Clinical Implications for Helping Professionals Learned from the Pastoral Care of LGBTQ+ Youth

Abstract

This qualitative article is informed by queer theory, and more specifically queer theology, and explores how youth ministers in various denominations care for LGBTQ+ teenagers in their congregations. Seven youth pastors from three major denominational groups were interviewed from the Cooperative Baptist Fellowship (CBF), Alliance of Baptists, and Presbyterian Church, USA (PC-USA). Participants had to identify as LGBTQ+ affirming, though their congregations could be in various states of affirmation. Thematic analysis found the following significant categories: confidentiality, implications of whole church engagement, student-led engagement, theology/image of God, and degree of support for identity development.

1. Introduction

It has long been known that LGBTQ+ teenagers suffer from increased mental and behavioral health difficulties (Brent and Birmaher 2002; Brent 1993; Garofalo et al. 1998; Goldstein and Brent 2009; Marshal et al. 2011). In the recent socio-political climate, the picture becomes starker (HRC 2023). The 2022 National Survey on LGBTQ+ Mental Health showed that 45% of LGBTQ+ youth have contemplated suicide in the last year and 60% were unable to access mental health when it was needed. More than half of trans and non-binary youth have contemplated suicide and 1 in 3 cisgender youth. When race and ethnicity are factored in, the results become increasingly alarming. In 2021, 21% of Native and Indigenous teens surveyed reported they had contemplated suicide, 12% of white teens, 20% of Middle Eastern/North African teens, 19% of Black teens, 17% of multiracial youth, 16% of Latinx youth, and 12% of Asian and Pacific Islander youth (The Trevor Project 2022). A crisis has emerged. Scholars have long since attributed the disproportionate effects of mental and behavioral health on LGBTQ+ people are due to a concept known as minority stress (Meyer 2003). Marshal et al. (2011), write, “Minority stress theory suggests that disparities between sexual minority and heterosexual youth can be attributed in part to stigma, discrimination, and victimization experiences that are a result of a homophobic and violent culture” (p. 16).

It can be postulated that religion plays a role in the stigma, discrimination, and victimization that minority stress notes drive poor mental health outcomes. Gibbs and Goldbach (2015) have written, “LGBT young adults who mature in religious contexts have higher odds of suicidal thoughts, and more specifically chronic suicidal thoughts, as well as suicide attempt compared to other LGBT young adults (p. 472).” There is some distinct connection between religious oppression and LGBTQ+ mental health. Several qualitative studies with young adults, however, have found religion, particularly in Christian contexts, serves as both a protective and risk factor for LGBTQ+ youth (Levy and Reeves 2011; Love et al. 2005; Rosenkrantz et al. 2016). Identity development has been shown to be a major factor in the reconciliation of LGBTQ+ young people’s gender and sexual identity and faith perspective (Rosenkrantz et al. 2016). Participation in a congregation can lead to strong faith and identity development, or it can complicate this important task for LGBTQ+ young people.

The political climate of the last several years has also proved to be volatile for LGBTQ+ youth. Florida’s HB-1557 or “Don’t Say Gay Bill,” is chief among them (Encarnacion 2022). The unprecedented divide in our political climate has led to numerous bills in states across the union criminalizing trans healthcare and legislating what conversations can be had in schools (Mazzei 2022). It seems possible that having an affirming youth pastor might be even more important to curb the effects of minority stress in today’s climate. This study will explore what youth pastors who identify as affirming are doing with their parishioners to make them feel loved and accepted. The practices they are employing will then be analyzed through the lens of queer theory and sexual minority stress theory to build interventions that could potentially be used by social workers and other helping professionals.

2. Theoretical Framework

Queer theory’s beginnings are often traced to philosopher Michel Foucault in the 1970s and began to be popularized more by Judith Butler in the 1980s and 1990s. Foucault and Butler writings have since inspired other scholars from across disciplines to examine how power structures harm queer people. Butler’s contributions (Butler 1989) include important ideas like the dissolution of binary systems. Dissolution of binary systems includes the dismantling of the idea that all humans are either male and female or gay and straight, but rather that a spectrum of identities exist in sexuality and gender. Butler (1989) also popularized the idea of gender as performance, in that gender is a metaphorical costume put on by people in society; gender is ultimately a social construct consisting of norms established by various societies.

