September 28, 2023 • 21 mins
On the third and final episode in our series on child suicide prevention, we discuss the spike in suicidality among our LGBTQIA+ youth, as reported in 2023 by the Centers for Disease Control & Prevention, as well as The Trevor Project. David Rosenthal, DO, PhD, and Helena Roderick, PhD, highlight the many challenges negatively impacting these kids, including minority stress, discrimination and unconscious bias, and how each contributes to this horrifying trend. They share what individuals and community institutions can do to help curb the high rates of suicidal ideation and behaviors.
More about the experts:- David Rosenthal, DO, PhD, is founding medical director for Northwell Health’s Center for Transgender Care and medical director for Northwell’s Center for Young Adult, Adolescent, and Pediatric HIV.
- Helena Roderick, PhD, is senior psychologist for the Center for Transgender Care and the Center for Young Adult, Adolescent, and Pediatric HIV and the Division of Medical Genetics.
Our team launched this series during National Suicide Prevention Month in September to offer parents and caregivers a resource as they navigate this very difficult reality, particularly as children return to school. Listen to the previous episodes in this series:
- Kids in crisis: How to start the conversation about child suicidality featuring Vera Feuer, MD, director of Emergency Psychiatry Services at Cohen Children’s Medical Center
- YourMomCares about how you feel, featuring Sharon Feldstein, co-founder and CEO of YourMomCares, and Robin Paul, member and "Power Mom.
NYS Schools update
Learn more about the 2023 update to New York Schools best practices: Creating a Safe, Supportive, and Affirming School Environment for Transgender and Gender Expansive Students
Resources for families- The Trevor Project is a nonprofit focused on suicide prevention efforts among LGBTQ youth. Reach a counselor 24/7. Call 1-866-488-7386 or text 678-678
- PFLAG is the nation's largest organization dedicated to supporting, educating, and advocating for LGBTQ+ people and those who love them. Find a support group.
- American Academy of Child & Adolescent Psychiatry provides education for families including what to expect when you have to go to the emergency department and how to handle suicidality in children.
- American Academy of Pediatrics provides education on various topics including mental health.
- National Alliance on Mental Illness (NAMI) – has local chapters in each state, which offer a wealth of resources to get connected to treatment, support and educat
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:04):
The challenges that we're seeing
for LGBT youth are enormous.
And what's really important is
not only that we identify
that the problem exists,
but we really then talk about
what we can do and what next
steps we need to look at about
how we can help address the
mental health disparities that
are occurring within the
LGBT population.
Hello,
(00:24):
and welcome to 20 Minutes Health
Talk. I'm Rob Hoell,
sitting in for Sandra Lindsay.
This is the third and final
episode in our series on child
suicide prevention. Today,
we look into the alarming stats
around suicidality in our
LGBTQIA+ youth.
September is National Suicide
Prevention Month,
and over the last several weeks,
we brought you conversations
(00:45):
with experts and advocates
working to address this
growing crisis.
Recent data shows a startling
spike in overall suicidality in
children and adolescents.
In part one,
Sandra spoke with child
psychiatrist Vera Foyer about
ways parents and caregivers can
address suicidal ideation in
children. In part two,
Sandra spoke with
(01:05):
representatives from
Your Mom Cares,
a group focused on addressing
behavioral health issues in
children. On today's episode,
we pivot our attention to a
group uniquely at risk for
suicidality LGBTQ plus children.
Two leading experts in their
field share their thoughts. Dr.
David Rosenthal,
Founding Medical Director for
Northwell Health Center for
Transgender Care and Medical
(01:27):
Director for Northwell Center
for Young Adult, Adolescent,
and Pediatric HIV.
Joining the conversation is the
Center's senior psychologist,
Dr. Helena Roderick,
who is also a senior
Psychologist for the center
for Young Adult,
Adolescent and Pediatric HIV
and the Division of
Medical Genetics.
(01:48):
In the CDC's 2023 report,
called the Youth Risk
Behavioral Survey,
70% of LGBTQ youth experienced
persistent feelings of sadness
or hopelessness,
and more than 20% of these
students attempted suicide.
And what we really found out was
that we're seeing scary trends
and concerns among youth in
general about persistence of
(02:10):
feelings of sadness
and hopelessness,
increased suicidality,
people that have made
suicidal plans,
and people that have
attempted suicide.
All are up in the general
population,
but all are up even more
dramatically within the
LGBT population.
This matches data that came out
a few years before saying that
there was a 35% contemplation
for suicidal ideation that was
(02:30):
published in the CDC
MMWR just in 2019.
MMWR stands for Morbidity and
Mortality Weekly Report.
A weekly digest from the CDC.
Another report released in 2023
shows that 41% of LGBTQ youth
seriously contemplated suicide.
That data is from the
Trevor Project,
(02:50):
a nonprofit focused on suicide
prevention efforts among
these students.
