Healthy Relationships: Information for Health Care Providers

Healthy Relationships: Information for health care providers working with LGBTQ+ adolescents and young adults. 
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Providers should ask all patients about both pleasure and harm in friendships, partnerships, and family relationships, without making assumptions about the number of partners they have or the gender of those partners.
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Young people who are perceived to be LGBTQ+ by family and peers (whether they are or not) are more likely to experience victimization in their relationships (1). It's important to ask all patients about both joy/pleasure and harm/abuse in their relationships, without making assumptions. People of all genders experience abuse or are abusive to others, therefore we cannot assume that patients who present as masculine are not experiencing abuse.  While it's important to ask about violence from sexual or romantic partners, it's just as important to ask about familial and peer relationships due to high rates of anti-LGBTQ abuse (2, 3).
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Asking about relationships in gender-neutral language ("are you dating or having sex with anyone?" rather than "do you have a girlfriend?") will be more inviting for youth to talk about their relationships honestly. Similarly, do not assume that patients are monogamous when asking about their relationships. 
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Questions that will help initiate conversation about healthy relationships include: 

• Do you have friends or partners who support you? 
• Do your relationships make you feel good? In what ways? 
• How are things at home, do you feel safe and supported? 
• Does anyone in your family or at school/work hurt you physically or emotionally? 
• Is sex consensual? Do you ever feel pressured to have sex? Have you ever traded sex for food, money, or a place to stay?
  

Sources: 

1. 2017 CDC Youth Risk Behavior Survey (cdc.gov/healthyyouth/data/yrbs/index.htm)
2. 2017 GLSEN School Climate Survey (glsen.org/research/school-climate-survey)
3. Edwards KM, Sylaska KM, Neal AM. Intimate partner violence among sexual minority populations: A critical review of the literature and agenda for future research. Psychology of Violence. 2015;5(2):112-121.

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