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We begin by acknowledging a paradox or tension that underlies public discourse of LGBT youth and mental health. First, we provide context for understanding the lives of contemporary LGBT youth. The conclusion considers legal, policy, and clinical implications of the current state of research. We consider the state of knowledge of risk and protective factors, focusing on those factors that are specific to LGBT youth and their experiences as well as on those that are amenable to change through prevention or intervention. In this article, we review mental health in LGBT youth, focusing on both theoretical and empirical foundations of this body of research.
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An important caveat at the outset of this article is that much of the current knowledge base will be extended in coming decades to illuminate how general patterns of LGBT youth mental health identified to date are intersectionally situated, that is, how patterns of mental health may vary across not only sexual and gender identities, but also across racial and ethnic, cultural, and social class identities as well. Further, the meanings of LGBT and the experiences of LGBT people must be understood as intersecting with other salient personal, ethnic, cultural, and social identities ( Consolacion et al. Sexual identities are informed by individuals’ romantic, sexual, or emotional attractions and behaviors, which may vary within persons ( Rosario et al. Most of the knowledge base has focused on sexual identities (and historically mostly on gay and lesbian identities), with much less empirical study of mental health among transgender or gender-nonconforming youth. Throughout this article, we use the acronym LGBT unless in reference to studies of subpopulations. LGBT is an acronym used to refer to people who select those sexual or gender identity labels as personally meaningful for them, and sexual and gender identities are complex and historically situated ( Diamond 2003, Rosario et al. During the past two decades there have been not only dramatic shifts in public attitudes toward LGBT people and issues ( Gallup 2015), but also an emergence of research from multiple and diverse fields that has created what is now a solid foundation of knowledge regarding mental health in LGBT youth. Yet the first public and research attention to young LGBTs focused explicitly on mental health: A small number of studies in the 1980s began to identify concerning rates of reported suicidal behavior among “gay” youth, and a US federal report on “gay youth suicide” ( Gibson 1989) became controversial in both politics and research ( Russell 2003). This awareness can be traced to larger sociocultural shifts in understandings of sexual and gender identities, including the emergence of the “gay rights” movement in the 1970s and the advent of HIV/AIDS in the 1980s. In the period of only two decades, there has been dramatic emergence of public and scientific awareness of lesbian, gay, bisexual, and transgender (LGBT) lives and issues.