Environments that are Supportive of LGBTQ+ Youth Mental Health: A Conversation with Advocates
June 21, 2022

A headshot of Gabrielle Smith


Gabrielle Beck (she/her) of AMCHP’s Youth Voice Amplified Committee recently sat down with advocates Damien Lopez (He/They) and Jahmila Smith (she/her) from Garden State Equality, the largest LGBTQ+ advocacy organization in New Jersey. They discuss how MCH professionals can support LGBTQ+ adolescent and young adult mental health and how to cultivate inclusive spaces.



A headshot of Damien Lopez


A published Queer author, Damien Lopez is a proud transgender man with hopes to shift the conversation of trans identities represented in children’s books and other mediums. His story has been recognized by First Lady Tammy Murphy of New Jersey, the 2021 dotCOMM Platinum Awards, El Vocero de Puerto Rico, and ThemsHealth 2021 Children’s Book Recommendation List.



A headshot of Jahmila Smith


Jahmila Smith is a proud Bronx native with over four years of experience working with diverse groups and populations. She has worked with Phipps Neighborhoods, in The Bronx, where she was a student advocate, and then became Program Coordinator, where she focused on the daily activities and functioning of one of their after school programs. She went on to work at Graham Windham, working and coaching young people to age 26. She is passionate about mental health and wellness, women empowerment, social emotional learning, literacy, nutrition, and community activism.


Gabrielle: Let’s start talking about your experiences as advocates, expanding LGBTQ+ resources and representation, as well as cultivating supportive educational environments.


Damien: Whenever I receive this question, I get excited because working specifically in my position at Garden State Equality I get to lead initiatives in education. I go into schools and conduct trainings for teachers, administrators, students, staff, non-teaching personnel, and social workers and have a direct foothold in cultivating inclusive spaces for LGBTQ+ youth. When I am conducting trainings for teachers, it’s amazing to see the teachers who are eager to learn about terminology, language, and how to better support students. In addition, I spread resources and educate youth about LGBTQ+ rights, especially because many students don’t know what their rights are or the curriculum implemented in New Jersey. For example, I was at a Student Wellness Fair and I brought binders to offer to students if they experience gender dysphoria. I’ve seen a few youth that have cried because this was the first binder they’ve ever had and some of their parents don’t support them or they have not found support in school. It’s humbling to see LGBTQ+ youth break out of their shell, knowing that they are being seen, their voices are being heard, and knowing that they have someone, particularly an organization like Garden State Equality, fighting for them. I also recently did a training in my hometown and I was talking to the students and parents and explained that I grew up around the corner. All the kids were so surprised because their perception of having someone who’s from an urban community, a person of color, who experiences queerness does comfort them. It reminds them that they are not isolated and alone. It’s been fulfilling to work on expanding these resources and providing representation for LGBTQ+ youth because they definitely need it.


Jahmila: Like Damien, the work I do at Garden State Equality is centered around management of programs and providing training to educators, health care providers, older adults facilities, law enforcement, and people in the judicial system. Our trainings are geared towards LGBTQ+ competency, aiming to get people familiar and comfortable with language and terminology. For example, our programs with school systems are focused on providing teachers and staff with resources to support LGBTQ+ students, as well as understanding the nuances of working with LGBTQ+ youth. For healthcare trainings, we provide medical professionals with information on barriers to care, healthcare disparities for LGBTQ+ individuals, and best practices to ensure their clients feel heard and respected. I also manage the older adult facilities to ensure that LGBTQ+ individuals at long term facilities have resources, rights, and protections.


Gabrielle: What should MCH professionals know as they strategize on how best to transform systems of mental health care for young LGBTQ+ individuals?


Jahmila: More LGBTQ+ competency trainings for MCH professionals is essential to reform systems of mental health care for LGBTQ+ youth. I’ve noticed that there is a broad spectrum of public health professionals that are very aware of LGBTQ+ identities, language, and best practices for supporting queer youth. Conversely, there’s a large population of professionals who are not familiar with terminology at all. I recommend consistent trainings throughout the year because you need refreshers and stages of training beginning with basic information, and then diving deeper to develop a more complex understanding. It is also important because identities and language used by LGBTQ+ communities are constantly evolving. Ultimately, educating MCH professionals is crucial to narrow gaps in knowledge and better support LGBTQ+ youth. This is especially important now as public health professionals notice the uptick in youth mental health needs, specifically LGBTQ+ adolescents, during the COVID-19 pandemic. Additionally, it is vital to examine ways to be more inclusive in healthcare forms, particularly intake forms. Intake forms are crucial for initial information gathering and understanding the patient. Inclusive data collecting tools should include sexual orientation, current gender identity, sex assigned at birth, chosen name, and gender pronouns. It is important when asking questions about sexual orientation and gender identity to leave a blank space for patients to input their own identifying information. It is also crucial not place LGBTQ+ individuals in an “Other” category, as this can cause further alienation.


