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The Tech Dilemma for LGBTQ+ Youth and Mental Health

How the internet can be used to support community and identity for LGBTQ+ youth.

I can’t stop thinking about how much has changed in a single generation. My kids are growing up with two moms who are legally married. They can hold a smooth rectangle in their hand and connect with virtually anybody, anywhere, any time. They have just witnessed the election of the queerest congress in history, including two openly-gay Black men. Every day my kids are exposed to images and messages that celebrate diversity and those that foster deep hatred and polarization. Technology is contributing to and facilitating this quagmire. I can’t stop thinking about it.

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In many ways, it’s a great time to be young and queer in America
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In many ways, it’s a great time to be young and queer in America. Discrimination based on sexual orientation and gender identity is less tolerated, both legally and socially. Happy, proud, thriving, visible LGBTQ+ people can be seen in virtually every profession, every lifestyle, in every stitch of the social fabric.

And yet, queer teens still face disproportionately high rates of bullying and violence, abuse and rejection, discrimination and isolation at school, at home, and in their communities. They are more likely to battle depression, anxiety, and suicidal ideation—a likelihood that increases along multiple axes for trans, gender non-binary, and queer people of color. It’s a complicated picture, made more complicated in the COVID era.

As we begin 2021, many American teens haven’t regularly attended school or in-person activities in almost a year. With COVID has come a breadth and intensity of isolation that creates a variety of new problems for young people, and exacerbates existing problems beyond what I think we have the capacity to imagine right now.

We don’t know what comes of this, but we do know a few things. We know that LGBTQ+ youth are at heightened risk of experiencing intimate partner violence and substance abuse. We know that racism and intersecting stigmas compound dangers for queer youth, and that they shoulder a disproportionate burden of mental health challenges, especially if they are youth of color. We know that protective factors for these young people include access to affirming services and belonging to a community.

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For LGBTQ+ teens, in this moment especially, technology can be a lifeline.
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We also know that isolation—whether it be from friends, community, teachers, or the outside world generally—is bad for mental health and safety under the best of circumstances, and especially dangerous for young people already in trouble.

Research has showed, over and over, that even today, online continues to be safer for many queer youth than offline. Virtual spaces provide a place for identity-building and social support, exploration and individuation—vital developmental components that are not always available for queer youth to engage with safely offline.

Right now, in this moment, queer teens are spending more time online than ever before, seeking affirmation and information, creating content, developing a self in relation to others—going ahead with the business of becoming a young adult. Because plans can be rescheduled, but growing up can’t.

All over America, young LGBTQ+ people are developing into the people they are going to be, and a lot of them are doing a large part of that work online.

Technology is rampant, but it’s also risky.

Technology may be a lifeline, but as a researcher and a parent, I can confirm the inverse truth as well: the internet can be a dangerous place, and LGBTQ+ teens can get especially hurt. For some, digital platforms are the only places where they express their authentic selves, and abuse or rejection in these spaces can be uniquely harmful. Gender- and sexuality-based cyberbullying and harassment is common, and LGBTQ+ youth are less likely to tell somebody or ask for help when they experience it. This is doubly true for LGBTQ+ youth of color.

None of this is new, but the scope and intensity of it is. COVID-19 has brought an additional layer of structural and psychosocial danger that, for those of us in the field of youth mental health, is worrying. The needs are deep, and the stakes are high.

How can we navigate the double-edged sword of technology for LGBTQ+ teens?

If the tech dilemma hinges on the promise versus the peril, young people are better served the more promise is in the mix. The Trevor Project, Born This Way Foundation, Gay, Lesbian & Straight Education Network (GLSEN), the It Gets Better Project, and media outlets such as Them, provide foundational support to build affirming ideas of the LGBTQ+ experience, strategies to deal with stress, and immediate help in times of crisis. The National Queer and Trans Therapists of Color Network (NQTTCN) has a directory of therapists who identify as queer people of color, and Violet is a source for queer-compentent therapists in the northeast United States. CenterLink’s Qchat space and Trevor Project’s TrevorSpace are two digital tools that provide an affirming community for LGBTQ+ youth.

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The need for online mental health services tailored to serve LGBTQ+ youth is critical in this moment.
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We need more.

In response to the sharp increase in demand brought on by pandemic conditions, many mental health and well-being services have cropped up in the digital sphere or have expanded from in-person services to virtual, but the focus of these services hasn’t diversified much. Resources specifically tailored to the emotional and cultural experiences of LGBTQ+ teens remain rare, and those for LGBTQ+ youth of color even more so. LGBTQ+ individuals and people of color consistently report a preference for mental health interventions that are tailored for them, and evidence suggests that such tailored online health programs may be more likely to work—especially transgender, gender non-binary, and youth of color. That's critical in this moment, as their needs are heightened, the dangers are complex, and the potential for harm is profound.

Tech and behavioral health have a unique and pressing opportunity to step into a critical role for these young people, and they can’t wait.

A version of this piece also appears in Scientific American.

References

Abreu, R.L., Kenny, M.C. (2018). Cyberbullying and LGBTQ Youth: A Systematic Literature Review and Recommendations for Prevention and Intervention. Journal of Child & Adolescent Trauma, 11, 81–97. doi: 10.1007/s40653-017-0175-7

Austin, A., Craig, S.H., Navega, N. & McInroy, L.B. (2020). It’s my safe space: The life-saving role of the internet in the lives of transgender and gender diverse youth, International Journal of Transgender Health, 21(1), 33-44. doi:10.1080/15532739.2019.1700202

Centers for Disease Control and Prevention. (2019). Youth Online: High School YRBS - United States 2019 Results. Retrieved January 11, 2020, from http://nccd.cdc.gov/youthonline/. Centers for Disease Control and Prevention (CDC). (2019). Youth Online: High School YRBS - United States 2019 Results. Retrieved January 11, 2020, from http://nccd.cdc.gov/youthonline/.

Centers for Disease Control and Prevention (CDC). (2019). Youth Online: High School YRBS - United States 2019 Results. Retrieved January 11, 2020, from http://nccd.cdc.gov/youthonline/.

Dank M., Lachman P., Zweig J.M., Yahner J. (2014). Dating violence experiences of lesbian, gay, bisexual, and transgender youth. Journal of Youth and Adolescence . 43(5), 846-57. doi: 10.1007/s10964-013-9975-8

Russell, S. T., & Fish, J. N. (2016). Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth. Annual Review of Clinical Psychology, 12(1), 465–487. doi: 10.1146/annurev-clinpsy-021815-093153

Liu, P., Astudillo K., Velez D., Kelley L.,, Cobbs-Lomax D., & Spatz, E.S. (2020). Use of Mobile Health Applications in Low-Income Populations. Circulation: Cardiovascular Quality and Outcomes, 13(9), e007031. https://doi.org/10.1161/CIRCOUTCOMES.120.007031

Vogel, E.A., Ramo, D.E., Meacham, M.C., Prochaska, J.J., Delucchi, K.L., Humfleet, G.L. (2020). The Put It Out Project (POP) Facebook Intervention for Young Sexual and Gender Minority Smokers: Outcomes of a Pilot, Randomized, Controlled Trial, Nicotine & Tobacco Research, 22(9), 1614–1621. doi:10.1093/ntr/ntz184

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