Contextualizing gay-straight alliances: student, advisor, and structural factors related to positive youth development among members

Supporting and Establishing Gender and Sexuality Alliances in Chicago Public Schools

School nurses are uniquely positioned to support lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) students. One approach is involvement in Gender and Sexuality Alliances (GSAs). GSAs have been found to improve outcomes for LGBTQ students. The purposes of this quality improvement project were to build infrastructure for GSAs by implementing a GSA Support Plan including a digital resource binder, GSA advisor trainings, and establishment of an Advisor Leadership Committee and increase the number of schools with a GSA. The binder was distributed electronically to 95 advisors. Forty-nine participants attending virtual trainings. A statistically significant increase in all measures of participant confidence occurred between the pre- and post-training surveys. The Advisor Leadership Committee was established. This paper adds to the literature by showing that support for GSAs is important to aiding LGBTQ students. Further, authors suggest ways in which school nurses can harness their expertise to be involved with GSAs.

Sexual harassment, sexual assault, violence, self-esteem, and the role of LGBTQ-specific parental support in a sample of Latinx sexual and gender minority youth

INTRODUCTION

Oftentimes as result of racism, cissexism, and heterosexism, many Latinx and sexual and gender minority (SGM) youth are victims of sexual harassment, sexual assault, and violence. These experiences of victimization are in part related to increased negative mental health outcomes such as decreased self-esteem. Some research links LGBTQ-specific parental support to mental health outcomes among Latinx SGM youth, yet, no research has explored the role of LGBTQ-specific parental support with self-esteem among Latinx SGM youth.

METHODS

In a sample of 1,012 Latinx SGM youth (ages 13-17), we assessed: (a) associations between sexual harassment, sexual assault, and violence and self-esteem, (b) association between LGBTQ-specific parental support and self-esteem, and (c) whether LGBTQ-specific parental support moderated the relation between sexual harassment, sexual assault, and violence and self-esteem. Main effect and moderation analyses examined interactions between LGBTQ-specific parental support with sexual harassment, sexual assault, and violence on self-esteem.

RESULTS

Latinx SGM youth experienced low levels of LGBTQ-specific parental support and various degrees of sexual harassment, sexual assault, and violence. Also, transgender and nonbinary/genderqueer Latinx youth experienced lower self-esteem than their Latinx cisgender counterparts. Increased LGBTQ-specific parental support was related to increased self-esteem. We also identified a significant interaction between sexual harassment, sexual assault, and violence and LGBTQ-specific parental support, such that parental support was more protective at low levels rather than high levels of sexual harassment, sexual assault, and violence among Latinx SGM youth.

CONCLUSIONS

Findings add to a growing body of research about the importance of LGBTQ-specific parental support for Latinx SGM youth, and the need to examine culturally appropriate approaches to understand parent-child relationship among these communities.

Examining suicide risk in sexual and gender minority youth: A descriptive observational study on depressive symptoms, social support and self-esteem

AIM

To understand the factors that contribute to the risk of suicide among lesbian, gay, bisexual, transgender, queer, intersex and asexual (sexual minorities) youth.

BACKGROUND

The increase in the likelihood of suicide has made it an urgent issue in public health, particularly among young people, where it now ranks as the fourth leading cause of death. This issue becomes even more significant when focusing on sexual minorities.

METHODS

A cross-sectional study was performed in targeted young individuals (15-29 years). Several variables were assessed, including suicide risk, self-esteem, presence and severity of depressive symptoms, perceived social support and self-reported levels of anxiety and depression.

RESULTS

Statistically significant disparities were observed in suicide risk, presence of depressive symptoms and self-reported levels of anxiety and depression, all of which were more pronounced in sexual minority youth compared to heterosexual cisgender individuals. Likewise, statistically significant differences were noted concerning self-esteem and family support, both of which were lower in sexual minority youth.

CONCLUSION

This study has identified risk factors, such as anxiety, depression and limited social support, as well as protective factors, like higher self-esteem and self-concept. Understanding and addressing all these factors are essential in reducing the elevated rates of suicide among sexual minority youth. Consequently, evidence-based interventions such as Gender and Sexuality Alliances, which empower and create safe spaces for sexual minority youth, possess substantial potential for effectively addressing this issue.

IMPLICATIONS FOR THE PROFESSION

Given sexual minorities vulnerability, healthcare pros, especially nurses, must grasp suicide risk factors. They can help by educating, offering care, assessing risk and fighting stigma. This guarantees safety and access to mental health services for at-risk individuals from sexual minorities.

REPORTING METHOD

The reporting follows the STROBE checklist.

PATIENT CONTRIBUTION

People who were invited to participate voluntarily completed a range of questionnaires.

Between Resilience and Agency: A Systematic Review of Protective Factors and Positive Experiences of LGBTQ+ Students

A negative school climate resulting from homophobic and transphobic bias and discrimination is associated with poor well-being and mental health among LGBTQ+ youth. However, protective factors and mechanisms may buffer against the impact of stigmatization. Drawing on the socio-ecological model, minority stress theory, and positive youth development and agency perspectives, we carried out a systematic review of research focusing on factors that can promote the well-being of LGBTQ+ students in educational settings, outlining the primary outcomes from studies published between 2012 and 2022. The PRISMA protocol was used for this review, and 64 articles were scrutinized. The results of the thematic analysis revealed that both external factors (school-inclusive policies and extracurricular activities; social support from school, family, and the community; and school connectedness) and internal factors (psychosocial characteristics and personal agency) promote positive school experiences, such as the exploration of sexual and gender identities in a safe environment. The present findings highlight the need for inclusive school policies and strategies and individual-level interventions that target the well-being and positive mental health outcomes of sexual and gender minority students.

