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Realities

in Mental Health

for Latinx SMY

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Disclaimer: This research is confined to Latinx youth (adolescents of Latin American descent) rather than the broad demographic Hispanic youth (Spanish-speaking adolescents with Spanish cultural linkage of myriad geographic origin). Source information for this research is from within the last 10 years.

Background

⦁    Salinas and Lozano (2017) defined Latinx as a gender-neutral term of online origin used to describe individuals of Latin American ancestry (as cited in Przeworski & Piedra, 2020, p. 211). The Latinx population increased to 18.3% of the total U.S. population in 2017 and is anticipated to represent 26% of the population by 2050 (United States Census Bureau, 2017). 12.8% of same-gender U.S. households self-identified as Latinx in the year of the survey.

⦁    Schrager et al. noted that sexual minority adolescents (SMA) experience well-documented behavioral health disparities compared to their heterosexual peers (as cited in Garcia-Perez, 2020, p. 451). In addition to reporting lower academic achievement, key outcomes for which SMA are at notably elevated risk include internalizing and externalizing disorders, internalizing psychopathology, such as depression, anxiety, and self-harm, eating disorders and obesity, and substance use.

⦁    Research by Hatchel et al. suggested that LGBTQ+ youth are at greater risk for suicidal ideation because peer victimization and rejection work against belonging and increase perceived burdensomeness (2019, p. 2451). Their studies found that a negative social context is associated with higher levels of chronic stress.


⦁    2016 research by McConnell et al. found that sexual and gender diverse (SGD) individuals that lack familial support experience poorer physical and mental health outcomes such as anxiety, depression, and increased suicidal ideation (as cited in Abreu & Gonzalez, 2020, p. 107).

⦁    Identity development is an important part of the youth developmental process for all. The period of adolescence is marked foremostly by identity formation. Coulter et al. (2018) noted that the presence of multiple identity-related stressors can interrupt healthy identity formation for LGBTQ+ youth (as cited in Garcia-Perez, 2020, p. 468). More specifically, Eisenberg et al. noted challenges for LGBTQ+ Latinx youth in developing a positive individual identity while simultaneously experiencing two stigmatized identities (2019, p. 247). Furthermore, Schrager et al. (2018) found domains of internalized homonegativity, identity management, intersectionality, and negative disclosure experiences influencing LGBTQ+ Latinx youth identity management (as cited in Garcia-Perez, 2020, p. 469).

⦁    Abreu and Gonzalez posited that most of the scholarship on SGD individuals and their social systems comes from predominantly White individuals in the United States and gives insufficient attention to understanding the role of race, ethnicity, and culture (2020, p. 107). Such studies typically lead to a deficiency mindset about SGD people of color and their communities.

Background
Gradient

Background Condensed

Sexual minority youth (SMY) are a health-disparate group, displayed higher risk of depression, anxiety, self-harm, and eating disorders, among other conditions.

Studies have shown that sexual and gender diverse (SGD) individuals lacking familial support experience worse physical and mental health outcomes. 

Internalized homonegativity, identity management, intersectionality, and negative disclosure experiences are some of the challenges that affect LGBTQ+ Latinx youth identity management.

Up to now, a deficiency mindset about SGD people of color and their communities has developed in typical research, which is far from capturing a full and accurate picture of mental health discoveries for these groups.

Sexual minority stigma

⦁    Sadika et al. found that LGBTQ people of color experience microaggressions within their families and communities because of their sexual and gender identities, and within the LGBTQ community because of their racial and ethnic identities (2020, pp. 115-116).


⦁    Applying minority stress theory to sexual minority status, it is theorized that sexual minority status, across several components such as attraction, behavior, and identity, is stigmatized and stressors resulted from this stigma may be associated with any or all of these areas (Bostwick et al., 2014, p. 1135). Hall categorized such stressors into four domains: prejudice events (or victimization, discrimination, rejection), expectations of prejudice events, concealment of identity, and the internalization of negative societal attitudes and beliefs (or internalized homophobia or internalized homonegativity), all of which constitute threats to mental health (2018, p. 264).

⦁    Heteronormativity is a social construct that imbues heterosexuality with power and establishes it as the norm along society's structure (Röndahl, 2011, p. 345). Heteronormativity is learned and perpetuated from a very early age and often leads to intolerance towards and the imposed invisibility of homosexual and other sexual minority members of society.

