LGBTQ SCHOOL-BASED SUPPORT

THE ROLE OF SCHOOL-BASED SUPPORT AND COPING SKILLS IN THE DEVELOPMENT OF ANXIETY IN LGBTQ YOUNG ADULTS

by

Jennifer Piccolo December 22, 2009

A dissertation submitted to the Faculty of the Graduate School of the University at Buffalo, State University of New York in partial fulfillment of the requirements for the degree of

Doctor of Philosophy

Department of Counseling, School and Educational Psychology

UMI Number: 3391075

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Copyright by Jennifer A. Piccolo 2010

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Dedication

This dissertation is dedicated to all of the people in my life who have tolerated my persistent crankiness, exasperating slowness, general unreliability, and all of the other frustrating habits I’ve developed during the past couple of years, who magically still love me anyway. I love you more than I can convey here, I wouldn’t have gotten here without you, & I owe you one (of everything).

LGBTQ SCHOOL-BASED SUPPORT Acknowledgements

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I would like to express my deepest gratitude to Dr. Catherine Cook-Cottone for her guidance and support as my academic advisor and committee chair. Her extraordinarily generous academic, intellectual, and emotional support and encouragement over the years, and especially during the dissertation process, have been amazing. I would also like to sincerely thank committee members Dr. Amy Reynolds and Dr. Delucia-Waack for their guidance and generous support. They have all gone above and beyond as dissertation committee members, and I am truly grateful.

I’d also like to thank CSEP faculty for sharing their expertise and lending support throughout my graduate education. I have genuinely enjoyed learning from all of you and it’s been a great privilege to have been trained by such brilliant, kind, and funny people. Special thanks to Nancy Myers for all of her support over the years.

Lastly, I’d like to thank Dr. Lisa Dekeon and Dr. Amy Hequembourg for their immeasurable understanding, wisdom, humor, and encouragement as I trudged through this dissertation. I am enormously grateful and incredibly fortunate to have had their support.

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Table of Contents Page Dedication Acknowledgements Abstract I. Introduction Definition of the Problem Incidence/ Prevalence Significance of the Study Organization of the Study Definition of Terms Overview of Chapters II. Review of the Literature LGBTQ Identity Development Stress and Resilience: A Minority Stress Framework Daily Challenges as Minority Stress Anxiety in LGBTQ Populations Examining the Response of Schools Supporting Resilience in LGBTQ Adolescents III. Method and Procedures Participants Procedures iii iv x 1 1 6 9 10 10 14 16 16 20 22 35 40 44 48 48 49

LGBTQ SCHOOL-BASED SUPPORT Instruments Research Questions and Statistical Analyses IV. Results Research Question One: How Prevalent are Experiences of DisclosureRelated Rejection and Generalized and Social Anxiety among LGBT Young Adults? Research Question Two: How Prevalent are the Identified Types of SchoolBased Support? Research Question Three: Which School-Based Supports Did LGBTQ Young Adults Perceive as Most Helpful? Research Question Four: Do an Individual’s Experiences of DisclosureRelated Rejection and Acceptance, LGBTQ-Related School-Based Support, and Coping Behaviors Predict the Development Of Trait Anxiety and/or Social Anxiety? Research Question Five: Which Components of School-Based Support Best Predict Active Coping Skills? Research Question Six: Which Components of School-Based Support Best Predict Levels of Trait- and Social Anxiety? V. Discussion Findings and Implications Limitations and Implications for Future Research References

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LGBTQ SCHOOL-BASED SUPPORT Appendices Appendix A: Informed Consent Document Appendix B: Debriefing Script Appendix C: Resources for Participants Appendix D: Brief COPE Part 1 Appendix E: Brief COPE Part 2 Appendix F: State-Trait Anxiety Inventory (Trait Scale) Appendix G: Brief Fear of Negative Evaluation Scale, Version II Appendix H: Disclosure and School-Based Support Questionnaire Appendix I: Tables

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LGBTQ SCHOOL-BASED SUPPORT List of Tables

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Page Table 1: Demographic Characteristics of the Study Sample Table 2: Sexual Orientation and Gender Identity of the Study Sample Table 3: Characteristics of High Schools Table 4: Descriptive Statistics for Brief COPE Subscales Table 5: Descriptive Statistics for STAI-T, BFNE-II, Total Rejection, Total Acceptance, Disengaged Coping, Active Coping, and School Support Index Table 6: School Based Supports: Prevalence and Perceived Helpfulness Table 7: Bivariate Correlations between Current Age and Presence of Individual School Supports Table 8: Bivariate Correlations between Age, Total Rejection, Total Acceptance, Disengaged Coping, Active Coping, Number of School Supports, School Support Index, Perceived Helpfulness of Each Support, and STAI-T and BFNE-II Scores Table 9: Partial Correlations between Total Rejection, Total Acceptance, Disengaged Coping, Active Coping, Number of School Supports, School Support Index, Perceived Helpfulness of Each Support, and STAI-T and BFNE-II Scores (Controlling for Age) Table 10: Regression Analysis for the Prediction of Trait Anxiety from DisclosureRelated Rejection and Acceptance, Coping Responses, and School Support Index 110 109 108 106 107 100 102 103 104 105