Understanding How School-Based Interventions Can Tackle LGBTQ+ Youth Mental Health Inequality: A Realist Approach

Globally, research indicates that LGBTQ+ young people have elevated rates of poor mental health in comparison with their cisgender heterosexual peers. The school environment is a major risk factor and is consistently associated with negative mental health outcomes for LGBTQ+ young people. The aim of this UK study was to develop a programme theory that explained how, why, for whom, and in what context school-based interventions prevent or reduce mental health problems in LGBTQ+ young people, through participation with key stakeholders. Online realist interviews were conducted in the UK with (1) LGBTQ+ young people aged between 13-18 years attending secondary schools (N = 10); (2) intervention practitioners (N = 9); and (3) school staff (N = 3). A realist retroductive data analysis strategy was employed to identify causal pathways across different interventions that improved mental health outcomes. The programme theory we produced explains how school-based interventions that directly tackle dominant cisgender and heterosexual norms can improve LGBTQ+ pupils' mental health. We found that context factors such as a 'whole-school approach' and 'collaborative leadership' were crucial to the delivery of successful interventions. Our theory posits three causal pathways that might improve mental health: (1) interventions that promote LGBTQ+ visibility and facilitate usualising, school belonging, and recognition; (2) interventions for talking and support that develop safety and coping; and (3) interventions that address institutional school culture (staff training and inclusion polices) that foster school belonging, empowerment, recognition, and safety. Our theoretical model suggests that providing a school environment that affirms and usualises LGBTQ+ identities and promotes school safety and belonging can improve mental health outcomes for LGBTQ+ pupils.

Gender-Sexuality Alliance Advisors' Self-Efficacy to Address Transgender Issues: An Interpersonal Protective Factor for Transgender Student Depression

Purpose: Our purpose was to assess the association between Gender-Sexuality Alliances (GSAs) advisors' self-efficacy to address transgender issues and their students' depressive symptoms, by students' gender identity (i.e., transgender vs. cisgender). We predict that higher advisor self-efficacy will be associated with decreases in student depressive symptoms for transgender students, though not necessarily for cisgender students. Methods: Data come from surveys of student members (n = 366) and advisors (n = 58) of 38 purposively sampled GSAs in Massachusetts high schools, in 2016-2017 and 2017-2018. We used a linear mixed-effects model to assess the association between advisor self-efficacy to address transgender issues and student change in Center for Epidemiological Studies Depression-10 scores between the beginning and end of the school year by gender identity, adjusting for student covariates. Results: Students were 10-20 years old (mean = 15, standard deviation [SD] = 1.4); 28% were transgender, 28% were students of color, and 86% were lesbian, gay, bisexual, or queer/questioning or other non-heterosexual identity. The GSA advisor self-efficacy scores ranged from 13 to 25 with a mean of 20.4 (SD = 3.0). Greater advisor self-efficacy to address transgender issues was associated with a decrease in depressive symptoms for transgender students (estimate = -0.47, p = 0.01), but not for cisgender students. Conclusions: GSA advisor self-efficacy to address transgender issues could be protective for transgender student depressive symptoms. Thus, increasing advisor self-efficacy to address transgender issues may help decrease depressive symptomatology for transgender youth, and intervention work in this area is needed to bolster this claim.

A Developmental Model of the Sexual Minority Closet: Structural Sensitization, Psychological Adaptations, and Post-closet Growth

Across the lifespan, most sexual minority individuals experience the closet-a typically prolonged period in which no significant others know their sexual identity. This paper positions the closet as distinct from stigma concealment given its typical duration in years and absolute removal from sources of support for an often-central identity typically during a developmentally sensitive period. The Developmental Model of the Closet proposed here delineates the vicarious learning that takes place before sexual orientation awareness to shape one's eventual experience of the closet; the stressors that take place after one has become aware of their sexual orientation but has not yet disclosed it, which often takes place during adolescence; and potential lifespan-persistent mental health effects of the closet, as moderated by the structural, interpersonal, cultural, and temporal context of disclosure. The paper outlines the ways in which the model both draws upon and is distinct from earlier models of sexual minority identity formation and proposes several testable hypotheses and future research directions, including tests of multilevel interventions.

Youth Advocacy Varies in Relation to Adult Advisor Characteristics and Practices in Gender-Sexuality Alliances

With growing attention to youth's efforts to address sexual and gender diversity issues in Gender-Sexuality Alliances (GSAs), there remains limited research on adult advisors. Do advisor characteristics predict their youth members' advocacy? Among 58 advisors of 38 GSAs, we considered whether advisor attributes predicted greater advocacy by youth in these GSAs (n = 366) over the school year. GSAs varied in youth advocacy over the year. Youth in GSAs whose advisors reported longer years of service, devoted more time to GSA efforts each week, and employed more structure to meetings (to a point, with a curvilinear effect), reported greater relative increases in advocacy over the year (adjusting for initial advocacy and total meetings that year). Relative changes in advocacy were not associated with whether advisors received a stipend, training, or whether GSAs had co-advisors. Continued research should consider how advisors of GSAs and other social justice-oriented groups foster youth advocacy.

