Emotional Distress Among LGBT Youth: The Influence of Perceived Discrimination Based on Sexual Orientation


The authors evaluated emotional distress among 9th–12th grade students, and examined whether the association between being lesbian, gay, bisexual, and/or transgendered (i.e., “LGBT”) and emotional distress was mediated by perceptions of having been treated badly or discriminated against because others thought they were gay or lesbian. Data come from a school-based survey in Boston, Massachusetts (n = 1,032); 10% were LGBT, 58% were female, and ages ranged from 13 to 19 years. About 45% were Black, 31% were Hispanic, and 14% were White. LGBT youth scored significantly higher on the scale of depressive symptomatology. They were also more likely than heterosexual, non-transgendered youth to report suicidal ideation (30% vs. 6%, p < 0.0001) and self-harm (21% vs. 6%, p < 0.0001). Mediation analyses showed that perceived discrimination accounted for increased depressive symptomatology among LGBT males and females, and accounted for an elevated risk of self-harm and suicidal ideation among LGBT males. Perceived discrimination is a likely contributor to emotional distress among LGBT youth.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Subscribe to journal

Immediate online access to all issues from 2019. Subscription will auto renew annually.

US$ 199

This is the net price. Taxes to be calculated in checkout.

Fig. 1


  1. Austin, S. B., Roberts, A. L., Corliss, H. L., & Molnar, B. E. (2008). Sexual violence victimization history and sexual risk indicators in a community-based urban cohort of “mostly heterosexual” and heterosexual young women. American Journal of Public Health, 98(6), 1015–1020. doi:10.2105/AJPH.2006.099473.

  2. Austin, S. B., Ziyadeh, N., Fisher, L. B., Kahn, J. A., Colditz, G. A., & Frazier, A. L. (2004). Sexual orientation and tobacco use in a cohort study of US adolescent girls and boys. Archives of Pediatrics and Adolescent Medicine, 158, 317–322. doi:10.1001/archpedi.158.4.317.

  3. Avery, A., Chase, J., Johansson, L., Litvak, S., Montero, D., & Wydra, M. (2007). America’s changing attitudes toward homosexuality, civil unions, and same-gender marriage: 1977–2004. Social Work, 52(1), 71–79.

  4. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182. doi:10.1037/0022-3514.51.6.1173.

  5. Bontempo, D. E., & D’Augelli, A. R. (2002). Effects of at-school victimization and sexual orientation on lesbian, gay, or bisexual youths’ health risk behavior. The Journal of Adolescent Health, 30(5), 364–374. doi:10.1016/S1054-139X(01)00415-3.

  6. Bos, H. M., Sandfort, T. G., de Bruyn, E. H., & Hakvoort, E. M. (2008). Same-sex attraction, social relationships, psychosocial functioning, and school performance in early adolescence. Developmental Psychology, 44(1), 59–68. doi:10.1037/0012-1649.44.1.59.

  7. Bosworth, K., Espelage, D. L., & Simon, T. R. (1999). Factors associated with bullying behavior in middle school students. The Journal of Early Adolescence, 19, 341–362. doi:10.1177/0272431699019003003.

  8. Busseri, M. A., Willoughby, T., Chalmers, H., & Bogaert, A. F. (2008). On the association between sexual attraction and adolescent risk behavior involvement: Examining mediation and moderation. Developmental Psychology, 44(1), 69–80. doi:10.1037/0012-1649.44.1.69.

  9. Centers for Disease Control and Prevention. (2005). 2005 national YRBS data users manual. Atlanta, GA: CDC.

  10. Centre for Multilevel Modeling. (2008). MLwiN software, version 2.01. Bristol, United Kingdom: Author.

  11. Clements-Nolle, K., Marx, R., & Katz, M. (2006). Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization. Journal of Homosexuality, 51(3), 53–69. doi:10.1300/J082v51n03_04.

  12. Corliss, H. L., Cochran, S. D., & Mays, V. M. (2009). Sampling approaches to studying mental health concerns in the lesbian, gay, and bisexual community. In W. Meezan & J. I. Martin (Eds.), Handbook of research with gay, lesbian, bisexual, and transgender populations (pp. 131–158). New York: Routledge.

  13. D’Augelli, A. R. (2002). Mental health problems among lesbian, gay, and bisexual youths ages 14 to 21. Clinical Child Psychology and Psychiatry, 7(3), 433–456.

  14. D’Augelli, A. R., Grossman, A. H., Salter, N. P., Vasey, J. J., Starks, M. T., & Sinclair, K. O. (2005). Predicting the suicide attempts of lesbian, gay, and bisexual youth. Suicide and Life-threatening Behavior, 35, 646–660. doi:10.1521/suli.2005.35.6.646.

