Promoting the Health of Gender and Sexual Minorities _ ____________________________________________
Many LGBTQ+ students also experienced other forms of discrimination [66]: • 25.2% of LGBTQ+ students were disciplined for public affection (e.g., kissing, holding hands) that is not simi- larly disciplined among non-LGBTQ+ students. • 16.6% of LGBTQ+ students were prevented from writ- ing or talking about LGBTQ+ issues in extracurricular activities. • 15.6% of LGBTQ+ students were prevented from writing about or doing school projects about LGBTQ+ issues. • 12.3% of LGBTQ+ students were prevented from wear- ing clothing supporting LGBTQ+ issues. • 12.3% of LGBTQ+ were prevented from forming or promoting a gay student alliance. • 11.3% of LGBTQ+ students shared that school staff or coaches had prevented or discouraged them from play- ing sports because they identified as LGBTQ+. LGBTQ+ students who had only been in in-person learning environments during the academic year were far more likely to experience any form of LGBTQ+-related discrimination than those in the other types of learning environments. A hostile school climate affects students’ academic success and mental health. LGBTQ+ students who experience victimization and discrimination at school have worse educational outcomes and poorer psychological well-being [66]. While there is some evidence that societal attitudes are less oppressive than in the past, contemporary GSM youth will nevertheless experience a lifetime of exposure to entrenched negative societal attitudes. Consequently, healthcare profes- sionals who have an awareness of and sensitivity to sexual minority youth and their unique health and safety concerns are in a position to assist the youth to manage their developmental tasks and address their health needs as they mature. The goal should be to encourage young adults to be comfortable with themselves, thus becoming more likely to demonstrate sound health practices. The “homosexual adolescent” was first acknowledged by empirical social science in 1972 [69; 70]. Additional empirical research reports were not available until the late 1980s, and sexual minority youth continued to remain largely invisible, even within the lesbian and gay community, until the 1990s [71]. Fortunately, the body of professional literature related to GSM youth has been evolving quickly. Many LGBTQIA youth say they knew at an early age that the sexual thoughts and feelings they were experiencing were some- how different from other youth, but they did not understand the meaning of the difference. Although much variability among GSM youth exists, the average age of same-sex attrac- tions is approximately 10 years of age for boys and 11 years of age for girls [72]. It is not until adolescence, when the capacity for abstract thought has been developed, that youth are able
to analyze their responses to others and place these responses and associated feelings in a larger context [73]. Behaviors and feelings that adolescents recognize as gender atypical may result in fear of humiliation or physical violence, shame, and judgment as unhealthy or deviant [74]. Events in our nation’s schools have contributed to public awareness of the prevalence of humiliation and violence among students. The school environment must be considered when thinking about the unique health and safety needs of LGBTQIA youth. “Because young people spend so much time in schools, and because of the relationship between academic achievement and later accomplishments, these settings are of crucial importance to understanding the transition of lesbian, gay, and bisexual youth into early adulthood” [69]. Survey results from public school educators and administrators have revealed that while public school educators acknowledge that problems for LGBTQIA youth exist in schools, administrators believe there are adequate programs already in place to handle the needs of the LGBTQIA youth population [75]. Several sources, documenting the dangerous and punishing atmo- sphere in school for some LGBTQIA youth, have challenged this perception [65]. This and other problematic attitudes in the schools have a significant impact on the academic perfor- mance and goals of LGBTQIA students, including absentee- ism, lower grades, and foregoing post-secondary education [66]. Heterosexist peer cultural norms make LGBTQIA youth extremely vulnerable in the school setting. Middle and high school students report that sexual orienta- tion and gender expression are among the top three reasons students in their schools are bullied or harassed. LGBT stu- dents in middle school may face more bullying and harassment than their high school peers, which mirrors the environment among the general student population [66]. The National School Climate Survey revealed that 68.0% of LGBT students felt unsafe at school because of their sexual orientation and 43.2% because of their gender expression [66]. In one study, approximately 73% of students interviewed indicated that they would be “very upset” if someone called them gay or lesbian, but only 61% indicated that they would report its occurrence, even when it was done to someone they knew personally [76]. In addition, 76.1% of LGBTQIA students report having been bullied and harassed at school in the past year, and more than one-half reported experiencing some form of electronic harass- ment (“cyberbullying”) in the past year [66]. The most frequent types of harassment are deliberate exclusion, being the target of mean rumors or lies, and sexual harassment. Some parents and teachers believe that verbal harassment, which belittles, demeans, and ridicules, is normal teasing and common among teens. This is reflected in comments such as, “Those are just words the kids use these days.” It has been suggested, however, that while teasing appears to be a posi- tive experience for most young people, ridicule is clearly not desirable. Ridicule has been connected with low self-esteem and several clinical symptoms, such as hostility, depression, and interpersonal sensitivity. Peer ridicule may also be a
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