The Substance and Circumstances of Race and Immigration Talk in High School Gender and Sexuality Alliances

Gender & Sexuality Alliances (GSAs) are school-based clubs that support youth of diverse sexual orientations and gender identities. As identity-centered spaces, GSAs could also foster discussions related to race and immigration (i.e., race and immigration talk). We conducted semi-structured interviews from 2016 to 2018 with 38 GSA members (ages 13-20 years old) of diverse racial/ethnic, immigrant-origin (first and second generations in the United States born of immigrant parents), sexual orientation, and gender identities. Race and immigration talk often occurred when discussing current events (e.g., the 2016 US Presidential Election). Students reported that race and immigration talk depended on representation (i.e., GSA demographics), if it was deemed personally relevant to members, and whether students perceived issues of race and immigration as part of the agenda of the GSA. Some students indicated motivation to discuss racism and nativism yet refrained from doing so due to discomfort or fear of misspeaking. Overall, youth primarily viewed the GSA as a space for LGBTQIA+-oriented discussions and support yet expressed potential for fostering productive race and immigration talk in GSAs given the ongoing US sociopolitical climate. Discussions facilitated by advisors focusing on inter-connected oppression (e.g., intersections of racism and heterosexism) and that leverage brave space discussion dynamics may help students develop competencies to engage in race and immigration talk.

Protective Factors for LGBTI+ Youth Wellbeing: A Scoping Review Underpinned by Recognition Theory

Considerable research has been undertaken regarding the mental health inequalities experienced by lesbian, gay, bisexual, transgender and intersex (LGBTI+) youth as a consequence of societal and individual prejudice, stigma and discrimination. Far less research has focussed on protective factors that promote wellbeing for this population. A scoping review was conducted using a six-stage methodological framework, and is reported in accordance with the PRISMA-ScR statement. This explored the extent, range and nature of the peer-reviewed, published, academic literature on what is known about the protective factors that promote LGBTI+ youth wellbeing. Six databases were systematically searched applying Population–Concept–Context key inclusion criteria, complemented by contact with authors to identify additional sources, reference checks and hand searches. Ninety-six individual research records were identified and analysed, drawing from Honneth’s Recognition Theory. Interpersonal relations with parents (n = 40), peers (n = 32) and providers (n = 22) were associated with indicators of enhanced wellbeing, as were LGBTI+ community relations (n = 32). Importantly, online (n = 10), faith (n = 10) and cultural (n = 5) communities were potentially protective. Content and thematic analysis highlighted the importance of Gay–Straight Alliances (GSAs) (n = 23) offering powerful protective opportunities through intersecting interpersonal, community and legal forms of recognition. GSAs enhance allyship by peers and providers (n = 21), facilitate access to LGBTI+ community networks (n = 11) and co-exist alongside inclusive policies (n = 12), curricular (n = 5) and extracurricular activities (n = 1). This scoping review underscores the need to move beyond the predominant focus on risk factors for LGBTI+ youth, which subsequently inform protectionist approaches. It concludes with an appeal to develop mechanisms to apply recognitive justice to policy, practice and, importantly, future research directions. This emphasises the salience of enhanced understandings of inclusion, which is rights-based, universally available and of potential benefit to all.

Changes in disclosure stress and depression symptoms in a sample of lesbian, gay, and bisexual youth

Disclosing a sexual minority (e.g., lesbian, gay, or bisexual) identity to others is an ongoing process throughout life. Research shows that disclosure is stressful, and this stress is related to poorer mental health for sexual minority youth. However, there are few theoretically grounded studies examining disclosure stress and its prospective association with mental health. The current study utilizes two conceptualizations of sexual identity development-stage models and milestone models-to contextualize how changes in disclosure-related stress are associated with depression symptoms from adolescence into young adulthood. Data come from a sample of lesbian, gay, and bisexual youth between ages 15-24 surveyed over three years (N=555; 82% youth of color; 40% bisexual; 63% free and reduced lunch; and 49% assigned female at birth). We estimated (1) parallel process models and (2) growth curve models with disclosure stress as a time-varying covariate, which were respectively informed by stage and milestone conceptualizations of sexual identity development. Results indicated that depression symptoms declined while disclosure stress increased. In the parallel process model, higher baseline disclosure stress correlated with higher baseline levels and steeper declines in depression symptoms. When disclosure stress was modeled as a time-varying covariate, it was most strongly associated with higher depression symptoms at earlier ages. Disclosure is a developmental process that confers differential risk for depression symptoms earlier in the life course, which can hinder the typical decline of depression symptoms in young adulthood. Supporting sexual minority youth when they disclose their sexual identity throughout adolescence can have long-term benefits for mental health.