  15. D’Augelli, A. R., Grossman, A. H., & Starks, M. T. (2006). Childhood gender atypicality, victimization, and PTSD among lesbian, gay, and bisexual youth. Journal of Interpersonal Violence, 21(11), 1462–1482. doi:10.1177/0886260506293482.

  16. D’Augelli, A. R., Pilkington, N. W., & Hershberger, S. L. (2002). Incidence and mental health impact of sexual orientation victimization of lesbian, gay, and bisexual youths in high school. School Psychology Quarterly, 17, 148–167. doi:10.1521/scpq.

  17. Dahlberg, L. L., Toal, S. B., Swahn, M., & Behrens, C. B. (2005). Measuring violence-related attitudes, behaviors, and influences among youth: A Compendium of assessment tools. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.

  18. Di Ceglie, D., Freedman, D., McPherson, S., & Richardson, P. (2002). Children and adolescents referred to a specialist gender identity development service: Clinical features and demographic characteristics. International Journal of Transgenderism, 6(1), NP.

  19. District of Columbia Public Schools. (2007). Youth risk behavior survey sexual minority baseline fact sheet: Senior high school YRBS 2007 baseline findings for GLBQ items. Washington, DC: District of Columbia Public Schools, HIV/AIDS Education Program.

  20. Dunbar, E. (2006). Race, gender, and sexual orientation in hate crime victimization: Identity politics or identity risk? Violence and Victims, 21, 323–337. doi:10.1891/vivi.21.3.323.

  21. Faulkner, A. H., & Cranston, K. (1998). Correlates of same-sex sexual behavior in a random sample of Massachusetts high school students. American Journal of Public Health, 88(2), 262–266. doi:10.2105/AJPH.88.2.262.

  22. Fetner, T., & Kush, K. (2008). Gay-straight alliances in high schools: Social predictors of early adoption. Youth & Society, 40(1), 114–130. doi:10.1177/0044118X07308073.

  23. Friedman, M. S., Koeske, G. F., Silvestre, A. J., Korr, W. S., & Sites, E. W. (2006). The impact of gender-role nonconforming behavior, bullying, and social support on suicidality among gay male youth. The Journal of Adolescent Health, 38(5), 621–623. doi:10.1016/j.jadohealth.2005.04.014.

  24. Galliher, R. V., Rostosky, S. S., & Hughes, H. K. (2004). School belonging, self-esteem, and depressive symptoms in adolescents: An examination of sex, sexual attraction status, and urbanicity. Journal of Youth and Adolescence, 33, 235–245. doi:10.1023/B:JOYO.0000025322.11510.9d.

  25. Garofalo, R., Wolf, R. C., Wissow, L. S., Woods, E. R., & Goodman, E. (1999). Sexual orientation and risk of suicide attempts among a representative sample of youth. Archives of Pediatrics and Adolescent Medicine, 153(5), 487–493.

  26. Gibson, R. (2006). From zero to 24–7: Images of sexual minorities on television. In L. Castañeda & S. B. Campbell (Eds.), News and sexuality: Media portraits of diversity (pp. 257–278). Thousand Oaks, CA: Sage Publications.

  27. Goldstein, A. L., Walton, M. A., Cunningham, R. M., Trowbridge, M. J., & Maio, R. F. (2007). Violence and substance use as risk factors for depressive symptoms among adolescents in an urban emergency department. The Journal of Adolescent Health, 40, 276–279. doi:10.1016/j.jadohealth.2006.09.023.

  28. Goodenow, C., Szalacha, L., & Westheimer, K. (2006). School support groups, other school factors, and the safety of sexual minority adolescents. Psychology in the Schools, 43(5), 573–589. doi:10.1002/pits.20173.

  29. Grossman, A. H., & D’Augelli, A. R. (2006). Transgender youth: Invisible and vulnerable. Journal of Homosexuality, 51(1), 111–128. doi:10.1300/J082v51n01_06.

  30. Grossman, A. H., & D’Augelli, A. R. (2007). Transgender youth and life-threatening behaviors. Suicide and Life-threatening Behavior, 37(5), 527–537. doi:10.1521/suli.2007.37.5.527.

  31. Hansen, A. L. (2007). School-based support for GLBT students: A review of three levels of research. Psychology in the Schools, 44(8), 839–848. doi:10.1002/pits.20269.

  32. Hawton, K., Rodham, K., Evans, E., & Weatherall, R. (2002). Deliberate self harm in adolescents: Self report survey in schools in England. British Medical Journal, 325(7374), 1207–1211. doi:10.1136/bmj.325.7374.1207.

