Safe Spaces, Safe Places: Creating Welcoming and Inclusive Environments for Traumatized LGBTQ Youth

[MUSIC PLAYING]

LGBT youth are taught
from a young age

that they are less valued.

You're constantly
aware of your safety.

I had no idea that I
should have went out

and seeked help,
because all I knew

was what my family
members were telling me,

or putting in my mind.

Sexual assault, physical
assault, verbal assault

are not uncommon.

We're used to
protecting ourselves,

and we kind of build
up our own walls.

And until we feel safe, those
walls will not come down.

The safety of our children is
one of society's most important

obligations.

The evidence is clear
that traumatized children

are significantly more
at risk for developing

behavioral, psychological,
physical health,

learning, and relationship
problems as adults

unless their trauma is
addressed early and effectively.

But trauma comes in many forms.

Domestic and community
violence, bullying,

sexual, physical, and emotional
abuse, just to name a few.

This presentation looks at the
trauma experiences of children

that many of us overlook
or never truly consider.

Lesbian, gay,
bisexual, transgender,

and questioning youth.

LGBTQ youth
experience high rates

of trauma, often related
to their sexual orientation

or gender identity.

74% of LGBTQ youth experience
verbal harassment related

to their sexual orientation.

LGBTQ youth are twice as
likely as their straight peers

to be physically
assaulted at school.

56% of LGBTQ students do
not feel safe at school.

I'm a victim of multiple
sexual assaults.

My first sexual assault
experience was by a doctor

when I was five.

So I need to have a patient
advocate in the room with me.

I need to have a
friend in there.

And so explaining all of that
and having space to do that

and not having pushback, because
sometimes medical providers will

say, this is a private
thing, this is your session.

But really great
medical providers

are able to meet
all of those needs

and then I have a
good experience.

And if I don't--

if they don't meet those
needs, then in fact,

I'm reliving trauma.

Discrimination has impacted
my life tremendously,

especially not just being
an African-American,

but being a gay
African-American.

Being in a Black
family, discrimination

has been internalized,
personalized so much.

And I was very close
with my father's side,

and my grandmother
put me in church,

and that was a big deal to me.

And, of course,
church and homosexuals

don't have very good
rapports with each other.

And I was put into
Exodus Ministries,

which is a gay conversion
ministry, at a very young age.

And it was huge.

It was always
telling me all day,

every day that you
are not who you are.

You're supposed to
be someone different.

The way you're feeling is wrong.

I was definitely
a victim of that.

I think that LGBT
youth experience

struggles after trauma again in
different ways from their peers.

In high school that was
pretty much the norm.

And probably for
a lot of reasons,

those people are not disclosing.

Over the past 20 years, more
adolescents, young adults,

and even children
have been coming out

about their sexual and gender
orientation or identity.

There has never
been a better time

to come out as cultural changes,
greater public awareness,

and information
accessible on the internet

have all provided
increased societal support.

Kids are coming out earlier,
embracing and asserting

their sexual and
gender identity.

For many LGBTQ youth, this is
a positive and exciting time

in their lives.

Yet for many, the result of
coming out at a younger age

is greater vulnerability
to experiencing trauma.

Any time you have
an individual who

is part of a
marginalized community,

the risk factors
certainly escalate,

and that's clearly
true for LGBTQ youth.

While some youth are
celebrated and embraced,

many youth experience rejection
by their parents, family,

school, friends and community.

I think LGBT youth
experience negative things

about their identity on
a daily basis growing up.

And rejection becomes a
part of their weekly ritual

depending on who
they choose to let in

and who they choose not to.

There have been times in my
life where I have felt the need

to conceal that part of my
identity, whether for work,

or because I did not feel
that it was otherwise

a safe situation.

This rejection
significantly affects

both the emotional and
physical health of the youth.

Studies indicate LGBTQ
youth who reported

high levels of
family rejection were

eight times more likely to
report having attempted suicide.

They are six times
more likely to report

high levels of depression.

As a result of these
trauma experiences,

many LGBTQ youth find
themselves isolated and alone,

requiring assistance from
community, mental health,

and other agencies.

