Addressing LGBTQ Student Bullying in Massachusetts Schools: Perspectives of LGBTQ Students and School Health Professionals

Abstract

Lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) youth face disparities in bullying victimization are associated with higher rates of physical injury, psychological distress, and even suicide. Innovative strategies to address bullying victimization are needed to prevent adverse physical and mental health outcomes, including those engaging school health professionals (SHPs; school nurses, psychologists). This mixed-methods study sought to identify factors that facilitate or impede SHPs’ reporting and responding to LGBTQ bullying in Massachusetts from the perspectives of LGBTQ students and SHPs. Between August 2017 and July 2018, asynchronous online focus group discussions and a brief survey were conducted separately for 28 LGBTQ students and 19 SHPs in Massachusetts (9–12 participants per group; n = 47 enrolled). Focus groups probed on bullying experiences. Rapid qualitative inquiry was used for thematic coding of facilitators and barriers to address LGBTQ student bullying described by youth and SHPs. Facilitators and barriers largely coalesced around the social ecological model. Youth and SHPs identified factors at multiple levels of the social ecological model: (1) individual (knowledge, skills, attitudes); (2) interpersonal (trust and follow-through, confidentiality and fear of being “outed,” close relationships, champion SHPs); and (3) structural (school buy-in, time, reporting and protocols, staff roles, resources, and school culture of inclusivity). LGBTQ students expressed a need for an intersectional lens for SHPs when addressing LGBTQ student bullying. Interventions that help SHPs overcome multilevel barriers and leverage facilitators are needed. Consideration of intersectionality will better equip SHPs to support LGBTQ students and address disparities in LGBTQ student bullying that confer health risks.

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References

  1. APHA (2014). Reduction of bullying to address health disparities among LGBT youth. https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2015/01/23/09/31/reduction-of-bullying-to-address-health-disparities-among-lgbt-youth.

  2. Beebe, J. (2001). Rapis assessment process: An introduction. Lanham: Rowman & Littlefield.

    Google Scholar 

  3. Beebe, J. (2014). Rapid qualitative inquiry: A field guide to team-based assessment (2nd ed.). Lanham: Rowman & Littlefield.

    Google Scholar 

  4. Bowleg, L. (2012). The problem with the phrase women and minorities: Intersectionality-an important theoretical framework for public health. American Journal of Public Health, 102(7), 1267–1273. https://doi.org/10.2105/AJPH.2012.300750.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bronfenbrenner, U. (1986). Ecology of the Family As A Context for Human-Development - Research Perspectives (Vol. 22).

  6. Council on School Health. (2016). Role of the school nurse in providing school health services. Pediatrics, 137(6), e20160852. https://doi.org/10.1542/peds.2016-0852.

    Article  Google Scholar 

  7. Crenshaw, K. (1991). Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43(6), 1241–1299. https://doi.org/10.2307/1229039.

    Article  Google Scholar 

  8. Daley, A., Solomon, S., Newman, P. A., & Mishna, F. (2007). Traversing the margins: Intersectionalities in the bullying of lesbian, gay, bisexual and transgender youth AU - Daley, Andrea. Journal of Gay & Lesbian Social Services, 19(3–4), 9–29. https://doi.org/10.1080/10538720802161474.

    Article  Google Scholar 

  9. Davis, C. (2006). School's out for bullying. Nursing Standard, 20(21), 24–25.

    Article  Google Scholar 

  10. DuBois, L. Z., Macapagal, K. R., Rivera, Z., Prescott, T. L., Ybarra, M. L., & Mustanski, B. (2015). To have sex or not to have sex? An online focus group study of sexual decision making among sexually experienced and inexperienced gay and bisexual adolescent men. Archives of Sexual Behavior, 44(7), 2027–2040. https://doi.org/10.1007/s10508-015-0521-5.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Earnshaw, V. A., Rosenthal, L., Carroll-Scott, A., Peters, S. M., McCaslin, C., & Ickovics, J. R. (2014). Teacher involvement as a protective factor from the association between race-based bullying and smoking initiation. Social Psychology of Education, 17(2), 197–209. https://doi.org/10.1007/s11218-014-9250-1.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Earnshaw, V. A., Bogart, L. M., Poteat, V. P., Reisner, S. L., & Schuster, M. A. (2016). Bullying among lesbian, gay, bisexual, and transgender youth. Pediatric Clinics of North America, 63(6), 999–1010. https://doi.org/10.1016/j.pcl.2016.07.004.

    Article  PubMed  Google Scholar 

  13. Earnshaw, V. A., Reisner, S. L., Juvonen, J., Hatzenbuehler, M. L., Perrotti, J., & Schuster, M. A. (2017). LGBTQ bullying: Translating research to action in pediatrics. Pediatrics, 140(4), e20170432. https://doi.org/10.1542/peds.2017-0432.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Earnshaw, V. A., Reisner, S. L., Menino, D., Poteat, V. P., Bogart, L. M., Barnes, T. N., et al. (2018). Stigma-based bullying interventions: A systematic review. Developmental Review, 48, 178–200. https://doi.org/10.1016/j.dr.2018.02.001.