Foucault (1990) is well known for his volumes on the history of sexuality. An idea that runs throughout Foucault’s work is the concept of discourse. Foucault believed that the content of speech is not always the most important aspect, but rather how words are used or controlled. In his theory, discussion of sex is not something that has been repressed by those in power, but instead a topic that has been controlled and discourse has been kept in appropriate context by those in power. Three main tenets of queer theory can be seen then in Butler and Foucault’s work. These include the dismantling of binary systems, dismantling of hierarchical systems, and last, disrupting power for the purpose of dismantling those systems. The data in this study were analyzed with these three tenets in mind.

Illan Meyer’s sexual minority stress theory also plays a role in the interpretation of data in this study. While the disproportionate mental health outcomes of queer people are well known in scholarly circles, Meyer argues that they have traditionally been used to pathologize queer people as diseased which is to say, the idea that queer people have mental health struggles because they are queer. Meyer (2003), instead, points the reason toward the stress, stigma, and violence that society threatens LGBTQ+ persons with. As a response to this violence and stigma, queer people are then affected by manifesting symptomology of mental health disorders. Data analysis will pay careful consideration to the way participants describe the mental health needs of LGBTQ+ youth as well as any attribution given to the reason behind these concerns, particularly because of the widespread stigmatization and violence that Meyer cites.

3. Methodology

Coburn and McGeorge (2019) offer a blending of a phenomenological approach with queer theory. Traditional phenomenology, which seeks to describe an individual’s lived experience, honors individual people as experts of their own stories (Creswell and Poth 2016). In this approach, the description of the participant’s life experience turns into the product of the research. Phenomenology also seeks to hold the participants as experts in their own narrative, the stories and lived experiences shared by study participants becomes the data studied (Dahl and Boss 2005). A queer-informed phenomenology centers the experience of queer people and considers how heteronormativity, i.e., the notion of heterosexual orientation being the norm, may influence the perception and/or lived experience of both the participants and the researchers who are analyzing the data (Coburn and McGeorge 2019). Honoring the perspective of the individual participants is still vital in this approach. In analyzing the data, the researcher will take notice of ways heteronormativity might affect the narrative presented. Although Judith Butler and Michel Foucault (Butler 1989, 1993; Foucault 1990) critique phenomenology for its tendency to universalize experience and obscure the operations of power, this study employs a phenomenological design to foreground the lived experiences of queer individuals as they negotiate embodiment and identity, particularly in religious contexts. In doing so, the research acknowledges these critiques while reinterpreting phenomenology as a method capable of illuminating how subjectivity is both constituted and contested within normative structures.

This study is a queer-informed phenomenology to determine what practices are used by youth pastors in the affirmation of LGBTQ+ youth that could aid social workers and other helping professionals. Often times, in the literature, the knowledge of therapists and other clinicians is used to help pastoral care providers. However, this study does the opposite, looking at lived experiences of those providing pastoral care to LGBTQ youth and sharing their expertise with social workers and other helping professionals. The study uses a snowball sample of youth pastors serving primarily in Cooperative Baptist Fellowship (CBF), with one in the Presbyterian Church (USA).

3.1. Participant Recruitment Description

Subjects were recruited through professional connections of the researcher and networks established by the denominations included in the study. Inclusion criteria included any youth pastor employed in congregations in the selected denominations who has at least 1 year of service in that congregation. The sample was limited to youth pastors who are affirming of LGBTQ+ youth, though their church does not have to have an official affirming stance. This criterion awas determined to navigate how an affirming minister, regardless of context might support and encourage LGBTQ youth. Initially, the sample was limited to youth pastors who have completed an advanced theological degree (MDiv, MTS, MACE, etc.) to determine what gaps exist in seminary training in working with LGBTQ+ individuals. Through the process of recruitment, it was noted for some mainline denominations, it is not the norm for youth pastors to be theologically educated, so this requirement was lifted.

There were seven participants in the study. This included five females and seven males. All participants were white. Six of the participants are currently in a Baptist context, either affiliated with the Cooperative Baptist Fellowship or the Alliance of Baptists, the exact breakdown is excluded to protect anonymity. There is one pastor who works in a Presbyterian church. The pastors were all living in the United States. The sample was geographically diverse and consisted of participants pastoring churches in three different states currently, with two other states added at various points of the pastor’s ministry experience. The sample was built from denominational networks and recommendations of participants and other contacts. The geographic diversity as well as the sheer size of the denominations represented ensure anonymity as any identifying information was excluded from transcription and the article. The lack of racial and ethnic diversity will be addressed in the limitation section, and it can be noted here that since the participants were recruited from denominations that are historically overwhelming white, this effected the racial and ethnic diversity of the sample significantly.