⦁    Dr. Becky Anthony, Assistant Professor at Salisbury University, added that, "Obviously being gay doesn't cause depression, but you can look at having to hide your identity, that can be causing depression. So it's not the identity, it's these ramifications of what that identity means for that person in that situation." She went further to say, "There's obviously the stress of stigma, but there's also the minority stress of having to give up so much to be your authentic self. For some, not for all, because I also think that there's plenty of LGBTQ youth who don't face that same step, whose families are supportive and there's not the shame...but when you have to leave physically, mentally, emotionally, that stress is astronomical" (personal communication, October 13, 2021).

  • Dr. Daniel Green, Assistant Professor of Social Work at Salisbury University, commented that, "If you're not identifying as gay or lesbian, there's even further stigmatization within the LBGTQ+ community. Bisexual stigma is a real thing that happens, so that's another layer of intersectional thought that you need to take into consideration" (personal communication, September 27, 2021).

Sexual Minority Stigma
Sociocultural

sociocultural aspects

⦁    Garcia-Perez opined that "LGBTQ+ Latinx youth receive positive reinforcement through the familiar cultural norms, but negative reinforcement through the strong homophobic cultural norms" (2020, p. 469).

⦁    Gender roles have an influence on parental reactions to their sexual minority children in the Latinx community. Marianismo and machismo inform female and male behavioral norms respectively. Delgado-Romero et al. (2013) opined that a young Latina may be raised along the values of self-sacrifice, nurturing, and submissiveness (as cited in Abreu et al., 2020, p. 195). Comparatively, Mora (2013) posited that a young Latino may be held to the expectations of masculinity and care to avoid appearing in a feminine manner (as cited in Abreu et al., 2020, p. 195). Therefore, the relaxed gender attitudes displayed amongst the gay and lesbian communities can come into conflict with these conceptualizations of appropriate male and female comportment.

⦁    Puckett et al. (2015) found that parental reactions may lead to experiences of more proximal stress by way of internalized stigma and self-isolation from the gay, lesbian, bisexual, transgender, and queer (GLBTQ) community (as cited in Abreu et al. 2020, p. 192). Przeworski and Piedra concluded that ill psychological outcomes in Latinx sexual minorities were attributed to a lack of family support by a multitude of studies, even as there were "varied means of assessing family support and differences in the qualitative or quantitative methods across studies" (2020, p. 227).

⦁    Some Latinx families hold the spiritual belief of fatalism (fatalismo), which professes that a particular condition is unavoidable or its course unalterable if it represents the will of God (Abreu et al, 2020, p. 195). In the case of parents who have a sexual minority child, this same belief could have a positive impact if a parent understands that their child’s sexual orientation is a result of the will the God. Thus, religion and spirituality may both create potential conflicts between Latinx parents and their children and be a source of support as parents attempt to resolve their ambivalence towards their child’s sexual minority identity. In their 2020 study, Abreu et al. noted this possibility for contention between religion and sexual minority identity, with one participant attesting to the "rigid teachings" regarding sexuality in the traditional Catholic faith that is prevalent in Latinx populations (p. 203).

⦁    "I think one of the main things is how do Latinx young people navigate their multiple marginalized identities?" Dr. Parra mused. "On average, from a Western perspective--from a community that's really tight-knit, family-oriented, we all are sticking together, that sometimes is really heavily relied on religion--how do queer Latinx youth make meaning of them feeling part of that world...but also their sexual orientation coming into emergence?" (personal communication, October 4, 2021)

⦁    Barnes and Meyer noted that for sexual minority individuals growing up in nonaffirming religious settings, religious teachings can play a major part in their socialization into anti-gay attitudes and stigma (2012, p. 506). They determined that a large majority of sexual minorities practice their faith in settings that are not affirming of their non-normative sexualities. Their research found that Latinx sexual minorities had higher internalized homophobia than Whites due to their greater exposure to nonaffirming religion via both affiliation and frequency of attendance.

