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Evidence and Action to Support LGBTQI+ Youth

1. A diverse sexual orientation or gender identity...

A. are considered mental illnesses or pathological conditions.

B. can be changed with variations of conversion or reparative therapy.

C. are viewed as abnormal and unhealthy variations in human behavior.

D. are normal, natural, and healthy variations of human sexuality and gender.


2. A prominent factor positively impacting the mental health of youth with a diverse sexual orientation and/or gender identity is...

A. a favourable socio-economic status.

B. an absence of psychological distress in early childhood.

C. having at least one supportive adult in their life.

D. identifying with a specific gender or sexual orientation at an early age.


3. Accurate, culturally sensitive and client-centered therapeutic interventions for LGBTQI+ youth emphasise...

A. promoting a specific gender or sexual orientation.

B. facilitating the best possible level of psychological functioning.

C. integrating minority stress reduction techniques for all clients.

D. providing implicit advice on sexual orientation, gender identity, and gender expression.


4. Awareness and acceptance of diverse sexual orientations in society...

A. make people more likely to switch to a diverse sexual orientation.

B. increases the likelihood that individuals with diverse sexual orientations will self-identify publicly.

C. have no impact on the willingness of individuals to identify publicly with a diverse sexual orientation.

D. lessens the number of individuals with a diverse sexual orientation in the society.


5. When providing therapy to LGBTQI+ youth, it is important to...

A. encourage them to change their gender or sexual orientation.

B. identify sources of distress and work to reduce this distress.

C. ensure that they conform to typical gender stereotypes.

D. avoid discussions around sexual orientation and gender identity.


6. According to professional consensus, which of the following is deemed an inappropriate practice for children and adolescents?

A. Evidence-based medical treatments

B. SOGI change efforts

C. Gender affirming care

D. Person-centered therapeutic interventions


7. As per professional consensus, culturally sensitive care for LGBTQI+ youth should include?

A. Delivering care that reflects respect and cultural humility

B. Promoting SOGI change efforts

C. Ignoring intersectional identities of the individual

D. Disregarding the individual's specific needs and identity


8. How does lack of social and emotional support impact the health of sexual and gender minority youth?

A. No impact as social and emotional support isn't important

B. Positive impact as it can help the individual to be independent

C. Negative impact likely causing harm, including family rejection of sexual orientation and/or gender diversity

D. Neutral impact as it doesn't carry weight on an individual's health


9. What is the likely consequence of tailoring care to an individual's identity and needs when working with LGBTQI+ youth?

A. Increase in inequities

B. Increase in minority stress

C. Decrease in trust

D. Increase in the likelihood of positive outcomes


10. What is the general consensus about sexual orientation and gender identity change efforts (SOGI) with youth?

A. They are effective and beneficial practices for LGBTQI+ youth and their families

B. They can cause significant harm and are ineffective in altering sexual orientation or gender identity

C. They are beneficial in altering gender identity but not sexual orientation

D. They are beneficial in altering sexual orientation but not gender identity


11. Which of the following actions contributes to reducing psychological distress for sexual minority college students?

A. Offering academic support services specific to sexual minority students

B. Recommending religious activities

C. Promoting self-acceptance of their sexual orientation

D. Encouraging participation in extracurricular activities


12. Which is an essential practice for behavioral health providers working with gender diverse adolescents for positive identity development?

A. Pushing the client to conform to societal norms

B. Ignoring the client’s gender identity in treatment

C. Advising the client to hide their gender identity

D. Supporting an integrated self-awareness encompassing their gender identity along with cultural, racial/ethnic identities


13. The modern scientific understanding of gender diversity suggests that it is:

A. Pathological and requiring clinical attention

B. Merely a phase that individuals grow out of

C. Part of the healthy spectrum of human diversity

D. Culturally imposed and not innate


14. How does access to gender affirmation influence mental and physical health outcomes among transgender and gender-diverse people?

