Intersecting Minority Identities in LGBT, Black and Hispanic Young Adult Service Users: Aspects of Identity and Accessing Services

Background and Purpose: Minority young adults (YAs) in the U.S. are at significantly higher risk for disengagement from mental health and supportive services. Lack of engagement in services is consistently linked to disparities in health and mental health outcomes. Strategies for engaging minority YAs in services need to include supporting positive minority identity development and mitigating the effects of discrimination. However little is known about the service use experiences of YAs with multiple marginalized identities. Very few studies have attended to service use in sexual minority YAs of color, offering scarce resources for providers to draw upon in seeking to improve service use by this population.

 This study adds to limited existing data by examining the views and experiences of YA service users with intersecting minority identities. YAs offered their own perspectives on salient aspects of collective minority identities, personal identities, and how intersecting identities differentially influenced accessing services.

Methods: Four focus groups were conducted with twenty-seven YAs who were receiving mental health, substance abuse, housing, and case management services at an agency in New York City. The young adults (ages 18-25) predominately identified as male (74% male, 19% cisgender female, 7% transgender female), Black (66% Black, 48% non-White Hispanic, 14% both Black and Hispanic), and low income (100% annual income below $12,000). All participants identified themselves as sexual minorities (19% lesbian, 70% gay, 7% bisexual, 7% transgender). Participants were recruited via flyers distributed to them by staff at the agency. Participants were asked broad, open-ended questions about personal experiences of accessing services and how people in their communities access services such as those provided by the agency. A definition of “communities” was not provided to elicit participants’ own perspectives on their collective identities. Focus groups were transcribed verbatim and coded utilizing thematic analysis, an inductive coding method. Using principles from grounded theory, meaningful analytic units were summarized into themes, patterns, concepts, and ideas that were common as well as unique in group discussions.

Findings: Analysis of the focus group data revealed three key themes: (a) intersecting collective identities vary in salience with regard to service use; (b) collective identities affirm resilience; and (c) collective identities differ from personal identities. Sexual minority identity facilitated access to services for the majority of participants. Many participants described finding out about services that were available and agencies providing services through LGBT peers. Some participants noted that when among heterosexual and cisgender majorities, racial/ethnic identity becomes more central to them than LGBT identity. Participants also described aspects of their collective identities that have fostered resilience and highlighted personal differences from their ethnic/racial or LGBT communities.

Conclusion and Implications: Findings indicate that YAs with intersecting sexual and racial/ethnic minority identities can be engaged in services that are organized around supporting their minority identity statuses, but that it will be important to assess which identity status is most salient to target for a given individual young adult. Strategies that incorporate a focus on supporting positive personal and collective identity development may promote engagement with minority YAs.