Safe and appropriate interventions for children and adolescents

There are safe and effective psychotherapies for children, youth, and families confronting these issues. The standard of care for this population stresses acceptance of the child as a whole person and includes affirming the validity of their identity conflicts, including those rooted in religious belief.

Appropriate therapy includes providing safety and protection from bullying, discrimination and harassment, and openness and commitment to their welfare without having a specific sexual orientation or gender identity outcome. This requires a careful assessment of the child and their concerns, including identifying if there is distress and its origins, the gender identity or sexual orientation issues, the child’s cognitive and emotional capacities in a developmental framework, and any mental health concerns.

Health professionals focus on reducing distress and increasing the child’s capacity to cope with stigma or cultural invalidation, including LGBT stigma. The mental health provider assists the child in developmentally appropriate exploration of sexual orientation and gender identity. Under both practice standards and ethical guidelines, the emergence of a minor’s unique identity should be allowed without interference from the therapist, such as a pre-set or imposed sexual orientation or gender identity outcome.

Such affirmative approaches have been empirically validated in the reduction of the depression, anxiety and suicidal ideation that harm those who are LGBTQ or are conflicted. Therapies can similarly help families understand their child’s conflicts and concerns and provide tools to communicate about these challenging issues without damage to the child’s mental health. A child’s distress can be reduced even when parents’ do not approve or accept their child’s sexual orientation or gender diversity.

Roland Behm