A. It has no significant impact on health outcomes

B. It exacerbates feelings of gender dysphoria

C. It reduces experiences of gender dysphoria and improves health outcomes

D. It leads to further confusion and mental distress


15. What is the primary cause of negative mental health outcomes among LGBTQI+ youth?

A. Their diverse sexual orientation and/or gender identity

B. Lack of self-acceptance and identity pride

C. Stress from social, academic, and family pressures

D. Exposure to stigma, discrimination, and violence resulting from their sexual orientation and/or gender identity


16. What factor is associated with negative outcomes in LGBTQI+ youth care?

A. Providing education and resources

B. Tailoring care to the individual’s identity and needs

C. Establishing a strict environment

D. Supporting exploration of gender and sexuality


17. Why are chosen families pivotal support systems for LGBTQI+ youth?

A. They offer a strong sense of acceptance and understanding

B. They enforce strict rules and boundaries

C. They discourage any exploration of gender identity and sexual orientation

D. They isolate LGBTQI+ youth from their biological families


18. Which of the following is an effective way behavioral health providers can increase acceptance of LGBTQI+ youth within their families?

A. Convince families to dismiss old beliefs and values

B. Refuse to acknowledge the impact of families' social and cultural backgrounds

C. Provide accurate information about sexual orientation and gender identity

D. Limit family involvement in the therapeutic process


19. What are some consequences of discrimination, victimization, and negative school climates on LGBTQI+ youth's mental health?

A. May lead to higher self-esteem and confidence

B. Increased likelihood of academic success

C. Associated with depressive symptoms, low self-esteem, and suicidality

D. Has no significant effect on mental health


20. Identify how religion and spirituality can influence the mental health and well-being of LGBTQI+ youth.

A. Religious views can lead to social exclusion, thereby affecting mental health

B. Religion and spirituality have no significant influence on mental health

C. Religion and spirituality consistently promote acceptance of LGBTQI+ individuals

D. Religious beliefs can streamline the interpretation of diverse sexual orientations and gender identities


21. Which of the following is a well-known harmful consequence of withholding gender-affirming care from an adolescent who needs it?

A. Increased happiness and self-esteem

B. Increased confidence

C. Exacerbation and prolongation of gender dysphoria

D. Improved social relationships


22. The support of a behavioral health provider during adolescents' gender transition can assist in multiple ways. Which of the following is NOT mentioned in the study?

A. Adjusting to their changing physical characteristics

B. Navigating responses from people in different aspects of their lives

C. Identifying care needs

D. Deciding on the right medical procedures for transition


23. LGBTQI+ youth, like all youth, could choose to seek psychological treatment. According to the study, under what circumstance might this not be necessary?

A. If they are confused about their gender identity

B. If they have supportive parents

C. If they have a high level of self-esteem

D. If there are no significant concerns


24. The study discusses increased focus on understanding factors that contribute to resilience and positive behavioral and physical health outcomes among LGBTQI+ youth. Which of the following future research opportunities is NOT suggested in this context?

A. Middle-aged experiences of individuals who identify as LGBTQI+

B. Dissemination of health-promoting interventions

C. Increased focus on the development and evaluation of health-promoting interventions

D. Better understanding of long-term medical and behavioral health outcomes associated with early experiences of family and community distress


25. Identify the incorrect statement amongst the following about U.S. Department of Health and Human Services (HHS) policy priorities aiming to improve the behavioral health of LGBTQI+ youth.

A. Policies are based on efforts to ensure LGBTQI+ civil rights

B. Policies focus on increasing access to, affordability of, and equity in health care

C. Policies include protection against discrimination based on sexual orientation and gender identity

D. HHS policy priorities solely focus on mental health issues among adult LGBTQI+ individuals


26. Why are SOGI change efforts considered harmful and ineffective?

A. They can cause significant harm and are not effective in altering sexual orientation or gender identity.

B. They provide a quick solution to problems faced by the LGBTQI+ community.

C. They are beneficial for adolescents, children, and their families.

D. They promote healthy behavioral changes in adolescents.


27. What purpose do federal, state, and local bans on SOGI change efforts serve?

A. They encourage the practice of such efforts.

B. They provide protection to minors and vulnerable adults from harmful practices, provide pathways to civil court claims, and restrict use of state and federal funds for such practices.

C. They eliminate the need for professional guidelines and regulations.

D. They ensure equal access to such efforts.


28. How can access to evidence-based care be improved for LGBTQI+ youth?

A. By banning all forms of care for LGBTQI+ youth

B. By discouraging professional training and education.

C. By preventing bans on gender-affirming care, improving access to gender-affirming care in health plan benefits across all payors, ensuring LGBTQI+ youth can access appropriate care in child welfare programs, and increasing professional training and education.