 


 

⦁    Dr. Alexandra Calix-Hughes of New Spring Counseling, PLLC stated, "I think that [cultural family values] can be protective in some ways if it's a healthy, well-adjusted family and I think it can be a hindrance when it's not; when there's a lack of boundaries, lack of agency, lack of respect of how the individual feels aside from the family. I think that that's when you see that it's a barrier: when it's not serving as protective in terms of social support and love and, 'if there's something going on, we're here to help you and support you through it and communicate.' If it's not that, then it's the lack of boundaries and the judgment and enmeshment in very unhealthy ways that can very much impact them in a very negative way" (personal communication, October 11, 2021).


⦁    Dr. Calix-Hughes stated that in her family work, she sees more of the enmeshment and lack of boundaries than she does the support. However, she added that, "I also though see, when we try to do family sessions, we're trying to educate the family to understand and to be more flexible in their thinking and to be more open to change, because I do feel like a lot of the parents and the family do love and care for their children but just don't know how to show up in a way that is meaningful and that this person needs. And so I do see a lot of willingness to change and to learn to be able to help their child. It's kind of like, 'this isn't how my parents did it, this is all I know, but I love my child, so help me understand how to help them.'"

 

⦁    Decena noted a pattern of Latinx sexual minority males choosing to disclose their sexual orientation to their families and friends through nonverbal, referred to as tacit, declaration such as bringing a partner to a social gathering (Decena, 2011). In these scenarios, the individual's sexual identity may become a reality which their social contacts are aware of but do not outwardly discuss, with the suggestion that a more open acknowledgement between them could disrupt these social ties.

⦁    For Latinx sexual minorities who do not have legal residence or citizenship, immigration status can pose an additional layer of precarity for their mental health. "Related to citizen status, if you are not a citizen of the U.S. yet, you're going to run into a lot of troubles when it comes to health insurance and access into the healthcare system," Dr. Green noted. "Potentially we're missing thousands and thousands of people who need help and support that, just because of the current system we have...we're leaving this entire group vulnerable" (personal communication, September 27, 2021).

⦁    "When we start thinking about health disparities among Latinos, there's a lot of work showing--and I'll go into the queer experience right now, but in general within the Latinx community, we know that there are a lot of suggestions that come from multiple angles to understand the mental health of Latino people," Dr. Parra opined. "One of them is culture, how for many people in Latin America, mental health is stigmatized significantly--'está loco' or all these different things that people hush and don't talk about and don't admit to that they have mental health illnesses--and this creates a big problem because if people are not getting treatment or seeking psychologists or this is a stigmatized condition, that stigma perpetuates more of these mental health disparities. So already here we have an operating from this perspective of silence, that there are things that are just not said" (personal communication, October 4, 2021).

⦁    Dr. Calix-Hughes gave insight into a notable gap in care, stating, "There aren't a lot of providers that can help the Latinx community who are fully Spanish-speaking and part of the community, so I think people feel safe when they see someone that kind of looks like them a little bit or knows about the culture and what comes with the culture" (personal communication, October 21, 2021).

⦁    Dr. Parra expressed some skepticism about some of the measuring approaches that are used in formal psychological research. "From a scientific perspective, trying to understand this phenomenon, is it that the measures that we're using to measure depression and anxiety are just not culturally adapted or meaningful to people? When we think about diagnosing depression among Latinx communities or other communities of color, if you ask them, 'do you feel depressed?' They are like 'what the hell is depressed?' Then 'do you feel sad?' 'Yeah, kind of.' So we have to start asking measures that are asking about mood and behavior, so a lot of times depression manifests to headaches, stomach aches, tiredness, fatigue, a lot of oversleeping, overeating, undereating, and I think this is where if we use those types of behavioral assessments of mental health, we might get a clear story of how people in those communities define depression or operationalize their mood. But of course scientists, we develop this concept of depression and we describe it in our own terms and try to validate it across multiple populations without having the population actually describe their experiences to us" (personal communication, October 4, 2021).
 

Sexual Minority Stigma Condensed

Sexual minorities of color may face hostility related to their sexual identity and/or racial status from a variety of social sources, including family and other LGBTQ+ identities.

Stigma is directed at sexual minorities on the basis of their attraction, behavior, and/or identity.

Stressors may come from 1) prejudice events, 2) expectations of prejudice events, 3) concealment of sexual identity, 4) internalization of negative societal attitudes and beliefs.

U.S. society remains heteronormative, meaning sexual minorities unfortunately often feel unwelcome due to their identity as they navigate our society.

