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.

This report presents a Landscape and Knowledge Gap Analysis which systematically maps research evidence on SGM youth in Ireland and other European countries. We examine which objectives of the LGBTI+ National Youth Strategy 2018-2020 are well supported with scientific evidence, where there are information gaps and where additional research is needed. The overall goal is to inform decision-makers on the disparities in gender and sexual minority young people that should be investigated in depth. Additional aims are:

1. To examine protective factors and positive aspects, in order to balance the predominant ‘victimising’ narrative on SGM youth.
2. Based on the synthesised evidence, provide recommendations to decision-makers and other stakeholder groups, including SGM young people’s families and friends/allies; teachers and school staff; educational, social and healthcare providers.

P.98 Substance use

Sarma (2007) reported on a mixed-methods study with lesbian, gay, bisexual, unsure orientation and transgender young people; the majority of respondents (60%) had taken drugs over the preceding 12 months, with a significant minority (8%) having done so on more than 60 occasions in that period. Lifetime prevalence of drug use was reported at: 56% for cannabis; 44% for poppers; 33% for ecstasy, and 32% for cocaine. In comparison with two other national-level surveys, SGM respondents in this study were more likely to engage in multiple substance use. During the qualitative part of the study, various short-term negative consequences of drug use were raised (i.e. unprotected sex, sexual assault while incapacitated, and underperforming at or missing from work).

Although alcohol use was not studied, many participants asserted its frequent use by SGM individuals. In a large-sample mixed-methods study with both younger and older LGBTI+ individuals (Mayock et al., 2009), more than 40% of the respondents reported that their alcohol consumption made them ‘feel bad or guilty’, and more than 60% felt they should reduce their alcohol intake. Standardised measures of alcohol consumption suggested that a significant minority of the respondents exceeded the thresholds of problematic or hazardous drinking. The qualitative findings illustrated that regular or heavy drinking was associated with distress and used as a way of coping or self-medication.