Youth

Many lesbian, gay, bisexual, and transgender (LGBT) youth are happy and thrive during their adolescent years. Going to a school that creates a safe and supportive learning environment for all students and having caring and accepting parents are especially important. This helps all youth achieve good grades and maintain good mental and physical health. However, some LGBT youth are more likely than their heterosexual peers to experience difficulties in their lives and school environments, such as violence.

Experiences with Violence

Negative attitudes toward gays, lesbians, bisexuals, and transgender people put LGBT youth at increased risk for experiences with violence, compared with other students [1]. Violence can include behaviors such as bullying, teasing, harassment, physical assault, and suicide-related behaviors.

How CDC Promotes Health Safety Among Youth – Read LGBTQ Youth Programs-At-A-Glance

A 2009 survey* of more than 7,000 LGBT middle and high school students aged 13–21 years found that in the past year, because of their sexual orientation—

Eight of ten students had been verbally harassed at school;
Four of ten had been physically harassed at school;
Six of ten felt unsafe at school; and
One of five had been the victim of a physical assault at school [2].

*Survey participants were recruited online and through community-based groups and service organizations serving LGBT youth.

Bullying and LGBT Youth

President Obama addresses bullying among LGBT Youth.

White House staff add their voices to the project, It Gets Better.

Secretary Sebelius's Message to LGBT Youth video

Secretary Sebelius's message to LGBT youth experiencing bullying and intolerance.

LGBT youth are also at increased risk for suicidal thoughts and behaviors, suicide attempts, and suicide. A nationally representative study of adolescents in grades 7–12 found that lesbian, gay, and bisexual youth were more than twice as likely to have attempted suicide as their heterosexual peers [3]. More studies are needed to better understand the risks for suicide among transgender youth.
Another survey of more than 7,000 seventh- and eighth-grade students from a large Midwestern county examined the effects of school climate and homophobic bullying on lesbian, gay, bisexual, and questioning (LGBQ) youth and found that

LGBQ youth were more likely than heterosexual youth to report high levels of bullying and substance use;
Students who were questioning their sexual orientation reported more bullying, homophobic victimization, unexcused absences from school, drug use, feelings of depression, and suicidal behaviors than either heterosexual or LGB students;
LGB students who did not experience homophobic teasing reported the lowest levels of depression and suicidal feelings of all student groups (heterosexual, LGB, and questioning students); and
All students, regardless of sexual orientation, reported the lowest levels of depression, suicidal feelings, alcohol and marijuana use, and unexcused absences from school when they were
- In a positive school climate and
- Not experiencing homophobic teasing [4].

More resources for LGBT youth and their friends

Effects on Education and Health

Exposure to violence can have negative effects on the education and health of LGBT youth. In a national study of middle and high school students, LGBT students (61.1%) were more likely than their non-LGBT peers to feel unsafe or uncomfortable as a result of their sexual orientation. LGBT students (over 25%) reported missing classes or days of school because of feeling unsafe in their school environment [2].
Overall, the stresses experienced by LGBT youth also put them at greater risk for mental health problems, substance use, and physical health problems [1].

What Schools Can Do

For youth to thrive in their schools and communities, they need to feel socially, emotionally, and physically safe and supported. A positive school climate has been associated with decreased depression, suicidal feelings, substance use, and unexcused school absences among LBGT students [5,6].
School personnel, leaders of community organizations, parents, and youth have a role to play in building positive, supportive, and healthy environments for youth. Such environments promote acceptance and respect and help youth feel valued [7]. Schools can assist by implementing clear policies, procedures, and activities designed to prevent violence. For example, a study, found that, in schools with LGB support groups (such as gay-straight alliances), LGB students were less likely to experience threats of violence, miss school because they felt unsafe, or attempt suicide than those students in schools without LGB support groups [8].
To help promote health and safety among LGBTQ youth, schools can implement the following policies and practices:

Encourage respect for all students and prohibit bullying, harassment, and violence against all students.
Identify “safe spaces,” such as counselors’ offices, designated classrooms, or student organizations, where LGBTQ youth can receive support from administrators, teachers, or other school staff.
Encourage student-led and student-organized school clubs that promote a safe, welcoming, and accepting school environment (e.g., gay-straight alliances, which are school clubs open to youth of all sexual orientations).
Ensure that health curricula or educational materials include HIV, other STD, or pregnancy prevention information that is relevant to LGBTQ youth; such as, ensuring that curricula or materials use inclusive language or terminology.
Encourage school district and school staff to develop and publicize trainings on how to create safe and supportive school environments for all students, regardless of sexual orientation or gender identity and encourage staff to attend these trainings.
Facilitate access to community-based providers who have experience providing health services, including HIV/STD testing and counseling, to LGBTQ youth.
Facilitate access to community-based providers who have experience in providing social and psychological services to LGBTQ youth.

More resources for educators and school administrators

What Parents Can Do

Parents should talk openly with their children about any problems or concerns and be watchful of behaviors that might indicate their children are victims or perpetrators of bullying or violence or are depressed or suicidal. If bullying, violence, or depression is suspected, parents should take immediate action, working with school personnel and other adults in the community.
Also, how parents respond to their LGBTQ child can have a tremendous impact on their child’s current and future mental and physical health [1,6,9,10]. Supportive reactions can help youth cope with the challenges of being an LGBTQ teen. However, some parents react negatively to learning that they may have an LGBTQ daughter or son. In some cases, children are thrown out of the house or stress and conflict at home can cause some youth to run away. As a result, LGBT youth are at greater risk for homelessness than their heterosexual peers [1].
Even less severe reactions can have long-lasting negative effects. Research published in the journal Pediatrics found significantly higher rates of mental and physical health problems among LGBT young adults who experienced high levels of rejection from their parents while they were adolescents [9]. Compared with LGBT young adults who experienced very little or no parental rejection, LGBT young adults who experienced high levels of rejection were

Nearly 6 times as likely to have high levels of depression;
More than 8 times as likely to have attempted suicide;
More than 3 times as likely to use illegal drugs; and
More than 3 times as likely to engage in unprotected sexual behaviors that put them at increased risk for HIV and other sexually transmitted infections.