Latinx SMY Strengths

⦁    Garcia-Perez found that numerous studies on the resilience hypothesis determined that individuals belonging to multiple minority groups recovered more quickly from posttraumatic stress disorder, felt more connected to their communities, and were less likely to exhibit suicidal behaviors as compared to single-axis minority individuals (2020). This provides evidence that the combination of racial minority and sexual minority identity could constitute a protective factor.

⦁    Recent research by Abreu et al. found that there are foundational Latinx cultural values including caballerismo and familismo that engender acceptance of a sexual minority child from Latinx fathers (2020, pp. 204-205).

⦁    Examining young gay and bisexual Latinx men, Li et al. identified three strategies of resilience through self-discovery, adaptive socialization, and self-advocacy (2017, p. 113). Acceptance and deeper understanding of their sexual identities, awareness of but not internalizing microaggressions and other hostilities, and asserting one's self and values to constructively challenge heteronegativity are all attainable goals for Latinx SMY.

⦁    Schmitz et al. found that LGBTQ+ Latinx youth demonstrated self-drivenness in seeking education on their personal health, utilizing avenues such as online LGBTQ+-related resources, communication with trusted friends and family members, and healthcare professionals (2019, p. 20). LGBTQ+ Latinx youth recognized the vitality of self-education to maintaining their wellbeing, also taking initiative in incorporating healthier changes in their actions, interpersonal relationships, and ways of feeling. The researchers noted that LGBTQ+ Latinx youth actively deconstructed cultural negativity that they faced, extracting the toxin out of stereotypes, prejudice, discrimination, and other stigmatic messaging directed at either marginalized identity.

Latinx SMY Strengths

Sociocultural Factors Condensed

Latinx sexual minorities may have cultural values such as familismo or respeto that can often be relied on as protective factors, but may also contribute to judgment and family disapproval of non-normative sexual identity.

Roman Catholicism is a prominent faith system in Latinx communities and in many of its forms is not affirming of LGBTQ+ identities, thus it may be a source of exclusion for sexual minorities, or conversely a reinforcement of closeness within the family.

The conflictual relationship between religion and non-normative sexual identity is not a factor in any way exclusive to the Latinx community, but rather is evident in various racial groups.

Latinx cultural values may differ from the individualistic values commonly held in the U.S. This may create a values gap between Latinx SMY and their elder relatives, most notably for first-generation immigrant Latinx SMY.

Latinx SMY Strengths Condensed

Being both a racial minority as a Latinx individual and a sexual minority minority can improve resilience and connection to community, according to some empirical evidence.

Gendered cultural values of the Latinx community such as caballerismo and marianismo may support acceptance by parents of Latinx SMY, despite common characterization as potential barriers, through reframing them to validate unconditional love.

Latinx sexual minorities are known to demonstrate self-discovery, self-education, and self-advocacy as assets for their psychological resilience.

LGBTQ+ Latinx youth are often able to dissolve cultural negativity that comes their way, presenting a useful means of coping.

latinx smy vulnerabilities

Latinx SMY face prejudice and persecution that exists at a cross between racism and homophobia, as well as secondary obstacles such as citizenship status and linguistic hierarchy.

 

⦁    Pastrana et al. (2017) stated that empirical evidence demonstrates that LGBTQ+ Latinx youth may be at greater risk of developing posttraumatic stress compared to their LGBTQ+ White and non-LGBTQ+ Latinx peers (as cited in Garcia-Perez, 2020, pp. 440-441).

⦁    A National Coalition of Anti-Violence Programs survey of 981 queer survivors of violence in the United States showed that in 2015, Latinx respondents were 4.5 times more likely to experience online and mobile harassment, 2.3 times more likely to experience a robbery, and 2.6 times more likely to experience violence by an employer compared to non-Latinx respondents (Garcia-Perez, 2020, p. 443).

⦁    Dr. Luis Parra, Researcher at Washington University in St. Louis, gave insight on the relevance of minority stress, stating, "A lot of my work focuses around understanding how queer people of color experience discrimination and how that gets under the skin, so I look at how these types of social stressors create heightened responses to our stress response mechanisms in our body. So I look at the fight or flight response system. In particular, I look at cortisol and how, when we're stressed, we produce cortisol and that's a normal response for us to cope with the stressor, but if we overly produce large amounts of cortisol, that can impact our bodies and our mental health" (personal communication, October 4, 2021).

