Promoting a positive school climate for sexual and gender minority youth through a systems approach: A theory-informed qualitative study

Going the Extra Mile: How High School Staff Use Informal Strategies to Support, Protect, and Care for LGBTQ+ Students

BACKGROUND

High school staff can play a key role in supporting students with LGBTQ+ identities through informal strategies; however, more research is needed to understand how staff are employing these strategies.

METHODS

We conducted semi-structured interviews, collecting information on informal strategies used to support students identifying as LGBTQ+ from a diverse sample of 23 school staff from high schools across the United States.

RESULTS

Staff employed informal support strategies across social ecological levels: within the school community, staff interacted with parents/guardians of students and advocated for more inclusive policies. Within the classroom, staff created inclusive physical environments, implemented inclusive curricula, and employed bullying prevention strategies. Interpersonally, staff listened to and affirmed students and collaborated to employ support strategies. Intrapersonal qualities, including having a personal connection to the LGBTQ+ community and demonstrating open-mindedness, facilitated staff efforts to support students.

CONCLUSIONS

Supporting staff in the implementation of the strategies we identified could foster more inclusive school environments, advancing equity for students identifying as LGBTQ+.

Mental ill-health and substance use among sexuality diverse adolescents: The critical role of school climate and teacher self-efficacy

INTRODUCTION

Mental ill-health, substance use and their co-occurrence among sexuality diverse young people during earlier adolescence is relatively understudied. The preventive utility of positive school climate for sexuality diverse adolescents' mental health is also unclear, as well as the role of teachers in conferring this benefit.

METHOD

Using Wave 8 'B Cohort' data from the Longitudinal Study of Australian children (N = 3127, Mage = 14.3), prevalence ratios and odds ratios were used to assess prevalence and disparities in mental ill-health and substance use, and multinomial logistic regression for co-occurring outcomes, among sexuality diverse adolescents relative to heterosexual peers. Logistic regression was used to assess associations between school climate and teacher self-efficacy with sexuality diverse adolescents' mental health.

RESULTS

Mental ill-health prevalence ranged from 22% (suicidal thoughts/behaviour) to 46% (probable depressive disorders) and substance use between 66% (cigarette use) and 97% (alcohol use). Sexuality diverse participants were significantly more likely to report self-harm and high levels of emotional symptoms in co-occurrence with cigarette, alcohol and/or cannabis use. For each 1-point increase in school climate scores as measured by the Psychological Sense of School Membership scale, there was 10% reduction in sexuality diverse adolescents reporting high levels of emotional symptoms, probable depressive disorder, self-harm thoughts/behaviour and suicidal thoughts/behaviour. For each 1-point increase in lower perceived (worse) teacher self-efficacy scores as measured by four bespoke teacher self-efficacy items, odds of sexuality diverse adolescent-reported suicidal thoughts/behaviour increased by 80%.

DISCUSSION

Mental ill-health, substance use and especially their co-occurrence, are highly prevalent and pose significant and inequitable health and well-being risks. Schools represent a potential site for focusing future prevention efforts and educating and training teachers on sexuality diversity is a promising pathway towards optimising these.

Minority stressors, traumatic events, and associations with mental health and school climate among gender and sexuality diverse young people in Australia: Findings from a nationally representative cohort study

INTRODUCTION

Population-level, nationally representative data on the prevalence of minority stressors and traumatic events, mental ill-health effects, and the preventative utility of school climate, among gender and sexuality diverse young people in Australia, is significantly lacking. In this study, we estimated the prevalence and distribution of minority stressors and traumatic events among young people by sexuality identity (gay/lesbian, bisexual, other sexuality, heterosexual), sexuality diversity (sexuality diverse, not sexuality diverse), and gender identity (transgender, cisgender) and assessed associations with mental ill-health and the moderating role of school climate factors.

METHODS

Using Wave 8 (2018) follow-up data from a population-level, nationally representative longitudinal cohort study, the sample comprised 3037 young people aged 17-19 years in Australia. Prevalence ratios for minority stressors and traumatic events were calculated for gender and sexuality diverse categories using logistic regression models. Linear regression models were used to test associations between traumatic events and minority stressors, and mental ill-health. Multivariate linear regression tested school climate factors as effect modifier between minority stressors and mental ill-health among sexuality diverse young people.

RESULTS

Rates of traumatic events and minority stressors were highest among bisexual and gay/lesbian young people and were significantly associated with mental ill-health among all gender and sexuality diverse young people. Highest mental ill-health effects were observed among trans young people. Among sexuality diverse young people, positive and negative feelings toward school climate were associated with decreased and increased mental ill-health, respectively. After accounting for sexuality diversity, positive overall school climate appeared protective of mental ill-health effects of sexuality-based discrimination.

DISCUSSION

Minority stressors, traumatic events, and associated mental ill-health are prevalent among gender and sexuality diverse young people in Australia, especially trans, bisexual, and gay/lesbian young people. Promotion of affirmative, safe, and inclusive school climate demonstrates significant promise for the prevention and early intervention of mental ill-health among gender and sexuality diverse young people.

