Youth With Sexual or Gender-Diverse Identities and Military Connection: Recommendations to Optimize Clinical Care

In the United States, an estimated 1.9 million youth 13 to 17 years of age (9.5%) identify as sexual and/or gender diverse (SGD), identifying as nonheterosexual and/or having a gender identity other than the assigned sex at birth.1 Up to 7% of SGD adolescents may have at least one parent currently or previously serving in the US military, an estimated 133,000 youth nationwide.1,2 SGD adolescents are highly exposed to acute and chronic stressors, including minority stress and discrimination, resulting in elevated rates of depression, anxiety, and suicidal ideation.3,4 SGD military-connected youth (ie, SGD youth with a parent or caregiver with military service experience) were found to be at even higher risk for these negative outcomes in one published report.2 While both military connection and SGD identity may foster strengths, these youth also face well-studied stressors,2,5 and the convergence of these identities and experiences is likely to produce greater challenges. Nearly half of military-connected youth are seen by civilian clinicians in local communities for primary care, and even more are seen for specialty care.6 As a result, all clinicians, both within and outside the military health system, and especially clinicians providing mental health care, must be familiar with these unique converging stressors facing SGD military-connected youth.