Professional Development From Our Research Center

School Health Staff Wonder: How Do You Help LGBTQ+ Students in a ‘Don’t Say Gay’ Era?

By Lauraine Langreo — June 13, 2023 5 min read
People with Pride flags stand outside Saticoy Elementary School in Los Angeles on June 2, 2023. Police officers separated groups of protesters and counter-protesters outside the elementary school that has become a flashpoint for Pride month events across California.
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The mental health of the nation’s 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.

“I would like more training on the LGBTQ+ community,” 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’t support that request. “It’s confusing and it’s hard to know how to respond while keeping my job. I’d like to both support the student and keep my job. I am walking on eggshells and I don’t like it.”

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’t believe it should be a school’s responsibility to educate students about LGBTQ+ issues because, they say, in most cases those discussions should be between the parent and the child.

“Keep politics out of school and simply allow districts to teach academics and not divisive cultural issues,” 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 “because of the disparities in social treatment,” 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’t do anything about it, “they have now sent the message that it’s acceptable behavior,” 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 “to create an engaged citizenry, who are ready to be global citizens,” 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.

“I don’t think it’s the responsibility of schools to tell students or their families what they have to believe, but I do think it’s 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,” 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.

“We 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,” 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’ 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, “it 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’re able to stay in school and learn,” King said.

But providing these opportunities is difficult, given the political climate in some states. “In 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’t do in that regard,” King said.

It’s 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’ expectation should be to remind school staff that they already know how to create supportive learning environments for all students, Oyenuga said.

“You don’t 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’t tolerate that at school,” 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’s requested name and pronouns (74 percent), according to the EdWeek Research Center survey.

The results show that, though school health care staff “may be nervous and feel very unsure,” they are already doing what will “benefit students the most,” Sampson said.

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Data analysis for this article was provided by the EdWeek Research Center. Learn more about the center’s work.

Coverage of race, opportunity, and equity is supported in part by a grant from The Wallace Foundation, at Education Week retains sole editorial control over the content of this coverage.


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