We are residents of a city of celebrations. This week, two prominent subgroups have reason to be jubilant. Our kids have another year of schooling under their belt and have earned some well-deserved vacation time. And for our LGBT population, Pride festivities are under way.

Considering this convergence, it makes sense to look at the status of lesbian, gay, bisexual, transgender and questioning or queer (LGBTQ+) youth. I think it’s important to consider where we’ve come from, where we might be going and what’s left to do. I mean, look at the changes all around you. We’ve had marriage in the U.S. for four years, and it’s increasingly common worldwide. Happy same-sex couples populate the airways in commercials for everything from mattresses to psoriasis meds. (I guess that means psoriasis has a little less heartbreak these days.)

As a professional, I’ve seen more efforts to help providers address the needs of young LGBT patients. Early in my practice career, the topic seemed to be largely off-the-radar of physicians who treat youth. Happily, things have improved where the medical community is concerned. The American Academy of Pediatrics has a section devoted entirely to the needs of LGBTQ+ youth and regularly disseminates the latest information to pediatricians. Other periodicals aimed at us have followed suit; one even has a regular column, “LGBT Consult.”

This is all well and good, but what has this meant for the younger set? We know that LGBT youth have historically suffered from school and family conflicts—and, as a result, an increased rate of problems such as substance use, homelessness and depression. So, my question: are these things any better?

By and large, the answer appears to be yes. At least one national youth survey has been done biannually since 2001. It’s found less harassment and physical violence against LGBT youth in the schools. This is true where both sexual orientation (whom one likes) and gender expression and/or identity (who one is) are concerned. 

There is some bad news: the rate of improvement appears to be slowing, and there’s even been a recent increase in verbal harassment based on gender expression.

To get some perspective from our neck of the mangroves, I spoke with Myra Stauffer, advisor of the Gay-Straight Alliance (GSA) at Key West High School. GSAs are seen in schools with increasing frequency and form a supportive community for teens of every sexual orientation and gender identity, with no requirement for a teen to even have all of that figured out yet. (They have T-shirts for sale if you’d like to support their efforts.) Stauffer agrees that we have made some strides but echoes the finding of some stalled progress as “it seems recently that bigotry has been okayed.” Nevertheless, she sees the GSA as “an important club to have” and notes that its motto, appropriately enough, is “One Human Family.”

More pediatric/adolescent providers still need to talk about sexuality with their patients. And most of us still have a lot of work to do to increase our knowledge of the spectrum of gender identity and expression. At the very minimum, we should all know whom to call if a teen needs help of any sort on this issue. 

But in this — dare I say it? — gala week, we can celebrate the strides that have been made and our resolve to improve the lot for LGBTQ+ youth. Happy Summer Vacation. And Happy Pride.

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