S its 2023 national survey
included 28,000 LGBTQ.
Young people ages 13 to 24,
and also highlights ways we can
support these populations,
which we'll talk about
later in the show.
Both surveys highlight the many
factors contributing to
(03:11):
this horrifying trend.
Among them are social media,
economic issues,
academic and home pressures,
and lack of access to care.
While those apply to all kids,
dr.
Roderick said there's yet
another that LGB t kids are
confronted with every day.
There is a term in psychology
called minority stress,
and that's essentially just the
(03:32):
stress that you experience as
being part of a minority group,
being marginalized for being a
member of a minority group.
That maybe there's nothing
inherently stressful about being
a minority, but it is, in fact,
the way you are treated by those
around you that can then
trigger the stress.
Experiencing rejection within
the home, within the school,
(03:53):
in other communities,
experiencing bullying,
physical harm,
all forms of discrimination
invalidation.
It could even be
microaggressions, honestly,
where perhaps people are unaware
and operating at an
unconscious level.
So those are some of the factors
that kind of snowball into
creating that stress. As Dr.
(04:14):
Rosenthal highlighted,
this is all amplified in the
era of social media,
where people can post
anonymously.
This is amplified in our current
political environment in the US.
Nationwide.
So I think those factors just
really amplify the stressors for
young people today who are
identifying as part of
(04:35):
the LGBTQ community.
And discrimination can occur on
several levels at once. Dr.
Rosenthal added,
there's a lot of things that are
really challenging. So, I mean,
one of the pieces that we see is
something that's discussed as
called intersectionality.
We really see multiple different
subpopulations that are coming
together. So we, for example,
see people that identify with,
let's say, a Latino,
(04:55):
African American gay boy that is
having more challenges because
of the intersectionality of
discrimination and challenges
upon them as a minority
stressed population.
And data supports the idea that
simply being aware and
supportive can have
a huge impact.
The resiliency literature for
decades always talks about,
like, one person.
(05:16):
You just need one person
to have your back.
And so I think that's so
important for our LGBTQ young
people is that they have an
ally, and if it's not at home,
then in the school setting,
in their friend group,
wherever it might be a coach,
whomever it might be just really
looking for those allies.
Of course,
we encourage parents to listen
(05:38):
to their children's voices and
try to help them feel proud of
whoever their authentic self is
and perhaps support them as they
grow with helping if
they're trans,
perhaps maybe helping their
outside align better with how
they see themselves
inside and so on.
A lot of parents talk about the
success of driving and having
(05:59):
a conversation.
When that young person
is next to them,
because somehow having just that
ability to look out that
windshield rather than stare
into each other's eyes really
does help promote
a good dialogue.
So I put that out there in
inviting parents to try to find
ways to open the doors
to communication,
but if not a parent,
then someone else in their
(06:19):
network to just say, I see you.
I provide that unconditional
support.
The 2023 Trevor project survey
further supports Dr.
Roderick's point.
It found that having at least
one accepting adult can reduce
the risk of a suicide attempt
among LGBTQ young people by 40%.
Yet fewer than 40% of
(06:40):
respondents found their home to
be affirming to their identity,
and a majority reported being
verbally harassed at school
because people thought they were
LGBTQ. So it's a heavy,
heavy burden,
and young people are obviously
connected to media at their
fingertips many,
many hours a day.
They are bombarded with
this information,
(07:00):
and they are sponges.
They are taking this in.
And so it's shaping how
they view themselves,
how they view the world
around them,
how they feel about the future.
So the effects are
super profound,
and the effects can kind
of snowball over time.
There's a lot of self esteem
issues that can kind of develop
as you're receiving these
negative messages.
(07:21):
You may then kind of be one of
these isolated young people that
you just don't know who's
safe to turn to.
So we're seeing that a lot,
that young people are
withdrawing into themselves,
not trusting the world around
them to be safe and responsive.
If you have a young person who
all of a sudden we talked about
isolating themselves,
but you can also think about a
(07:42):
student who all of a sudden has
a dramatically different
performance in school where
their grades are declining
without any real obvious reason
for why that might be.
Certainly if a parent is seeing
a young person who's
crying often,
who's even making statements or
threats around self harm,
I really do encourage that they
(08:03):
connect with mental health
professionals and get an
evaluation, get some answers,
and see if there can be
solutions for that young person.
And I think there's other
warning signs that we need to
look at as well. I mean,
one of the things that we know
is that adolescents often will
want to be able to create their
own identities and create their
own perceptions and be able to
have their own friends and
figure out their own
way in the world.
(08:23):
And that's all part of
normal development.
But what we really do want to
make sure we're having is that
if we do see a lot more of
isolation if we do see a lot
more people only living in
virtual worlds rather
than in real worlds,
if we do see people not
interacting with peers or
society or being able to kind of
be able to go to school or being
able to have those social
interactions.