  33. Hawton, K., Zahl, D., & Weatherall, R. (2003). Suicide following deliberate self-harm: Long-term follow-up of patients who presented to a general hospital. The British Journal of Psychiatry, 182, 537–542. doi:10.1192/bjp.182.6.537.

  34. Hoover, R., & Fishbein, H. D. (1999). The development of prejudice and sex role stereotyping in white adolescents and white young adults. Journal of Applied Developmental Psychology, 20(3), 431–448. doi:10.1016/S0193-3973(99)00026-X.

  35. Horn, S. S. (2006). Heterosexual adolescents’ and young adults’ beliefs and attitudes about homosexuality and gay and lesbian peers. Cognitive Development, 21(4), 420–440. doi:10.1016/j.cogdev.2006.06.007.

  36. Huebner, D. M., Rebchook, G. M., & Kegeles, S. M. (2004). Experiences of harassment, discrimination, and physical violence among young gay and bisexual men. American Journal of Public Health, 94(7), 1200–1203. doi:10.2105/AJPH.94.7.1200.

  37. Kelder, S. H., Murray, N. G., Orpinas, P., Prokhorov, A., McReynolds, L., Zhang, Q., et al. (2001). Depression and substance use in minority middle-school students. American Journal of Public Health, 91, 761–766. doi:10.2105/AJPH.91.5.761.

  38. Kessler, R. C., Mickelson, K. D., & Williams, D. R. (1999). The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. Journal of Health and Social Behavior, 40(3), 208–230. doi:10.2307/2676349.

  39. Lock, J., & Steiner, H. (1999). Gay, lesbian, and bisexual youth risks for emotional, physical, and social problems: Results from a community-based survey. Journal of the American Academy of Child and Adolescent Psychiatry, 38(3), 297–304. doi:10.1097/00004583-199903000-00017.

  40. Lombardi, E. L., Wilchins, R. A., Priesing, D., & Malouf, D. (2001). Gender violence: Transgender experiences with violence and discrimination. Journal of Homosexuality, 42(1), 89–101. doi:10.1300/J082v42n01_05.

  41. Mays, V. M., & Cochran, S. D. (2001). Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health, 91(11), 1869–1876. doi:10.2105/AJPH.91.11.1869.

  42. Murdock, T. B., & Bolch, M. B. (2005). Risk and protective factors for poor school adjustment in lesbian, gay, and bisexual (LGB) high school youth: Variable and person-centered analyses. Psychology in the Schools, 42(2), 159–172. doi:10.1002/pits.20054.

  43. Poteat, V. P., & Espelage, D. L. (2005). Exploring the relation between bullying and homophobic verbal content: The homophobic content agent target (HCAT) scale. Violence and Victims, 20(5), 513–528. doi:10.1891/vivi.2005.20.5.513.

  44. Rasbash, J., Steele, F., Browne, W., & Prosser, B. (2004). A user’s guide to MLwiN version 2.0. London: London Institute of Education.

  45. Remafedi, G., French, S., Story, M., Resnick, M. D., & Blum, R. (1998). The relationship between suicide risk and sexual orientation: Results of a population-based study. American Journal of Public Health, 88(1), 57–60. doi:10.2105/AJPH.88.1.57.

  46. Remafedi, G., Resnick, M., Blum, R., & Harris, L. (1992). Demography of sexual orientation in adolescents. Pediatrics, 89(4 pt 2), 714–721.

  47. Roberts, R. E., Roberts, C. R., & Chen, Y. R. (1997). Ethnocultural differences in prevalence of adolescent depression. American Journal of Community Psychology, 25, 95–110. doi:10.1023/A:1024649925737.

  48. Robin, L., Brener, N. D., Donahue, S. F., Hack, T., Hale, K., & Goodenow, C. (2002). Associations between health risk behaviors and opposite-, same-, and both-sex sexual partners in representative samples of Vermont and Massachusetts high school students. Archives of Pediatrics and Adolescent Medicine, 156(4), 349–355.

  49. Rosario, M., Schrimshaw, E. W., Hunter, J., & Gwadz, M. (2002). Gay-related stress and emotional distress among gay, lesbian and bisexual youths: A longitudinal examination. Journal of Consulting and Clinical Psychology, 70(4), 967–975. doi:10.1037/0022-006X.70.4.967.

  50. Russell, S. T. (2002). Queer in America: Citizenship for sexual minority youth. Applied Developmental Science, 6(4), 258–263. doi:10.1207/S1532480XADS0604_13.