3.2. Data Collection and Interview Protocol

Participants were directly asked their sexual orientation with five options given including bisexual, gay/lesbian, heterosexual, prefer not to answer, and prefer to self-describe their answer, to which they were provided a text box to do so. For analysis of this variable, a LGB category was created by combining the bisexual and gay/lesbian responses. From the gender variable which provided five options including male, female, nonbinary/gender fluid, prefer not to answer, and prefer to self-describe, a transgender/gender non-conforming variable was created from the participants that chose nonbinary/gender fluid as well as two of the self-description responses, where participants identified as a “trans male” and as “genderqueer.”

The interviews were conducted via Zoom and recorded using Zoom software version 6.6.2. Trint was utilized for transcription, and the accuracy of the transcriptions was checked by the researcher. Interviews ranged from thirty minutes to just over an hour. Each participant was interviewed individually.

4. Analysis

Thematic analysis according to Braun and Clarke (2008) is “a method for identifying, analyzing, and reporting patterns (themes) within the data set in (rich) detail” (p. 79). The analysis was conducted by identifying major themes and placing those themes into categories that are indicative of the response of the participants. According Braun and Clarke (2008), categories are broader ideas used to group the smaller ideas (themes) determined from each individual interview. These categories were then used to draw meaning from the interview. The approach was phenomenological. In phenomenology, researchers examine a social phenomenon, and participants inform the phenomenon by highlighting key aspects of it (Creswell and Poth 2016).

The researcher immersed himself in the data reading each interview over three times seeking to identify major themes in each transcript. A line-by-line analysis was completed with comments made on significant findings as the interviews are read. Special attention was given to themes that focus on the research questions. A process on in vivo coding was used, where researchers use whole phrases and sentences, quoting the participants’ words, rather than isolating key words or phrases (Gandy et al. 2023). This process allows the researcher to eliminate distance from the words spoken by the participants and to more fully immerse themselves into the data (Gandy et al. 2023). Chilisa (2012) encourages coders to examine their own positionality and social location in the analysis of the data. The researchers used self-reflection to determine how their own positionality affected the coding process. After self-reflection, the researchers wrote statements of reflexivity in the form of a memo and adjusted the codes as necessary based on this self-reflection (Coburn and McGeorge 2019). At the half-way point after coding four interviews and again at the end, the researcher wrote a reflection, answering three questions:

• How do the codes adhere or not adhere to binary categories?
• How do the codes perpetuate and support dominant power structures, or how do they seek to dismantle them?
• How might this work, these codes, these words said by interviewees, to disrupt dominant structures?

Based on the answers to these questions and discussion over the written reflections with the second independent coder, language given to codes was alerted to uphold the values of a queer theoretical framework.

For intercoder reliability, a second independent coder also followed the procedure outlined above. Throughout the coding process, the researcher and the coder wrote two reflexive positionality statements as outlined above. The statements were shared with each other and examined considering queer theoretical frameworks looking for ways the codes might perpetuate heteronormativity, binary categories, or oppressive ways of thinking.

5. Findings

Several major codes emerged from the data that will be explored below. They included confidentiality, degree support for identity formation, image of God and/or theology, implications of whole church engagement, overnight trips and logistics, role models examples, and youth leading engagement. Each theme tied well back into the literature and provided further insight into how best to care for LGBTQ+ youth.

5.1. Degree of Support for Identity Formation

Participants in the study found that supporting young people as they establish their own identity is a normal part of youth ministry. This is important for any student, including LGBTQ+ teenagers. An easy way to support LGBTQ+ students as they explore their identities is shifting language. Participant 1 said even though she is not perfect when it comes to using inclusive language, she works hard to correct herself. She noted, “I talk about people, significant others not a boyfriend or girlfriend. Just as a signal…. just to be make sure they know.” Participant 2 also mentioned she works hard to use non-binary language, even in her own home with her young son, but certainly in front of her youth group. She said, “I really watch how I use gendered language. About kids, about their experiences. Like, okay, so this is just a small example, but like my own kid, right? When I talk about his future partner, I intentionally say partner, I do not say future girlfriend or your wife.” This translates to her youth group, as her young son likes to paint his nails. Her husband, who volunteers with the youth group will also paint his nails with their child, which is an example to the youth group that painting your nails is not a gendered activity.