(08:44):
Those are really a critical part
of childhood development in
being able to develop who we are
and so really making sure that
we can create spaces that we
understand those things
that are going on.
Self harm is another other
significant concern. And so,
obviously,
if a child does considering self
harm or something like that.
Certainly something that
we need to do.
So all of these things are
really other issues that we need
(09:04):
to address and make sure that
when we see them as parents,
as family members, as teachers,
as trusted adults in
these kids'lives,
that we're able to help them get
the mental health support
that they need.
While social media and
traditional media play a major
role in kids'mental health, dr.
Rosenthal added,
it's no longer just commentary
in the news.
Anti LGBTQ legislation is being
(09:24):
an it into law in states like
Florida, North Dakota,
Tennessee, and Texas,
and kids Notice.
In addition to everything that's
happening in the media and
that we see online,
I think that there are new laws
that are being passed that
specifically are created to
remove rights from individuals
that identify as part of
the LGBT community,
to be able to limit people's
decisions about how they're
(09:45):
going to lead their lives.
As of this year,
there are more than 520 bills
targeting LGBTQ rights that have
been introduced in state
legislatures. Of those,
over 125 would prevent trans
youth from being able to
access health care.
This sort of additional stress
that's kind of created by
different agendas that exist,
(10:07):
add additional stress.
And I think that that brings
it kind of is not only just
something that people experience
in their lives,
but it's sort of like something
that they're hearing
on the news,
they're seeing in their feeds
that's showing up on CNN,
that's showing up in their
information that they look at
from so many different angles.
They feel continually that the
world is necessarily putting
weight on them.
And what we need to do is figure
(10:27):
out how we can help lift that
and really help provide safe
spaces for those individuals so
that they feel that they
can have space,
spaces to talk about in our
schools, with our families,
in our healthcare environments.
And that's what we spend
a lot of time doing.
And the burden is amplified for
LGBTQ kids living in states
where these laws are proposed
or in effect.
We know of families that are
(10:48):
picking up and moving.
They are relocating.
Where mom and dad or mom and
mom, for that matter,
dad and dad, whatever,
where they don't have
all the answers,
but they just know they need to
find appropriate health care and
have that access for
that young person.
There are families where they're
just terrified of punitive
measures that will be
taken against them.
(11:09):
So these are very real concerns.
It is an enormous burden,
and we're doing what we can in
terms of Northwell telehealth
and reaching who we can here
in New York State.
But, yeah,
I think it's a huge concern
nationwide.
So how do you create these safe
spaces on an individual level?
(11:31):
Simply knowing more about
certain topics related to these
communities and experiences
can help.
According to those surveyed in
the 2023 Trevor Project report,
over 70% of respondents
cited gender identity,
sexual orientation and pronouns
as topics they wish people
around them knew more about.
Other topics included the gender
binary, microaggressions,
(11:52):
racism and intersectionality.
And Dr.
Rosenthal said you can show that
you understand these
topics in Creative.
Of ways for him and Dr.
Roderick that includes wearing
colorful pins on their name
tags and lanyards.
I have a pronoun pen that lets
people know that my pronouns are
he and him because it really
makes an enormous difference.
Because regardless of what
(12:13):
pronoun someone else uses,
the fact that I'm telling other
people that I know what a
pronoun is and how it's
critically important to an
identity for some people makes
an enormous difference.
I have rainbow pens for
LGBT key patients.
I have trans flag pens for
my trans patients.
You walk into our office and
you see a rainbow flag.
You see a big sign that says
trans rights equals
(12:33):
human rights.
These are going to let these
young people be seen and feel
that they can find other people
like themselves and create those
kinds of environments.
But I think patients love it.
I think parents are like, oh,
my gosh, you like, it my kid.
I think that's one of the key
messages that I'd really like
to have come out of today.
We started this story really
talking about the staggering
statistics that are coming out
of the CDC and all the
(12:54):
challenges that we have there.
But the real question is,
what can we do and how can we
really change this so that we
can make people feel that they
have safe spaces and they have
things that they can do that can
make a difference for them and
that can really make them feel
comfortable in different
environments beyond non
verbal cues. Dr.
Roderick had this advice for
parents to help their children
(13:14):
feel more supported at home.
I just want parents to think
about it not as a black
and white issue,
but think about all the
different degrees of acceptance
that they can communicate.
I think it can be a little
overwhelming for parents to kind
of envision their own
journey sometimes.
But if they can think about one
small step of perhaps using a
different pronoun
(13:34):
for their child,
a different name for
their child,
and just starting
small like that,
if their child is trans and kind
of looking to be seen
in a different way,
that's just one example.
So I think those changes in the
home are really important,
but changes in the school are
also really important.
And one thing that I was
fortunate to participate with it
was a change that occurred
within it was a committee that
was formed by the New York State
(13:55):
Department of Education Board of
Regents over the past year.