Walking the Talk: LGBTQ Allies in Australian Secondary Schools

Sexual culture(s) are an active presence in the shaping of school relations, and LGBTQ issues have long been recognized as a dangerous form of knowledge in school settings. Queer issues in educational domains quickly attract surveillance and have historically often been aggressively prosecuted and silence enforced. This paper examines the intersections of straight allies in promoting an LGBTQ visibility and agency in Australian secondary schools. Drawing on interviews with "straight"-identified secondary students, a narrative methodology was utilized to explore the presence of student allies for making safe schools. Drawing on straight secondary students' responses to LGBTQ issues in their schools, firsthand accounts of intervening in heteronorming school cultures focus on experiences of being an ally to address LGBTQ inclusivity in Australian secondary schools.

Gender-sexuality alliance membership and activities: associations with students' comfort, confidence and awareness regarding substance use resources

Belonging to a school Gender and Sexuality Alliance (GSA) is associated with lower substance use among LGBTQ+ youth. However, it is unknown whether GSA participation facilitates access to resources for substance use concerns. Using longitudinal data from 38 Massachusetts high schools, we compared sources of support for substance use concerns listed by GSA members (n = 361) and nonmembers (n = 1539). Subsequently, we tested whether GSA membership was associated with comfort, confidence and awareness regarding substance use resources in school and the community. Finally, we assessed whether specific GSA activities and discussions (e.g. social support) were associated with these outcomes. Among students with recent substance use, GSA membership was associated with greater comfort, confidence and awareness regarding school-based substance use resources in the spring semester, adjusted for fall semester levels and non-GSA club involvement. Furthermore, students in GSAs where members reported more advocacy and social support activities reported higher levels of comfort, confidence and awareness regarding community-based substance use resources. These results indicate that among students using alcohol or nicotine products, GSA members may be more receptive to school-based substance use prevention efforts. Furthermore, GSA-based social support and activism experiences may promote access to community-based substance use resources.

A Mixed-Methods Examination of the Unique Associations of Gender-Sexuality Alliance Involvement and Family Support on Bravery in Sexual and Gender Minority Youth

Research among sexual and gender minority (SGM) youth has suggested associations between Gender-Sexuality Alliance (GSA) involvement and better health. Emergent research has similarly demonstrated associations between family support and general well-being among SGM youth. However, the trait of bravery has received little attention in this literature, despite its relevance for youth in marginalized positions. We examined the association between level of GSA involvement, family support, and bravery among GSA members (n = 295; M age = 16.07), and whether those associations differed based on sexual orientation or gender identity. We then conducted one-on-one interviews with SGM youth (n = 10), to understand how they understood bravery and experienced support in both GSA and family contexts. Greater GSA involvement significantly predicted greater bravery for all youth, whereas greater family support predicted greater bravery only for heterosexual youth. No significant moderation was found for gender minority youth. Our qualitative findings clarified how SGM youth conceptualized bravery and how they experienced it within their GSA and family settings. GSAs were associated with more frequent displays of explicit support for SGM identity, while families were perceived as providing less explicit support.

Homophobic Bullying in Positive and Negative School Climates: The Moderating Role of Gender Sexuality Alliances

The presence of Gay-Straight Alliances (GSAs) in schools has been linked to low rates of bullying for lesbian, gay, bisexual, questioning (LGBQ), transgender, and all students. However, little is known about how the heterogeneity in GSA functioning and school climates may affect these rates. This study examines whether a well-functioning GSA would limit the effect of a negative school climate as a risk factor for homophobic victimization experiences. The sample included 38,872 students (3401 LGBQ and 453 transgender) from 58 California high schools. Several independent databases were combined. Students reported on homophobic victimization, the school climate, and demographic information. At the school level, reports from all students were aggregated for school climate; reports from GSA members were aggregated on their perceptions of GSA functioning; publicly-available data were used for school characteristics. The results suggest that greater GSA functioning may be beneficial for all students in schools that have a negative school climate, and particularly protective for transgender students.

The link between LGBTQ-supportive communities, progressive political climate, and suicidality among sexual minority adolescents in Canada

Despite supportive structural changes to reduce stigma towards lesbian, gay, and bisexual, transgender, queer, and questioning (LGBTQ) Canadian residents, sexual minority youth still face disparities compared to heterosexual peers. We aimed to characterize LGBTQ-supportive environments and political climates, and examine their links to suicidal behavior among sexual minority adolescents in western Canada. Data were from the 2013 British Columbia Adolescent Health Survey, a cluster-stratified random cross-sectional survey of public school students in BC, Canada; We sampled 2678 self-identified LGB and mostly heterosexual students (69% girls) from 274 schools, representing an estimated provincial population of 24,624 sexual minority students in weighted models. Student reports of past-year suicidal ideation, suicidal attempts, and self-harm behaviors were merged with community-level data assessing diverse aspects of LGBTQ-supportive resources and progressive political climates in communities surrounding the schools. Adjusted multilevel models showed that for sexual minority adolescent girls, higher community LGBTQ-supportiveness predicted marginally significant lower suicidal ideation (aOR = 0.94, 95% CI [0.88, 1.01]) and suicidal attempts (aOR = 0.91, 95% CI [0.83, 1.00]) and significantly lower self-harm behaviors (aOR = 0.91, 95% CI [0.85, 0.98]). Further, progressive political climates predicted marginally significant lower suicidal ideation (aOR = 0.89, 95% CI [0.78, 1.02]) and significantly lower self-harm behaviors (aOR = 0.87, 95% CI [0.77, 0.99]). For sexual minority adolescent boys, no community-level variables were associated with suicidal behavior in adjusted models. Thus, LGBTQ-supportive communities and progressive political climates appear to be protective against suicidal behavior among sexual minority adolescent girls, but not sexual minority adolescent boys.

