LGBTI+ Youth in Ireland and across Europe: A two-phased Landscape and Research Gap Analysis Suggested reference: Költő, A., Vaughan, E., O’Sullivan, L., Kelly, C., Saewyc, E. M., & Nic Gabhainn, S. (2021). LGBTI+ Youth in Ireland and across Europe: A two-phased landscape and research gap analysis. Dublin: Department of Children, Equality, Disability, Integration and Youth. https://doi.org/10.13025/wpbs-nw37 DOI: 10.13025/wpbs-nw37 ISBN: 978-1-908358-93-6 Disclaimer This report is produced by the Health Promotion Research Centre, National University of Ireland Galway and published by the Department of Equality, Disability, Integration and Youth. The author(s) are solely responsible for the views, opinions, findings, conclusions and/or recommendations expressed, which are not attributable to the Department. The researchers are responsible for the accuracy of the research and all published reports are peer-reviewed. © Department of Children, Equality, Disability, Integration and Youth and NUI Galway, 2021 Dublin and Galway, Ireland, May 2021 LGBTI+ Youth in Ireland and across Europe: A two-phased Landscape and Research Gap Analysis LGBTI+ Youth in Ireland and across Europe: A two-phased Landscape and Research Gap Analysis András Költő, Elena Vaughan, Linda O’Sullivan, Colette Kelly, Elizabeth M. Saewyc and Saoirse Nic Gabhainn Department of Children, Equality, Disability, Integration and Youth Health Promotion Research Centre, National University of Ireland Galway 3 LGBTI+ Youth in Ireland and across Europe: A two-phased Landscape and Research Gap Analysis Contents EXECUTIVE SUMMARY 6 Introduction 6 Aims 10 Method 10 Results 12 Policy and practice implications 16 1. INTRODUCTION 19 1.1. What is LGBTI+? 20 1.2. Why it is important to study the lives of LGBTI+ young people? 21 1.3. A lack of systematic evidence in Ireland and Europe 23 1.4. Aims 23 1.5. Research questions 24 1.6. The structure of this report 24 2. METHOD 26 2.1. Phase 1: Landscape analysis – review of existing Irish and international research 27 2.2. Phase 2: Research and Data Gap Analysis 30 2.3. Data collection procedures 32 3. RESULTS 35 3.1. Objective 1: Supportive and inclusive environments in formal education 38 3.2. Objective 2: Safe environments 50 3.3. Objective 3: Inclusive youth services 60 3.4. Objective 4: Equal employment and inclusive work environment 63 3.5. Objective 5: Representation and participation 66 3.6. Objective 6: Supports to parents and families 70 3.7. Objective 7: Capacity building for service providers 76 4 LGBTI+ Youth in Ireland and across Europe: A two-phased Landscape and Research Gap Analysis 3.8. Objective 8: Gaps in legislation and policy 83 3.9. Objective 9: Fragmentation in funding and networking for collaborative work 85 3.10. Objective 10: Inclusive environment for transgender and intersex youth 87 3.11. Objective 11: Mental health 92 3.12. Objective 12: Sexual health 105 3.13. Objective 13: Health of transgender youth 113 3.14. Objective 14: Intersex youth 121 3.15. Objective 15: Research 125 4. DISCUSSION 131 4.1. A varied landscape 132 4.2. How specific or generic are the findings? 134 4.3. Bullying and exclusion 136 4.4. Health 137 4.5. Specific needs of trans and intersex youth 139 4.6. Promoting protective factors and resilience 140 4.7. Policies 141 4.8. Knowledge gaps 142 4.9. Strengths and limitations 146 5. IMPLICATIONS FOR RESEARCH 147 REFERENCES 151 APPENDICES 175 Appendix A. Glossary 175 Appendix B. Search terms 179 Appendix C. List of the studies identified in the landscape analysis 181 ACKNOWLEDGEMENTS 208 5 LGBTI+ Youth in Ireland and across Europe: A two-phased Landscape and Research Gap Analysis Executive Summary Introduction Individuals who identify as lesbian, gay, bisexual, trans or intersex, or belong to other sexual or gender minorities (LGBTI+) have worse health and life outcomes than those who identify as heterosexual and/or whose sex assigned at birth and gender identity are aligned to each other. These inequalities have been confirmed by examination of the lived experiences of, and scientific research with, sexual and gender minority (SGM) people. Since the 1980s, in many countries there has been a growing tolerance and acceptance towards LGBTI+ persons, yet many SGM people face rejection, harassment or physical violence and stigmatisation. It seems that their poor health indicators can at least partly be attributed to chronic minority stress and its negative consequences. Many SGM people report that they began to recognise their sexual orientation or gender identity during adolescence. Due to developmental- psychological reasons, this is the life stage where they are the most vulnerable to negative health outcomes from adverse experiences such as bullying, harassment, and social