And in June of this year,
the New York State Department of
Education Board of Regents
released new guidance for
schools within all the public
schools within New York state
called creating a safe and
supporting and affirming school
environment for transgender and
gender expansive students.
It's a 2023 legal update
(14:16):
and best practices.
And one of the things that we
did is we brought together
resources that were from
LGBT agencies,
from school psychologists,
from school boards,
from other organizations that
represent the community and the
legal community. Really,
to be able to represent the
medical community on behalf of
Northwell Health was
quite an honor.
The 42 page document highlights
(14:37):
existing protections within New
York law to help public schools
better cultivate a safe
environment for all students,
regardless of sex,
gender identity, or expression.
Importantly,
it also included comments from
the same students it's
looking to support.
Really what we heard was the
voices of the students students,
and one student actually told
us, just be polite to everyone.
(14:58):
Treat someone like a person and.
Not like they're strange or
they're out of place.
Small things like that
will go a long way.
It's those words that make
a huge difference.
And so there are opportunities
now to make sure that you can
grab that document and be able
to have those resources to
understand what you can do to
help your child navigate the
school waters about how you're
(15:19):
able to create safe
spaces in schools.
What bathroom are your
kids going to use?
How are they going to make
sure that no bullying?
What are we going to do to make
sure that your child's preferred
name appears on the school roll
when they're calling the
kid's name in class?
How do we make sure that your
kid's pronouns are addressed?
How do we make sure that there's
clubs that provide other
supportive environments and safe
(15:39):
spaces where you can have an
opportunity to talk to other
kids that are interested in the
same thing as you are or
about LGBT identities?
So I think that different people
want different things.
Kids don't necessarily all
want the same thing.
Some kids are going to say,
I want to read a book.
Some kids are going to say,
I want to talk to someone,
and some kids are going to just
see a flag and feel like they've
got a safe classroom that
they can walk into.
(16:00):
So I think that the key thing is
creating these safe
spaces at schools.
And the same truly applies to,
I think,
other places where young
people congregate.
If that's going to be
congregations of prayer,
mosques, synagogues, churches,
if that's going to be youth
centers or community centers,
all of these places need to
create an opportunity for the
(16:21):
young people to be themselves.
The new guidance also
facilitates compliance with
state and federal laws
concerning bullying, harassment,
discrimination,
and student privacy.
You can find a link to the
document in the show notes while
centers dedicated to treating
these communities like the one
at Northwell Health are
growing in number,
access to care remains a major
pain point for many LGBTQ kids.
(16:43):
Mental health is still a scary
word to some people.
There's still stigma
associated with it.
There's still challenges
associated with it.
Over half of the patients that
wanted to see a mental health
provider from the LGBT community
didn't see a mental
health provider.
The youth sometimes feel that
they're afraid to talk to mental
health concerns about
(17:03):
someone else,
but they also feel that they
need to get their parents
permission in order to
talk to someone else.
And they also feel that there
wouldn't be taken seriously
or that it wouldn't work.
One way to bridge the gap, Dr.
Rosenthal says,
is better collaboration between
schools and health systems.
Our schools have school
psychologists and school social
workers that can be a gateway
(17:23):
for helping to make sure that
your mental health
needs can be met.
And it's really essential that
you can get that as a starting
point to be able to kind of make
sure you can have
those resources,
to be able to have the
opportunity to talk to someone
and to be able to get that
support so that you can go
through adolescence and have the
additional resources available
by creating programs that
(17:44):
partner with schools.
That work with schools
is really essential.
And northwell health
is very fortunate.
We have school based health
clinics which have both medical
and mental health providers in
them in several different areas,
but we also have the phenomenal
newer mental health
clinics that are.
Associated with the schools
within Queens specifically and
other areas that have mental
(18:05):
health providers that are
dedicated mental health
providers,
social worker psychologists and
other mental health providers
that are on site,
that are there specifically to
provide embedded services
within these schools.
And there's also other programs
that really talk about health
education for the LGBT community
and populations like that that
go into schools and provide
resources and our work with
community engagement. It.
And so the answer is not yes
(18:28):
or no, one or the other.
I think the answer is yes,
yes and yes.
And I think the reality is that
we have an access problem.
We know that there aren't enough
mental health professionals
to go around.
We know that there's a
disproportionate individuals
that have an ability to pay,
that have access to health care.
So how can we,
as an organization and
as a health system,
(18:49):
do the work that you were just
describing that's really
occurring with these programs?
To be able to bring mental
health resources to the doors of
places that need it and to make
sure that we can bring the care
towards people rather than
having people have
to come to us?
I know there's a lot of waiting
lists out there nowadays for
mental health services,
so certainly we encourage
families to be assertive,
(19:10):
aggressive, almost,
in kind of seeking out
those services.
I know Northwell is definitely
doing a lot to try to reach
students where they are in
their school district.
So just families know that there
are new linkages at all
times from Northwell.
So there's definitely a push
in our local community,
(19:32):
from families as well as school
communities to be affirming,
to be supportive.
