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1. In comparison with their heterosexual counterparts, sexual minority adolescents are at increased risk for all of the following, except:
A. Substance use and abuse
B. Bipolar disorder
C. Suicidal ideation and attempts
D. Homelessness
2. Which of the following is an appropriate therapeutic approach when providing services to children, adolescents, and families?
A. Providing accurate information on the development of sexual orientation and gender identity and expression.
B. Increasing family and school support.
C. Reducing family, community, and social rejection of sexual and gender minority children and adolescents.
D. All of the above.
3. Working with parents and guardians is important as parental behaviors and attitudes have a significant effect on the mental health and well-being of sexual and gender minority children and adolescents.
A. True
B. False
4. Interventions aimed at a fixed outcome, such as gender conformity or heterosexual orientation, including those aimed at changing _____, are coercive, can be harmful, and should not be part of behavioral health treatments.
A. Gender identity
B. Gender expression
C. Sexual orientation
D. All of the above
5. For peri-pubertal adolescents, the purpose of pubertal suppression is all of the following, except:
A. Treat same-gender sexual identity, behavior, or attraction mental disorders.
B. Provide time to support identity exploration.
C. Alleviate or avoid potential distress associated with physical maturation and secondary sex characteristics.
D. Improve future healthy adjustment.
6. Withholding timely physical gender transition interventions for pubertal and post-pubertal adolescents, when such interventions are clinically indicated, prolongs gender dysphoria and exacerbates emotional distress.
A. True
B. False
7. On average, children develop gender consistency between ages 3 to 4.
A. True
B. False
8. As a culture becomes more supportive of gender diversity, more children are affirming a transgender identity or diverse gender expressions.
A. True
B. False
9. For most gender minority children, gender dysphoria persists through adolescence.
A. True
B. False
10. All of the following apply to gender minority children, on average, compared to their gender conforming peers, except for:
A. They have poorer relationships with parents and peers.
B. They experience high rates of mistreatment from peers.
C. They are at increased risk of intimate partner violence in adulthood.
D. They are at increased risk of physical and sexual abuse in childhood.
11. The onset of typical physical changes associated with puberty is often associated with worsening of anatomical dysphoria and distress in adolescents with gender dysphoria.
A. True
B. False
12. All of the adolescents with gender dysphoria that have already started living in their desired gender role upon entering high school express a strong desire for hormone therapy and gender affirming surgeries.
A. True
B. False
13. The increased risks faced by sexual or gender minority youth stem from all of the following, except:
A. Their identity
B. Stresses of prejudice
C. Discrimination
D. Violence
14. Sexual and gender minority adolescents are at increased risk for experiencing which type of violence and victimization from those within their families compared to adolescents from the general population?
A. Psychological abuse
B. Physical abuse
C. Sexual abuse
D. All of the above
15. High levels of family acceptance in adolescence predicts greater self-esteem, social support, and general health status, and protects against depression, substance abuse, and suicidal ideation and behaviors in young adulthood as compared to those with low levels of family acceptance in adolescence.
A. True
B. False
16. Similar relationships between various aspects of religion and well-being are seen among gender minority youth and among sexual and gender minority youth from non-Christian religious backgrounds as compared to Christian religious backgrounds.
A. True
B. False
17. Those who experience victimization due to sexual orientation or gender expression are more likely to report all of the following, except:
A. Depressive symptoms
B. Anxiety
C. Suicidality
D. Low self-esteem
18. Internalized transphobia is expected to have a deleterious effect on mental health, therefore, important areas of focus for behavioral health professionals who work with sexual and gender minority adolescents include which of the following?
A. Internalized homophobia
B. Transphobia
C. Clients’ minority identity
D. All of the above
19. In providing services to children, adolescents, and families experiencing distress related to sexual orientation or gender, behavior health providers should consider all of the following as the scientific basis of treatment, except:
A. Same-gender sexual identity, behavior, and attraction do not constitute a mental disorder.
B. Transgender identities and diverse gender expressions constitute a mental disorder.
C. Same-gender sexual attractions are part of the normal spectrum of sexual orientation and occur in the context of a variety of sexual orientations and gender identities.
D. Variations in gender identity and expression are normal aspects of human diversity, and binary definitions of gender may not reflect emerging gender identities.
20. There is scientific consensus that for many people, medical intervention in the form of hormone therapy or gender affirming surgeries may be medically necessary to alleviate gender dysphoria.