exclusion by their peers or others. While warm, caring and accepting families can, to some extent, buffer the negative impact of such experiences, many LGBTI+ individuals also report negative relationships within their families. Adverse childhood and adolescent experiences, through stigmatisation and minority stress, have a long-lasting impact on SGM people. Research also demonstrates that many SGM individuals encounter a lack of understanding and respect in educational, health and social services. Providers of such services, in turn, often report that they lack adequate information and training on LGBTI+ issues. Research shows that these effects are embedded within a complex network of psychosocial determinants, including socio-economic status. They are interwoven with other dimensions of inequality, including gender, ethnic or cultural background, residence, immigration, or chronic conditions. For instance, SGM adults are more likely than heterosexual and cisgender people to live in poverty and have poor health status. People with multiple, intersecting minority statuses are more likely than others to face inequalities. The normative and developmental stress of adolescence is further increased if somebody identifies as SGM: this is the effect we refer to as ‘additionality’ in this report. Decision-makers need to consider these complexities and facilitate evidence-based initiatives that help SGM young people live in more understanding and tolerant societies which are attentive to their specific needs. 6 LGBTI+ Youth in Ireland and across Europe: A two-phased Landscape and Research Gap Analysis It is important to recognise that many SGM young people report warm and loving parents and family, supportive friends and teachers, and have a full and healthy life. Therefore a merely ‘victimising’ narrative is not helpful in understanding their experiences. It should be recognised that SGM youth “can flourish when they have consistently positive interactions with those around them and supportive experiences in the services with which they most engage” (DCYA, 2018, p. IV). In 2018, the Department of Children and Youth Affairs of Ireland published the LGBTI+ National Youth Strategy 2018-2020, the world’s first governmental strategy document that aims to improve the lives of LGBTI+ young people. It was built on the foundations of Better Outcomes, Brighter Futures, the national policy framework for young people in Ireland. It is an action-oriented plan built around three goals. These goals are further broken down to 15 objectives, and each objective contains one or more concrete actions. They are aligned with the Irish Better Outcomes, Brighter Futures (BOBF) national youth policy framework. The three overarching goals and the 15 objectives of the strategy and their alignment with the BOBF national outcomes are presented in Table 1. The actions assigned to the individual objectives are presented in the introductory parts of Subsections 3.1–3.15. Altogether these constitute a comprehensive action plan that involves legislative changes and policy development as well as allocating additional financial resources to provide training, create or enhance interventions, develop or transform curricula, and strive for a more accepting and inclusive society. The objectives and actions were generated through consultations with LGBTI+ young people as well as various other stakeholder groups and were based on the best available scientific evidence. 7 LGBTI+ Youth in Ireland and across Europe: A two-phased Landscape and Research Gap Analysis Table 1. Goals and objectives of the LGBTI+ National Youth Strategy 2018-2020 and their alignment with the Better Outcomes Brighter Futures national youth policy framework Better Outcomes National LGBTI+ Youth Strategy 2018-2020 Brighter Futures Goal Objective National Outcome Goal 1: Create a Objective 1: Create a more supportive and Outcome 2: safe, supportive inclusive environment for LGBTI+ young people Achieving full and inclusive in formal education settings potential in all areas environment for of learning and LGBTI+ young development people Objective 2: Create safe environments for Outcome 3: Safe and LGBTI+ young people protected from harm Objective 3: Make all youth services more Outcome 3: Safe and inclusive of LGBTI+ young people and provide protected from harm accessible LGBTI+ youth services nationally Objective 4: Ensure equal employment Outcome 4: opportunity and an inclusive work environment Economic security for LGBTI+ young people and opportunity Objective 5: Provide a more supportive and Outcome 5: inclusive environment that encourages positive Connected, LGBTI+ representation and participation in respected and culture, society, and sport, and reduces LGBTI+ contributing to their stigma