Certainly there's a lot of
crisis resources out there.
So we've mentioned all sorts of
research by the Trevor Project,
but also there's a hotline
for young people,
there's a social media space
that is very supportive,
so that comes through the Trevor
Project and is definitely very
(19:54):
specialized for LGBTQ
young people.
So I want families to know there
are resources out there.
There's p flag support groups
for families where they can meet
others who are perhaps going
along their journey as well
trying to figure it out.
So we just encourage families to
access supports that are out
there to gather information from
(20:15):
trusted, reliable resources.
So if you're doing
an online search,
be mindful of what those
resources are that you're
drawing from.
To learn more about the warning
signs and to find helpful
resources,
listeners can visit
northwell.edu mentalhealth.
If you think a child has harmed
themselves or is in immediate
(20:36):
danger of harming themselves,
call 911 or get them
immediate care.
That does it for this episode on
child suicidality in the
LGBTQIA Plus community.
On behalf of Sandra,
Lindsay and our entire 20
minutes health talk team,
thank you for listening.
I'm Rob Hoyle.
Have a great day and stay safe.
The challenges that we're seeing
for LGBT youth are enormous.
And what's really important is
not only that we identify
that the problem exists,
but we really then talk about
what we can do and what next
steps we need to look at about
how we can help address the
mental health disparities that
are occurring within the
LGBT population.
Hello,
(00:24):
and welcome to 20 Minutes Health
Talk. I'm Rob Hoell,
sitting in for Sandra Lindsay.
This is the third and final
episode in our series on child
suicide prevention. Today,
we look into the alarming stats
around suicidality in our
LGBTQIA+ youth.
September is National Suicide
Prevention Month,
and over the last several weeks,
we brought you conversations
(00:45):
with experts and advocates
working to address this
growing crisis.
Recent data shows a startling
spike in overall suicidality in
children and adolescents.
In part one,
Sandra spoke with child
psychiatrist Vera Foyer about
ways parents and caregivers can
address suicidal ideation in
children. In part two,
Sandra spoke with
(01:05):
representatives from
Your Mom Cares,
a group focused on addressing
behavioral health issues in
children. On today's episode,
we pivot our attention to a
group uniquely at risk for
suicidality LGBTQ plus children.
Two leading experts in their
field share their thoughts. Dr.
David Rosenthal,
Founding Medical Director for
Northwell Health Center for
Transgender Care and Medical
(01:27):
Director for Northwell Center
for Young Adult, Adolescent,
and Pediatric HIV.
Joining the conversation is the
Center's senior psychologist,
Dr. Helena Roderick,
who is also a senior
Psychologist for the center
for Young Adult,
Adolescent and Pediatric HIV
and the Division of
Medical Genetics.
(01:48):
In the CDC's 2023 report,
called the Youth Risk
Behavioral Survey,
70% of LGBTQ youth experienced
persistent feelings of sadness
or hopelessness,
and more than 20% of these
students attempted suicide.
And what we really found out was
that we're seeing scary trends
and concerns among youth in
general about persistence of
(02:10):
feelings of sadness
and hopelessness,
increased suicidality,
people that have made
suicidal plans,
and people that have
attempted suicide.
All are up in the general
population,
but all are up even more
dramatically within the
LGBT population.
This matches data that came out
a few years before saying that
there was a 35% contemplation
for suicidal ideation that was
(02:30):
published in the CDC
MMWR just in 2019.
MMWR stands for Morbidity and
Mortality Weekly Report.
A weekly digest from the CDC.
Another report released in 2023
shows that 41% of LGBTQ youth
seriously contemplated suicide.
That data is from the
Trevor Project,
(02:50):
a nonprofit focused on suicide
prevention efforts among
these students.
S its 2023 national survey
included 28,000 LGBTQ.
Young people ages 13 to 24,
and also highlights ways we can
support these populations,
which we'll talk about
later in the show.
Both surveys highlight the many
factors contributing to
(03:11):
this horrifying trend.
Among them are social media,
economic issues,
academic and home pressures,
and lack of access to care.
While those apply to all kids,
dr.
Roderick said there's yet
another that LGB t kids are
confronted with every day.
There is a term in psychology
called minority stress,
and that's essentially just the
(03:32):
stress that you experience as
being part of a minority group,
being marginalized for being a
member of a minority group.
That maybe there's nothing
inherently stressful about being
a minority, but it is, in fact,
the way you are treated by those
around you that can then
trigger the stress.
Experiencing rejection within
the home, within the school,
(03:53):
in other communities,
experiencing bullying,
physical harm,
all forms of discrimination
invalidation.
It could even be
microaggressions, honestly,
where perhaps people are unaware
and operating at an
unconscious level.
So those are some of the factors
that kind of snowball into
creating that stress. As Dr.
(04:14):
Rosenthal highlighted,
this is all amplified in the
era of social media,
where people can post
anonymously.
