Victoria Rawlings

The social determinants of lesbian, gay, bisexual and transgender youth suicidality in England: a mixed methods study

Abstract Background Lesbian, gay, bisexual and transgender (LGBT) youth have a higher risk of suicidality and self-harm than heterosexual youth populations but little is known about the underlying mechanisms. We aimed to investigate the social determinants of this mental health inequality. Methods A two-stage sequential mixed method study was conducted. Firstly, 29 semi-structured interviews with LGBT youth (aged 13–25 years old) were completed. Data was analysed thematically. Stage 2 involved a self-completed questionnaire employing an online community-based sampling strategy (n = 789). Logistic regression analysis was performed to predict suicidality. Results Five social determinants explained suicidal risk: (i) homophobia, biphobia or transphobia; (ii) sexual and gender norms; (iii) managing sexual and gender identities across multiple life domains; (iv) being unable to talk; (v) other life crises. Youth who were transgender (OR = 1.50, P < 0.022), disabled (OR = 2.23, P < 0.000), had self-harmed (OR = 7.45, P < 0.000), were affected by abuse (OR = 2.14, P < 0.000), and affected by not talking about their emotions (OR = 2.43, P < 0.044) were most likely to have planned or attempted suicide. Conclusions Public health universal interventions that tackle bullying and discrimination in schools, and selected interventions that provide specific LGBT youth mental health support could reduce LGBT mental health inequalities in youth suicidality.

Mental health staff perceptions and practice regarding self-harm, suicidality and help-seeking in LGBTQ youth : Findings from a cross-sectional survey in the UK

ABSTRACT Young people who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ) experience higher levels of suicidality compared to heterosexual or cisgender peers, and face significant barriers accessing mental health services including prejudice from staff. In a cross-sectional survey, mental health staff who reported receiving LGBT awareness training were significantly more likely to report in relation to working with LGBT youth that they routinely discussed issues of sexuality and gender (χ2=8.782, df=2, p < 0.05); to feel that their organisation supported them to work with this group (χ2=14.401, df=2, p < 0.001); and report that they had access to adequate skills training that supported their work with suicidality and self-harm with this group (χ2=21.911, df=2, p <0.001). There is a need to enhance the mental health workforce in LGBTQ awareness, and these findings indicate that awareness training could impact positively on practice.

Norms and Normalisation: Understanding Lesbian, Gay, Bisexual, Transgender and Queer Youth, Suicidality and Help-Seeking

Abstract Young people who identify as lesbian, gay, bisexual, and queer transgender have elevated rates of suicidality. Despite the increased risk, there is a paucity of research on lesbian, gay, bisexual, transgender and queer help-seeking and suicidality. We report on a UK sequential exploratory, two-stage, mixed-method study. Stage 1 involved 29 online and face-to-face semi-structured interviews with lesbian, gay, bisexual, transgender and queer youth aged 16–25 years old. Stage 2 utilised an online youth questionnaire employing a community-based sampling strategy (n = 789). Results indicated that participants only asked for help when they reached a crisis point because they were normalising their emotional distress. Those who self-harmed, had attempted or planned suicide or had experience of abuse related to their sexuality or gender were most likely to seek help. Results suggested that the reluctance to seek help was due to three interconnecting factors: negotiating sexuality, gender, mental health and age norms; being unable to talk about emotions; and coping and self-reliance. Policies aiming to prevent lesbian, gay, bisexual, transgender and queer youth suicide recognise that norms and normalising processes connected to sexual orientation and gender identity are additional difficulties that youth have accessing mental health support.

Recognising Power, Privilege and Context

This chapter contains five brief sections with concluding messages from this research. The first details the main aims of the study and its research questions. The second section identifies the key research findings, specifically drawing links between the discourses that were produced by the teachers, principals and students and illustrating the discursive realities that they constructed in collaboration. These collaborative findings produced three overarching themes: ‘gender regulation’, ‘institutional influence on social norms’ and ‘inevitability’, which are outlined below. This is followed by a description of the study’s contributions to the research field and some concluding thoughts.

Kick a Slut in the Head Day

This book began with a very brief description of this event. Since then, the intermediary chapters have detailed the discursive environments that minimise the severity of aggression, persecution and ‘bullying’, which devalue girls through valuing misogyny, and which shift blame onto the receptors of violence. Concluding these data chapters with a detailed examination of one incident allows us to see how the environment where these discourses flourish can lead to the manifestation, and dismissal, of a violent incident. This chapter again contains descriptions of the discursive constructs and their discourses that were employed in the (re)construction of this event. These continuously reiterate and reconstitute the social, gendered and institutional contexts that enable (and close down) acts, identities, interpretations and subjectivities into the future. In other words, ‘kick a slut in the head day’ was an act that was pre-determined by the discursive context from which it emerged, while simultaneously fortifying these discourses through its own constitution.

Unpacking and Reframing ‘Bullying’

The phenomenon of bullying is undoubtedly one of the most prominent, divisive and inflammatory issues faced by schools and educational policy makers in contemporary times. In reflection of this, it has received extensive attention in academic, political and popular discourses over the last few decades. The ways in which it has been constructed in these arenas has impacted upon perspectives and actions related to intervention and policies, as well as individuals involved in bullying incidents.

Head Teacher and Principal Realities

The following two chapters integrate references to relevant literature with results and discussion of the study. This structure situates the productions of the participants within wider social, political, historical or cultural frameworks. Information about which group is speaking can be found underneath each quote.