    Article  PubMed  Google Scholar 

  15. Espelage, D. L. (2016). Sexual orientation and gender identity in schools: A call for more research in school psychology-no more excuses. Journal of School Psychology, 54, 5–8. https://doi.org/10.1016/j.jsp.2015.11.002.

    Article  PubMed  Google Scholar 

  16. Friedman, M. S., Koeske, G. F., Silvestre, A. J., Korr, W. S., & Sites, E. W. (2006). The impact of gender-role nonconforming behavior, bullying, and social support on suicidality among gay male youth. The Journal of Adolescent Health, 38(5), 621–623. https://doi.org/10.1016/j.jadohealth.2005.04.014.

    Article  PubMed  Google Scholar 

  17. Gower, A. L., Forster, M., Gloppen, K., Johnson, A. Z., Eisenberg, M. E., Connett, J. E., et al. (2018). School practices to Foster LGBT-supportive climate: Associations with adolescent bullying involvement. Prevention Science, 19(6), 813–821. https://doi.org/10.1007/s11121-017-0847-4.

    Article  PubMed  Google Scholar 

  18. Graybill, E. C., & Proctor, S. L. (2016). Lesbian, gay, bisexual, and transgender youth: Limited representation in school support personnel journals. Journal of School Psychology, 54, 9–16. https://doi.org/10.1016/j.jsp.2015.11.001.

    Article  PubMed  Google Scholar 

  19. Hillard, P., Love, L., Franks, H. M., Laris, B. A., & Coyle, K. K. (2014). "They were only joking": Efforts to decrease LGBTQ bullying and harassment in Seattle public schools. The Journal of School Health, 84(1), 1–9. https://doi.org/10.1111/josh.12120.

    Article  PubMed  Google Scholar 

  20. IBM. (2015). IBM SPSS Statistics for Windows (23.0 ed.). Armonk: IBM Corp..

    Google Scholar 

  21. Juvonen, J., & Graham, S. (2014). Bullying in schools: The power of bullies and the plight of victims. Annual Review of Psychology, 65, 159–185. https://doi.org/10.1146/annurev-psych-010213-115030.

    Article  PubMed  Google Scholar 

  22. Kann, L., Olsen, E. O., McManus, T., Harris, W. A., Shanklin, S. L., Flint, K. H., et al. (2016). Sexual identity, sex of sexual contacts, and health-related behaviors among students in grades 9-12 - United States and selected Sites, 2015. MMWR Surveill Summ, 65(9), 1–202. https://doi.org/10.15585/mmwr.ss6509a1.

    Article  PubMed  Google Scholar 

  23. Kolbert, J. B., Crothers, L. M., Bundick, M. J., Wells, D. S., Buzgon, J., Berbary, C., et al. (2015). Teachers' perceptions of bullying of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) students in a southwestern Pennsylvania sample. Behav Sci (Basel), 5(2), 247–263. https://doi.org/10.3390/bs5020247.

    Article  Google Scholar 

  24. Kosciw, J. G., Greytak, E. A., Bartkiewicz, M. J., Boesen, M. J., & Palmer, N. A. (2012). The 2011 national school climate survey: The experiences of lesbian, gay, bisexual and transgender youth in our nation's schools. Washington: GLSEN.

    Google Scholar 

  25. Lesesne, C. A., Rasberry, C. N., Kroupa, E., Topete, P., Carver, L. H., Morris, E., et al. (2015). Communicating with school staff about sexual identity, health and safety: An exploratory study of the experiences and preferences of black and Latino teen young men who have sex with men. LGBT health, 2(3), 258–264. https://doi.org/10.1089/lgbt.2014.0087.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Li, M. J., Distefano, A., Mouttapa, M., & Gill, J. K. (2014). Bias-motivated bullying and psychosocial problems: Implications for HIV risk behaviors among young men who have sex with men. AIDS Care, 26(2), 246–256. https://doi.org/10.1080/09540121.2013.811210.

    CAS  Article  PubMed  Google Scholar 

  27. Marshall, A., Yarber, W. L., Sherwood-Laughlin, C. M., Gray, M. L., & Estell, D. B. (2015). Coping and survival skills: The role school personnel play regarding support for bullied sexual minority-oriented youth. The Journal of School Health, 85(5), 334–340. https://doi.org/10.1111/josh.12254.

    Article  PubMed  Google Scholar 

  28. McMullen, C. K., Ash, J. S., Sittig, D. F., Bunce, A., Guappone, K., Dykstra, R., et al. (2011). Rapid assessment of clinical information systems in the healthcare setting: An efficient method for time-pressed evaluation. Methods of Information in Medicine, 50(4), 299–307. https://doi.org/10.3414/me10-01-0042.