This is amplified in our current
political environment in the US.
Nationwide.
So I think those factors just
really amplify the stressors for
young people today who are
identifying as part of
(04:35):
the LGBTQ community.
And discrimination can occur on
several levels at once. Dr.
Rosenthal added,
there's a lot of things that are
really challenging. So, I mean,
one of the pieces that we see is
something that's discussed as
called intersectionality.
We really see multiple different
subpopulations that are coming
together. So we, for example,
see people that identify with,
let's say, a Latino,
(04:55):
African American gay boy that is
having more challenges because
of the intersectionality of
discrimination and challenges
upon them as a minority
stressed population.
And data supports the idea that
simply being aware and
supportive can have
a huge impact.
The resiliency literature for
decades always talks about,
like, one person.
(05:16):
You just need one person
to have your back.
And so I think that's so
important for our LGBTQ young
people is that they have an
ally, and if it's not at home,
then in the school setting,
in their friend group,
wherever it might be a coach,
whomever it might be just really
looking for those allies.
Of course,
we encourage parents to listen
(05:38):
to their children's voices and
try to help them feel proud of
whoever their authentic self is
and perhaps support them as they
grow with helping if
they're trans,
perhaps maybe helping their
outside align better with how
they see themselves
inside and so on.
A lot of parents talk about the
success of driving and having
(05:59):
a conversation.
When that young person
is next to them,
because somehow having just that
ability to look out that
windshield rather than stare
into each other's eyes really
does help promote
a good dialogue.
So I put that out there in
inviting parents to try to find
ways to open the doors
to communication,
but if not a parent,
then someone else in their
(06:19):
network to just say, I see you.
I provide that unconditional
support.
The 2023 Trevor project survey
further supports Dr.
Roderick's point.
It found that having at least
one accepting adult can reduce
the risk of a suicide attempt
among LGBTQ young people by 40%.
Yet fewer than 40% of
(06:40):
respondents found their home to
be affirming to their identity,
and a majority reported being
verbally harassed at school
because people thought they were
LGBTQ. So it's a heavy,
heavy burden,
and young people are obviously
connected to media at their
fingertips many,
many hours a day.
They are bombarded with
this information,
(07:00):
and they are sponges.
They are taking this in.
And so it's shaping how
they view themselves,
how they view the world
around them,
how they feel about the future.
So the effects are
super profound,
and the effects can kind
of snowball over time.
There's a lot of self esteem
issues that can kind of develop
as you're receiving these
negative messages.
(07:21):
You may then kind of be one of
these isolated young people that
you just don't know who's
safe to turn to.
So we're seeing that a lot,
that young people are
withdrawing into themselves,
not trusting the world around
them to be safe and responsive.
If you have a young person who
all of a sudden we talked about
isolating themselves,
but you can also think about a
(07:42):
student who all of a sudden has
a dramatically different
performance in school where
their grades are declining
without any real obvious reason
for why that might be.
Certainly if a parent is seeing
a young person who's
crying often,
who's even making statements or
threats around self harm,
I really do encourage that they
(08:03):
connect with mental health
professionals and get an
evaluation, get some answers,
and see if there can be
solutions for that young person.
And I think there's other
warning signs that we need to
look at as well. I mean,
one of the things that we know
is that adolescents often will
want to be able to create their
own identities and create their
own perceptions and be able to
have their own friends and
figure out their own
way in the world.
(08:23):
And that's all part of
normal development.
But what we really do want to
make sure we're having is that
if we do see a lot more of
isolation if we do see a lot
more people only living in
virtual worlds rather
than in real worlds,
if we do see people not
interacting with peers or
society or being able to kind of
be able to go to school or being
able to have those social
interactions.
(08:44):
Those are really a critical part
of childhood development in
being able to develop who we are
and so really making sure that
we can create spaces that we
understand those things
that are going on.
Self harm is another other
significant concern. And so,
obviously,
if a child does considering self
harm or something like that.
Certainly something that
we need to do.
So all of these things are
really other issues that we need
(09:04):
to address and make sure that
when we see them as parents,
as family members, as teachers,
as trusted adults in
these kids'lives,
that we're able to help them get
the mental health support
that they need.
While social media and
traditional media play a major
role in kids'mental health, dr.
Rosenthal added,
it's no longer just commentary
in the news.
Anti LGBTQ legislation is being
(09:24):
an it into law in states like
Florida, North Dakota,
Tennessee, and Texas,
and kids Notice.
In addition to everything that's
happening in the media and
that we see online,
I think that there are new laws
that are being passed that
specifically are created to
remove rights from individuals
that identify as part of
the LGBT community,
to be able to limit people's
decisions about how they're
(09:45):
going to lead their lives.
As of this year,
there are more than 520 bills
targeting LGBTQ rights that have
been introduced in state
legislatures. Of those,
over 125 would prevent trans
youth from being able to
access health care.
