Abstract
Sexual minority youth in military families have a unique set of stressors that affect
their mental, emotional, and physical health. There is a pronounced gap in data addressing
the specific stressors of this population and how they interact to impact the health
of the adolescent. The culture of the United States military has historically been
heterosexist and homophobic, propelled primarily by policies that restricted the recruitment
and service of lesbian, gay, bisexual, or transgender individuals, leading to a continued
secrecy around sexual orientation that may affect how sexual minority youth within
the community view themselves. Homophobia, social stigma, and victimization lead to
significant health disparities among sexual minority youth, and youth connected to
the military have additional stressors as a result of frequent moves, parental deployment,
and general military culture. Primary care providers must be aware of these stressors
to provide a safe environment, thorough screening, and competent care for these adolescents.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pediatric Health CareAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Emotional distress among LGBT youth: The influence of perceived discrimination based on sexual orientation.Journal of Youth and Adolescence. 2009; 38: 1001-1014
- Deployment and military medical home resources.August, 2013 (Retrieved from)
- Disparities in tobacco use by sexual orientation among high school students.Preventive Medicine. 2014; 69: 307-311
- Don't ask, don't tell: Is the gay ban based on military necessity?.Parameters. 2010; 40 (Retrieved from): 173-183
- Comfort levels of active duty gay/bisexual male service members in the military healthcare system.Military Medicine. 2013; 178: 1335-1340
- LGB and questioning students in schools: The moderating effects of homophobic bullying and school climate on negative outcomes.Journal of Youth and Adolescence. 2009; 38: 989-1000
- Sexual-orientation disparities in school: The mediational role of indicators of victimization in achievement and truancy because of feeling unsafe.American Journal of Public Health. 2014; 104: 1124-1128
- Military health care utilization by teens and young adults.Pediatrics. 2014; 133: 627-634
- Lesbian, gay, and bisexual victimization in the military: An unintended consequence of “Don't Ask, Don't Tell”?.American Psychologist. 2011; 66: 604-613
- Well-being and suicidal ideation of secondary school students from military families.Journal of Adolescent Health. 2014; 54: 672-677
- Sexually transmitted diseases treatment guidelines, 2010 (No. RR-12).2010 (Retrieved from)
- Sexual identity, sex of sexual contacts, and health-risk behaviors among students in grades 9-12—Youth Risk Behavior Surveillance, selected sites, United States, 2001-2009.2011 (Retrieved from)
- Estimated HIV incidence in the United States, 2007-2010.2012 (Retrieved from)
- Children on the homefront: The experience of children from military families.Pediatrics. 2010; 125: 16-25
- Best practices to identify gay, lesbian, bisexual, or questioning youth in primary care.Pediatric Nursing. 2013; 39: 99-103
- The demographics of military children and families.Future of Children. 2013; 23 (Retrieved from): 13-39
- The health and health care of lesbian, gay, and bisexual adolescents.Annual Review of Public Health. 2010; 31: 457-477
- Office-based care for lesbian, gay, bisexual, transgender, and questioning youth.Pediatrics. 2013; 132: 198-203
- Military children, families, and communities: Supporting those who serve.Pediatrics. 2012; 129: S3-S10
- Sexual orientation disparities in sexually transmitted infection risk behaviors and risk determinants among sexually active adolescent males: Results from a school-based sample.American Journal of Public Health. 2014; 104: 1107-1112
- Demographics and LGBT health.Journal of Health and Social Behavior. 2013; 54: 72-74
- How to reach sexual minority youth in the health care setting: The teens offer guidance.Journal of Adolescent Health. 2002; 31: 407-416
- Wartime military deployment and increased pediatric mental and behavioral health complaints.Pediatrics. 2010; 126: 1058-1066
- Sexual behavior in the United States: Results from a national probability sample of men and women ages 14-94.Journal of Sexual Medicine. 2010; 7: 255-265
- It gets better: Resolution of internalized homophobia over time and associations with positive health outcomes among MSM.AIDS and Behavior. 2013; 17: 1423-1430
- Healthcare preferences of lesbian, gay, bisexual, transgender and questioning youth.Journal of Adolescent Health. 2009; 45: 222-–229
- Evaluating risk-taking behaviors of youth in military families.Journal of Adolescent Health. 2006; 39: 927-928
- The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding.2011 (Retrieved from)
- After “Don't Ask Don't Tell”: Competent care of lesbian, gay and bisexual military personnel during the DoD policy transition.Professional Psychology: Research and Practice. 2013; 46: 107-115
- Probing for scars: How to ask the essential questions.Contemporary Pediatrics. 2014; 31 (22-28): 16-20
