The mental health of the nation鈥檚 LGBTQ+ teens is plummeting and lawmakers have curtailed how gender identity can be discussed in schools. All the while, the number of students who identify as LGBTQ+ has increased.
Yet health workers in schools have received little training on how to respond in this rapidly changing landscape.
鈥淚 would like more training on the LGBTQ+ community,鈥� said a social worker from Tennessee in an open-ended response in an EdWeek Research Center survey. The social worker had a student who wanted to go by different pronouns but whose parents didn鈥檛 support that request. 鈥淚t鈥檚 confusing and it鈥檚 hard to know how to respond while keeping my job. I鈥檇 like to both support the student and keep my job. I am walking on eggshells and I don鈥檛 like it.鈥�
More than 40 percent of U.S. K-12 school-based health professionals have not received any professional development on working with LGBTQ+ students, according to an EdWeek Research Center survey of 3,480 health educators, nurses, psychologists, social workers, and other health care staff conducted in March.
That, in turn, is probably why 37 percent of respondents said they would benefit from more professional development on working with LGBTQ+ students, according to the survey.
Meanwhile, open-ended responses in the survey also show that some school health workers are uncomfortable discussing the topic. They cite personal beliefs, or don鈥檛 believe it should be a school鈥檚 responsibility to educate students about LGBTQ+ issues because, they say, in most cases those discussions should be between the parent and the child.
鈥淜eep politics out of school and simply allow districts to teach academics and not divisive cultural issues,鈥� said a social worker in Minnesota.
All students need safe learning environments
But LGBTQ+ advocates counter that schools do have a role to play in ensuring that all students are safe and feel a sense of belonging in schools.
LGBTQ+ teens report higher rates of anxiety, depression, and suicidal ideation 鈥渂ecause of the disparities in social treatment,鈥� said Elijah Oyenuga, a program coordinator for the National LGBTQIA+ Health Education Center at Fenway Health, a nonprofit LGBTQ+ health care, research, and advocacy organization.
Students spend a lot of time at school, and if a student is being bullied because of the gender they identify with, and a teacher doesn鈥檛 do anything about it, 鈥渢hey have now sent the message that it鈥檚 acceptable behavior,鈥� which creates an unsafe learning environment for that student, Oyenuga said.
Research from The Trevor Project, an LGBTQ+ advocacy group, found that when LGBTQ+ students feel that their teachers care about them, they report higher self-esteem and lower levels of depression and anxiety, and they are less likely to seriously consider or attempt suicide.
Along with creating safe learning environments for students, another goal of education is 鈥渢o create an engaged citizenry, who are ready to be global citizens,鈥� said Darrell Sampson, the executive director of student services for the Arlington Public Schools in Virginia and a licensed professional counselor. That means students need to learn how to engage with people who are different from them.
鈥淚 don鈥檛 think it鈥檚 the responsibility of schools to tell students or their families what they have to believe, but I do think it鈥檚 our responsibility to provide information and to create those supportive and respectful communities, so that all of our students see themselves as belonging and feel safe to focus on learning,鈥� Sampson said.
What professional development should look like
Oftentimes, school health workers are unsure of what to do or what to say to students who are questioning their gender or are part of the LGBTQ+ community.
鈥淲e have a larger population of LGBTQ+ [students] and it would be helpful to know how to speak to these children going through the questioning aspect of it,鈥� said a school nurse in New Jersey, in an open-ended response to the EdWeek Research Center survey.
Experts say professional learning opportunities should include information on the health disparities that these students experience; any specific school, state, and federal policies related to LGBTQ+ students鈥� rights; and ways to best support and affirm these students.
Such training should also include evidence-based strategies. School health care workers want to follow research-proven practices, said Kate King, the president-elect of the National Association of School Nurses and a school nurse for Columbus City Schools in Ohio.
If districts provide effective training to school health workers, 鈥渋t will then translate into better help and better relationships with our students, because when we have those relationships and those services for our students, they鈥檙e able to stay in school and learn,鈥� King said.
But providing these opportunities is difficult, given the political climate in some states. 鈥淚n different states, laws are changing on a daily basis. It is difficult for school staff and school districts sometimes to know what they can talk about, what they can do, and what they can鈥檛 do in that regard,鈥� King said.
It鈥檚 also difficult to find time in a structured school day to provide training and get buy-in from administrators, she added.
At a minimum, district leaders鈥� expectation should be to remind school staff that they already know how to create supportive learning environments for all students, Oyenuga said.
鈥淵ou don鈥檛 need to know anything about being gay or being trans in order to be able to tell people that treating people badly, calling people names, discriminating against people is not acceptable behavior and we don鈥檛 tolerate that at school,鈥� he said.
In fact, when asked how they reacted when they encountered a student or students seeking counseling or support about transitioning to a different gender, the most common response among school-based health workers was listening in a neutral manner (77 percent), followed by using the student鈥檚 requested name and pronouns (74 percent), according to the EdWeek Research Center survey.
The results show that, though school health care staff 鈥渕ay be nervous and feel very unsure,鈥� they are already doing what will 鈥渂enefit students the most,鈥� Sampson said.
Data analysis for this article was provided by the EdWeek Research Center. Learn more about the center鈥檚 work.