The resources provided below can help parents better understand and respond to the needs of LGBTQ adolescents.
More resources for parents

References

Coker TR, Austin SB, Schuster MA. The health and health care of lesbian, gay, and bisexual adolescents. Annual Review of Public Health 2010;31:457–477.
Kosciw JG, Greytak EA, Diaz EM, Bartkiewicz MJ. The 2009 National School Climate Survey: The Experiences of Lesbian, Gay, Bisexual and Transgender Youth in Our Nation’s Schools. New York: Gay, Lesbian Straight Education Network; 2010. Available at www.glsen.org/binary-data/GLSEN_ATTACHMENTS/file/000/001/1675-5.PDF .
Russell ST, Joyner K. Adolescent sexual orientation and suicide risk: Evidence from a national study. American Journal of Public Health 2001;91:1276–1281.
Birkett M, Espelage DL, Koenig B. LGB and questioning students in schools: The moderating effects of homophobic bullying and school climate on negative outcomes. J Youth Adolescence 2009;38:989–1000.
Eisenberg ME, Resnick MD. Suicidality among gay, lesbian and bisexual youth: The role of protective factors. Journal of Adolescent Health 2006;39:662–668.
Espelage DL, Aragon SR, Birkett M. Homophobic teasing, psychological outcomes, and sexual orientation among high school students: What influence do parents and schools have? School Psychology Review 2008;37:202–216.8.
FindYouthInfo.gov [Internet]. Bullyinfo.org Bullying Prevention and Response. [cited 2010 Nov 29]. Interagency Working Group on Youth Programs; [1 screen]. Available at www.findyouthinfo.org/topic_bullying.shtml .
Goodenow C, Szalacha L, Westheimer K. School support groups, other school factors, and the safety of sexual minority adolescents. Psychology in the Schools 2006;43:573–89.
Ryan C, Huebner D, Diaz RM, Sanchez J. Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics 2009;123:346–352.
Bouris A, Guilamo-Ramos, Pickard A, Shiu C, Loosier PS, Dittus P, Gloppen K, Waldmiller JM. A systematic review of parental influences on the health and well-being of lesbian, gay, and bisexual youth: time for a new public health research and practice agenda. Journal of Primary Prevention 2010;31:273–309.

Stigma and Discrimination

Homophobia, stigma, and discrimination persist in the United States and negatively affect the health and well-being of gay, bisexual, other men who have sex with men (MSM), and other members of the LGBT community. Homophobia, stigma, and discrimination are social determinants of health that can affect physical and mental health, whether MSM seek and are able to obtain health services, and the quality of the services they receive. Such barriers to health need to be addressed at different levels of society, such as health care settings, work places, and schools in order to increase opportunities for improving the health of MSM.
Homophobia and stigma persist in the United States even though acceptance of same-sex relationships has been steadily increasing. For example, a Gallup poll

conducted in May 2010 found that more than half (52%) of Americans believed that gay and lesbian relationships were acceptable. Forty-three percent of Americans believed that gay and lesbian relationships are not morally acceptable.

The Effects of Negative Attitudes About Homosexuality

Negative attitudes about homosexuality can lead to rejection by friends and family, discriminatory acts and violence that harm specific individuals, and laws and policies that adversely affect the lives of many people; this can have damaging effects on the health of MSM and other sexual minorities. Homophobia, stigma and discrimination can:

Limit MSM's ability to access high quality health care that is responsive to health issues of MSM
Affect income, employment status, and the ability to get and keep health insurance
Contribute to poor mental health and unhealthy behaviors, such as substance abuse, risky sexual behaviors, and suicide attempts
Affect MSM's ability to establish and maintain long-term same-sex relationships that reduce HIV & STD risk
Make it difficult for some MSM to be open about same-sex behaviors with others, which can increase stress, limit social support, and negatively affect health

The effects of homophobia, stigma and discrimination can be especially hard on adolescents and young adults. Young MSM and other sexual minorities are at increased risk of being bullied in school. They are also at risk of being rejected by their families and, as a result, are at increased risk of homelessness. A study published in 2009 compared gay, lesbian, and bisexual young adults who experienced strong rejection from their families with their peers who had more supportive families. The researchers found that those who experienced stronger rejection were:

8.4 times more likely to have tried to commit suicide
5.9 times more likely to report high levels of depression
3.4 times more likely to use illegal drugs
3.4 times more likely to have risky sex

Reducing the Effects of Stigma and Discrimination

MSM and their family and friends can take steps to reduce the effects of homophobia, stigma and discrimination and protect their physical and mental health. One way to cope with the stress from stigma and discrimination is social support. Some studies show that gay men who have good social support—from family, friends, and the wider gay community—have:

higher self-esteem,
a more positive group identity, and
more positive mental health.

Whether you are gay or straight, you can help reduce homophobia, stigma and discrimination in your community and decrease the negative health effects. Even small things can make a difference, such as supporting a family member, friend, co-worker.