Strong in Spite of Stigma*: Protective Factors, Resilience and Mental Health among Gay and Bisexual Teens in BC

McCreary Centre Society

Stigma And Resilience Among Vulnerable Youth Consortium

Strong in Spite of Stigma:

Protective Factors, Resilience & Mental Health

Among

Gay & Bisexual Teens in BC

Dr. Elizabeth M. SaewycNovember 25, 2010



We know about disparities…

Studies throughout the world show LGB populations face stigma, and report health disparities

BUT

Not all LGB teens have these health challenges

The majority of LGB teens do not!



Beyond disparities: A focus on the positive

What do we know about gay & bisexual teens’ mental health in BC?

What are the protective factors and assets in their lives that promote health?

What might help those who are trying to cope with stigma or heal from trauma?



Sources of info:

BC province-wide data

BC Adolescent Health Surveys from 1998, 2003, 2008 (McCreary Centre Society)

Other studies from elsewhere

Our research with other data sources like the Minnesota Student Survey

Other researchers in Canada & beyond



More than a decade of data…

1992 1998 2003 2008



Measuring Mental Health

The challenge of problem-focused healthcare and policies

Measures of risk are common, positive mental health much less so

Suicidal ideation & attempts, self-harm, stress, anxiety, sadness/hopelessness

Reversing these?

Self-esteem



Flipping the negatives



Flipping the negatives

Although more likely to report self-harm (cutting, etc.), more than half have not

56% of Gay and 57% of Bisexual teens

Same with suicidal thoughts:

2 out of 3 gay or bi boys had no suicidal ideation

Suicide attempts are even less common:

75% of gay or by boys did not attempt suicide in the past year



What about Stress?

Feeling “under pressure,” in the past month is one of the few areas that more than half of gay or bisexual teens report “quite a bit,” or “almost more than I can take”

49% of gay bi teens report feeling under pressure “not at all,” “a little bit,” or “some”



Lack of Anxiety and Despair

61%65%

78%71%

No or low anxiety Not sad, discouraged or hopeless

Gay males

Bi males

BC Adolescent Health Survey 2003



What about self esteem?

Although somewhat lower than Hetero males, in the 2008 BC AHS, gay and bisexual teens still report an average self-esteem score above the mid-point (i.e., more than half of them have a positive self-esteem)



What leads to mental health?

A combination of risk factors increase emotional distress and mental health challenges

AND

Protective factors that foster positive mental health and buffer risk factors



What are protective factors?

Opportunities, relationships, and internal characteristics that promote healthy development

For people who have experienced adverse events (violence, trauma, stigma) protective factors help foster resilience in spite of adversity



The 7 C’s of Resilience

Written about by Dr. Ken Ginsberg

Competence

Confidence

Connection

Contribution

Character

Coping

Control



Protective Factors: Connection

Feeling cared about by parents and family members (family connectedness)

Feeling a part of your school, happy to be at school, feeling teachers care (school connectedness)

Feeling safe at school

Feeling cared about by other adults

At least one adult you can turn to if you have a problem



Protective factors: Competence

Having at least one thing you can identify being “good at”

Organized sports

Dance, band, hobbies



Contribution, Confidence, Character

Volunteering at school or in the community

Self esteem

Friends with healthy attitudes about risky or problem behaviours

Involvement in clubs or youth groups



Protective factor: Coping

Managing stress

Understanding trauma

Meaningful activity (incl. spirituality)

Healthy choices

In the BC AHS: exercise, sports without a coach, spirituality



Strong Despite Stigma

Gay and bi teens face much higher levels of harassment, exclusion, assault, abuse, discrimination than hetero teens—enacted stigma

How do we explain mental health in gay and bi teens?



Explaining health disparities

Unknown

factors

Known risk and protective

factors

All youth

LGBTQ

LGBTQ-specific



A Key Risk: Enacted stigma

Self esteem if targeted for violence: .56

Self-esteem if not targeted: .75

Perceived school safety if targeted: .63

Perceived school safety if not: .85

Enacted stigma increases odds of self-harm 14X, skipping school 3X, binge drinking 2X



Example: Suicide attempts

What risks in the general population are higher among LGBTQ youth? Anxiety, depression, hopelessness, substa

nce use/abuse

Family conflict and rejection

Sexual and physical abuse

School bullying, school problems

Lack of friends, or lower social support

Violence victimization in community



Example: Suicide attempts

Are there general protective factors that are lower for gay and bi youth?

Family connectedness

School connectedness

Supportive teachers

Caring other adults

Self-esteem

But what about those gay and bi teens who have these protective factors?



Countering Stigma: Suicide

40

2

92

21

0 20 40 60 80 100

0 Protective factors School & Family

Bi males

0 risks

Bi males

Abuse &

Distress

ProbabilityBC Adolescent Health Survey 1998



Countering Stigma in 2008: Protective factors & suicide

Gay Teens

Family connected-ness: 0.02

School connected-ness: 0.001

Adult who can ask for help: 0.35

Bisexual Teens



Adult who can ask for help: Not Sig



Protective factors for other mental health issues: Binge drinking

Gay Teens



Adult who can ask for help: 0.35

Bisexual Teens



Adult who can ask for help: Not Sig



Protective factors for other mental health issues: Self-injury

Gay Teens



Bisexual Teens





Variations by ethnic group

With 2003 data, explored protective for problems from substance use for gay/bi

European: School connectedness, volunteering, sports w/ coach, dance, hobbies, healthy peers

Aboriginal: Family connectedness, spirituality, volunteering, healthy peers

Asian: School connectedness, exercise, volunteering, hobbies



Even with enacted stigma

Effects of having at least one caring adult you can talk to about problems:

Reduces skipping school by AOR .56

Increases perceived safety in school from .48 to .71

Increases self-esteem from .44 to .62



So: How do we foster strength despite stigma?

Work to reduce risks, especially reducing harassment & stigma

Promote the 7 C’s of resilience in young people by helping foster protective factors



What to do?

Family connectedness? Caitlyn Ryan and colleagues have developed an intervention to help parents

School connectedness? Several researchers point to GSAs and anti-bullying policies that specifically mention homophobia as efffective



What to do?

Other caring adults? Mentor programs with great role models for teens

Examples: Camp Out and Camp FYrefly

Coping? Exercise, stress reduction strategies, spirituality that affirms all orientations

Competence? Encourage gay & bi teens to get involved in organized sports, creative activities, volunteer



What to do?

Contributions? Engage young men in volunteer opportunities, they are needed and they have a lot to offer

Control? Give them a voice and decision making power

All of these interventions will help gay and bi young men build Confidence & Character!



Strong in spite of Stigma

What can you do to recognize and celebrate the gay and bi teens who are coping?

What can you do to support those who need more connectedness to foster their resilience?



Thank you!

For more information:

Dr. Elizabeth Saewyc

[email protected]

SARAVYC

www.saravyc.ubc.ca


www.mcs.bc.ca

mailto:[email protected]

Health & Medicine

Strong in Spite of Stigma*: Protective Factors, Resilience and Mental Health among Gay and Bisexual Teens in BC