Development of youth advocacy and sociopolitical efficacy as dimensions of critical consciousness within gender-sexuality alliances

Attention to youth advocacy and sociopolitical efficacy has been evident in developmental research on critical consciousness, yet this literature has given little attention to sexual and gender minority (SGM) youth or issues, or to the interplay between these dimensions of critical consciousness over time. We addressed these limitations within the context of gender-sexuality alliances (GSAs). Among 366 youth members (Mage = 15.53 years) in 38 GSAs across Massachusetts who completed surveys at the beginning and end of the school year, multilevel models indicated that youth who reported more active engagement in GSAs at the beginning of the school year reported greater advocacy throughout the year and greater sociopolitical efficacy at the year's end (adjusting for baseline advocacy and efficacy). There was a significant indirect association between greater GSA engagement and greater sociopolitical efficacy at the year's end through reported advocacy done over the school year. Furthermore, group-level contextual effects indicated that youth in GSAs with a more youth-led orientation reported doing less advocacy but reported greater sociopolitical efficacy at the year's end than youth in GSAs with less of a youth-led orientation. Finally, advocacy and sociopolitical efficacy were reciprocally associated with one another: Greater initial efficacy was associated with greater advocacy over the school year, and advocacy was associated with greater efficacy at the year's end. These findings extend the critical consciousness literature and carry implications for how GSAs and similar groups could support SGM youth and their allies in resisting oppression. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Membership experiences in gender-sexuality alliances (GSAs) predict increased hope and attenuate the effects of victimization

We examined whether students' experiences in their Gender-Sexuality Alliances (GSAs) over the school year predicted positive development or thriving in the form of higher relative levels of hope at the end of the school year and whether GSA experiences also promoted resilience by attenuating the link between victimization and lower relative levels of hope among 366 student members of 38 GSAs (M_age = 15.53 years; 85% sexual minority; 55% cisgender female; 72% White). Our findings indicated that, when considered one at a time, students' perceptions of receiving more social-emotional support, receiving more information and resources, and undertaking more advocacy in their GSA throughout the school year predicted higher relative levels of hope at the end of that school year (adjusted for students' initial hope at the beginning of the year). When considering all three GSA-based experiences concurrently, receiving more information and resources in their GSA had a unique predictive association with hope and it reduced the extent to which reported experiences of victimization at school predicted diminished hope at the end of the year. There was a similar, though statistically non-significant, moderating trend for advocacy.

Extracurricular Settings as a Space to Address Sociopolitical Crises: The Case of Discussing Immigration in Gender-Sexuality Alliances Following the 2016 U.S. Presidential Election

School-based extracurricular settings could promote dialogue on sociopolitical crises. We considered immigration discussions within Gender-Sexuality Alliances (GSAs), which address multiple systems of oppression. Among 361 youth and 58 advisors in 38 GSAs (19 in 2016-2017/Year 1; 19 in 2017-2018/Year 2), youth in Year 1 reported increased discussions from baseline throughout the remaining school year; differences were non-significant in Year 2. In both years, youth reporting greater self-efficacy to promote social justice, and GSAs with advisors reporting greater self-efficacy to address culture, race, and immigration discussed immigration more over the year (adjusting for baseline). In interviews, 38 youth described circumstances promoting or inhibiting discussions: demographic representation, open climates, critical reflection, fear or consequences of misspeaking, discomfort, agenda restrictions, and advisor roles.

Greater Engagement in Gender-Sexuality Alliances (GSAs) and GSA Characteristics Predict Youth Empowerment and Reduced Mental Health Concerns

Extracurricular groups can promote healthy development, yet the literature has given limited attention to indirect associations between extracurricular involvement and mental health or to sexual and gender minority youth. Among 580 youth (M_age  = 15.59, range = 10-20 years) and adult advisors in 38 Gender-Sexuality Alliances (GSAs), multilevel structural equation models showed that greater engagement in GSAs over the school year predicted increased perceived peer validation, self-efficacy to promote social justice, and hope (baseline adjusted). Through increased hope, greater engagement indirectly predicted reduced depressive and anxiety symptoms at the year's end (baseline adjusted). GSAs whose members had more mental health discussions and more meetings reported reduced mental health concerns. Findings suggest how groups addressing issues of equity and justice improve members' health.

Building Resilience, Reducing Risk: Four Pillars to Creating Safer, More Supportive Schools for LGBTQ+ Youth

In 2017 Delaware, LGBTQ+ Youth reported that almost 1 out of 3 were bullied on school grounds. Additionally, over 50% reported feeling sad/hopeless; and almost as many seriously considered suicide as an option, while 32% planned for suicide with almost 1 in 4 reporting having acted on their suicide plan at least once. Of all the students who reported a suicide attempt, 10% required medical treatment as a result of their attempt.¹ The Delaware Department of Education does not have comprehensive statewide protections in place to support some of our most vulnerable youth, yet school districts can make a positive difference in implementing policy/practices to build resilience and reduce risk.