⦁    Dr. Parra continued, "I also look at telomeres, so cellular aging. The more experiences of discrimination cause the endcaps of your chromosomes to shrink, and if they do, that's an indicator of early mortality and of cellular aging, in which the cells stop reproducing themselves, so you stop healing and that's a pathway to disease." Dr. Parra conducts ongoing research to better understand the impact of these disparities and work toward resolving their societal causes. "I've been trying to think about my research questions as normalizing the queer experience, that we've always been here, we live, we thrive. It's just that systems and people's beliefs and attitudes that buy in to those bigger systems like racism, heterosexism, and classism and perpetuate that hatred toward people are the ones who are creating problems for people who are marginalized" (personal communication, October 4, 2021).

 

⦁    A study by Bostwick et al. discovered that Latinx SMY were significantly more likely than White SMY to report feeling sad (2014, p. 1133). Latino SMY had twice the odds of 1-year prevalence of feeling sad.

⦁    Garcia-Perez asserted that empiric evidence supports two ostensibly-competing theories: the risk hypothesis and the resilience hypothesis (2020, p. 441). Furthering the risk hypothesis, Hayes et al. found that being a sexual minority within a racial minority group creates a “double jeopardy” correlated with heightened risk of distress associated with depression, substance use, generalized anxiety, and family concerns relative to heterosexual students of color (2011, p. 124). It is important, however, to note that in their study, these higher rates of distress were not discovered for sexual minority students of color relative to White sexual minority students.

⦁    Strong familial ties, such as fostered through the custom of familismo, can conversely be a predictor of more detrimental outcomes following family rejection. Latinx sexual minorities experience lower levels of self-worth in the aftermath of parental rejection (Snapp et al., 2017, p. 427).

⦁    O'Donnell et al. conducted a study of sexual minorities of color in New York City, finding that Black and Latino respondents showed a significantly elevated risk for suicide attempts relative to White respondents, with the majority of reported attempts occurring in adolescence and young adulthood (2011, p. 1057). Interestingly, they found no evidence of a higher prevalence of major depressive disorder or substance abuse for respondents of color relative to White respondents.

 

⦁    Observing on possible challenges for Latinx sexual minority clients, Dr. Calix-Hughes mentioned "acceptance, feeling unloved, definitely depression, trying to navigate life without support and understanding from family members, and a lot of shame and guilt" (personal communication, October 11, 2021).

Latinx SMY Vulnerabilities

Latinx SMY Vulnerabilities Condensed

Latinx SMY were found in one study to be significantly more likely to report feeling sad than White SMY.

The experience of discrimination and other social stressors can have wide-ranging consequences on physical and mental health for Latinx SMY, including accelerated cellular aging and the risky overproduction of cortisol.

Marginalized status in the modern-day U.S., in part comprising tensions around immigration and the prioritization of the English language over Spanish, often imposes a sense of second-class stature on Latinx residents that causes added stress.

The closeness of family within Latinx cultures can lead to worsened emotional harm on SMY in the event of family rejection.

Optimal Supportive Practices

Optimal Supportive Practices

⦁    A potential buffer to negative outcomes for LGBTQ+ Latinx youth is membership in organizations and groups. Toomey and Russell (2013) found that involvement in GSA (Gay Straight Alliance) and LGBTQ+ social justice activities was positively associated with school belonging and GPA, as such groups spur queer youth and allies to work together and develop mutual understanding in the process (as cited in Garcia-Perez, 2020, p. 468).

⦁    Sadika et al. recommended engaging in open discussions to dispel myths about sexual and gender diversity within racial and ethnic minority communities as well as creating programming within LGBTQ+ organizations to meet the needs of LGBTQ+ racial and ethnic minorities (2020, p. 142).

⦁    Before being able to support the mental health of Latinx SMY, therapists must confront their own biases and prevent any and all that would not serve their clients from interfering with the therapeutic relationship. It is upon providers to be affirming of Latinx SMY, as the clients are the experts on what their own identities are and should be respected as such, and to also give their clients ample room to grow and evolve.

⦁    Lardier et al. (2017) asserted a "strong need" to work with youth to develop a positive relationship with their family as a key safeguard against a heightened vulnerability for depression (as cited in Garcia-Perez, 2020, p. 470). 