Part of this support for identity formation is a blanket support for students telling them often that they are loved and accepted. Participant 3 works with volunteers to send the message to students that, “they are loved. It’s a safe place and anything they need to talk about, they can do it. And so I think that that’s been communicated well, like I said, even whenever it had to be a little more in code.” Participant 3 has been in his church for over 20 years and the last part of the quote refers to before the congregation was openly affirming of LGBTQ+ persons. Participant 6 noted that she lets students know as they come out that, “I love you. We at this church love you. Nothing. Nothing can change that. And we love who you are and who you believe to be at any moment.” A simple way that participant 5 supports student identities is by, “affirm[ing] students through what they will post on social media. [For example,] on National Coming Out Day if someone posts something I always try to like it and, send them a DM, like just saying I love them and care about them.”

Identity is also not a fixed concept. Youth pastors worked to help students as identity shifts and changes. Participant 5 does this by shifting from considering being straight as a default. She said, “I’ve heard from students that something that is not helpful is assuming, you know, I think we just go to the place of assuming that a student is straight unless we’re told otherwise.” She goes on to say that this assumption can hurt students, so being open and not making assumptions is key to students feeling welcome. Participant 6 spoke about this happening where a student who had previously identified as a cisgender lesbian, one day while sharing pronouns during a group introduction, announced they used they/them pronouns. By asking pronouns in the introduction, the student’s nonbinary identity was able to be affirmed.

5.2. Confidentiality

Confidentiality is a key component of early education in social work, counseling, and other helping professions. Confidentiality is especially important when working with young people, as parents often play a role in treatment. This can also be true in spiritual care, when pastors are providing care for young people in churches, inevitably questions will arise as to when to break confidentiality and when to keep information given by youth between them and the pastor with whom they have shared. The concern is ever present with any teenager as they explore and develop self-awareness and identity. LGBTQ+ youth experience the need for confidentiality as paramount to their well-being. It seemed that the youth pastors in this study understood that well. Participant 2 noted that she makes sure to ask the student if they have told their parent early in the conversation. She said she “would want to know how much the student already told their parents because, it would need to be at their pace.” However, she also noted that she sets up the expectation and limits of confidentiality upfront in her work with the teenagers at her church. Participant 2 said she tells kids, “Unless you’re going to hurt yourself, hurt somebody else, or do something illegal, I’m not a snitch.” Other participants echoed this sentiment concerning confidentiality. Participant 4 explains confidentiality to congregants in this way, “I tell people of all ages, as long as I don’t think you’re going to harm yourself or someone else, I will keep your confidence. And that includes everything.” Participant 3 noted that he views confidentiality as, “I’m not talking about kids’ personal lives behind their backs.” In other words, he holds in confidence and honors what has been told to him. Participant 5 spoke about a culture of confidentiality that she developed in her youth ministry as a whole. She said, “confidentiality plays a huge part in this. My rule of thumb is if you’re doing something that’s harming yourself or like hurting other people or if you’re doing something illegal, I will tell your parent. But other than that, I really like to try and keep things confidential. And so, I do think that opens up a lot of doors… They could tell me a myriad of things, not just something about their sexuality. But I would hold that close and respect their journey and their privacy in that journey.” Participant 7 stated that she tells each student before she feels like they may be about to share sensitive information, “before you say any more, you have to know if you say anything to me about you hurting yourself or someone else being hurt by an adult, I am a mandated reporter by the state, and I do not have an option.”

5.3. Questions from Parents

One challenge to confidentiality includes when parents come to youth pastors and directly ask questions. As participant 2 mentioned above, asking students what their parents do and do not know is key to maintaining confidentiality. Participant 5 noted that when parents ask her about what students tell her about their sexuality, gender identity, or anything else that is confidential she, “errs on the side of acting like I didn’t know. Just because, I really do try and respect that confidentiality.” Participant 6 spoke about his time working in a rural congregation before his current role. He noted that confidential information was hard to navigate as oftentimes rumors and information traveled quickly around the town, but if parents asked confidential information about a student, he always erred on the side of caution. He said he “wouldn’t give out confidential information about a student. You know, really for any reason.” He particularly spoke about being an affirming youth pastor in a non-affirming church when one particular youth had come out openly and was attending an overnight trip. He said that in this case, he openly spoke up for the student saying, “they’ve come out as a lesbian. They’re not, they’re not a predator.” Participant 3 said he does not promise confidentiality and has an open rule that if something is shared with him, he may share it with parents. Though, since his church has become openly affirming that there is little need to “come out” publicly as being LGBTQ+ seems to be widely accepted in his group.

