Statewide survey sheds light on health experiences of LGB but not T high school students for the first time

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Being a teenager can be tough work — you’re in the business of becoming who you are. For some teens, being who they are means being unlike many of their peers. A recent statewide survey shows just how hard growing up can be for Colorado high school students who identify as lesbian, gay or bisexual.

The Healthy Kids Colorado Survey has provided data about the health of middle and high school students around the state for a number of years, but the most recent version of the biannual survey was the first to capture the health-related experiences of lesbian, gay and bisexual (LGB) high school students in Colorado. Data shows that students who identified as LGB were six times more likely than their heterosexual peers to have attempted suicide, twice as likely to have smoked marijuana or to have been bullied, three times as likely to smoke cigarettes and five times as likely to have been forced into sexual intercourse.

“There is disproportionate risk across every health domain in the survey, from nutrition to substance abuse to bullying,” says Sarah Nickles, program coordinator at the Colorado Department of Public Health and Environment. “It’s hard to pull out what’s the most shocking because they’re all pretty disproportionately high.”

This was the first year that the Healthy Kids Colorado Survey was conducted in a unified manner by three state agencies: The Colorado Department of Public Health and Environment, The Colorado Department of Human Services and the Colorado Department of Education. Nickles says this allowed the agencies to combine their resources and reach a larger number of students across the state — more than 40,000 middle and high school students, though high schoolers were the only ones asked to address questions about their sexual experiences. This large sample size provides an accurate representation of Colorado students statewide.

Nickles has held a number of positions that directly support and advocate for LGBT youths, including a year with the Boulder County Public Health department, where she worked closely with Boulder Valley and Saint Vrain school districts.

“Unfortunately, to me, these data weren’t surprising,” Nickles says. “These were the lived experiences of many of the young people I’ve supported over the years. … I think seeing the numbers is so important because supporters, advocates and even youths themselves can say, ‘We know there are issues… ’ but it’s hard to demonstrate the need for resources and programming and prevention activities allocated for this community [unless you have data to support that need].”

And while the newest survey provides hard numbers that can aid significantly in securing funding for programs that support LGB youths, the survey fails to address the issue of gender identity, those who might identify as transgender.

“The fact that gender identity wasn’t acknowledged is a big deal,” says Bethy Leonardi, a research associate at the University of Colorado Boulder. “Gender identity is huge and I think we discount that phrase at the end of LGBT.”

Leonardi co-heads a CU College of Education-based program called A Queer Endeavor. The initiative supports pre-service teachers by helping them better understand how to incorporate topics of gender and sexual diversity in education.

Leonardi also expresses concern about the fact that the executive summary of the survey notes that “16.3 percent of students are missing sexual orientation status or responded ‘not sure’; these students are excluded from sexual orientation analyses.”

“That’s an entire category of people, those who are questioning. I was really curious about [the experiences of those youths,]” Leonardi says.

Nickles readily admits that the lack of information regarding gender identity is a shortcoming of the survey, but she says that gathering information about gender identity is “part of the conversation” as researchers construct the upcoming 2015 survey.

“There’s a lot of interest in being able to capture the experiences of nonconforming and transgender youth in Colorado — we are talking with community partners like One Colorado, the Gill foundation and the Gay and Lesbian Foundation to figure out how to approach that in a way that allows us to capture what we expect to find are health disparities among those young people,” Nickles says.

But Nickles emphasizes the difficulty in obtaining statistically significant numbers on a state survey such as this, where students aren’t asked open-ended questions.

“We need to have enough young people identify in a category to be able to have representative data. So when you’re talking about a very proportionally small group of young people, you want to make sure you’re able to get the kind of information you’re looking for,” Nickles says.

Mardi Moore, executive director for Out Boulder, says that it’s not just the Healthy Kids Colorado Survey that isn’t tracking the transgender population — The U.S. Census Bureau doesn’t ask who is transgender, nor do the Centers for Disease Control and Prevention. Essentially, there are no reliable numbers about the trans population — youth or adult — in the U.S.

Moore acknowledges that getting solid data about gender identity can be tricky.

“Some [youths] might not know, they might not have the language yet,” Moore says. “But if we’re going to count people, we’re going to count people, and why exclude one group of individuals?”

