Trigger Warning: Mention of self-harm, suicide, abuse, homelessness
Risk factors and protective factors can dictate the onset and course of illness, both physical and mental. Good examples of risk factors for physical illness would be an unhealthy diet or having a mutated gene. This aspect of the person’s life may make them more susceptible to having a certain illness, compared to people who have a healthy diet or have normally functioning genes. A protective factor is the opposite, it can decrease the person’s likelihood of having an illness, or the severity of the illness if they do end up contracting it. These terms mean the same thing for mental health.
O’Connell, Boat, and Warner (2009, pg. xxviii) define a risk factor as “a characteristic at the biological, psychological, family, community, or cultural level that precedes and is associated with a higher likelihood of problem outcomes”. They also define a protective factor as “a characteristic at the biological, psychological, family, or community (including peers and culture) level that is associated with a lower likelihood of problem outcomes or that reduces the negative impact of a risk factor on problem outcomes” (O’Connell, Boat & Warner, 2009, pg. xxvii).
As is indicated by the blog post titled “Minority Stress Theory”, LGBTQ+ individuals are more likely to be highly stressed, which is a huge risk factor for mental illness. This stress can emerge simply from the knowledge that they are part of a stigmatized group and are therefore in danger in any given environment. A study by Herek, Cogan, and Gillis (2002b) surveyed 450 LGBTQ+ people and found that 94% of them remembered being the victim of a hate crime, or a crime where they were specifically targeted because of their sexuality. The interviewees reported a variety of crimes towards them, including assault, murder, vandalism. Public places were seen as threatening, but homes were not safe either. One man reported that his house had been firebombed. It is legitimate that members of the LGBTQ+ community have concerns about physical safety. Another risk factor is lack of close relationships. As mentioned in the blog post titled “Invisible Stigma”, keeping a secret can be detrimental to relationships. The exhausting work that goes into it can result in the individual feeling anxious, depressed, hostile, or guilty. Feeling these emotions for long periods of time can result in very poor mental health. It also means that the person may distance themselves from others, never finding social support with whom they can be vulnerable and lean on in times of need.
LGBTQ+ individuals generally have lower protective factors as a result of their identity being stigmatized by society. One protective factor that is very important in psychology is social support (mentioned briefly in the previous paragraph). The person’s family can be a tremendous protective factor- if the relationships are healthy. Unfortunately, many families are unaccepting of their LGBTQ+ relative. Even if they do not have an extremely negative reaction, their initial feelings may not be celebratory. Many parents struggle with the idea that their child is a member of the LGBTQ+ community. In a study by Roe (2017) which interviewed LGBTQ+ teens about the way their family responded to their sexuality, most of the teens recalled reactions from parents ranging from openly hostile to coolly dismissive. One interviewee (who went by the alias of Jonathan) said “They wrote a letter disowning me and signing it at the bottom saying for homosexuality [and a host of other behaviors].’’ (p. 57) These youths often reported their family’s religion as a factor in their parent’s negative responses, and many of them were not religious or stopped going to church because of it. This is, again, unfortunate because religion can be a great source of emotional support for people who feel passionate about their faith. The teens stated very firmly that they felt most accepted when their families made their support explicit and verbal. Many of them never received that validation.
Due to the possibility of being disowned, LGBTQ+ youth are also at increased risk for homelessness and becoming runaways, which is itself a risk factor for mental health. As you can see, risk factors can cascade. A researcher named John Ecker (2016) reviewed research on queer homeless youth. After reading a series of studies estimating how many homeless youth are queer, he wrote “…even the lowest estimates of the prevalence of homeless queer youth are substantially higher than queer youth in the general population” (pg. 336). And these numbers are just including the people who responded to the questionnaires as being queer. The actual number may be much higher, since people who queer may not identify themselves that way for fear of being discovered (Clark, 2006). Ecker (2016) is also quick to point to evidence which indicates that LGBTQ+ youth are likely to become homeless as a result of reactions to their sexuality, and that they are individually leaving their families because of it. They are also more likely to be maltreated by their family members than heterosexual youth. Psychologists Moskowitz, Stein, and Lightfoot (2013) found that homeless LGBTQ+ youth experience more stress than non-LGBTQ+ homeless youth, and that they are more prone to self-harm and suicide.
Another study by Saewyc, Homma, Skay, Bearinger, Resnick and Reis (2009) looked at protective factors for bisexual students. This study had multiple cohorts- a psychological term which means a group that shares something in common. These cohorts were from different time periods and different areas, but the respondents were given surveys at the same age. There were 6 different groups. Most of the bisexual respondents had lower levels of protective factors compared to their heterosexual peers. They felt less connected to family and school, and their religious involvement was mixed. Almost all of them felt less connected to their family than heterosexual teens. Ueno (2005) examined protective factors in sexual minority students similarly to Saewyc et. al. (2009), but he also brought up an intriguing point which lends more nuance to the often-hostile reactions of parents. He states “For other minority adolescent groups (e.g., racial minorities), family is a significant source of social support, in part because family members commonly share minority backgrounds. This is not true of sexual minorities, however." (Ueno, 2005, p. 259). Ueno found that sexual minority students had a higher degree of distress and they were more likely to have conflict with their parents and school. However, their ability to build friendships was unaffected by their sexuality. Ueno noted that sexual minorities tend to have the same number of sexual minority friends as heterosexual students: one per friend group. This is a shame, because he also found that sexual minority teens are more likely to benefit from knowing other members of the LGBTQ+ community.
As can be seen from this post, LGBTQ+ individuals are incredibly vulnerable to risk factors which can increase their likelihood of developing a mental disorder such as depression or anxiety. Poor mental health can spiral into poor physical health, and issues such as drug abuse and self-harm.
Below is a video where LGBTQ+ youth talk about experiencing homelessness. It shows real, raw examples of risk factors.
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