5.4. Suicidality

A topic of conversation in confidentiality is counseling and social work education is often suicidality. LGBTQ+ youth are at increased risk for suicidal ideation and for completing suicide and religious environments can increase suicide risk. Participant 7 spoke of her time in college ministry at a conservative university and a student coming out to her and expressing suicidal ideation. She said that the student was “terrified because that school had a policy that if a student came out to a staff member, the staff member had to report that, and the student had to attend counseling. I’m very proud to say that I never reported a student for [coming out].” She went on to say that these exact situations led to students expressing suicidal ideation and she was often, “trying to make sure they weren’t going to hurt themselves.” In one situation during an overnight trip when a student expressed suicidal thoughts, she, “ended up spending the night with, like this [student], this 19-year-old kid, spent the entire night sleeping with his face in my lap in my hotel room so that I could make sure that he was safe.” In this situation, even when breaking confidentiality, doing so could further harm the student as they would be punished for their sexuality, which, in turn, would increase their risk for suicidality.

Other participants noted that suicide is a major concern for them in their youth groups and certainly warrants a break in confidentiality, but it is, indeed, a delicate thing to manage when the ideation may be caused by dissonance between sexual orientation and/or identity and religious affiliation. Participant 4 noted that, in one church she served, there had been a suicide occur just before she was called. Though she never confirmed that the student’s suicide was related to their sexual orientation, she had reason to believe that the student “had struggled with their identity and did not have access to affirmation.” She said this incident caused increased anxiety in the youth group and that she was careful to talk openly and honestly with students about their feelings which created a safe space to explore what was happening.

Participant 5 had two students who attempted suicide early on in her ministry at her current church. She said,

“This is a matter of life and death for teenagers. I have had two children in my time as youth minister try to commit suicide. I think both of those kids struggled with sexual identity. And I can’t ignore that, and, it’s not worth it. I’d much rather have someone [angry] at me for 40 years because I asked them not to say those [non-affirming] things [in Sunday school] and not to teach anymore, then have one student die.”

For her, confidentiality and the ability to manage the nuances it brings was and is a matter of life and death, and affirmation of youth can lead to increasing safety and belonging, which, in turn, mitigates suicide risk.

5.5. Overnight Trips and Logistics

A practical concern for youth pastors in the study was how to handle overnight trips and logistics when traditional binary categories would usually be used, such as boys and girls rooms and/or spaces. For example, Participant 1 noted she has concerns about taking her youth group to a popular denominational camp because she has been unable to discern what lodging arrangements might be. She expressed that she “won’t [go to camp] unless there’s access to a bathroom that has a lock on the door. That’s one of my lines in the sand. We will accommodate our group because that’s nonsense. Every kid needs that safety. Nor do I want to single out my one kid.” In other words, she is unwilling to isolate a student who identifies as transgender to a single room as it will separate them from their peers. She has also made inclusive rules such as, “I just [chose] blanket safety then. Everyone is safe. So…no one takes their shirts off. Because why does half of them get to and the other half don’t? What do I do about the trans boy that’s in the boy’s room that doesn’t need to have that exposure?” These blanket rules worked for her group. Participant 7 noted when she began to take overnight trips early on her last church call, she, “did not have a whole lot of questions from the congregation. I was really open with the parents and the deacons, who were on my youth council, about the fact that I just let the kids pick for themselves.” On one trip she called the students together and asked them all (a small group) what they would be most comfortable with as far as sleeping arrangements. In picking room assignments, she, “looked at four of them and said, I don’t care who sleeps in what room. As long as everyone is okay with who they’re sharing a room with, and my four kids decided to, all four sleep in the same room because they wanted to have fun together. I said, that’s fine.” Participant 5 shared that she has had to challenge “how things have always been done” and think outside the box when preparing for overnight situations. On one trip she, “had four girls in a room playing cards, and there was one boy in there who is not like out to his family but is out to his friends and not he’s not out to me yet.” The students challenged her rule, and this forced her to reconsider the standard rules. She acknowledged that these logistics are complicated and hard to navigate, but “not many people have answers to what how to like, what to do in this scenario.”

