Taking an upstream approach to preventing LGBTQ youth cannabis use

Valentino Reyes, 20, hopes to become a therapist for lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) teenagers. Like other LGBTQ people, Reyes experienced feelings of isolation when they were growing up. It wasn’t until they worked with their high school counselor, who identified as a gay man, that their mental health began to improve. “Having someone there who understands what you’re going through and has lived experience is really beneficial,” Reyes explains.  

Another place where Reyes and other LGBTQ youth have found other people with similar experiences is Gay City: Seattle’s LGBTQ Center, a hub for LGBTQ individuals. In addition to being a resource center – helping people find housing, healthcare, and meet other needs – Gay City serves as place for people to congregate. This is especially important for LGBTQ youth who may not feel like they have a strong community. Building community can improve mental health and wellbeing.  

LGBTQ youth cannabis use 

This community also educates youth about cannabis use and managing mental health: Gay City’s Youth Advisory Council (YAC) supports effective youth cannabis and vaping prevention strategies.

LGBTQ youth report the highest rates of marijuana use in King County, and data from the Healthy Youth Survey suggest a link between marijuana use, bullying, and mental health distress symptoms such as anxiety and depression. 

“This makes perfect sense to me,” Reyes says, considering all of the stressors that young LGBTQ people experience. In addition to typical high school stressors, LGBTQ teens may experience discrimination, feelings of isolation, or lack basic needs. LGBTQ youth are more likely to experience homelessness, food insecurity, or unresolved medical issues that may lead them towards cannabis use.  

“Nothing is really set up for us,” Reyes elaborates. “The medical system is hard, education, even small things like going to the bathroom. All of these things are exclusive to LGBTQ people. Using marijuana is a way to cope with that.” Given these exclusions, LGBTQ youth look for ways to cope, even if the strategy is harmful to their health.  

Reyes, as a member of Gay City’s YAC, is involved in an assessment of LGBTQ youth cannabis use in King County, in partnership with Public Health – Seattle & King County’s Youth Marijuana Prevention and Education Program (YMPEP) and Matt Harnpadoungsataya, a graduate student at the University of Washington. This work is funded by the Washington State Department of Health through the Dedicated Marijuana Account.  

For the assessment, the YAC conducted interviews with young people who use cannabis. These conversations have revealed how youth are introduced to cannabis, the stressors they face, their perceptions of people who use cannabis, and what supports they need. After the assessment is finished, the YAC will again partner with Public Health to take action on the findings, making changes to decrease stressors or support healthier coping.  

Upstream Prevention

Early findings from the YAC’s assessment suggest that upstream factors, particularly those that help develop healthy coping skills, may be key to preventing cannabis use. These include: welcoming spaces for LGBTQ youth, mental health support in schools, and meeting fundamental needs (food, housing, and inclusive healthcare).  

Reyes explains: “Many people have tried to address marijuana usage among youth with fear mongering and scare tactics. It’s clear that doesn’t work. We [Gay City] focus on addressing ‘why are they doing this in the first place?’”  

Gay City and the YAC’s approach to preventing youth cannabis use is focused on creating welcoming spaces for LGBTQ youth and educating future healthcare workers on providing care to LGBTQ patients and clients: 

  • This past year, Gay City has planned virtual events, such as Queer N’Teen, a virtual gathering space for youth. Having a welcoming space to talk through challenges or things they are excited about is beneficial. 
  • In previous years, the YAC has also met with the University of Washington Leadership Education in Adolescent Health (LEAH) program. LEAH trains graduate students who study adolescent health disciplines, including future physicians, nurses, psychologists, and social workers. The YAC has worked with LEAH students on providing care to LGBTQ patients and clients.  

Providing a space for LGBTQ youth to build community and addressing some of the underlying factors that exacerbate stressors helps young people build strong foundations for developing healthy coping skills. These skills may make them less likely to use cannabis when faced with stressful and overwhelming situations.  

However, strategies that are further upstream are likely to have an even greater impact on whether an LGBTQ individual copes with cannabis. These include affirming healthcare, familial and societal acceptance, and equitable workplace and housing practices, among others.  

Reyes, whose dedication to serving LGBTQ youth is clear, summarizes: “I hope there’s a world one day where LGBTQ youth don’t have to worry about things like discrimination or going homeless if their parents find out about their identity. If you really want to help youth cope better and not rely on marijuana,” Reyes explains, “you have to provide solid ground to work on and community support.” 


Gay City: Seattle’s LGBTQ Center – Central hub for LGBTQ individuals seeking affirming and responsive resources, wellness, and community. Resources available for COVID-19, LGBTQ families, youth, and community members.

Ingersoll Gender Center – Peer-led support groups, virtual events, advocacy, education, and financial assistance available for trans and gender diverse community members.

Peer Washington – Made up of Peer Seattle, Peer Spokane and Peer Kent, Peer WA provides emotional support, coaching, advocacy, and resource navigation for LGBTQ+ community members impacted by addiction, mental health and/or HIV/AIDS.

Seattle Counseling – Resources, counseling and therapy referrals for LGBTQ individuals, and support for LGBTQ community based organizations.

Originally published June 14, 2021