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The victimization, harassment, and isolation that sexual and gender minority (SGM) youth often face in school settings are associated with poor mental health (e.g., depression, suicidal ideation and attempts, anxiety) as well as negative academic outcomes including lower academic performance and dropping out. School-based supports, such as gay-straight alliances (GSAs), SGM-affirming school climates, and access to supportive individuals in schools have been associated with positive well-being among SGM students, yet this research is overwhelmingly cross-sectional and experimental designs remain exceedingly rare. The purpose of this study was to use systematic review and meta-analysis to synthesize previous correlational research findings and identify which school-based supports are most strongly associated with SGM youth’s well-being and thus represent key targets for future intervention development and testing. This extends the work of previous meta-analyses and systematic reviews by attending specifically to the role of the school environment on the well-being of SGM youth.
Methods
Following PRISMA guidelines, we searched for all available published or unpublished school-based studies involving SGM adolescents by using key search terms and their variations. After reviewing studies for eligibility, 15 studies remained. Predictor variables, outcome variables, statistics measuring the association between the two, sample sizes and other characteristics were gathered from the studies meeting the inclusion criteria.To maintain independence between effect sizes, when multiple effect sizes for a predictor-outcome pair came from the same study the effect sizes were aggregated. The effect size estimate from each study was converted to a common metric (Hedges’s g). Given the small number of effect size estimates for each predictor-outcome pair, a fixed effects model was used.
Results
The final analysis included 34 effect size estimates for 18 predictor-outcome pairs drawn from 15 studies. Presence of a GSA was positively associated with a school attachment (g= 0.52, 95% CI [0.19, 0.84]) and decreases in truancy (g= 0.18, 95% CI [0.14, 0.23]) and victimization (g= 0.11, 95% CI [0.08, 0.14]). An SGM-affirming school climate was positively associated with school attachment (g= 0.67, 95% CI [0.32, 1.01]) and decreases in truancy (g= 0.21, 95% CI [0.16, 0.25]), suicide ideation and attempts (g= 0.10, 95% CI [0.08, 0.13]), and victimization (g= 0.25, 95% CI [0.20, 0.29]). Supportive individuals in schools was positively associated with grade point average (g= 0.47, 95% CI [0.30, 0.64]) and decreases in truancy (g= 0.27, 95% CI [0.22, 0.31]), depression (g= 0.56, 95% CI [0.52, 0.60]), and victimization (g= 0.20, 95% CI [0.16, 0.25]).
Discussion
Employing effective interventions to address the exclusion, discrimination, and victimization SGM students face in school is a critical step toward addressing health and mental health disparities among SGM populations. Our study suggests that future interventions should aim to develop and rigorously test the impact of GSAs, SGM-affirming school climates, and trainings to increase the cultural competence and supportive capacities of teachers and staff. Overall, these findings encourage social workers to promote school-level interventions to help end community violence and promote positive wellbeing for SGM youth.