So when kids got kicked
out of their homes,

we had to take
them into our homes

and where students
were going to college.

We're trying to figure
stuff out and we

have no idea what we're doing.

Sexual abuse for LGBTQ youth
can be much more complicated

than it can be for
majority youth,

because the fundamental element
of being sexually violated

calls into question
for everybody,

a sense of was there
something about who

I am as a sexual being that
somehow made me more vulnerable

to being preyed upon?

And that is a question
that kids that

are struggling with
sexual orientation

are dealing with anyway,
regardless of a trauma.

Traditionally, the mental health
and social service providers

in our country have not
done a very great job

of understanding and protecting
the needs of LGBTQ youth.

And so I can imagine for a
youth who's experienced trauma,

even figuring out if they
should seek treatment or support

is kind of an added
layer or a barrier

that they might experience.

And if they decide to seek
support, if they want to report,

if they want to seek
treatment, they're

going to have maybe a difficult
decision making process

about where to go, where
are they going to be safe?

The way that professionals
respond to traumatized

LGBTQ youth makes a
real and lasting impact

on the lives of these youth
at perhaps the most critical

juncture of their lives.

If youth encounter
bias when seeking help,

they may be retraumatized and
not seek help in the future.

Without strategies for including
and welcoming traumatized LGBTQ

youth, therapists and
agencies may inadvertently

retraumatize these youth.

These problems go unrecognized,
the trauma untreated,

and the cycle continues.

I think more youth
who need help are not

accessing help
because they don't

feel like that
environment, or they

don't anticipate that the
environment will be welcoming.

If they go there and they
have an experience that

makes them uncomfortable, or
where they feel like they don't

quite belong it gives the
message that this isn't for me,

or you may not really
know how to help me.

I think it's important
for providers

to know what
assumptions they might

be making around their clients.

Are you asking girls if
they have boyfriends?

Are you asking boys
about sports teams?

Are you using preferred
pronouns for trans youth?

Organizations need to
look at their settings

and look at it from the eyes
of an LGBTQ youth walking in.

If I walked in the
setting, do I see me there?

Do I feel like this
is a place for me,

or does it look nothing like me?

Because that sends a
really strong message.

A safe place is a space
where youth are not

only safe from harm, but
where they're also nurtured,

empowered, and I think where
they feel free to be themselves

and not afraid of
being themselves.

We're a product of the
world that we live in,

and we've been
acculturated a certain way.

And I think that there
are a lot of ways

that unintentionally, we
as therapists, as helpers,

may be sending messages that
actually kind of are barriers

that are can be harmful to
our traumatized clients.

And sometimes that takes
the form of the language

that we're using.

I think language in
therapy can always

be a bridge and an obstacle.

And it takes-- it has a lot to
do with the therapist's skill

to make sure that
we're using language,

and we are using language
that the youth refers to,

can identify with,
and language that it's

empowering to their needs.

If you genuinely want to
attract LGBTQ clients,

if you want to be able to
provide adequate services,

create visibility.

Don't be ashamed that you're
targeting your recruitment

efforts for this population.

Say we are a safe space.

Be vocal that you
are a supporter

and then back up that claim.

So have a rainbow
flag in the office

and tell me about how you
went down to pride, even

though you're an ally.

Or explain to me how you
are familiar somewhat

familiar with this
because you have

treated other patients like me.

Because word gets
around the community

if you just have the flag
and you know nothing,

or if you are
completely unwelcoming,

or if you are very welcoming
and very accommodating.

I think when working
with LGBTQ youth,

we need to realize that
not unlike all youth,

they have an amazing radar.

They are scanning
for lots of things.

They are looking at the
environment in which we

are interacting with them
and looking at and picking up

on nuances that maybe sometimes
we sort of take for granted.

Context becomes everything
for adolescents.

Be mindful that many
traumatized youth are LGBTQ.

Don't make assumptions about
sexual orientation or gender

identity when
meeting new clients.

We've been able to create
our own safe spaces.

And I think when
people respond, just

in general practice with real
and with real interest, that's

where change is made.

Everybody can be a potential
bridge and ally for these youth.

You don't need
tons of education.

