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Also: pistachio, saffron, caviar, Ghorme sabzi! Kabab.. PURPOSE We assessed whether existing guidelines for the primary care of lesbian, gay, and bisexual LGB people meet appropriate standards of developmental rigor, and whether they provide consistent recommendations useful for primary care clinicians. For sources, we used electronic databases, guidelines databases, primary care professional organizations, government departments of public health, LGB health care textbooks, and national LGB organizations. Frot We assessed the quality of existing guidelines using the validated Appraisal of Guidelines for Research and Evaluation AGREE instrument and compared the recommendations from all fully appraised guidelines. Of 2, documents identified, we initially reviewed 30 and fully appraised 11, none of which completely satisfied the AGREE criteria for quality and only 2 of which were specifically designed for primary care. Developmental rigor was poor. Particular gaps were a lack of explicit inclusion criteria, independent reviewers, and updating procedures.

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The authors evaluated emotional distress among 9 th th grade students, and examined whether the association between LGBT status and emotional distress was mediated by perceptions of having been treated badly or discriminated against because others thought they were gay or lesbian. LGBT youth scored significantly higher on the scale of depressive symptomatology. Mediation analyses showed that perceived discrimination accounted for increased depressive symptomatology among LGBT males and females, and accounted for an elevated risk of self-harm and suicidal ideation among LGBT males. Perceived discrimination is a likely contributor to emotional distress among LGBT youth.

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