    CAS  Article  PubMed  Google Scholar 

  29. Meezan, W., & Martin, J. L. (2009). Handbook of research with lesbian, gay, bisexual, and transgender populations (1ed.). New York: Routledge.

    Book  Google Scholar 

  30. Menkin, D., & Flores, D. D. (2018). Transgender students: Advocacy, care, and support opportunities for school nurses. NASN School Nurse, 34, 173–177. https://doi.org/10.1177/1942602X18801938.

    Article  PubMed  Google Scholar 

  31. Nansel, T. R., Overpeck, M., Pilla, R. S., Ruan, W. J., Simons-Morton, B., & Scheidt, P. (2001). Bullying behaviors among US youth: Prevalence and association with psychosocial adjustment. Jama, 285(16), 2094–2100.

    CAS  Article  Google Scholar 

  32. Reisner, S. L., Greytak, E. A., Parsons, J. T., & Ybarra, M. L. (2015). Gender minority social stress in adolescence: Disparities in adolescent bullying and substance use by gender identity. Journal of Sex Research, 52(3), 243–256. https://doi.org/10.1080/00224499.2014.886321.

    Article  PubMed  Google Scholar 

  33. Reisner, S. L., Randazzo, R. K., White Hughto, J. M., Peitzmeier, S., DuBois, L. Z., Pardee, D. J., et al. (2018). Sensitive health topics with underserved patient populations: Methodological considerations for online focus group discussions. Qualitative Health Research, 28(10), 1658–1673. https://doi.org/10.1177/1049732317705355.

    Article  PubMed  Google Scholar 

  34. Russell, S. T., & Joyner, K. (2001). Adolescent sexual orientation and suicide risk: Evidence from a national study. American Journal of Public Health, 91(8), 1276–1281.

    CAS  Article  Google Scholar 

  35. Russell, S. T., Ryan, C., Toomey, R. B., Diaz, R. M., & Sanchez, J. (2011). Lesbian, gay, bisexual, and transgender adolescent school victimization: Implications for young adult health and adjustment. The Journal of School Health, 81(5), 223–230. https://doi.org/10.1111/j.1746-1561.2011.00583.x.

    Article  PubMed  Google Scholar 

  36. Schuster, M. A., Bogart, L. M., Elliott, M. N., Klein, D. J., Feng, J. Y., Tortolero, S. R., et al. (2015). A longitudinal study of bullying of sexual-minority youth. The New England Journal of Medicine, 372(19), 1872–1874. https://doi.org/10.1056/NEJMc1413064.

    Article  PubMed  Google Scholar 

  37. Taras, H. L. (2004). School-based mental health services. Pediatrics, 113(6), 1839–1845.

    Article  Google Scholar 

  38. The National Academies of Sciences, Engineering, and Medicine. (2016). Preventing bullying through science, policy, and practice. Washington, DC.

  39. Vessey, J. A., & O'Neill, K. M. (2011). Helping students with disabilities better address teasing and bullying situations: A MASNRN study. The Journal of School Nursing, 27(2), 139–148. https://doi.org/10.1177/1059840510386490.

    Article  PubMed  Google Scholar 

  40. Williams, S. G. (2017). Mental health issues related to sexual orientation in a high school setting. The Journal of School Nursing, 33(5), 383–392. https://doi.org/10.1177/1059840516686841.

    Article  PubMed  Google Scholar 

  41. Wolke, D., & Lereya, S. T. (2015). Long-term effects of bullying. Archives of Disease in Childhood, 100(9), 879–885. https://doi.org/10.1136/archdischild-2014-306667.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30–41. https://doi.org/10.1207/s15327752jpa5201_2.

    Article  Google Scholar 

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Acknowledgments

The authors thank Eli Godwin and the youth and community advisory board for their contributions on this study (alphabetical): Landon Callahan, Sonya Epstein, Opal Hines-Fisher, Lee Hoegler, Kira Houston, Karen Jarvis-Vance, Karen Rufo, and Rothsaida Sylviance.

Funding

This study was funded by Harvard Catalyst |The Harvard Clinical and Translational Science Center (National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001102) and financial contributions from Harvard University and its affiliated academic healthcare centers. Dr. Valerie A. Earnshaw’s contributions were further supported by the National Institute on Drug Abuse (K01 DA042881). Funders were not involved in the study design; collection, analysis, or interpretation of the data; write up of the report; or decision to submit the article for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic healthcare centers, or the National Institutes of Health.

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Correspondence to Sari L. Reisner.

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Reisner, S.L., Sava, L.M., Menino, D.D. et al. Addressing LGBTQ Student Bullying in Massachusetts Schools: Perspectives of LGBTQ Students and School Health Professionals. Prev Sci 21, 408–421 (2020). https://doi.org/10.1007/s11121-019-01084-4

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Keywords

  • Sexual and gender minorities
  • Adolescent
  • Schools
  • Public health
  • Bullying