You don't need tons of anecdotal
and personal experience

around it.

What you need is an open
heart and an open mind

and a willingness
to be that bridge.

Bias can come in many
forms and situations.

It can go unnoticed
by professionals

with years of experience.

Look deep and hard at your
own bias, we all have them.

And it's hard for
professionals to look at bias

because they went into this
work loving and helping, wanting

to help people.

And so you don't want to think,
well, I have these biases,

but we all do.

So if an LGBTQ youth, a
traumatized LGBTQ youth

seeks services, and an agency
or organization that is not

supportive or does not
create that safe space,

I think we would be perpetuating
what they went through

outside our office space.

They may be more reluctant
to access social and health

services.

They may have a larger fear
of family, loss of family,

loss of friends, disclosing
in a different environment

because trauma is then
overlaid with sexual identity

and any kind of
disclosure issues

that may be associated
with that disclosure.

Even the most subtle
forms of insensitivity

can retrigger chronic
emotional trauma.

We're different.

We're so much different.

And a lot of the
different negative things

that happen in our lives
that are similar to someone

from the general
population sometimes

just have a bigger effect on us,
because we see the world much

more through sensitive eyes.

And we've been forced to
do that our whole lives,

because we've always been trying
to figure out where we fit in.

Bias directed toward LGBTQ youth
occurs every day in our care

centers, and it represents
a growing, ongoing,

and unanswered problem.

It's not just about creating
this cosmetic effect that

makes it look like I'm
a safe organization.

Are we really?

Have we individually
and collectively

as an agency, as
an organization,

looked at how we
feel about this?

What are our own biases?

What are our own histories
around sexual orientation

and gender identity?

What are our own judgments
that we bring into that?

And have we really
talked about that?

Have we created a space
for our professional staff

to talk about that first?

If that kind of
conversation and exploration

hasn't already been
done, it doesn't

matter how many of those
other sort of safe cues

you've created in
your environment,

those youth are going to pick up
on that right away and actually

in many ways feel kind of
they've been led astray.

So to create a safe space is
not just about the external,

it's also about the
internal process

of the individual
and the organization,

and both need to be there.

Our challenge is to become aware
of and eliminate this bias.

Examples of ignorance
and bias include

being completely unaware that
an LGBTQ youth is sitting across

from you because you didn't
ask, or simply assumed.

One of the ways that
they are not inclusive

is simply they're blind to
the existence of LGBTQ youth.

They don't see them, and
they think that they--

that the youth are straight, or
the youth are gender congruent,

and so they simply don't see it.

Some of the ways that the
not inclusiveness shows up

is in not asking.

So when we just assume
what we know about somebody

and we don't really ask, then
they're not identified to us,

so that's one way.

Even before they
get in the door,

sometimes we're not inclusive
because we're not reaching out

to those particular communities
or those kids where they are

or where they congregate,
and so they're not

invited to come to care.

Bias includes giving a message
that you hope the LGBTQ youth is

mistaken about their identity.

It could be suggesting that
their trauma was caused

by their LGBTQ identity,
or their identity

was caused by their trauma.

I think a lot of LGBTQ youth
might be struggling with

their identity,
but a lot aren't.

And it's important
to know that you

might have a gay client in front
of you, or a trans client who's

totally fine with
their identity,

and it's not has nothing
to do with the trauma they

experienced.

So again, I think it's important
to kind of let the youth provide

those answers.

Assuming that everybody
else's experience is the same,

you are opening yourself up
for a whole world of trouble.

Because of bias
and discrimination,

LGBTQ youth are at a higher
risk for mental and other health

disparities.

I think it's really
important for LGBT youth

to be out of the closet to their
doctor or to their counselor

because there's different
health disparities that

LGBT youth face that are unique
and may be in more of a crisis

than heterosexual youth.

And for the doctor to
understand their patient,

they can already
make the connection

what that person might be
facing as far as health

disparities or mental health.

It's important for them to know
what sexual risk behaviors are,

what behaviors are risky.

I think it's also
important for them

to know how to protect
themselves from sexually

transmitted
infections, how to get

tested for HIV or
for other infections.

