Adolescence and Suicide: Subjective Construction of the Suicidal Process in Young Gay and Lesbian Chileans

Using the Generic Model of Psychotherapy to Develop a Culturally-Sensitive Approach to Psychotherapy With Sexual and Gender Minority Patients

“…LGBT harassment, 4.9% due to mourning or separation, and 1% due to sexual violence (Tomicic et al, 2019). Another survey conducted in the same year, entitled Being a Lesbian in Chile (Ser lesbiana en Chile), indicated that 32.8% of the women surveyed had received psychological or psychiatric care specifically due to their sexual orientation (Agrupación Rompiendo el Silencio, 2019).…”

“…The studies published by Meyer (1995 , 2003) on the Minority Stress Model have made it possible to generate a large body of evidence on how permanent victimization, discrimination, and homolesbotrans negativity cause LGBT people to display poorer mental health indicators than their heterosexual and cisgender peers ( APA/Division 44, 2000 ; Meyer, 2003 ; Logie, 2012 ; Hatzenbuehler et al, 2013 ; Barrientos et al, 2014 ; Bidell and Stepleman, 2017 ). Specifically, the internalization of sexual stigma and the concealment of one’s diverse sexual identity constitute stressors that may be expressed through low self-esteem and self-loathing, causing distress around revealing one’s sexual orientation to others, self-exclusion and detachment from other LGBT individuals, a negative view of same-sex sexual activity, depression, and self-inflicted violence ( Gillis and Cogan, 2009 ; Newcomb and Mustanski, 2010 ; Pereira and Rodrigues, 2015 ; Michaels et al, 2016 ; Tomicic et al, 2016 , 2019 ; Austin and Goodman, 2017 ; Martínez et al, 2019b, Unpublished).…”

“…In addition, it has been observed that LGBT people display high prevalence of mood disorders and anxiety ( Cochran and Mays, 2000 ; Meyer et al, 2007 ; King et al, 2008 ) and problematic alcohol and drug use ( Cochran and Mays, 2006 ; King et al, 2008 ; Institute of Medicine, 2011 ; Kelly et al, 2015 ). A mental health survey aimed at LGBTI+ people conducted in Chile revealed that 64.4% of the respondents had thought about committing suicide and 24.4% had made at least one attempt; also, it showed that 22% of the GB+ men and 34% of the GB+ women surveyed had symptomatology indicative of moderate to severe depression ( Tomicic et al, 2019 ).…”

“…Also in Chile, a survey of mental health in LGBTI+ people conducted between September and October 2018 showed that 18.1% of the participants were in psychotherapy, while 64% stated that they had received psychological and/or psychotherapeutic treatment at least once. Of the 489 participants who reported having attended therapy at least once, 34.9% had consulted a professional due to mood disorders, 22.6% due to issues with their sexual orientation, and/or gender expression, 18.6% due to anxiety disorders, 12.4% due to relational problems, 8.1% due to suicidal behavior, 5.1% due to other disorders, 1.6% due to LGBT harassment, 4.9% due to mourning or separation, and 1% due to sexual violence ( Tomicic et al, 2019 ). Another survey conducted in the same year, entitled Being a Lesbian in Chile (Ser lesbiana en Chile), indicated that 32.8% of the women surveyed had received psychological or psychiatric care specifically due to their sexual orientation ( Agrupación Rompiendo el Silencio, 2019 ).…”

“…Barriers hindering LGBT people’s access to mental health and psychotherapeutic treatment are of three types: individual, related to the health care system, and associated with psychiatrists, psychologists, and psychotherapists ( McIntyre et al, 2011 ). Regarding individual barriers, some studies suggest that internalized stigma, hypervigilance, anticipation and fear of discriminatory situations, and negative expectations of psychological and psychotherapeutic care constitute major access barriers affecting LGBT people ( Avery et al, 2001 ; Tomicic et al, 2019 ). Thus, for instance, due to stigmatization, many patients decide not to reveal their sexual orientation or gender identity ( D’Augelli and Grossman, 2001 ; Calton et al, 2016 ; Rossman et al, 2017 ) or refrain from seeking professional help ( Calton et al, 2016 ; Bidell and Stepleman, 2017 ).…”