This sort of additional stress
that's kind of created by
different agendas that exist,
(10:07):
add additional stress.
And I think that that brings
it kind of is not only just
something that people experience
in their lives,
but it's sort of like something
that they're hearing
on the news,
they're seeing in their feeds
that's showing up on CNN,
that's showing up in their
information that they look at
from so many different angles.
They feel continually that the
world is necessarily putting
weight on them.
And what we need to do is figure
(10:27):
out how we can help lift that
and really help provide safe
spaces for those individuals so
that they feel that they
can have space,
spaces to talk about in our
schools, with our families,
in our healthcare environments.
And that's what we spend
a lot of time doing.
And the burden is amplified for
LGBTQ kids living in states
where these laws are proposed
or in effect.
We know of families that are
(10:48):
picking up and moving.
They are relocating.
Where mom and dad or mom and
mom, for that matter,
dad and dad, whatever,
where they don't have
all the answers,
but they just know they need to
find appropriate health care and
have that access for
that young person.
There are families where they're
just terrified of punitive
measures that will be
taken against them.
(11:09):
So these are very real concerns.
It is an enormous burden,
and we're doing what we can in
terms of Northwell telehealth
and reaching who we can here
in New York State.
But, yeah,
I think it's a huge concern
nationwide.
So how do you create these safe
spaces on an individual level?
(11:31):
Simply knowing more about
certain topics related to these
communities and experiences
can help.
According to those surveyed in
the 2023 Trevor Project report,
over 70% of respondents
cited gender identity,
sexual orientation and pronouns
as topics they wish people
around them knew more about.
Other topics included the gender
binary, microaggressions,
(11:52):
racism and intersectionality.
And Dr.
Rosenthal said you can show that
you understand these
topics in Creative.
Of ways for him and Dr.
Roderick that includes wearing
colorful pins on their name
tags and lanyards.
I have a pronoun pen that lets
people know that my pronouns are
he and him because it really
makes an enormous difference.
Because regardless of what
(12:13):
pronoun someone else uses,
the fact that I'm telling other
people that I know what a
pronoun is and how it's
critically important to an
identity for some people makes
an enormous difference.
I have rainbow pens for
LGBT key patients.
I have trans flag pens for
my trans patients.
You walk into our office and
you see a rainbow flag.
You see a big sign that says
trans rights equals
(12:33):
human rights.
These are going to let these
young people be seen and feel
that they can find other people
like themselves and create those
kinds of environments.
But I think patients love it.
I think parents are like, oh,
my gosh, you like, it my kid.
I think that's one of the key
messages that I'd really like
to have come out of today.
We started this story really
talking about the staggering
statistics that are coming out
of the CDC and all the
(12:54):
challenges that we have there.
But the real question is,
what can we do and how can we
really change this so that we
can make people feel that they
have safe spaces and they have
things that they can do that can
make a difference for them and
that can really make them feel
comfortable in different
environments beyond non
verbal cues. Dr.
Roderick had this advice for
parents to help their children
(13:14):
feel more supported at home.
I just want parents to think
about it not as a black
and white issue,
but think about all the
different degrees of acceptance
that they can communicate.
I think it can be a little
overwhelming for parents to kind
of envision their own
journey sometimes.
But if they can think about one
small step of perhaps using a
different pronoun
(13:34):
for their child,
a different name for
their child,
and just starting
small like that,
if their child is trans and kind
of looking to be seen
in a different way,
that's just one example.
So I think those changes in the
home are really important,
but changes in the school are
also really important.
And one thing that I was
fortunate to participate with it
was a change that occurred
within it was a committee that
was formed by the New York State
(13:55):
Department of Education Board of
Regents over the past year.
And in June of this year,
the New York State Department of
Education Board of Regents
released new guidance for
schools within all the public
schools within New York state
called creating a safe and
supporting and affirming school
environment for transgender and
gender expansive students.
It's a 2023 legal update
(14:16):
and best practices.
And one of the things that we
did is we brought together
resources that were from
LGBT agencies,
from school psychologists,
from school boards,
from other organizations that
represent the community and the
legal community. Really,
to be able to represent the
medical community on behalf of
Northwell Health was
quite an honor.
The 42 page document highlights
(14:37):
existing protections within New
York law to help public schools
better cultivate a safe
environment for all students,
regardless of sex,
gender identity, or expression.
Importantly,
it also included comments from
the same students it's
looking to support.
Really what we heard was the
voices of the students students,
and one student actually told
us, just be polite to everyone.
(14:58):
Treat someone like a person and.
Not like they're strange or
they're out of place.
Small things like that
will go a long way.
It's those words that make
a huge difference.
And so there are opportunities
now to make sure that you can
grab that document and be able
to have those resources to
understand what you can do to
help your child navigate the
school waters about how you're
(15:19):
able to create safe
spaces in schools.
What bathroom are your
kids going to use?