This article will focus on four key areas where schools and school districts may implement changes toward creating safer, more supportive schools: (1) policy/procedures that protect LGBTQ+ students at the administrative level; (2) comprehensive cultural sensitivity training for serving LGBTQ+ students and their families; (3) incorporating inclusive curriculum on LGBTQ+ history into the classroom; (4) and creating, supporting, and sustaining gender sexuality alliances in both the middle and high schools.

Strengthening Our Schools to Promote Resilience and Health Among LGBTQ Youth: Emerging Evidence and Research Priorities from The State of LGBTQ Youth Health and Wellbeing Symposium

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) adolescents face well-documented health disparities in suicide risk, substance use, and sexual health. These disparities are known to stem, in part, from stigma directed toward LGBTQ youth in the form of minority stressors such as violence, discrimination, and harassment. Given the proportion of time that LGBTQ students spend in school, schools provide a critical context within which protective factors may be developed and leveraged to improve the health and wellbeing of these populations. This article provides a summary of key findings from a discussion among researchers, practitioners, and community members who participated in "The State of LGBTQ Youth Health and Wellbeing: Strengthening Schools and Families to Build Resilience," a public symposium held in June 2017. We detail emerging science on and future priorities for school-based research with LGBTQ youth which were identified by attendees at this meeting, with a particular focus on intersectionality, supportive adults in schools, and in-school programs. We call for more school-based research on priority gaps such as how LGBTQ students' intersecting identities affect their in-school experiences, how to design professional development programs that cultivate supportive educators, and how to leverage gay-straight alliances/gender and sexuality alliances as sites of health programming for LGBTQ students.

Investigating site-level longitudinal effects of population health interventions: Gay-Straight Alliances and school safety

There is limited research on evaluating nonrandomized population health interventions. We aimed to introduce a new approach for assessing site-level longitudinal effects of population health interventions (SLEPHI) by innovatively applying multiple group multilevel (MG-ML) modeling to repeated cycles of cross-sectional data collected from different individuals of the same sites at different times, a design commonly employed in public health research. For illustration, we used this SLEPHI method to examine the influence of Gay-Straight Alliances (GSAs) on school-level perceived safety among lesbian, gay, and bisexual (LGB) and heterosexual (HET) adolescents. Individual-level data of perceived school safety came from 1625 LGB students (67.4% female; mean age, 15.7 years) and 37,597 HET students (50.2% female; mean age, 15.4 years) attending Grades 7–12 in 135 schools, which participated in 3 British Columbia Adolescent Health Surveys (BCAHS: 2003, 2008, 2013) in Canada. School-level data of GSA length since established were collected by telephone in 2008 and 2014. Nested MG-ML models suggested that after accounting for secular trend, cohort effects, measurement error, measurement equivalence, and student age, GSA length linearly related to increased school-level perceived safety among LGB students (b = 1.57, SE = 0.21, p < .001, β = 0.32) and also among HET students (β = 0.34 in 2003 & 2013, β = 0.32 in 2008) although statistical differences between years for HET youth were likely due to the large sample size. By conducting MG-ML analysis on repeated cross-sectional surveys, this SLEPHI method accounted for many confounding factors and followed schools for a longer period than most longitudinal designs can follow individuals. Therefore, we drew a stronger conclusion than previous observational research about GSAs and LGB students’ well-being. The SLEPHI method can be widely applied to other repeated cycles of cross-sectional data in public health research.

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We created a new method to evaluate nonrandomized population health interventions.

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The SLEPHI method can draw causal inferences from repeated cross-sectional data.

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GSA length is linked to increased school-level safety among LGB and heterosexual students over time.

Characteristics of Schools With and Without Gay-Straight Alliances

Research shows that Gay-Straight Alliances (GSAs) are associated with school climate and student well-being, but it is unclear what school characteristics may account for some of these findings. The current study describes characteristics of schools with and without GSAs. Using a population-based sample of 1360 California public high schools, inferential statistics show that schools with larger enrollment, more experienced teachers, and lower pupil/teacher ratios were more likely to have GSAs. In addition, among schools with GSAs, larger enrollment, more experienced teachers, fewer socioeconomically disadvantaged students, and higher academic achievement are among the factors related to a longer presence of GSAs. Implications for GSA and policy implementation, as well as the importance of accounting for school characteristics in research on GSAs are discussed.

Fostering youth self-efficacy to address transgender and racial diversity issues: The role of gay-straight alliances

Gay-Straight Alliances (GSAs) aspire to empower youth to address multiple systems of oppression, including those affecting transgender and racial/ethnic minority youth, yet there is little indication of factors contributing to youths' self-efficacy to do so. We examined individual and group factors predicting self-efficacy to address transgender and racial issues among 295 youth in 33 high school GSAs. Multilevel results indicated that level of GSA engagement, individual and collective involvement in transgender- and race-specific discussions, and in some cases intergroup friendships were associated with each form of self-efficacy. The association between GSA engagement and transgender self-efficacy was stronger for youth in GSAs with greater collective transgender-specific discussions. Associations with racial self-efficacy differed based on youths' race/ethnicity. Continued research needs to identify how GSAs and similar youth programs promote self-efficacy to address diversity issues. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Discussing Transgender Topics within Gay-Straight Alliances: Factors that Could Promote More Frequent Conversations

Background

Gay-Straight Alliances (GSAs) have potential to facilitate conversations on transgender and gender diversity issues among members. We examined how frequently GSA members discussed transgender and gender diversity topics within GSAs, whether GSAs varied from one another in the extent to which these conversations occurred, and identified factors that distinguished which members and GSAs discussed such topics more often than others.