Most communities have free
HIV testing available,

and I think it's
important for providers

to be able to give that
information to youth

because they might not be able
to get that elsewhere, or even

know that that's important
information for them to know.

By turning to emerging,
evidence-based research,

and proven best practices,
youth serving professionals

can significantly improve their
services and the quality of care

to our country's
traumatized LGBTQ youth.

If we can make really
good corrections

in schools, in medical services,
in counseling services,

in faith communities,
when all of those systems

become more competent
and less biased,

then kids will go
through their development

and the world in the way
that every other kid does.

So it will even the playing
field, that's my hope.

I have lots of respect
for professionals

who are willing to
leave their comfort zone

and become more informed
and aware of the needs

of LGBTQ youth and
how to support them,

and how to provide effective,
evidence-based treatment.

And I will tell
them that to please

join us in helping this
youth because there's not

enough of us, so we
need more professionals.

How can you improve the
quality of your care related

to serving LGBTQ youth?

The place to start
is with yourself.

By examining your own beliefs
about the LGBTQ community,

you can honestly assess what
type of support, resources,

and training you might need
to improve your services

and work environment.

Be mindful that most LGBTQ
youth have experienced

trauma such as bullying,
sexual, or physical abuse,

or other forms of trauma.

As a professional, it
is important to ensure

that you are safe and
welcoming for LGBTQ youth.

A safe place is a place where
a youth can walk in and feel

comfortable being all
aspects of themselves,

whether that's with regard
to their sexual orientation,

their gender identity, their
gender expression, their race,

their ethnicity, their
culture, their religion,

all parts of themselves are
comfortable and welcome.

In talking about
creating a safe space,

I think it's also
important for us

to look at what happens if
that safety is not there?

We understand those of us
that work in the trauma field,

that safety is a fundamental
component in trauma resolution.

Our youth, our adults, anyone
that's experienced trauma

is never going to be able
to fully resolve that

unless and until they feel
like they're in a safe space.

That's just a basic 101.

That's it.

Build good relationships
with local resources

because your consumers
are going to need them.

So you need to know who are
your friendly practitioners,

your friendly medical people,
your friendly schools,

your friendly churches?

All of the places so that
wherever you refer LGBTQ youth

to, you're not sending
them somewhere where

they'll have a bad
experience, but you're

sending them somewhere
where they will be welcomed.

It's also good to know about
websites and organizations,

online resources that might
be important for LGBTQ youth

to have access to,
so maybe printing out

some of these materials.

Next, take a good close look
at your working environment.

Is your office a safe and
welcoming place for LGBTQ youth?

You can quickly and easily
create a more inclusive

environment using signage.

Make certain you
have literature meant

for LGBTQ individuals
openly displayed along

with a non-discriminatory
policy.

I look for policy.

I look for
non-discrimination policies.

I look to see that gender
identity and sexual orientation

are included in those things.

I look for materials
around waiting

rooms that indicate that there
is an idea that LGBT people

exist in this environment.

Small things such as having an
LGBTQ brochure or the rainbow

flag in the waiting
area, in your office,

and having questions
in your assessment

process that target
specifically questions

about LGBTQ youth that are asked
in a very safe, non-judgmental

judgmental way.

So if I go to you
seeking medical care,

and I tell you that in order
to create a safe space for me,

these certain things
need to be done,

I need you to follow through,
and I need you to listen.

I need you to
respect my pronouns.

I need you to respect
what my name is.

I need you to respect any kind
of extra needs that I have.

If I tell you that
I need something,

listen, and then
follow through on it.

It's so important for
organizations to really make

sure to do some self-reflection
and to do some work

to ensure that they themselves
as individual providers,

and also that the program
that they and the institutions

that they work for are
LGBTQ affirming and really

understanding of
what those needs are.

To kids and
professionals if you're

watching this video,
what I would say to you

is that you've already taken
a really great step already,

and I just encourage
anyone watching

to continue on that
path, to continue

to be enlightened, and continue
to pursue knowledge so that you

can help all types of people.

For more information about
guidelines and policies

for counseling LGBTQ
youth and trauma,

please visit the
following websites.