Effects of School Policies and Programs on Violence Among All High School Students and Sexual and Gender Minority Students

BACKGROUND

Youth identifying as lesbian, gay, bisexual (LGB) and/or transgender/gender nonconforming (TGNC) are at increased risk of violence. School policies and practices may mitigate this risk.

METHODS

Researchers merged data from the 2016 New Mexico School Health Profiles and the 2017 New Mexico Youth Risk and Resiliency Survey. Researchers employed multivariable logistic regression to test the associations between school-level measures and violence outcomes.

RESULTS

Genders and sexualities alliances (GSAs) were associated with reduced odds of lifetime forced sex among all, heterosexual cisgender, and LGB students, reduced odds of sexual violence among heterosexual cisgender students, and reduced odds of dating violence among LGB students. Inclusive sexual health education was associated with reduced odds of lifetime forced sex among LGB and TGNC students, reduced odds of sexual violence among LGB students, and increased odds of dating violence among heterosexual cisgender students. Inclusive teacher training was associated with increased odds of lifetime forced sex among TGNC students.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Inclusive sexual health education and the presence of active GSAs may have the greatest potential for reducing violence, especially among LGB and TGNC students.

CONCLUSIONS

Findings highlight the important role of school policies and practices in addressing violence.

Exploring the Mental Health Challenges and Coping Behaviour of Lesbian, Gay, and Bisexual Students at an Institution of Higher Learning

The South African university community is predominantly heterosexual, which fosters stigmatisation and discrimination against LGBTQI students despite the efforts to create conditions where LGBTQI students can succeed academically, socially, and personally. The study aimed to explore and describe the challenges experienced by LGBTQI students and their mental well-being as well as the coping behaviours adopted in a university in South Africa. This was accomplished using a descriptive phenomenological approach. A snowballing sampling method was used to select ten students who identified themselves as gay, lesbian, and bisexual (LGB). Semi-structured one-on-one interviews were conducted, and data were analysed thematically. The students perceived character defects stigma from fellow students and lecturers in and out of class. The mental health challenges experienced included a diminished sense of safety, lack of a sense of belonging, low self-esteem, and acting out of character. As a result, confrontation, passive withdrawal, and active dependent behaviour were utilised as different types of coping behaviour. The LGB students were subjected to stigma that negatively affected their mental health. Therefore, creating awareness about the rights of LGBTQI students to education, safety, and self-determination is recommended.

Libraries advancing health equity:a literature review

Purpose

Progress toward health equity is necessary to reduce health disparities, and health literacy is key to achieving this goal. Because libraries provide access to knowledge and insights about their communities, they are effective partners in advancing health equity and implementing programs to reduce health disparities. A literature review on library programs and activities that focus on promoting health equity was conducted.

Design/methodology/approach

A literature review on library programs and activities concerning health equity and social determinants of health was conducted. Relevant literature was identified from searches of databases, library publications and grey literature.

Findings

The authors found 224 eligible sources and many types of libraries advancing health equity. Libraries frame their role in advancing health equity through external programs in three ways: (1) providing access to high-quality health information, (2) delivering health literacy training and resources and (3) connecting their communities with community health services. Libraries also advance health equity by focusing on internal library operations and providing research services focused on cultural humility and competence as they apply to health care.

Originality/value

This literature review will help the National Library of Medicine (NLM) develop a strategy to support libraries advancing health equity through information made available by programs and activities of NLM and the Network of the National Library of Medicine.

'Bending' against straightening devices: queer lived experiences of sexuality and sexual health in Bangladesh

BACKGROUND

Despite global data around increased health risks among sexual and gender diverse populations, lived experiences of young lesbian, gay, bisexual, transgender, queer or questioning, and others (LGBTQ+) people are often ignored in mainstream health research. This is particularly evident in countries such as Bangladesh where the rights of sexual minorities are not recognised. This article looks at queer lived experiences of sexuality and sexual health within such a context. We use the phenomenological framework of heteronormative 'straightening devices' - mechanisms working to direct people towards heterosexuality, gender conformity, and procreative marriage - to identify 'invisible' structures upholding normative sexual behaviours and see how young people in Bangladesh navigate these in their everyday lives.

METHODS

This article is based on qualitative data collected in Dhaka, Bangladesh over nine months in 2019 as part of the first author's doctoral research. Using thematic analysis, we draw on experiences of normative sexual expectations from biographical in-depth interviews with 14 purposively sampled LGBTQ + individuals aged 18 to 24.

RESULTS

Respondents identified heteronormative expectations around gender norms of traditional behaviour and presentation for men and women as well as parental expectations of compulsory heterosexuality through marriage. These straightening devices existed at multiple levels, including individual, interpersonal, community, and societal. The four main themes around straightening devices include marriage norms for women; harassment of feminine-presenting bodies in public spaces; heteronormative healthcare; and consequences of not embodying heteronormativity.

