual orientation, gender identity, and gender expression are within the normal range of sexuality expression—they are not classified as a mental disorder.
  • Existing research does not support mental or behavioral health interventions aimed at changing gender identity or sexual orientation.
  • Behavioral health interventions to modify gender identity or expression, or to ensure conformity to heterosexual orientation, can harm, not help; therefore, they should not be practiced.

Clinical issues in childhood are also addressed in the report. Distress over nonconformity of sexual orientation, gender identity, and gender expression can contribute to gender dysphoria, which is defined as significant distress experienced by gender nonconforming children. This distress is characterized by increased risk of behavioral health issues and internalizing disorders, including depression and anxiety, compared to children in the general population. Research findings confirm that the parental and peer relationships of gender minority children, on average, are poorer than those of the general population; their peers are more likely to mistreat them or to physically or sexually abuse them.

Researchers and clinical experts provide the following guidance and resources to families and others working with LGBTQ children and adolescents:

  • Support of diverse family, caregiver, and kinship systems within families, cultures, and faith communities
  • Access to accurate information about sexual orientation and gender identity
  • Application of a family support model of assistance to diverse families, including conservative ones, to support their LGBTQ children while accounting for their values and beliefs
  • Building of safe and supportive school environments
  • Understanding of appropriate therapeutic approaches by pediatricians working with LGBTQ children and their families.

The authors of this report conclude that it is not just important to end potentially harmful practices such as conversion therapy, but that it is also imperative that the communities surrounding LGBTQ youth construct supportive environments and work to eradicate negative social attitudes toward them.

Access Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth on the SAMHSA website at (11 MB).

Related Items

The Annie E. Casey Foundation recently published a guide highlighting best policies that juvenile justice facilities can implement to advance the safety and well-being of LGBT youth. Access Lesbian, Gay, Bisexual and Transgender Youth in the Juvenile Justice System at