LGBTQ SCHOOL-BASED SUPPORT Table 11: Regression Analysis for the Prediction of Social Anxiety from DisclosureRelated Rejection and Acceptance, Coping Responses, and School Support Index Table 12: Regression Analysis for the Prediction of Active Coping from Age and Perceived Helpfulness of Particular School-Based Supports Table 13: Regression Analysis for the Prediction of Trait Anxiety from Age and Perceived Helpfulness of Particular School-Based Supports Table 14: Regression Analysis for the Prediction of Social Anxiety from Age and Perceived Helpfulness of Particular School-Based Supports

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LGBTQ SCHOOL-BASED SUPPORT Abstract

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This study examined the relationships between lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) young adults’ experiences of disclosure-related acceptance and rejection, perceived helpfulness of LGBTQ-specific school-based support during high school, current coping responses, and current level of generalized and social anxiety. Data were gathered from 184 LGBTQ young adults nationwide via web-based survey. Results indicated that disengaged coping responses predicted trait and social anxiety. Results did not evidence relationships between active coping and trait or social anxiety. Perceived helpfulness of school based supports did not predict coping behavior or anxiety. Implications for practice and future research are discussed.

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Chapter I Definition of the Problem Beginning at a young age, lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) individuals are confronted by an array of unique challenges. Many of these obstacles are directly related to stigmatization based on sexual orientation or gender identity, and are therefore not typically experienced by their heterosexual peers. These include the development and disclosure of their LGBTQ identity; elevated likelihood of interpersonal rejection; proneness to verbal, sexual, and physical victimization at school, work, and in the community; and exclusion from heterosexist policies, traditions, and expectations. Despite decades of advocacy and psychoeducation, members of the LGBTQ community continue to be the targets of discrimination, harassment and exclusion based on their personal identities. As a result of these experiences, LGBTQ individuals must contend with a unique combination of stressors (Meyer, 2003). These stressors have been implicated in the greater incidence of certain mental health concerns among LGBTQ individuals, including depression and anxiety disorders (e.g., Cochran, Sullivan, & Mays, 2003; D’Augelli, 2002; Herek, Gillis, & Cogan, 1999; Koh & Ross, 2006; Pachankis & Goldfried, 2006; Sandfort, de Graaf, Bijl, & Schnabel, 2001). Research has demonstrated that effective coping skills and social supports are directly related to positive adjustment among LGBTQ youth and may offer protection against stressors (Cohen, 2004; Detrie & Lease, 2007; Martin & Hetrick, 1988; Pringle & Mallon, 2003; Safren & Heimberg, 1999). In fact, a growing body of research suggests that when these and other psychosocial factors (e.g., socioeconomic status, family mental health, family support) are controlled for, significant differences in distress indicators between LGBTQ and heterosexual

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adolescents are greatly reduced or eliminated (Busseri, Willoughby, Chalmers, & Bogaert, 2008; Elze, 2002; Safren & Heimberg, 1999). There is also evidence to suggest that social anxiety may be a barrier to obtaining social support and engaging in positive events, over and above the effects of sexual orientation (Safren & Pantalone, 2006). In their study of LGB and heterosexual youths, the authors explain that during adolescence, young people typically experience social pressure to conform to heterosexual social and dating behaviors. In response to this pressure, many LGB adolescents make efforts to hide their sexual orientation. Toward that end, they may avoid participation in the social situations that typically provide access to supportive peer networks (Safren & Pantalone). In another study of young gay and heterosexual men between the ages of 18 and 24, Pachankis and Goldfried (2006) found that gay men reported greater fear of negative evaluation and social interaction anxiety, and lower self-esteem than heterosexual men. They also found that gay men who were less open about their sexual orientation as well as those who were less comfortable with being gay were more likely to experience anxiety in social interactions. These findings have important implications for the attainment of social support, a crucial protective factor for LGBTQ individuals (Detrie & Lease, 2007; Martin & Hetrick, 1988; Pringle & Mallon, 2003; Safren & Heimberg, 1999). They also offer guidance for the provision of supports for LGBTQ youth, as social anxiety may present a potential barrier to service utilization. Disclosure Adolescence is a time of significant growth and development, and a critical period for identity formation. Many LGBTQ youth experience significant challenges related to the emerging awareness of their sexual orientation and gender expression for the first time during this life stage (e.g., Floyd & Stein, 2002; Maguen, Floyd, Bakeman & Armistead, 2002; Mosher, 2001). In addition to their own developing identity as a LGBTQ person, these youth are often faced with

