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Lesbian, Gay, Bisexual and Transgender Health

LGBTQ Youth Programs-At-A-Glance

Image of young female college students.Lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth are at elevated risk for many health risk behaviors, bullying, violence, discrimination, and associated health and mental health outcomes. Recognizing these serious health risks, CDC works with national, state, and local partners to address the health, education, and safety needs of LGBTQ youth.

Data Collection and Analysis

CDC provides funding for state, territorial, and local education agencies; state health agencies; and tribal governments to conduct the Youth Risk Behavior Survey (YRBS), which monitors health risk behaviors among U.S. high school students. CDC encourages its sites to add optional questions about same-sex sexual contact and sexual identity to their state, territorial, or local YRBS questionnaires. Collecting such data enables sites to better understand the health and safety risks among sexual minority youth and then adjust prevention priorities accordingly.

During the 2011 YRBS—

  • Five sites asked only about the sex of students’ sexual contacts
  • One site asked only about students’ sexual identity
  • Twenty-one sites asked about both the sex of students’ sexual contacts and about students’ sexual identity

In 2011, CDC analyzed data from YRBS to identify associations between sexual minority status and health risk behaviors. The findings of this analysis are described in a CDC report, “Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9–12 in Selected Sites—Youth Risk Behavior Surveillance, United States, 2001–2009.” The report documents the disproportionate rates at which sexual minority students experience many health risks, including tobacco, alcohol, and other drug use; sexual risk behaviors; and violence.

School Health Profiles and the School Health Policies and Practices Study, CDC’s two large surveillance systems measuring school health policies and practices, assess school health policies and practices relevant to LGB youth, such as

  • Existence of gay-straight alliances (GSAs) or similar student organizations in schools
  • Identification of safe spaces for LGBTQ youth
  • Prohibition of harassment and bullying
  • Provision of health and mental health services to LGBTQ  youth
  • Professional development and training for school staff about the needs of LGBTQ youth
  • Inclusion of LGBTQ-related topics in sex education curricula
  • Classroom teaching about sexual orientation
  • Referrals to health and mental health service providers experienced in serving LGBTQ youth

State, Territorial, Tribal, and Local Prevention Programs

CDC provides funding and technical assistance to 49 states, the District of Columbia, 16 large urban school districts, 6 territories, and 1 tribal government to help school districts and schools implement effective policies and practices to reduce sexual risk behaviors among youth. These programs are increasingly focusing on LGBTQ youth as part of their HIV, STD, and pregnancy prevention activities.

Examples of program activities include

  • Providing training for district and school staff to ensure that health curricula are inclusive of and relevant to LGBTQ students
  • Supporting schools in establishing gay-straight alliances or similar groups
  • Linking schools to community organizations that provide health and mental health services for LGBTQ youth
  • Developing resources to help school staff understand the special concerns and needs of LGBTQ youth
  • Collecting data on risk behaviors among LGB youth as part of the Youth Risk Behavior Survey

In 2010, 24 state education agencies and 15 local education agencies funded by CDC reported specific activities to address LGBTQ youth. See the following for examples:

  • The School District of Philadelphia provides annual skills-based training entitled “Fostering Knowledge About and Respect for LGBT Youth” for all K-12 staff and teachers; developed a community resource guide for schools and community-based organizations on referral services for LGBTQ youth; and collaborates with the APA to provide training to school nurses, psychologists, social workers, and counselors.
  • The Rhode Island Department of Education established a statewide task force on lesbian, gay, bisexual, transgender, queer, and questioning youth. The task force released a statewide plan with recommendations in the areas of education, policy, health and human services, child welfare, mental health, and data collection to ensure these young people’s needs are addressed. Among the recommendations were that 1) questions about same-sex sexual activity and sexual orientation be added to the state YRBS, 2) training be provided for school staff on issues pertaining to LGBTQ youth, 3) GSAs be established when requested by students, and 4) lesbian, gay, bisexual, transgender, queer, and questioning identity be included in definitions of diversity.
  • The HIV/AIDS Prevention Unit of the Los Angeles Unified School District (LAUSD) developed a chapter about sexual orientation for inclusion in the Sexuality and Society textbook that is used in required health education courses in LAUSD high schools. The district also employs two full-time staff members to address issues pertaining to LGBTQ youth, and approximately 35,000 LAUSD employees and students—including all teachers hired since 2003—have received the district’s anti-bias training.
  • The Wyoming Department of Education held a GSA summit and leadership training for students from across the state to discuss school climate and how they’re working in their individual schools and districts to create safer spaces for LGBTQ youth. The state also sponsors trainings for school district professionals on working effectively with young people in this population.
  • In response to requests from school districts throughout Michigan for guidance on creating safe school environments for sexual minority students, the Michigan Department of Education (MDE) collaborated with the Calhoun (Michigan) Intermediate School District (CISD) to update a guide and training program on the topic and to offer trainings statewide. Copies of the guide, A Silent Crisis: Creating Safe Schools for Sexual Minority Youth, have been distributed throughout Michigan and 20 other states. MDE has conducted workshops using the guide for educators in 180 Michigan school districts.

Program Evaluation

CDC collaborated with Seattle Public Schools to evaluate the effectiveness of the school system’s initiatives to establish safe and supportive school environments for LGBTQ youth. The evaluation found that GSAs provided avenues for students to participate meaningfully and feel more connected at school, an important protective factor.

Collaboration with National Nongovernmental Organizations

CDC provides funding and technical assistance to the Gay–Straight Alliance Network (GSA Network) and the Gay, Lesbian, and Straight Education Network (GLSEN) to increase the capacity of schools and community-based organizations to meet the health and mental health needs of LGBTQ youth.

GSA Network’s activities include—

  • Increasing the number of safe spaces for LGBTQ youth in schools through the creation of new GSAs
  • Coordinating GSA regional networking and capacity building summits for youth and adult advisors

GLSEN’s activities include—

  • Training school staff to combat anti-LGBTQ bullying and harassment and to promote the health and well-being of LGBTQ students, particularly African American and Latino youth
  • Providing technical assistance and Safe Space Kits to school staff

Both GLSEN and GSA Network collaborate with community partners to support policies that better meet the mental and sexual health needs of LGBTQ youth and to promote YRBS data collection on same-sex sexual contact and sexual identify.

Young Men Who Have Sex with Men (YMSM) Project

Among adolescents aged 13–19 years, nearly two-thirds of all diagnosed HIV infections are from male-to-male sexual contact. HIV infection rates are disproportionately high among African American and Latino YMSM. To assess and target efforts towards YMSM, CDC provides funding to and collaborates with Advocates for Youth, the National Association of School Nurses, and the National Assembly on School-Based Health Care to work with local education agencies, health departments, and community-based organizations in New York City, Philadelphia, and San Francisco. Project activities are centered on assessing and strengthening the following services for adolescent YMSM, particularly African American and Latino youth:

  • Referrals and linkages to STD and HIV testing, counseling, and treatment
  • Evidence-based interventions
  • Social media and social marketing
  • Policies that support health and mental health care

For more information about the Young Men Who Have Sex With Men (YMSM) Project, please visit the CDC Healthy Youth web site.

Training for School Counselors, Nurses, Psychologists, and Social Workers

School health professionals can benefit from training to help them understand the needs of gay, lesbian, and bisexual youth, and shape behavioral health messages accordingly. During 2006–2011, CDC funded the American Psychological Association (APA) Healthy Lesbian, Gay, and Bisexual Students Project to help schools and youth-serving organizations improve health and mental health outcomes for these young people. APA created a training manual and offered science-based workshops for school counselors, nurses, psychologists, and social workers on how to effectively reach sexual minority students with HIV prevention messages and other health information. Many education agencies funded by CDC have formed their own training cadres to offer the workshop locally.

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