Youth of color perceptions of sexual orientation and gender identity discrimination in mental healthcare settings

Through interviews with youth of color, we explored how sexual orientation or gender identity (SOGI) discrimination affected the youth’s experiences with mental healthcare. Youth were recruited between November 2021 and April 2022 in a public safety net hospital during a psychiatric emergency services (PES) visit. Data were collected from audio-recorded interviews with six youth and observations of their interactions with clinicians. Inductive coding was used to identify themes. Participants self-identified as: Latinx (4), Black (1), or Asian (1); sexual orientations as bisexual (2), pansexual (1), asexual (2), or gay (1); and gender identities as cisgender (3), nonbinary (2), or transgender (1). Participants described past bullying, hidden identities, uncertain expectations of support, and mitigating harm in community and healthcare spaces. Youth who publicly expressed their SOGI were victims of discrimination in healthcare settings. Opening up to clinicians to express SOGI and mental health needs was taxing, inhibiting engagement with new providers. Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth of color experienced SOGI-related discrimination early in their adolescence. Previous experiences of stigma and rejection hindered LGBTQ+ youth of color’s trust of clinicians and created challenges during their mental health treatment.