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decisions related to the disclosure of their sexual orientation or gender identity to others. In recent years, LGBTQ individuals have been “coming out” at younger ages than ever before (Floyd & Bakeman, 2006). In some cases, disclosure of one’s sexual orientation or gender identity is not a choice. For example, an individual may be “outed” by someone else, or their gender expression may lead others to draw conclusions about their sexual orientation and gender identity (Carragher & Rivers, 2002). Decisions regarding if, when, how, and to whom one might disclose are complicated by a variety of complex factors. For example, internalized homophobia has been shown to negatively correlate with disclosure of sexual orientation (Herek et al., 1997; Jellison & McConnell, 2003). Individual development of self-identification may also be related to disclosure. One study of 2,401 lesbian and bisexual women suggested that the longer women self-identified as lesbian or bisexual, the more likely they were to self-disclose (Morris, Waldo, & Rothblum, 2001). Further, they reported that the more involved with the LGBTQ community that an individual was, the greater the likelihood that she would disclose her sexual orientation. The psychological impact of disclosure is equally complicated. For example, Morris et al. (2001) found that an individual’s degree of disclosure predicted lower psychological distress. However, other studies have proposed a different set of findings. For example, in their study of 350 LGB youth aged 14 to 21, D’Augelli, Pilkington, and Hershberger (2002) discovered that the earlier young people came out to self and others, the more they were victimized in high school. Clearly, the implications of disclosure can vary and are influenced by a variety of complex factors. LGBTQ youth who disclose their sexual orientation or gender identity as well as those who are assumed to be LGBTQ based on appearance or behavior are often met with rejection from parents, family members, peers, teachers, and other members of their communities (D’Augelli, Grossman, & Starks, 2005; D’Augelli, Hershberger, & Pilkington, 1998; Kosciw, Greytak, & Diaz,

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2009; Murdock & Bolch, 2005). Unlike members of many other minority groups, LGBTQ youth often do not have the support of their families, places of worship, or other cultural organizations to provide an identity framework or to serve as a buffer against the hostility that they face (Taylor, 2000). Rejection by parents and other family members during adolescence have been associated with negative health outcomes for LGBTQ young adults, including depression, suicidality, substance abuse, and unprotected sex (Ryan, Huebner, Diaz, & Sanchez, 2009). Many LGBTQ youth are at risk of encountering these difficulties, as parents’ initial reactions to a child’s disclosure of his or her sexual orientation are often negative (D’Augelli et al., 1998). Family support, when combined with self-acceptance, has been found to mediate the relationship between victimization and mental health for LGBTQ youth (Hershberger & D’Augelli, 1995). A study of 542 LGB youths from community settings also suggested that mental health symptoms were significantly related to parents’ reactions to disclosure of sexual orientation (D’Augelli, 2002). The disclosure of one’s sexual orientation can result in an interruption or complete loss of social supports (D’Augelli et al., 1998). In his study of 542 LGBT adolescents, D’Augelli (2002) found that more than one third lost friends due to their sexual orientation. In addition, he found that those individuals who had lost friends reported more mental health problems and more past suicide attempts than those who did not lose friends. Support from family and friends, where it exists, has a clear positive impact on LGBTQ youth. Unfortunately, rejection can have equally apparent detrimental effects on mental health outcomes, including emotional distress, depression, anxiety, suicidality, substance abuse, high-risk sexual behaviors, academic disengagement, school avoidance, and externalizing behaviors (Almeida, Johnson, Corliss, Molnar, & Azrael, 2009; Birkett, Espelage, & Koenig, 2009; Hatzenbuehler, McLaughlin, & Nolen-Hoeksema, 2008; Ryan et al., 2009).