  51. Russell, S. T., Franz, B. T., & Driscoll, A. K. (2001). Same-sex romantic attraction and experiences of violence in adolescence. American Journal of Public Health, 91(6), 903–906. doi:10.2105/AJPH.91.6.903.

  52. Russell, S. T., & Joyner, K. (2001). Adolescent sexual orientation and suicide risk: Evidence from a national study. American Journal of Public Health, 91(8), 1276–1281. doi:10.2105/AJPH.91.8.1276.

  53. Safren, S. A., & Heimberg, R. G. (1999). Depression, hopelessness, suicidality, and related factors in sexual minority and heterosexual adolescents. Journal of Consulting and Clinical Psychology, 67(6), 859–866. doi:10.1037/0022-006X.67.6.859.

  54. SAS Institute Inc. (2008). Statistical applications software, version 9.1.3. Cary, NC: Author.

  55. Savin-Williams, R. C. (1994). Verbal and physical abuse as stressors in the lives of lesbian, gay male, and bisexual youths: Associations with school problems, running away, substance abuse, prostitution, and suicide. Journal of Consulting and Clinical Psychology, 62(2), 261–269. doi:10.1037/0022-006X.62.2.261.

  56. Savin-Williams, R. (2001). A critique of research on sexual minority youths. Journal of Adolescence, 24, 5–13. doi:10.1006/jado.2000.0369.

  57. Savin-Williams, R. C., & Ream, G. L. (2007). Prevalence and stability of sexual orientation components during adolescence and young adulthood. Archives of Sexual Behavior, 36, 385–394. doi:10.1007/s10508-006-9088-5.

  58. Silenzio, V. M., Pena, J. B., Duberstein, P. R., Cerel, J., & Knox, K. L. (2007). Sexual orientation and risk factors for suicidal ideation and suicide attempts among adolescents and young adults. American Journal of Public Health, 97, 2017–2019. doi:10.2105/AJPH.2006.095943.

  59. Sobel, M. E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. In S. Leinhardt (Ed.), Sociological methodology (pp. 290–312). Washington, DC: American Sociological Association.

  60. Szalacha, L. A. (2003). Safer sexual diversity climates: Lessons learned from an evaluation of Massachusetts safe schools program for gay and lesbian students. American Journal of Education, 110, 58–88. doi:10.1086/377673.

  61. Taywaditep, K. J. (2001). Marginalization among the marginalized: Gay men’s anti-effeminacy attitudes. Journal of Homosexuality, 42(1), 1–28. doi:10.1300/J082v42n01_01.

  62. Williams, T., Connolly, J., Pepler, D., & Craig, W. (2003). Questioning and sexual minority adolescents: High school experiences of bullying, sexual harassment and physical abuse. Canadian Journal of Community Mental Health, 22(2), 47–58.

  63. Williams, T., Connolly, J., Pepler, D., & Craig, W. (2005). Peer victimization, social support, and psychosocial adjustment of sexual minority adolescents. Journal of Youth and Adolescence, 34(5), 471–482. doi:10.1007/s10964-005-7264-x.

  64. Wyss, S. E. (2004). ‘This was my hell’: The violence experienced by gender non-conforming youth in US high schools. International Journal of Qualitative Studies in Education, 17(5), 709–730. doi:10.1080/0951839042000253676.

Download references


The Boston Youth Survey 2006 (BYS) was funded by a grant from the CDC/NCIPC (U49CE00740) to the Harvard Youth Violence Prevention Center (David Hemenway, Principal Investigator). BYS was conducted in collaboration with the City of Boston and Mayor Thomas M. Menino. The survey would not have been possible without the participation of the faculty, staff, administrators, and students of Boston Public Schools. We also acknowledge the work of Daria Fanelli, Alicia Savannah, Angela Browne, and Steven Lippmann. We appreciate the assistance of Mary Vriniotis with data collection and management. Note: The funding agency did not play a role in the design or conduct of this study, nor did they take part in the preparation of this manuscript. Individuals from the City of Boston contributed to survey development in that they made content recommendations. Both the CDC/NCIPC and the City of Boston have been notified that this manuscript is being submitted for publication.

Author information

Correspondence to Renee M. Johnson.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Almeida, J., Johnson, R.M., Corliss, H.L. et al. Emotional Distress Among LGBT Youth: The Influence of Perceived Discrimination Based on Sexual Orientation. J Youth Adolescence 38, 1001–1014 (2009) doi:10.1007/s10964-009-9397-9

Download citation


  • Emotional distress
  • LGBT
  • Self-harm
  • Suicide
  • Depression