D. By limiting access to gender-affirming care and other therapeutic services


29. What can be the possible outcomes of withholding gender-affirming care from LGBTQI+ youth?

A. Reduced depression and decreased risk for suicide.

B. Improved social interaction and performance.

C. Increased levels of self-confidence and happiness.

D. Increased risk of suicidal ideation, depression, and trauma.


30. How is policy influencing the provision of care to LGBTQI+ youth?

A. By introducing and passing laws denying access to medically necessary care.

B. By enforcing regulations that discourage family counseling and support.

C. By taking steps such as issuing executive orders, introducing legislative restrictions, and implementing policies to ensure access to necessary care and discourage harmful practices.

D. By reducing the availability of family counseling and support programs in federally funded, human services, and child welfare programs.


31. Which government actions aim to improve the availability of necessary care for LGBTQI+ youth?

A. The executive order on Advancing Equality for Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Individuals issued by the Biden Administration

B. HHS provision of information on existing federal protections for LGBTQI+ youth

C. The DOJ intervention in lawsuits challenging state laws that limit access to gender-affirming care

D. The executive order on Regulating Online Markets issued by the Biden Administration


32. What was the purpose of the Proposed Rulemaking related to Section 1557 of the ACA issued by HHS in July 2022?

A. To codify protections against discrimination based on sexual orientation and gender identity

B. To deregulate gender-affirming care

C. To introduce a new healthcare system

D. To exclude mental health care from the ACA


33. What is a key priority in expanding the number of behavioral health providers for LGBTQI+ children and youth?

A. Increasing the knowledge of sports

B. Reducing the number of available services

C. Expanding the number of providers with training and expertise in LGBTQI+ care

D. Limiting the number of available services


34. In what ways can local communities contribute to the behavioral health of LGBTQI+ youth?

A. By fostering an environment of support and acceptance

B. By enacting policies that promote inequality

C. By reducing the availability of resources

D. By promoting discrimination and exclusion


35. Why is it crucial for therapeutic services for LGBTQI+ youth to respect and understand differences in culture, ethnicity, geography, race, among others?

A. To increase cost

B. To hinder communication

C. To bypass unique stressors and behavioral health inequities within the sexual- and gender-diverse community

D. To promote exclusion


36. Which among these is NOT a recommended educational policy to create a positive and healthy environment for all youth, especially those who are LGBTQI+ or have emerging sexual orientation or gender identities?

A. Limit full participation and access to school activities including athletics and resources for all students and school personnel consistent with their gender identity.

B. Establish protective policies, such as antibullying and antidiscrimination policies, that explicitly include protections for sexual orientation, gender identity, and gender expression.

C. Establish and implement supportive policies that promote acceptance of all sexual orientations and gender identities and expressions.

D. Provide high-quality, evidence-informed LGBTQI+ professional development for school staff.


37. What is the main benefit of incorporating an intersectional approach in collecting data on sexual orientation and gender identity in LGBTQI+ research?

A. It considers multiple aspects of diversity and demography, including cultural background, values, ethnicity, geography, and race.

B. It simplifies data collection by treating the LGBTQI+ population as a homogeneous group.

C. It prioritizes certain demographics over others in order to streamline the research.

D. It overlooks the diversity within the LGBTQI+ population in data collection and research.


38. In light of different stress factors that can affect behavioral health, what is NOT a recommended therapeutic approach for working with LGBTQI+ youth?

A. Supporting youth as they learn more about their sexual orientation and gender identity.

B. Efforts to change a youth’s sexual orientation, gender identity, or gender expression.

C. Helping youth navigate sexual orientation, gender identity and expression within the context of other intersecting identities.

D. Identifying sources of and working to reduce distress.


39. What can lead to the establishment of the education policies needed to provide an affirming school environment for LGBTQI+ youth?

A. Strong, research-backed advocacy at the local, state, and federal levels.

B. Adopting a laissez-faire (hands-off) approach to LGBTQI+ matters.

C. Avoiding any discussions or policies related to sexual orientation and gender identity.

D. Excluding LGBTQI+ youth from school activities or athletics.


40. Based on current research and clinical expertise, which of the following is seen to be harmful when working with transgender and gender-diverse youth?

A. Providing accurate information on sexual orientation and gender identity and expression.

B. Supporting adaptive coping.

C. Withholding timely gender-affirming medical care when indicated.

D. Helping youth navigate sexual orientation, gender identity and expression.


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