⦁    Przeworski and Piedra asserted that it is essential for clinicians to ascertain and consider which Latinx cultural values are held by the youth and their family so as to attain an accurate picture of which familial ideals are influencing a client's mental wellbeing, whether supportively or disapprovingly (2020, p. 232). The researchers added that clinicians should provide a safe space for clients to explore any present conflicts, such as between beliefs and identities, in a self-directed way that lowers the risk of imposing the clinician's views.

⦁    Family members, even considering personal reservations, can play a tremendous part in supporting SMY. Working through that process with the help of clinicians is pivotal. Dr. Anthony shared, "I've worked with very religious parents who came to me and were like, 'I don't agree, I don't like it, but I want to support my child and I don't know how to do this.' So we would talk about how those are conversations that we can have because this is where we do that, but we do not do that with your child. At least they had someone to say that to. That's hard to hold on to that space for folks, but some parents need that and I'd much rather they say it to me than to their kid" (personal communication, October 13, 2021). 

⦁    Dr. Green described cognitive behavioral therapy as the gold standard of therapeutic practice that we see today and as commonly being the first line of treatment (personal communication, September 27, 2021). CBT is a reliable intervention which clinical social workers can utilize to help implement coping means for Latinx SMY clients.

⦁    Fathers may face a particularly challenging process of embracing their sexual minority sons, partly in reaction to deeply rooted sentiments about masculinity. Abreu et al. suggested that, from a strengths-based approach, clinicians talk with fathers of sexual minority sons "about the love they feel for their child, and how such love may be a product of embracing their identity as a Latinx male" (2020, p. 205). A clinician can provide a therapeutic environment in which a father and his sexual minority son are able to each express their feelings regarding vulnerability and actions between them that have been contributing to either rejection or acceptance for the child. The researchers also suggested that, in recognizing the power of familismo, it may be appropriate to encourage discussion about the views of other family members, even potentially taking the step of inviting them into the therapeutic space.

⦁    Changes in our day-to-day, casual contexts are instrumental as well. "I think that when people are not well-versed in the conversation, they revert to heteronormative conversations, so like, 'tell me about your girlfriend, tell me about your boyfriend,' and I think that culturally, we need a shift in our language," Dr. Anthony commented. "I always tell students that you can ask about significant others or use whatever term you want, but don't make it gendered and let people tell you" (personal communication, October 13, 2021).

⦁    Discussing the contemporary practice sphere, Dr. Anthony concluded, "The vast majority of social workers want to know [sexual and gender identity] about their clients and are not going to bias or shame people, but they don't even know some of the questions to ask, so I think that the start is getting people to, 'this is everyone's thing'" (personal communication, October 13, 2021).

Optimal Supportive Practices Condensed

Involvement in LGBTQ+ support groups and queer-allied organizations is a very helpful intervention for mutual aid and supporting mental wellbeing for Latinx SMY and sexual minorities in general.

Mental health interventions should highlight identity integration, a process in which the LGBTQ+ identity is incorporated and consolidated by the individual, as a benefit to mental health outcomes for LGBTQ+ Latinx youth.

Sadika et al. emphasized agency, coping, and resilience as notable assets for sexual minority people of color to protect their freedom and safety in homonegative cultures (2020, p. 139). These should be areas of focus for clinical interventions with clients.

A key step is to work on developing your comfort around talking about sexual orientation. People often don't want to sound foolish or unintentionally hurt someone, but avoiding the conversation entirely is actually more hurtful. Instead, strive to build up your knowledge and confidence in your ability to have conversations about queer identity, rather than allowing the fear of using the wrong terminology or saying the wrong thing to rule you.

If you say, 'I don't want to work with LGBTQ folks,' don't work in an LGBTQ center, but we're everywhere, it's not like we're just in one little space. So I think that that's part of it too, how do we help people identify that and then truly do that self-work instead of just hiding behind their own ignorance and biases?

- Dr. Becky Anthony

Focuses of Future Research

Focuses of Future Research 

⦁    Hall found in 2018 that evidence-based mental health interventions for LGBTQ+ youth--and by extension LGBTQ+ Latinx youth--are virtually nonexistent, which indicates that intervention research is vitally needed at present (p. 307).


