The Role of School-Based Health Centers in Supporting LGBTQ+ Youth During COVID-19
As June comes to a close and the COVID-19 pandemic continues throughout the country, we at the New York School-Based Health Foundation recognize the unique impact that COVID-19 has on our LGBTQ+ youth. Schools provide LGBTQ+ students with an outlet to feel connected and supported by peers. Especially considering that LGBTQ+ students are more likely to experience familial issues and homelessness, schools often serve as a safe space for these students who do not feel comfortable in their homes. Although existing research points to concerns about how COVID-19 will impact LGBTQ+ youth mental health and well-being, it also suggests there are steps to be taken to minimize its impact. Now more than ever, it is imperative that LGBTQ+ youth receive access to a wide range of support and life-saving resources, and School-Based Health Centers (SBHCs) have the unique opportunity and ability to provide these services.
Staying at Home
In a report released by the Human Rights Campaign, parents and families were highlighted as playing an essential role in LGBTQ+ youth well-being. However, the report also found that 76% of LGBTQ+ youth do not feel they can be themselves at home (1). Furthermore, many LGBTQ+ youth do not feel comfortable “coming out” to their families, in fear for their safety and mental well-being. The results of which are higher rates of depression, anxiety, and suicide among LGBTQ+ youth, with 85% of these students rating their average stress level as ‘5’ or higher on a 1-10 scale (1). These rates are even more concerning for Transgender youth, who are four times as likely to experience depression than their non-transgender peers (2). While these facts would be concerning during a normal year, COVID-19 makes these realities even more dire.
Based on existing research on rates of family rejection, about ⅓ of LGBTQ+ youth experience parental acceptance, ⅓ experience parental rejection, and ⅓ do not disclose their sexuality to their parents until they are adults (3). This means a majority of LGBTQ+ youth have been spending their days confined to spaces that are not supportive of their sexual orientation and/or gender identity and are being forced to remain there for an indefinite amount of time, "It's really a minority of LGBTQ youth who, when they're in their home environment, are in a place that supports them in their authentic self” (Amy Green, Trevor Project Director of Research). As detailed in the Trevor Project’s report on the Implications of COVID-19 for LGBTQ Youth Mental Health and Suicide Prevention, youth who are in an environment unsupportive to their identities can benefit from having access to supportive individuals who can help them navigate their environments and maintain their safety.
SBHCs are an especially important resource for these students, both during the regular school year and while they are staying at home. In a research study published in the journal of School Nursing, SBHCs were able to create more inclusive and culturally competent environments for LGBTQ+ students attending the school-based clinic (4). In a time of telehealth, it is important to consider what culturally competent care looks like for LGBTQ+ students at home. It means understanding the unique barriers LGBTQ+ youth face, both during COVID-19 and after, as well as ensuring that these students are provided a space to speak freely without fear of parent involvement. LGBTQ+ youth need access to remote support through telehealth as well as phone and digital based crisis services. Compiling these resources and services in your area to disseminate to these students discretely is important in ensuring their safety.
Physical distancing (commonly referred to as “social distancing”) is a crucial aspect of slowing the spread of coronavirus, but means that LGBTQ+ youth do not have access to positive social interactions with friends and mentors in their schools. It is important to note that not all LGBTQ+ youth feel safe and supported in their school environments, but in many cases, schools provide these students with the opportunity to find supportive peers and mentors. Research shows that social connections help to buffer stress, reduce depression, and improve overall well-being (5).
When it comes to LGBTQ+ students and their mental health, these positive social connections become crucial components in suicide prevention. With schools closing and classes going online, LGBTQ+ students lose access to these daily positive connections, including identity-affirming extracurriculars such as Gender and Sexual Alliances (GSAs). These alliances provide LGBTQ+ student with safe environments that allow them to feel empowered, socialize with supportive peers, and receive guidance. The presence of GSAs in schools has been found to significantly reduce the risk for depression and increase well-being among LGBTQ+ youth, making the switch to remote even more concerning for LGBTQ+ student health (6). President of the Texas Psychological Association, Megan Mooney, comments on the impact of physical distancing on LGBTQ+ youth, "So not having their social outlets through school – and hanging out with friends, and clubs, and sports and those sorts of things – takes away a lot of their ability to live freely as themselves.”
With this in mind, it is imperative that schools make every effort to ensure that these extracurricular activities, such as GSA involvement, and access to supportive mentors is provided to all students. SBHCs can aid in this process by advocating for students and providing materials and support to these alliances as instruction continues online. This could mean reaching out to leaders to compile resources for LGBTQ+ students and utilizing these alliances to make connections with students who may be struggling.
With the impacts of staying at home and physical distancing in mind, SBHCs will be better able to address the mental health concerns of LGBTQ+ students during COVID-19. SBHCs have already demonstrated that they are able to attract harder-to-reach populations and provide them with crucial services such as mental health care (7). It is necessary to recognize that when provided with the right support, LGBTQ+ students are able to thrive, "I think that that's an important message to share – that our LGBTQ youth are incredibly resilient. They're strong, and they are dedicated to making things better for themselves and others in the future." (Megan Mooney, president of the Texas Psychological Association). Parental and community support makes all the difference in protecting the well being of LGBTQ+ youth, and at the New York School-Based Health Alliance, we are dedicated to advocating for these communities in our work.
For resources related to LGBTQ+ student health, visit our new LGBTQ+ Resource Page. For more information on SBHCs, visit the New York School-Based Health Alliance or the New York School-Based Health Foundation.