Damien: I focus on growing healthcare resources and support for those who are gender non-conforming in the LGBTQ+ community. Garden State Equality is designing an online forum where people would be able to pinpoint LGBTQ+ friendly healthcare facilities without feeling scared to go into the healthcare system because, unfortunately, a majority of LGBTQ+ Americans are scared to go into the hospitals and get necessary care. Like Jahmila stated, creating an inclusive space is more than just the safe space stickers that cover the walls. Cultivating a safe environment starts with forms. It’s essential that intake forms include legal name, chosen name, gender assigned at birth, pronouns— effectively shifting the language used when constructing forms. For example, not all people who bear children are particularly feminine or female presenting. With more accurate and comprehensive information, medical professionals can better understand their patient and provide gender-affirming care. By educating medical professionals on language and cultivating safe spaces, more queer people would be willing to receive necessary care. I have heard a lot of other stories of queer folks who are scared to go and get help within the healthcare system, myself included, because of discrimination, mistrust, and negative past experiences. There is a long way to go, but with trainings, redesigning intake forms, and incorporating more compassionate care, there is hope for change.


Gabrielle: What are some strategies that MCH professionals might consider when looking to create clinical, school, and community environments that are supportive of the mental health of LGBTQ+ individuals?


Damien: For LGBTQ+ folks, and their intersecting identities, it’s really important that we acknowledge that a majority of LGBTQ+ individuals, particularly youth, do face a lot of mental health crises and are at higher risk of depression and anxiety. At trainings, I always say you can’t be an ally without understanding the disadvantages or the trauma that these communities face or have faced in the past because if you don’t comprehend it, how can you support them? As an MCH professional, you have to take an alternate path to understand and identify why LGBTQ+ individuals have trauma. It’s incredibly important to create a more inclusive environment that is open to conversation and is understanding of what the disadvantages are, whether that be in school, healthcare, or at home. Listening is such a crucial element of being an active ally. It’s vital to push personal beliefs aside and be open to hearing someone self-identifying, and then mirroring that language to respect their identity. Also, it’s crucial to provide necessary resources like binders or obtaining a letter of approval for gender-affirming care, especially since some LGBTQ+ individuals may be enduring financial hardship or experiencing homelessness— in fact, 40% of homeless youth identify as LGBTQ+. There could be more improvements for LGBTQ+ individuals’ well-being if we eliminate information barriers, so LGBTQ+ communities are aware of all the resources available. For example, in New Jersey there is a gender-affirming healthcare center specifically for low-income individuals, with a built-in pharmacy that sets sliding scale fees and has mental behavioral health aid, but not many people in need know about this center. It’s crucial to promote resources and keep people informed about where they can find gender-affirming healthcare systems. It is also important to alter policies to ensure that mental health professionals, health care workers, know the law, implement it, and abide by it. It’s not just the rights, but it’s also about access. Marginalized groups have experienced this for years. Without expanding access, rights are merely empty words wielded by politicians.


Jahmila: MCH professionals can foster a mental health care system that is more inclusive of LGBTQ+ folks and their intersecting identities by creating a needs assessment to identify key health issues through systematic, comprehensive data collection and analysis. Before MCH professionals begin to serve a community, it’s essential to understand the needs of the individuals and speak directly to community stakeholders— examining disparities, the desires of the community, gaps in knowledge, and maybe issues current professionals aren’t aware of.


Gabrielle: How can state public health agencies support and partner with local-level grassroots organizations like Garden State Equality in their efforts?


Jahmila: Networking opportunities between local-level grassroots organizations and public health agencies is really important because there are many people doing great work for LGBTQ+ equality. The more that people know about what organizations like Garden State Equality are doing, the better those organizations are able to strategize and launch ideas. Some of the barriers for non-profits are small networks, and also not knowing the right people or the right connections to get initiatives funded and off the ground. By creating partnerships and a networking database, nonprofits can form connections that open the doors for more collaboration across organizations that can then strengthen impact for LGBTQ+ advocacy work.


Damien: To echo Jahmila, public health agencies can help local-level grassroots organizations by developing partnerships and collaborating on joint initiatives. Agencies can help smaller nonprofits spread the word about their services by telling people in need that organizations, like Garden State Equality, are here to cater to them, support them, advocate for them, and fight for their rights.


For more information about Garden State Equality, visit: https://www.gardenstateequality.org/





This work is funded by the Maternal and Child Health Bureau, Health Services and Resources Administration, USDHHS (cooperative agreement U45MC27709). The content of this blog are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government.