⦁    As noted by Garcia-Perez, some majors challenges to conducting research studies on Latinx SMY are in finding a large sample of youth under 18, representation of diverse stages of coming out, youth not being associated with organizations or youth groups, and the common objections by Institutional Review Boards to the participation of youths when parental consent cannot safely be obtained (2020, p. 472).

⦁    In 2014, Coulter et al. discovered that only 0.1% of the National Institutes of Health (NIH) funding focuses on projects dealing with LGBTQ+ health, not counting studies focusing on HIV/AIDS (as cited in Garcia-Perez, 2020, p. 473).

⦁    Garcia-Perez urged the need for wider research on psychosocial factors, which include identity integration, identity management, vigilance related to expectations of prejudice, LGBTQ+ identity prominence, early move-out and housing instability, peer relations, intimate partner violence, social support from a romantic partner, social network diversity and participation, sociopolitical environment, LGBTQ+ activism involvement, civic engagement as a coping behavior, and exposure to LGBTQ+ coverage in the media (2020, p. 473).


⦁    O'Donnell et al. suggested more research into the role of discrimination in mediating suicidal behavior among sexual minorities of color (2011, p. 1058).


⦁    Abreu et al. offered the view that more research is needed into how much disapproving reactions by Latinx fathers towards their gay sons are linked to machismo rather than simply part of the multi-directional process of parenting a sexual minority child.

⦁    Barnes and Meyer suggested future longitudinal studies to analyze mental health outcomes for sexual minority members who stay in nonaffirming religious settings versus those who traverse to affirming faith environments (2012, p. 513). Such studies can help inform the currently sparse scholarly understanding of how significant a role socioreligious acceptance of their sexual identity has upon the psychological wellbeing of sexual minorities.

⦁    Przeworski and Piedra recommended that more studies on Latinx sexual minorities in the future should be conducted in Spanish in order to reduce sociocultural barriers in communicating about experiences that affect mental health (2020, p. 234). They also opined that studies should further examine differences in considerations for sexual minorities of differing nationalities of origin across Latin America as well as comparing those who are raised in the U.S. to those raised internationally.

⦁    "I think also another important thing for research is how, just in general, how do [Latinx queer youth] go seek out queer friendships?" Dr. Parra contemplated. "We really don't know...what are those bonds for people as they start wanting to learn and be part of a community?...I also think that, if we're looking at Latinx people and it is true that their religiosity is a really big important thing, how do they manage religious beliefs in the context of their identities and being marginalized for their sexual orientation? How does that tap into internalized homonegativity?" (personal communication, October 4, 2021)

⦁    Dr. Green stated, "How we can make gay-affirming therapy better in the future is acknowledging that maybe identity isn't as static as we thought, that it's a little bit more flexible and that people can identify as gay at one point in their life and then through time, through experience, through personal growth and exploration, can say, 'you know what, actually I identify as bisexual now,' and understanding that that's okay, too" (personal communication, September 27, 2021).

Focuses of Future Research Condensed

More future studies on Latinx sexual minorities should be conducted in Spanish in order to reduce sociocultural barriers in communicating about experiences that affect mental health.

There is a great value in studies that will explore differences in mental health considerations for sexual minorities among varying nations in Latin America and for those raised in the U.S. compared to those raised internationally.

Much more funding needs to be allocated to LGBTQ+ health-focused studies at a national level, as a paltry share has been accomplished so far.

Several subtopics can and should be examined further, including LGBTQ+ identity integration and management, early move-out and housing instability, peer relations, intimate partner violence, LGBTQ+ activism involvement, and civic engagement as a coping behavior.

Longitudinal studies would be helpful to analyze mental health outcomes for sexual minority members who stay in nonaffirming religious settings versus those who adopt affirming faith communities.

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References

References

Abreu, R. L., & Gonzalez, K. A. (2020). Redefining collectivism: Family and community among sexual and gender diverse people of color and indigenous people: Introduction to the special issue. Journal of GLBT Family Studies, 16(2), 107-110. https://doi.org/10.1080/1550428X.2020.1736038
Abreu, R. L., Gonzalez, K. A., Rosario, C. C., Pulice-Farrow, L., & Domenech Rodriguez, M. M. (2020). “Latinos have a stronger attachment to the family”: Latinx
fathers’ acceptance of their sexual minority children. Journal of GLBT Family Studies, 16(2), 192-210. https://doi.org/10.1080/1550428X.2019.1672232
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