5.6. Theology

Churches are places where people come to connect with others and in doing so, to connect with God. Theology, literally the “study of God,” is a natural thing for churches to engage with. This is no less true for youth groups navigating LGBTQ+ issues. Framing theological issues often come with creating a space where students can ask questions. Some of the theological conversation in youth groups is seen in how youth pastors have set up the ethos and culture of the group. For example, participant 2 tries to set up an environment where her teenagers know that “the right thing to do was include anybody and everybody in the family of God.” This is not simply a statement; it is a theological statement. Some students question the legitimacy of scripture, particularly passages that have been used to harm LGBTQ+ people. Participant 1 talked about a youth group member who, “hates the Old Testament. Which, weirdly, is my favorite. It’s beautiful, so we argue about the Old Testament all the time, but he wants to throw it out because there’s so much like war and violence and rape and so instead of saying, let’s toss it all out… let’s wrestle with that part.” In doing so, she opens discussion on parts that are difficult, encouraging students to wrestle with uncomfortable truths. Participant 3 added that theology is not a set of beliefs to be pondered, but principles to be acted upon saying if “theology isn’t something you’re acting out, then it’s not much good anyway. [We have to] model that, adolescents, they’re trying to figure out what do I think about all this kind of stuff? And, if the theology part of it that they’re hearing is not, modeled in any kind of way that is useful for real [life then] they’ll just throw it out.”

Participant 4 spoke about how she uses theological concepts to help young people who come to her that are struggling with their sexuality or gender identity. She mentioned that oftentimes the word “abomination” is used when discussing LGBTQ+ people. She uses her theological education to help young people understand that,

“I like to tell the kids, do you know that the Hebrew, Aramaic, and Greek words were abomination, although we translate them as abomination, and we treat it as if that means that God hates. It’s an abomination that God hates, and it’s an abomination that would send you to hell. In the Hebrew, Aramaic, in Greek, it actually means that is not of our culture. That is, something other than how we do it. It doesn’t assume that God hates it, and it doesn’t assume that it is damnation of any kind. If you can begin to understand that what the actual Scriptures say, it is very different from what people today generally understand. It’s because of interpretations and a lot of hate and manipulation around it.”

Participant 6 believes it is important for students to understand that there will not always be answers to theological questions, but there is an authenticity in not “pretending to have [theology] figured out right now.” Instead of focusing on presenting theological views as absolute truth he tries to help teenagers understand, “that love is the ultimate virtue. Loving God and loving people. I guess that’s kind of the virtues and the ethics that we’re developing those things on.”

Participant 7 spoke about ways she had to challenge theological views when she was working in non-affirming spaces that could lead to harm, even suicide. She spoke of one student who was “hopeful that God would forgive them and let them into heaven anyway, and that they would rather have that happen now than wait and continue on in life with all of this internal torment. And there was one who specifically told me. They would rather be dead than put their family through this shame, coming out. So, they thought that their family would be affected by, the family’s reputation and standing in church, and, that other people would look down on their parents because they were gay, and so they would rather have their parents deal with the sorrow of losing a child and have to deal with the fact that they were gay.” These types of beliefs to this student led to severe suicidal ideation. Challenging these theological ideas was imperative to healing and to the pastoral care she provided.

5.7. Image of God

One way to combat these harmful theological truths is to offer students an alternative. For several of the participants in the study, this was conducted by letting queer students know they were uniquely made in the image of God. Participant 3 uses the phrase as a mantra for his entire youth group as he tells them, “You are uniquely created in the image of God and worthy to be loved. We tell them that a million times so that they’ll eventually believe it. The idea is that you are who you are, and God has created you for a specific reason. And we let them know that we embrace all that means.” Participant 4 has also made the image of God a cornerstone of her ministry, “I make sure that they know that I believe that the world is crazy about religion and using it in this way to say it, anything other than the way God made you is wrong. You’re not burdening anyone. You know, if I need to learn a new name and start using new pronouns, that’s not a burden.” Participant 5 echoes these sentiments saying she tells her youth, “The world is better with you in it. We love you. We support you exactly how you are and to me, you were made in the image of God like this. Is that in you? This is what makes you who you are.” Participant 7 said this includes why she is careful to choose curriculum and other resources that use gender neutral language about God. She says this helps students to see the image of God in themselves. She said, “I want them to be as gender expansive as possible. I want them to use gender inclusive and gender expansive terms for God and for the divinity of humans. Like that. That spark of the divine that’s within all of us. That we all reflect the image of God.”