Methods

Participants were 295 members of 33 high school GSAs in the state of Massachusetts who completed surveys that assessed their experiences within their GSA.

Results

On average, youth discussed transgender and gender diversity issues with some regularity, but this varied significantly across GSAs and among youth within each GSA. Youth who had transgender friends, perceived a more respectful GSA climate, and accessed more information/resources and engaged in more advocacy within the GSA reported more frequently discussing transgender and gender diversity issues. Also, GSAs with transgender members, whose members collectively perceived a more respectful climate, accessed more information/resources and did more advocacy, and who reported lower socializing or support discussed transgender and gender diversity issues more frequently than other GSAs.

Conclusions

This information could inform GSA programming to facilitate more transgender and gender diversity topic discussions and ensure that members feel encouraged to participate in them.

Gay-Straight Alliance Involvement and Youths' Participation in Civic Engagement, Advocacy, and Awareness-Raising

Civic engagement among lesbian, gay, bisexual, transgender, or questioning (LGBTQ) youth and heterosexual cisgender allies can challenge oppressive systems. Among 295 youth in 33 Gay-Straight Alliances (GSAs; 69% LGBQ, 68% cisgender female, 68% white, M_age = 16.07), we examined whether greater GSA involvement was associated with greater general civic engagement, as well as participation in greater LGBTQ-specific advocacy and awareness-raising efforts. Further, we tested whether these associations were partly mediated through members' sense of agency. Greater GSA involvement was associated with greater civic engagement, advocacy, and awareness-raising; associations did not differ based on sexual orientation or gender identity. Finally, the association between GSA involvement and civic engagement was partially mediated through youths' greater sense of agency. Agency did not mediate the association between GSA involvement and engagement in advocacy or awareness-raising efforts. The results suggest GSAs are settings with potential to foster students' capacity to be active and engaged citizens.

Social Support and Mental Health in LGBTQ Adolescents: A review of the literature

LGBTQ adolescents experience higher rates of mental health disorders than their heterosexual peers. The purpose of this systematic review of the literature was to examine studies evaluating social support and its effects on mental health in the LGBTQ adolescent population. Higher levels of social support were associated with positive self-esteem. Lack of social support (or low social support) was associated with higher levels of depression, anxiety, alcohol or drug misuse, risky sexual behaviors, shame, and low self-esteem. Interdisciplinary research teams from multiple and diverse professions could provide valuable insight supporting the development of inclusive and comprehensive interventions programs for this population.

Gay-Straight Alliances as Settings for Youth Inclusion and Development: Future Conceptual and Methodological Directions for Research on These and Other Student Groups in Schools

Outside the immediate classroom setting, efforts within other school spaces also can shape school climate, address inequality, and affect student performance. Nevertheless, in this respect there has been little research on school-based extracurricular groups focused on issues of social inclusion and justice. An exception to this lack of focus has been Gay-Straight Alliances (GSAs), which promote social inclusion and justice for sexual and gender minority youth (e.g., lesbian, gay, bisexual, transgender, or questioning youth; LGBTQ) through support, socializing, education, and advocacy. As this literature has matured, we detail and provide examples of the following conceptual and methodological recommendations to address emerging research needs for GSAs: (1) Move from a monolithic to contextualized treatment of GSAs, (2) attend to heterogeneity among members, (3) utilize multiple data sources for triangulation, (4) apply a range of methodological approaches to capitalize on strengths of different designs, (5) collect longitudinal data over short-term and extended time periods, and (6) consider GSAs within a broader umbrella of youth settings. Further, we note ways in which these recommendations apply to other student groups organized around specific sociocultural identities. These advances could produce more comprehensive empirically supported models to guide GSAs and similar groups on how to promote resilience among their diverse members and address broader social issues within their schools.

Gay-Straight Alliances as settings to discuss health topics: individual and group factors associated with substance use, mental health, and sexual health discussions

Sexual minority (e.g. lesbian, gay, bisexual, questioning; LGBQ) and gender minority (e.g. transgender) youth experience myriad health risks. Gay-Straight Alliances (GSAs) are school-based settings where they may have opportunities to discuss substance use, mental health, and sexual health issues in ways that are safe and tailored to their experiences. Attention to these topics in GSAs could aid in developing programming for these settings. Among 295 youth from 33 Massachusetts high-school GSAs (69% LGBQ, 68% cisgender female, 68% White, Mage = 16.06), we examined how often youth discussed these topics within their GSA and identified factors associated with having more of these discussions. Youth and GSAs as a whole varied in their frequency of discussing these topics. Youth who accessed more information/resources in the GSA and did more advocacy more frequently engaged in discussions around substance use, mental health and sexual health. Youth who reported greater victimization more often discussed substance use and mental health, but not sexual health. Finally, GSAs whose members collectively reported greater victimization more frequently discussed these topics. These findings can assist the development of health programming to be delivered within GSAs.