A. True
B. False
21. A clear treatment goal is to:
A. Provide children, adolescents, and their families with developmentally-appropriate multiculturally-competent and client-centered interventions.
B. Provide interventions that emphasize acceptance, support, assessment, and understanding.
C. Identify sources of distress and work to reduce any distress experienced by children, adolescents, and their families.
D. Change children’s gender expression, prevent a transgender identity, and prevent a future minority sexual orientation.
22. Appropriate therapy approaches include:
A. Providing a developmentally-informed cognitive, emotional, mental health, and social assessment of the child and family.
B. Supporting children and adolescents in their developmental processes and age-appropriate milestones and facilitating adaptive coping.
C. Providing developmentally-appropriate affirmative information and education on sexual orientation, gender identity, gender expression, sexuality, and the identities and lives of lesbian, gay, bisexual, transgender people and those who are questioning their sexual orientation or gender identity (LGBTQ) to children and adolescents, parents or guardians, and community organizations.
D. All of the above.
23. One of the most important messages that can be communicated to a young person is:
A. That their safety is important to the provider and to the family.
B. Teaching non-rejecting ways to communicate positive emotions.
C. How to create an atmosphere of mutual respect.
D. That even in cases in which family members may disagree about decisions each person may make, there may be opportunity to agree on broader principles and concepts that can lead to mutual understanding.
24. All of the following are factors that need to be considered in determining when and if a child should socially transition, except for:
A. The potential impact on the child’s siblings.
B. The potential impact on the child’s parents.
C. Whether it is safe for the child to socially transition in his or her community.
D. The possibility that the child’s gender identity and gender expression may change as development continues.
25. Pubertal suppression using gonadotrophin-releasing hormone prevents the development of unwanted secondary sex characteristics in a peri-pubertal adolescent, which are irreversible and highly distressing for some adolescents with gender dysphoria.
A. True
B. False
26. Pubertal suppression is fully reversible and serves as an extended diagnostic period.
A. True
B. False
27. Withholding GnRHa is considered a neutral option.
A. True
B. False
28. Like GnRH analogues, hormone therapy is also completely reversible.
A. True
B. False
29. Which of the following steps has the Administration taken to reduce discrimination and negative social attitudes towards and increase support for LGBT communities?
A. Ended the “Don’t Ask, Don’t Tell” policy in military service for lesbian, gay, and bisexual people, and taken steps to remove barriers to service for transgender people.
B. Supported same-sex marriage and ensured that same-sex couples and their families have full access to federal benefits.
C. Prevented employment discrimination by federal contractors.
D. All of the above.
30. By denying the inherent worth of LGBT individuals and engaging in an intervention based on negative social or cultural attitudes, practitioners of conversion therapy could potentially violate principles that dictate respect for people’s dignity.
A. True
B. False
31. There is currently a federal ban on conversion therapy.
A. True
B. False
32. For LGBTQ youth, which of the following has been found to have the strongest influence on overall adjustment and well-being in young adulthood?
A. Peer support and acceptance during adolescence.
B. Community support and acceptance during adolescence.
C. Family support and acceptance during adolescence.
D. Spiritual support and acceptance during adolescence.
33. The largest proportion of families are which of the following about having an LGBTQ or gender diverse child?
A. Highly rejecting
B. Ambivalent
C. Highly accepting
D. There is an equal proportion of the above
34. Parents and caregivers who are perceived as rejecting their LGBTQ children and who engage in rejecting behaviors are typically motivated by all of the following, except for:
A. Trying to help their LGBTQ child with spiritual held beliefs.
B. Trying to help their LGBTQ child “fit in.”
C. Trying to help their LGBTQ child to have a good life.
D. Trying to help their LGBTQ child to be accepted by others.
35. Which of the following is a way that parents that are struggling with having an LGBTQ or gender diverse child can respond with other supportive behaviors that help increase parent-child connectedness and have been identified in research to help protect against risk and help promote an LGBTQ child’s well-being, without “accepting” an identity they believe is wrong?
A. Talking with their child and listening respectfully to understand their child’s experiences.
B. Requiring that other family members treat their child with respect even if they disagree.
C. Ensuring their child’s safety by standing up for their child when others hurt, mistreat, or discriminate against their LGBTQ or gender diverse child because of who they are.
D. All of the above.
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