Szkody Erica, Sotomayor Ian, Hobaica Steven, Jans Laura, Lopez Colette, Pinder Juno, Schleider Jessica L
Medical Social Sciences, Northwestern University, Chicago, Illinois.
Department of Psychology, Stony Brook University, Stony Brook, New York.
J Adolesc Health. 2025 Aug 15. doi: 10.1016/j.jadohealth.2025.06.014.
Lesbian, gay, bisexual, transgender, queer, intersex, asexual plus (LGBTQ+) youth face significant barriers to mental health care, ranging from a lack of access to therapists, months-long waitlists, and lack of insurance coverage to receiving incompetent care from non-affirming providers. The current study sought to understand the experiences of LGBTQ+ youth when accessing mental health care.
The current study utilized a fixed, embedded mixed methods design with 808 LGBTQ+ youth in the United States. Participants reported their experiences with mental health access and use, as well as provided qualitative responses about their experiences.
In this sample, less than half of LGBTQ+ adolescents stated they were able to access mental health care when it was needed. Youth described experiencing unethical therapy practices by clinicians, cited their parents and practical concerns as barriers to accessing care, and concealing their identity from providers out of fear and mistrust. Youth also described feeling both validated and invalidated once they did receive care. Youth provided recommendations around LGBTQ+ competence, respect for youths' identities and autonomy, and making care as accessible as possible.
Recommendations for caregivers, providers, organizations and programs, and policymakers are provided based on youth responses and previous literature. For example, guidelines were provided for parents on how to communicate with youth about mental health concerns, for therapists on how to improve cultural competency when working with LGBTQ+ youth, and for policymakers on how to improve access to affirming care through legislation and community engagement.
女同性恋、男同性恋、双性恋、跨性别、酷儿、双性人、无性恋及其他群体（LGBTQ+）的青少年在获得心理健康护理方面面临重大障碍，包括难以获得治疗师的服务、数月的等候名单、缺乏保险覆盖，以及从不认同该群体的提供者那里得到不称职的护理。当前的研究旨在了解LGBTQ+青少年在获得心理健康护理时的经历。
当前的研究采用了固定的、嵌入式混合方法设计，对美国的808名LGBTQ+青少年进行了研究。参与者报告了他们在获得和使用心理健康护理方面的经历，并对他们的经历提供了定性的回答。
在这个样本中，不到一半的LGBTQ+青少年表示他们在需要时能够获得心理健康护理。青少年描述了临床医生不道德的治疗行为，指出他们的父母和实际问题是获得护理的障碍，并出于恐惧和不信任而向提供者隐瞒自己的身份。青少年还描述了在接受护理后既有被认可的感觉，也有未被认可的感觉。青少年围绕LGBTQ+能力、对青少年身份和自主权的尊重以及尽可能使护理易于获得等方面提出了建议。
根据青少年的回答和以前的文献，为照顾者、提供者、组织和项目以及政策制定者提供了建议。例如，为父母提供了关于如何与青少年谈论心理健康问题的指导方针，为治疗师提供了关于如何在与LGBTQ+青少年合作时提高文化能力的指导方针，为政策制定者提供了关于如何通过立法和社区参与来改善获得认可护理的机会的指导方针。