But counting the transgender population isn’t as simple as adding a “transgender” box to surveys — as Moore says, some people may not have an understanding of their gender identity yet, while others may disagree on the definition of transgender. Does being transgender deal more with identity, behavior or both? For example, those who have undergone gender reassignment surgery may simply identify with their new gender and not as transgendered individuals. The possibilities for miscounting the trans population are immense.

Moore echoes Nickles sentiments about the difficulty in obtaining funding for risk prevention or other targeted programs when there’s no data available to illustrate the need.

“We need to fund some creative thinking around this issue [of counting the transgender population],” Moore says.

But Moore is quick to emphasize the positive, noting the multitude of resources available in Boulder County for queer youth, particularly the OASOS program for youth ages 13 to 18.

Heather Crate is the program specialist for OASOS. Crate says that she sees youths who are experiencing the kind of negative health issues illustrated in the Healthy Kids Colorado Survey, but that support makes all the difference in a young person’s life.

“When kids have supportive families, school environments and friends, they aren’t experiencing that social stigma,” Crate says. “But on the other end of the spectrum when we have kids that don’t have that support in their family, school or faith environment, when they’re hearing negative messages about who they are, those are the kids we are often giving more support to, helping them cope in this world that’s not accepting to them.”

Nickles says data from the Healthy Kids survey backs up Crate’s statement. For the first time, the survey looked at potential protective factors that could be associated with reduced risk among all young people, not just LGB students.

“At first glance, LGB students who said they had someone to go to with a problem were significantly less likely to have attempted suicide or to have been electronically bullied in the last 12 months,” Nickles says. “We found similar protective effects between those who said they felt safe at school and those who participated in extracurricular activities.”

But Moore, Leonardi and Crate all emphasize that LGB and gender non-conforming students will experience even greater levels of support if communities can engage in shifting the existing ethos around sexuality and gender.

“We can talk about what programs for at-risk youth can be put in place forever, but the reality is that we have to change the culture through increased visibility of the queer community in schools, in congregations, in churches,” says Moore.

“I think a larger systemic or policy level approach would be taking a look at our schools’ curriculum,” Crate says. “Does it ever mention a gay person? In English or literature classes, are they reading any LGBTQ authors? [When teachers do that,] those kids are seeing themselves reflected.”

This is exactly what Leonardi, through the A Queer Endeavor project, seeks to do. In the first year of the program, Leonardi says that she and her project partner have been in contact with perhaps 700 pre-service teachers in the area.

“In the work that we do out of CU, we focus on the context of education,” Leonardi explains. “It’s one thing to not be bullied, but it’s another thing to see yourself in the curriculum, to have your teacher acknowledge who you are, who you’re going to prom with, who your parents are.

“Teachers get into teaching, I think, because they care about kids. All [my project partner] and I do is notice how under supported teachers are to not only understand the issue [of being a non-conforming youth], because there’s been pervasive silence on any of these issues for so long, but to have the support to not just stop bullying but to have this be part of the ‘normal’ of the school,” Leonardi says. “The pictures on the wall, the way you address family, the stories that you read, the ways that you read history. Bringing a critical eye to the curriculum and to sort of get students to think about how heteronormativity, as with racism or any other systemic oppressive system, is a function not only in society but in the curriculum that we have, in the stories that we read, in what certain characters do … I think that’s the kind of stuff that brings about a culture shift. It can’t just be no bullying. That doesn’t work.”

In addition to agreeing on the need for a culture shift, the experts also agree fully on one other account: while there’s room for growth, Boulder is doing a lot of things right for LGBTQ youths.

“Boulder County Public Health, they are a pretty unprecedented public health agency in that they develop and sponsor and fund LGBTQ youth programs,” Nickles says.

Crate agrees, saying, “I’m really proud to work for a public entity where LGBTQ youth is a priority. You won’t find that in many public health agencies in the country.”

Crate also points to Boulder Valley School District’s progressive policy in support of transgender and gender nonconforming students, “one of the most progressive transgender policies in the nation,” she says.

The policy doesn’t require students to legally change their name or gender before allowing them to change their name with the school district. Students are allowed to use the bathroom or locker room they identify with.

“I feel really positive about what’s happening in Boulder,” Leonardi says. “We might not be there yet but a lot of people have their hearts and mind and energy in the right place. I think we could be a leading district in this country in understanding how to do this well.”