According to the Appalachian Regional Commission, Kentucky has 1.2 million residents over 54 Appalachian counties. However, a general search on the website using keywords like “LGBT” or “queer” provides zero results. 

“If we don’t have the data, then we can’t know how to meet the needs, address the inequalities, or support individuals,” said Holden Dillman, a licensed clinical social worker and doctoral student at the University of Kentucky who lives in Eastern Kentucky and provides telehealth psychotherapy to individuals and couples across the state—particularly those in the LGBTQ+ community—through Bridge Counseling and Wellness, based in Louisville.

Dillman is working on a new study called We Are Here, focusing on the unique mental health challenges and resilience of sexual and gender minority youth in Appalachia.

According to a 2017 report by the American Psychological Association on Sexual Identity and Risk Behaviors Among Adolescents in Rural Appalachia, LGBQ+ youth showed higher signs of risks including bullying, poor mental health outcomes, substance abuse problems and lower academic achievement. 

The study, conducted in two western North Carolina high schools, had over 2,000 students participate in the Youth Risk Behavior Survey created by the Centers for Disease Control and Prevention. Of the students who answered the survey, LGBTQ+ students were at five times the risk for reporting suicide risk factors and perceived a lower level of school and community support than their heterosexual counterparts. 

Despite providing a snapshot of the region’s youth population, the study left some gaps. One of the gaps included any insight into the transgender experience, with the only sex options on the survey being male or female.

“Right now, the research isn’t as diverse as what it could be,” said Dillman, who has been working with a limited dataset, adding, “there’s not a lot of data that from a national kind of perspective really speaks to this experience.”

Dillman will use a mixed methods study approach, looking at information from a national secondary dataset as quantitative data and primary interviews from recruited participants in Appalachia as qualitative data.

His goal is to focus on the intersection of self-esteem, acceptance, and regional culture within the Appalachia youth ranging in ages 12 to 32. 

For the interview portion of the study, participants will be asked a set of open-ended questions, aimed at providing deeper conversations. “The goal is to get to the essence of the lived experience,” said Dillman, about creating a space for people to reflect on impacts both internally and externally. 

Only individuals who are currently living or lived in the Appalachian region through their adolescence will qualify to participate in an interview for the study. 

As a native Southeastern Kentuckian, for Dillman it was important to name the study We Are Here because it fights back against a “sad story of trauma” often referenced with Appalachian queer-lived experiences. 

“We’re not just surviving anymore, we’re actually thriving in a lot of ways,” he said. 

To expand the reach of the study set to begin receiving applicants in June, Dillman has partnered with Queer Kentucky. 

For Dillman, the collaboration goes beyond the research. He hopes the results will lead to tangible change by “working together to make sure that it’s being translated to benefit the communities that it involves.”

Some of the ways Dillman hopes it’ll create change include by informing policies and interventions that better support the well-being of youth in rural communities.

Almost a year since his start in assembling the We Are Here study, Dillman plans to start interviews in July and said the process could last up to six months. For interested applicants, the interest form is now live.

“We’re at a point in academia, in research and in science where person-centered research is validated and it is reliable,” he said.