Bullying: For health care providers working with LGBTQ+ youth

Bullying: Information for health care providers working with LGBTQ+ adolescents and young adults. 

Anti-LGBTQ+ bullying is caused by systemic bias that goes beyond one student harming another student. Providers should ask all patients about experiences of discrimination and harassment from both peers and figures of authority (parents, teachers, coaches, principles). 

51% of LGBTQ+ high schoolers report feeling unsafe at school and 71% report hearing transphobic remarks from teachers or staff (1). Bullying puts youth at increased risk for depression, suicidal ideation, misuse of drugs and alcohol, risky sexual behavior, and can affect academics (2). These risks are not limited to LGBTQ youth, but youth perceived to be LGBTQ are at higher risk. Bullying is a form of violence that is a symptom of social stigma throughout our society. Young people who bully others have often experienced abuse themselves and learned abusive behavior from their parents, peers, teachers, administrators, coaches, and media. 

While it is important to ask openly LGBTQ+ patients about bullying, it is equally important to ask all patients about experiences of harassment, abuse, and discrimination. Young people who are currently experiencing bullying behavior (either as a target or the person responsible) are almost certainly experiencing broader forms of discrimination based on gender, sexual orientation, race, religion, body size or ability, or mental capacity (3). 

When finding out that a patient has been bullied, never suggest that the patient caused this to happen, either through their behavior, dress, or openness about their identity. Rather, affirm their identity (e.g. “Thank you for telling me. I want you to know that you are wonderful as you are and that this harassment is unacceptable.” Studies show that the more support and affirmation that a person being bullied has, the better their health outcomes. You might ask: 

When does this happen and who is doing it to you? 

How do the adults around you respond? 

Is there anyone who supports you who we could reach out to for help? 

How can we build more support for you as we address this? (Provide some ideas for them, such as youth support groups and clubs, a therapist, or reaching out to allies). 

Sources: 

1. 2017 GLSEN School Climate Survey (glsen.org/research/school-climate-survey)
2. Bullying: LGBT Youth (mhnational.org/bullying-lgbt-youth)
3. Eleanor Formby (2015) Limitations of focusing on homophobic, biphobic, and transphobic ‘bullying’ to understand and address LGBT young people’s experiences within and beyond school, Sex Education, 15:6, 626-640

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