- Validity of the CRAFFT substance abuse screening test among adolescent clinic patients.Archives of Pediatrics and Adolescent Medicine. 2002; 156: 607-614
- Experiences of military youth during a family member's deployment: Changes, challenges, and opportunities.Youth & Society. 2015; 47: 319-342
- The 2013 National School Climate Survey: The experiences of lesbian, gay, bisexual and transgender youth in our nation's schools (7th Biennial Report).2014 (Retrieved from Gay, Lesbian, & Straight Education Network website:)
- The PHQ-9: Validity of a brief depression severity measure.Journal of General Internal Medicine. 2001; 16: 606-613
- Reintegration stress and family mental health: Implications for therapists working with reintegrating military families.Contemporary Family Therapy. 2014; 36: 443-451
- Promoting the successful development of sexual and gender minority youths.American Journal of Public Health. 2014; 104: 976-981
- Nondisclosure of sexual orientation to a physician among a sample of gay, lesbian, and bisexual youth.Archives of Pediatrics and Adolescent Medicine. 2006; 160: 1248-1254
- Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence.Psychological Bulletin. 2003; 129: 674-697
- Suicide ideation and bullying among US adolescents: Examining the intersections of sexual orientation, gender, and race/ethnicity.American Journal of Public Health. 2015; : e1-e6
- Envisioning an America without sexual orientation inequities in adolescent health.American Journal of Public Health. 2014; 104: 218-225
- Internalized homophobia and internalizing mental health problems: A meta-analytic review.Clinical Psychology Review. 2010; 30: 1019-1029
- Adolescent primary care visit patterns.Annals of Family Medicine. 2010; 8: 511-516
- School violence and bullying among sexual minority high school students, 2009-2011.Journal of Adolescent Health. 2014; 55: 432-438
- Lesbian, gay, and bisexual military families: Visible but legally marginalized.in: MacDermid Wadsworth S. Riggs D.S. Military deployment and its consequences for families (pp. 133-147). Springer, New York, NY2014
- Military children and families: Strengths and challenges during peace and war.American Psychologist. 2011; 66: 65-72
- Adolescent well-being in Washington State military families.American Journal of Public Health. 2011; 101: 1676-1682
- Risk and resilience in military families experiencing deployment: The role of the family attachment network.Journal of Family Psychology. 2011; 25: 675-687
- Mediation by peer violence victimization of sexual orientation disparities in cancer-related tobacco, alcohol, and sexual risk behaviors: Pooled youth risk behavior surveys.American Journal of Public Health. 2014; 104: 1113-1123
- Sexual orientation, sexual abuse, and HIV-risk behaviors among adolescents in the Pacific Northwest.American Journal of Public Health. 2006; 96: 1104-1110
- Prevalence and stability of sexual orientation components during adolescence and young adulthood.Archives of Sexual Behavior. 2007; 36: 385-394
- Ensuring appropriate care for LGBT veterans in the Veterans Health Administration.Hastings Center Report. 2014; 44: S53-S55
- Communication between VA providers and sexual and gender minority veterans: A pilot study.Psychological Services. 2014; 11: 235-242
- Impact of victimization on risk of suicide among lesbian, gay, and bisexual high school students in San Francisco.Journal of Adolescent Health. 2012; 50: 418-420
- Health and mental health needs of children in US military families.Pediatrics. 2013; 131: e2002-e2015
- Recommendations for promoting the health and well-being of lesbian, gay, bisexual, and transgender adolescents: A position paper of the society for adolescent health and medicine.Journal of Adolescent Health. 2013; 52: 506-510
- Trauma faced by children of military families: What every policymaker should know.2010 (Retrieved from National Center for Children in Poverty website:)
- Sexual minority youth.Primary Care: Clinics in Office Practice. 2014; 41: 651-669
- Predictors of unprotected sex among young sexually active African American, Hispanic, and White MSM: The importance of ethnicity and culture.AIDS and Behavior. 2008; 12: 459-468
- Washington State healthy youth survey: 2012 analytic report.2014 (Retrieved from)
- The relationship of perception of invincibility, demographics, and risk behaviors in adolescents of military parents.Journal of Pediatric Health Care. 2010; 24: 25-33
- Resiliency theory: A strengths-based approach to research and practice for adolescent health.Health Education and Behavior. 2013; 40: 381-383
Biography
Ashley N. Gyura, PNP-PC Student, School of Nursing, Columbia University, New York, NY.
Biography
Sabrina Opiola McCauley, Assistant Professor of Nursing, School of Nursing, Columbia University, New York, NY.
Article info
Publication history
Published online: November 17, 2015
Footnotes
Conflicts of interest: None to report.
Identification
Copyright
Copyright © 2015 by the National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.