5.8. The Importance of Whole Church Engagement

Speaking out in Corporate Settings. The participants were clear that a willingness for the whole church to engage on LGBTQ+ issues was key to the affirmation and acceptance of their youth. There are explicit ways this has been conducted as participant 2 noted, “I have done this, and my boss has done this in preaching from our pulpit, we have said things to show that we’re open. I can’t remember the exact line, but I talked about being open to God, working in ways that surprise us. And, and I said something about making space for people who because of their race or their past or their sexuality may not feel like they belong in church.” Participant 2 is not in a church that is theologically affirming, however, noting that the pastors are leading out in preaching about acceptance and belonging from the pulpit was crucial to her youth feeling welcomed in their church. Participant 3 discussed how their church was not affirming in its theology in the beginning of their tenure there. He noted the shift to explicit affirmation has been meaningful to both him as a leader and to his youth. He said, “I regret that we weren’t able to have as open conversations as we are now. I mean, that’s certainly true, I think what I would tell kids even back, you know, ten, 15 years ago was there’s not any topics that are off limits. But, you know, we just, as a church weren’t necessarily in a place to have quite as open a conversation.” Participant 5 related her church’s affirmation of LGBTQ+ individuals as similar to their stance on women in ministry. She said, “It’s no longer like a confusing thing. I think even if a church doesn’t have a senior pastor, who’s a woman and maybe just has like one person on staff or like even like deacon wise, has deacons who are women. I think that like opens up a lot of doors for people who feel like women can be affirmed in ministry to and it becomes very tangible. And if I were a youth minister at a church that didn’t affirm women, it would be very hard for me to talk to a female student called in to ministry. To me, it’s the same thing with LGBTQ inclusion.” Participant 7 served at a progressive church who had held an affirming theology for quite some time. She herself identifies as queer and noted how welcome she felt when her new girlfriend came to church with her, “They were so happy for me. They wanted to celebrate this great thing happening in my life. They wanted to get to know her and care for her.” This example from adults affirming her relationship also set an example for the students. Participant 2 noted that their church, a Baptist congregation who attends Pride events, and has queer pastors, staff, and members can still feel home to people who have shifted their beliefs.

5.9. Youth Leading Engagement

Inside the Church. One theme that arose in several churches was the leadership of their youth in working toward LGBTQ+ inclusion both inside the church and outside. Though participant 5’s church was not theologically affirming, she noted that she “would not say that our church is not fully affirming. But I would say that our youth group is, and I think that was pretty clear to anyone who is a youth who would come to visit, which I appreciate. And I think that has come with a lot of time and a lot of years spent establishing that. So, like, it’s not anything that I’ve necessarily done like, hey, we’re going to make this shift. It’s just kind of been a product of the way that we do youth ministry.” The youth group has proceeded with the church in making visitors feel welcome and celebrated in their sexual orientation and gender identity. Participant 4 spoke about how she felt called into youth ministry after being a high school teacher and that LGBTQ+ students inspired her to make the church a more inclusive place. She said, “part of something that happened with one of my kids, led me to want to do something different than teach.” The student’s bravery to speak out led her to advocate herself.

Outside the Church. Participant 1 spoke about how her students have been able to speak out beyond the church walls. In her state, as in many cases across the nation anti-LGBTQ+ bills, particularly anti-trans bills, have been coming up in the state legislature. She noted the dissonance this created for students not only at school as peers were not speaking out and instead supporting these bills, but also with their own families. She noted, “I think I do think a lot of times, especially maybe in the South, the LGBTQ question is so much at play that it becomes the breaking point if that makes sense. They’re hearing their parents say things and then hearing a friend say things, and these two things aren’t matching.” This dissonance, in turn, has led students to come to her discussing how they can then speak out in their schools and in their families.

6. Discussion

An idea of openness permeated the conversations that were conducted with each youth pastor in this study. This is an important lesson to be learned. Identity formation and development is not a fixed, binary experience. Tilsen (2013) uses queer theory to say that hitting developmental or identity formation markers are binary systems, accepting young people as they are and how they uniquely develop is key. The theological implications that youth pastors bring to the conversation is that this diversity better reflects the image of God. Critical theorist Maggie Nelson (2015) writes, “How does one get across the fact that the best way to find out how people feel about their gender or their sexuality—or anything else, really—is to listen to what they tell you, and to try to treat them accordingly, without shellacking over their version of reality with yours?” (p. 53). The pastors in this study acknowledged how youth voices could lead the church in becoming more affirming of queer people. They supported youth voices to let them know what sleeping arrangements made them feel safe, and they honored those feelings. The youth pastors in this study acknowledged that they mess up. They admitted they make mistakes, and they adjusted accordingly. This attitude seems to foster the belief in students that they can learn as they grow as well. A key tenant of queer theory discussed in the conversation above is the dismantling of hierarchal systems. Youth pastors who elevate the voices of queer and trans youth are sharing power with youth, instead of only holding hierarchical power over them.

