Protective Factors for LGBT Youth: Information for Health and Education Professionals

Very little research was found on sexual health-related protective factors for LGBT youth 15-24 years. A search for articles about individual-level factors (things like knowledge, attitudes and skills) that promote positive sexual health outcomes for LGB youth identified 20 articles reporting on 12 studies.⁴ A second search for articles about relationship-level protective factors (things like how people communicate with partners and parents) for the sexual health of LGB youth identified 42 articles reporting on 32 studies.⁵ Most of this research on LGB youth looks at young gay and bisexual men and does not include young lesbian, bisexual, and other women who have sex with women.^4,5 Only 21 articles, reporting on the results of 19 studies, addressed protective factors that support sexual and mental health and positive education outcomes for transgender and other gender-variant youth.⁶  

The published articles looked at a variety of different factors; however, many of these factors only appeared in one or two studies. Some factors that have been found to be protective for straight youth were not studied at all. For example, most studies of individual-level factors focused on beliefs and attitudes; only a few considered skills and competencies. 

Given the limits of existing research, it is hard to say what factors promote sexual health among LGB youth and broader positive outcomes among transgender youth. However, some factors had protective effects in multiple studies.

For gay and bisexual young men, these include:

• Positive attitudes about condoms, such as thinking that condoms are pleasurable or important for healthy relationships. 
• Increased peer group acceptance of safer sex, meaning that friends support condom use and other behaviors that reduce risk.

For transgender youth, these include:

• Acceptance and support from parents and peers, particularly when it comes to sexual orientation and gender identity.
• Gay-straight alliances, which are student-led clubs that provide a safe place for students to support each other around issues related to sexual orientation and gender identity.

Health and education professionals engaged in practice or research need to pay more attention to protective factors for LGBT youth. In addition to reducing risk, developing the assets of LGBT youth gives them resources to successfully navigate challenges. The articles included in the reviews and the broader literature suggest promising practices for doing so. Health and education professionals working to support programs in community and school settings can promote:

• Positive youth development. Positive youth development (PYD) involves strengthening protective factors, including skills, competencies and supportive relationships. PYD programs have improved sexual health⁷ and should be open and welcoming to LGBT youth. Resources on PYD are available at youth.gov.
• Inclusive sexual health education. Sex education that is relevant to LGBT youth can increase their ability to use condoms and talk with their partner about safer sex.⁸ The Office of Adolescent Health provides information on sex education that speaks to LGBT youth.
• Gay-straight alliances. Gay-straight alliances (GSAs) have been found to help LGBT youth as well as heterosexual youth.^9,10 The Genders Sexualities Alliance Network has developed tools for creating and supporting GSAs.
• Parent engagement. Family acceptance has been linked to positive health outcomes for sexual and gender minority youth.^11,12 The Family Acceptance Project offers resources to strengthen family support of LGBT youth.