CONCLUSION

Our study highlighted young people's everyday experiences of having to 'bend' to - and against - heteronormative straightening devices at home, in public spaces, and within institutions such as healthcare in Bangladesh. The exploration of queer experiences provides new insights into context-specific ways in which sexual and gender diverse people understand themselves. Further research using the framework of straightening devices can help public health professionals to identify more 'barriers' confronted by sexual and gender diverse young people.

Dosage in Implementation of an Effective School-Based Health Program Impacts Youth Health Risk Behaviors and Experiences

PURPOSE

This study is part of a larger evaluation of a multilevel, multistrategy federal program to reduce high school students' risk for HIV/sexually transmitted infection and unintended pregnancy. Local education agencies supported schools in implementing three strategies: delivering exemplary sexual health education, increasing student access to quality sexual health services, and enhancing safe and supportive school environments (SSE). We examined how levels of school implementation of these strategies moderated program effects on targeted student outcomes.

METHODS

The Youth Risk Behavior Survey was implemented in participating local education agencies in 2015 and 2017 to assess student behaviors and experiences, whereas the School Health Profiles surveys assessed school policies and practices in 2014 and 2016. We used these surveys to measure student-level outcomes and school-level program delivery, respectively, which were analyzed using multilevel modeling in a difference-in-differences framework.

RESULTS

Levels of SSE implementation significantly moderated program effects on multiple student outcomes, including ever having sex, having four or more lifetime sexual partners, being sexually active, using hormonal birth control, dual use of a condom and hormonal birth control, ever being forced to have sex, missing school because of safety concerns, and lifetime and current marijuana use. However, we found few moderating effects of exemplary sexual health education and sexual health services dosage.

DISCUSSION

We found a significant relationship between incremental increases in implementation of activities to increase the safety and supportiveness of school environments and enhanced program effects in improving multiple student health outcomes. These findings suggest that school implementation of SSE activities contributed to intended program effects.

Under Psychological Safety Climate: The Beneficial Effects of Teacher-Student Conflict

Previous studies have mainly focused on the negative effects of teacher-student conflict; the positive effects of conflict have rarely been mentioned. This paper suggests that encouraging conflict could act as a teaching method to improve students' innovative competence. This study has two objectives: (1) to examine how various types of teacher-student conflict affects students' innovative competence and (2) to identify the mediating role of a psychological safety climate in the association between conflict and students' innovative competence. To achieve the objectives, we used evidence from 1207 university students. Multivariable logistic regression analysis revealed that conflicts were associated with students' innovative competence, and the mediation role of a psychological safety climate is significant. Specifically, the results revealed that Cognitive Conflict had significant positive effects on students' innovative competence, whereas Affective Conflict had a significant negative effect on students' innovative competence. In addition, we clarified a psychological safety climate as the boundary condition for the relationship between conflict and students' innovative competence.

Social support in schools and related outcomes for LGBTQ youth: a scoping review

Recent research has increasingly focused on positive factors and supports for LGBTQ youth. This scoping review explores existing social support for LGBTQ youth in schools through the Ecological Systems Theory to respond to the following four objectives: (1) define social support systems in schools, (2) identify current research on outcomes for LGBTQ youth, (3) identify barriers to support LGBTQ youth in schools, and (4) identify areas for future research for LGBTQ youth and social support in schools. A systematic search (Arksey and O'Malley in Int J Soc Res Methodol 8(1):19-32, 2005) between 2007 through 2021 resulted in 94 articles. This review gave rise to an organizational framework to consolidate various systems of social support for LGBTQ youth in schools. Social support consisted of seven social support systems (family, curriculum, family, peers, school policies, GSAs and programs, and school climate) that are positively associated with the promotion of positive socioemotional, behavioural, and educational outcomes for LGBTQ youth. Though the literature has been clear surrounding the risks associated with LGBTQ youth, this scoping review provides a positive outlook on LGBTQ youth's school experiences and how these systems of social support allow for LGBTQ youth to act as active participants to foster a positive school climate and sense of safety.

Supplementary Information

The online version contains supplementary material available at 10.1007/s44217-022-00016-9.

Bidirectional associations between biased language exposure and school-based relationships across gender

Students often hear their peers use biased language regarding race, religion, sexual orientation, or disability status in the school setting. Prior research has indicated that biased language is related to school climate, and specifically to school-based relationships between peers and between students and their teachers. This study investigated the longitudinal associations among student-student relationships, teacher-student relationships, and being the target of or hearing biased language in middle school students. Students (N = 501; 46.5% White, 21.8% Hispanic, 13% African American, and 15% Multi-Racial; 48.7% female) reported on how much they were targeted or heard biased language related to race/religion, sexual orientation, and disability status. Students also reported on their relationships with their peers and teachers. Using a cross-lagged panel model with the overall sample, a negative unidirectional association from being the target of or hearing biased language and student-student relationships and teacher-student relationships was identified. Separate models for boys and girls identified unique patterns. For boys, biased-language exposure predicted more negative student-student relationships and teacher-student relationships, whereas for girls, biased-language exposure was not associated with school-based relationships. Implications include addressing language use and building positive student-student and teacher-student relationships.