Culture seemed to be another important part of the work the participants do in their churches. It was important to them to create spaces where youth can thrive. They made sure that confidentiality was assured, and it was clear what the limits were upfront and they reminded students of this often. They allowed students to ask questions and even to dislike parts of the Bible. Instead of pushing back and telling students they were wrong, they engaged their questions and explored different alternatives. Students were told that they were loved not only by the pastors and volunteers, but by God… that God made them the way they were in a unique and beautiful way. Not only did they make sure to set up a culture where these things were celebrated, they protected this culture. Youth pastors went out of their way to create a safe place for students, where student choices and voices were centered at all aspects of the ministry.

7. Clinical Implications

Therapists working with LGBTQ+ young people have much to learn from this study. As a therapist, confidentiality is something that is at the cornerstone of one’s work. Confidentiality and its limits are almost a rote part of a clinician’s routine, repeated to clients almost daily. In working with LGBTQ+ youth, the limits to confidentiality may be questioned. For example, when LGBTQ+ young people express suicidality, the situation is more complicated than to report to parents and help the teenager receive help. For example, if disclosing the teen is suicidal because of their gender identity or sexual orientation puts them at more risk for harm, due to non-affirming parents or other factors, clinicians must form a safety plan for how to best mitigate further risks. Listening to youth voices, as was demonstrated in this study, is key to this. Asking questions about what the parents or caregivers know and how the student would like to tell them and to what degree of information they would like to tell is essential. In choosing more advanced levels of care, clinicians must know if facilities and treatment centers are equipped to care for LGBTQ+ youth. While often times the clinician and parents are at the center of this process, youth voice is critical to success.

As clinicians build rapport with clients, LGBTQ+ clients included, making intake questions and language inclusive is essential. Setting a tone of inclusivity early on in a therapeutic relationship is essential. As youth pastors in this study made sure to tell students that they were loved by God, therapists can follow suit by ensuring students that they affirm all of who they are is of vital importance. Setting the stage for successful therapy with LGBTQ+ teenagers also involve letting them know they can ask questions and challenge what they hear if it does not fit for their own identity. Therapists must also understand there is not a “gold standard” for LGBTQ+ teens to develop their identity. It is a unique and individual journey. Allowing young people to explore their identity through creative expressions, including art, could be helpful to allow them to understand the unique nature of their identity and to celebrate this uniqueness.

Therapists would also do well to understand affirming theology and how it might be life-giving to LGBTQ+ youth. When youth may have heard that they are an abomination in religious spaces, therapists must be equipped to show students that there is an alternative approach that is available to them. Asking young people questions like, “what do you think God thinks about your sexuality?” or “what do you think God would say to you if God were in this room?” can help young people reframe the unhelpful thoughts that have been put in their heads by their religious traditions.

Pastoral theologian and trained clinician Cody Sanders (2024) speaks of the idea of chrono-stress. This idea comes from the Greek word, “chronos” meaning “time.” According to Sanders, LGBTQ+ persons are not told the history of the queer movement and are not given successful stories of queer lives and queer thriving. The truth is these stories do exist. They exist in queer history, and they also are included in the history of the church. Offering psychoeducation on these examples of queer thriving can be life-affirming to youth. Further, therapists can keep a list of affirming congregations for youth and their parents to find religious community. Sanders (2020) and Petersen (2022) found in their works on LGBTQ+ suicide and trauma that often queer individuals long for religious community and simply do not know one exists in their backyard. Therapists can point young people and their families to these communities as important resources.

8. Limitations

The sample in this study was a convenience sample consisting primarily of Baptist clergy that were referred by personal networks of the primary investigator. Further study needs to be conducted to explore how queer youth are affirmed and supported in a variety of congregations, denominations, and religious affiliations. The sample was also overwhelmingly white and thus the perspective of people of color and churches primarily serving BIPOC communities was missed. As the study was limited in scope, the results may not be generalizable to the larger population.

9. Suggestions for Further Research

The works of this study need to be replicated with a more diverse sample in terms of age, gender, sexual orientation, gender identity, and race. The broader scope would increase the generalizability of the work. It is no secret that LGBTQ+ young people live in a society where the political climate has once again brought into question how we best care for them. Helping professionals have their work cut out for them in caring for these young people who are often navigating the hardest parts of life alone. Often in research at the intersection of social work practice and faith, the focus is put on what faith communities can learn from social workers. However, this study has shown that social workers and other helping professionals can learn a great deal from clergy serving on the front lines as well.

Further study needs to be conducted on a diverse sample of denominations and religious affiliations as well as diverse faiths outside of Christianity. Religious leaders are helpers that are reached out to first in many communities in many cultures across the world and a great deal can be learned from listening to and learning from them.