Greater Engagement Among Members of Gay-Straight Alliances: Individual and Structural Contributors

Using youth program models to frame the study of Gay-Straight Alliances (GSAs), we identified individual and structural predictors of greater engagement in these settings with a cross-sectional sample of 295 youth in 33 GSAs from the 2014 Massachusetts GSA Network Survey (69% LGBQ, 68% cisgen-der female, 68% White, M_age = 16.07). Multilevel modeling results indicated that members who perceived more support/socializing from their GSA, had more LGB friends, were longer serving members, and were in GSAs with more open and respectful climates reported greater engagement. Further, there was a curvilinear association between organizational structure in the GSA and engagement: Perceptions of more structure were associated with greater engagement to a point, after which greater structure was related to less engagement.

Promoting Youth Agency Through Dimensions of Gay-Straight Alliance Involvement and Conditions that Maximize Associations

Gay-Straight Alliances (GSAs) may promote wellbeing for sexual minority youth (e.g., lesbian, gay, bisexual, or questioning youth) and heterosexual youth. We considered this potential benefit of GSAs in the current study by examining whether three GSA functions-support/socializing, information/resource provision, and advocacy-contributed to sense of agency among GSA members while controlling for two major covariates, family support and the broader school LGBT climate. The sample included 295 youth in 33 Massachusetts GSAs (69 % LGBQ, 68 % cisgender female, 68 % white; M age = 16.06 years). Based on multilevel models, as hypothesized, youth who received more support/socializing, information/resources, and did more advocacy in their GSA reported greater agency. Support/socializing and advocacy distinctly contributed to agency even while accounting for the contribution of family support and positive LGBT school climate. Further, advocacy was associated with agency for sexual minority youth but not heterosexual youth. Greater organizational structure enhanced the association between support/socializing and agency; it also enhanced the association between advocacy and agency for sexual minority youth. These findings begin to provide empirical support for specific functions of GSAs that could promote wellbeing and suggest conditions under which their effects may be enhanced.

Are school policies focused on sexual orientation and gender identity associated with less bullying? Teachers' perspectives

Bullying is common in U.S. schools and is linked to emotional, behavioral, and academic risk for school-aged students. School policies and practices focused on sexual orientation and gender identity (SOGI) have been designed to reduce bullying and show promising results. Most studies have drawn from students' reports: We examined teachers' reports of bullying problems in their schools along with their assessments of school safety, combined with principals' reports of SOGI-focused policies and practices. Merging two independent sources of data from over 3000 teachers (California School Climate Survey) and nearly 100 school principals (School Health Profiles) at the school level, we used multi-level models to understand bullying problems in schools. Our results show that SOGI-focused policies reported by principals do not have a strong independent association with teachers' reports of bullying problems in their schools. However, in schools with more SOGI-focused policies, the association between teachers' assessments of school safety and bullying problems is stronger. Recent developments in education law and policy in the United States and their relevance for student well-being are discussed.

The Potential to Promote Resilience: Piloting a Minority Stress-Informed, GSA-Based, Mental Health Promotion Program for LGBTQ Youth

This article describes the results of a pilot study to determine the feasibility and acceptability of a mental health promotion program that was developed to address minority stressors and promote coping skills among lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth. It was hypothesized that the program would be feasible to implement within the context of a gay-straight alliance (GSA) and that GSA members would find the program acceptable (e.g., educational, enjoyable, helpful, and relevant). Participants included ten members of a high school GSA in the northeastern United States. The program sessions were delivered during GSA meetings. The first session emphasized the identification of minority and general stressors, which was followed by a discussion of coping strategies. The remaining sessions emphasized the development of cognitive coping, affect regulation, and problem-solving skills. After each session, participants completed a 13-item feedback form. Ten items assessed acceptability and three open-ended items allowed participants to provide constructive feedback. Although the program was feasible to implement within the GSA setting, attendance at the sessions was variable. Those who attended the sessions reported them to be enjoyable, informative, relevant to their lives, and potentially helpful for other LGBTQ students. After revising the program, future research is needed to investigate its dissemination potential and determine whether the program can disrupt the minority stress-psychiatric distress relationship.

Gay-Straight Alliances vary on dimensions of youth socializing and advocacy: factors accounting for individual and setting-level differences

Gay-Straight Alliances (GSAs) are school-based youth settings that could promote health. Yet, GSAs have been treated as homogenous without attention to variability in how they operate or to how youth are involved in different capacities. Using a systems perspective, we considered two primary dimensions along which GSAs function to promote health: providing socializing and advocacy opportunities. Among 448 students in 48 GSAs who attended six regional conferences in Massachusetts (59.8 % LGBQ; 69.9 % White; 70.1 % cisgender female), we found substantial variation among GSAs and youth in levels of socializing and advocacy. GSAs were more distinct from one another on advocacy than socializing. Using multilevel modeling, we identified group and individual factors accounting for this variability. In the socializing model, youth and GSAs that did more socializing activities did more advocacy. In the advocacy model, youth who were more actively engaged in the GSA as well as GSAs whose youth collectively perceived greater school hostility and reported greater social justice efficacy did more advocacy. Findings suggest potential reasons why GSAs vary in how they function in ways ranging from internal provisions of support, to visibility raising, to collective social change. The findings are further relevant for settings supporting youth from other marginalized backgrounds and that include advocacy in their mission.