How are they going to make
sure that no bullying?
What are we going to do to make
sure that your child's preferred
name appears on the school roll
when they're calling the
kid's name in class?
How do we make sure that your
kid's pronouns are addressed?
How do we make sure that there's
clubs that provide other
supportive environments and safe
(15:39):
spaces where you can have an
opportunity to talk to other
kids that are interested in the
same thing as you are or
about LGBT identities?
So I think that different people
want different things.
Kids don't necessarily all
want the same thing.
Some kids are going to say,
I want to read a book.
Some kids are going to say,
I want to talk to someone,
and some kids are going to just
see a flag and feel like they've
got a safe classroom that
they can walk into.
(16:00):
So I think that the key thing is
creating these safe
spaces at schools.
And the same truly applies to,
I think,
other places where young
people congregate.
If that's going to be
congregations of prayer,
mosques, synagogues, churches,
if that's going to be youth
centers or community centers,
all of these places need to
create an opportunity for the
(16:21):
young people to be themselves.
The new guidance also
facilitates compliance with
state and federal laws
concerning bullying, harassment,
discrimination,
and student privacy.
You can find a link to the
document in the show notes while
centers dedicated to treating
these communities like the one
at Northwell Health are
growing in number,
access to care remains a major
pain point for many LGBTQ kids.
(16:43):
Mental health is still a scary
word to some people.
There's still stigma
associated with it.
There's still challenges
associated with it.
Over half of the patients that
wanted to see a mental health
provider from the LGBT community
didn't see a mental
health provider.
The youth sometimes feel that
they're afraid to talk to mental
health concerns about
(17:03):
someone else,
but they also feel that they
need to get their parents
permission in order to
talk to someone else.
And they also feel that there
wouldn't be taken seriously
or that it wouldn't work.
One way to bridge the gap, Dr.
Rosenthal says,
is better collaboration between
schools and health systems.
Our schools have school
psychologists and school social
workers that can be a gateway
(17:23):
for helping to make sure that
your mental health
needs can be met.
And it's really essential that
you can get that as a starting
point to be able to kind of make
sure you can have
those resources,
to be able to have the
opportunity to talk to someone
and to be able to get that
support so that you can go
through adolescence and have the
additional resources available
by creating programs that
(17:44):
partner with schools.
That work with schools
is really essential.
And northwell health
is very fortunate.
We have school based health
clinics which have both medical
and mental health providers in
them in several different areas,
but we also have the phenomenal
newer mental health
clinics that are.
Associated with the schools
within Queens specifically and
other areas that have mental
(18:05):
health providers that are
dedicated mental health
providers,
social worker psychologists and
other mental health providers
that are on site,
that are there specifically to
provide embedded services
within these schools.
And there's also other programs
that really talk about health
education for the LGBT community
and populations like that that
go into schools and provide
resources and our work with
community engagement. It.
And so the answer is not yes
(18:28):
or no, one or the other.
I think the answer is yes,
yes and yes.
And I think the reality is that
we have an access problem.
We know that there aren't enough
mental health professionals
to go around.
We know that there's a
disproportionate individuals
that have an ability to pay,
that have access to health care.
So how can we,
as an organization and
as a health system,
(18:49):
do the work that you were just
describing that's really
occurring with these programs?
To be able to bring mental
health resources to the doors of
places that need it and to make
sure that we can bring the care
towards people rather than
having people have
to come to us?
I know there's a lot of waiting
lists out there nowadays for
mental health services,
so certainly we encourage
families to be assertive,
(19:10):
aggressive, almost,
in kind of seeking out
those services.
I know Northwell is definitely
doing a lot to try to reach
students where they are in
their school district.
So just families know that there
are new linkages at all
times from Northwell.
So there's definitely a push
in our local community,
(19:32):
from families as well as school
communities to be affirming,
to be supportive.
Certainly there's a lot of
crisis resources out there.
So we've mentioned all sorts of
research by the Trevor Project,
but also there's a hotline
for young people,
there's a social media space
that is very supportive,
so that comes through the Trevor
Project and is definitely very
(19:54):
specialized for LGBTQ
young people.
So I want families to know there
are resources out there.
There's p flag support groups
for families where they can meet
others who are perhaps going
along their journey as well
trying to figure it out.
So we just encourage families to
access supports that are out
there to gather information from
(20:15):
trusted, reliable resources.
So if you're doing
an online search,
be mindful of what those
resources are that you're
drawing from.
To learn more about the warning
signs and to find helpful
resources,
listeners can visit
northwell.edu mentalhealth.
If you think a child has harmed
themselves or is in immediate
(20:36):
danger of harming themselves,
call 911 or get them
immediate care.
That does it for this episode on
child suicidality in the
LGBTQIA Plus community.
On behalf of Sandra,
Lindsay and our entire 20
minutes health talk team,
thank you for listening.
I'm Rob Hoyle.
Have a great day and stay safe.
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