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Protective Factors in LGBT Development and Disclosure LGBTQ youth often possess adaptive strengths and interpersonal resources that may help to buffer against the impact of stressors such as heterosexism, exclusion, peer rejection and victimization. Research has demonstrated that effective coping skills and social supports are directly related to positive adjustment and may offer protection against stress (Safren & Heimberg, 1999). Coping as a protective factor. Individual differences in coping response have been shown to affect mental health outcomes (e.g., Szymanski & Owens, 2008). Coping responses during childhood and adolescence may affect the impact of stress on both current and future mental health (Compas, Connor-Smith, Saltzman, Thomsen, & Wadsworth, 2001). The development of characteristic adaptive or maladaptive coping responses during childhood and adolescence may be a precursor to adult coping styles (Compas et al., 2001). Individual differences in coping behavior may have important implications for mental health outcomes; therefore, the development of effective coping skills may be an area of particular interest for school-based intervention. School-based support as a protective factor. Specific school-based supports have the potential to mitigate the damaging effects of the compounded stressors experienced by LGBTQ youth. School-based support in the form of Gay-Straight Alliances (GSAs), comprehensive antiharassment policies, supportive school staff, and LGBTQ-related resources and curricula appear to alleviate some of the difficulties faced by LGBTQ students. For example, GSAs have been shown to improve school climate and school-related experiences (e.g., academic performance, social relationships, feelings of belongingness) for LGBTQ students (Kosciw & Diaz, 2006; Lee, 2002; Todd, 2001). According to the 2007 National School Climate Survey (NSCS) conducted by

LGBTQ SCHOOL-BASED SUPPORT Kosciw, Diaz, and Greytak (2008) for the Gay, Lesbian, and Straight Education Network (GLSEN), LGBTQ students in schools with GSAs are more likely to feel safe in school than students whose schools do not have a GSA. This and the survey’s other findings have important

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implications for school psychologists and other school-based mental health service providers. There is a clear need for effective supports for LGBT youth in our schools. More research is needed as we move toward an understanding of protective factors for these students. School-based supports such as GSAs, inclusive curricula and supportive adults, as well as specific school-wide efforts to minimize LGBT students’ experiences of rejection in school, may buffer against the effects of rejection experienced elsewhere. Incidence and Prevalence School-Based Support Gay-Straight Alliances. In a 2006 GLSEN report on the growing number of GSAs in the United States, Kosciw and Diaz found that 47% of LGBT high school students across the country reported having a GSA. Despite the increasing prevalence of GSAs and other LGBTQ-supportive student groups in schools, most districts still lack such social opportunities for LGBTQ students. The report also indicated that African American LGBTQ students were less likely to have a GSA in their school than other students of color, particularly those who attended schools where the student population was predominantly African American. LGBTQ students in the South and in small towns or rural areas were least likely to have a GSA in their schools. Inclusive curricula. School curricula rarely include positive mention of LGBTQ people or issues. Kosciw et al. (2008) found that only 10.5% of high school students who responded to the GLSEN 2007 NSCS were exposed to positive representations of LGBTQ people, history or events in their classes. In their 2001 study, SEICUS reported that 80.6% of LGBT students surveyed

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indicated that there were no positive portrayals of LGBT people, history, or events in any of their classes. Inclusive language in school policies. Students whose schools had a safe school policy that included protections based on sexual orientation and/or gender identity/expression reported that they heard fewer homophobic remarks, experienced lower levels of victimization related to their sexual orientation, and were more likely to report incidents of harassment and assault to school staff (Kosciw et al., 2008). They were also more likely to report that staff intervened when hearing homophobic remarks. However, less than one in five or 18.7% of NSCS respondents attended a school with a comprehensive policy for reporting harassment and assault that specifically mentioned sexual orientation (37.6% reported a generic policy). Almost half of students surveyed reported that their schools did not have any type of safe school policy in place. Supportive faculty. The presence of supportive staff contributed to a range of positive indicators among NSCS respondents including fewer reports of missing school, greater academic achievement, higher educational aspirations and a greater sense of belonging to their school community (Kosciw et al., 2008). However, the survey also found that the majority (60.8%) of students who were harassed or assaulted in school did not report the incident to school staff, believing little or no action would be taken or the situation could become worse if reported. Alarmingly, almost a third (31.1%) of the students who did report an incident said that school staff did nothing in response. In their 2001 report, the Sexuality Information and Education Council of the United States (SEICUS) found that 25% of students surveyed perceived that teachers exhibited significant prejudice against LGBT students, and 38.2% reported not feeling comfortable speaking about LGBT issues to teachers or staff in class. In another study, 80% of prospective teachers and 67% of guidance counselors surveyed reported at least some negative attitudes toward LGBT

LGBTQ SCHOOL-BASED SUPPORT people (Todd, 2001). The study also found that less than 20% of teachers surveyed had received training on LGBT students and the unique issues they face. Risk Factors Disclosure-related rejection. Reactions to disclosure of sexual orientation and gender

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identity vary widely. LGB adolescents report fear of negative reactions and rejection as the primary reason for their reluctance to disclose to friends and parents (D’Augelli, et al., 2005; Diamond & Lucas, 2004). LGB youth cite a variety of reasons for not disclosing to their parents, including fears of harassment, rejection, or eviction; fear of relationship deterioration; and not having close relationships with parents (D’Augelli et al., 2005). D’Augelli (2002) found that more than one third of a sample of 542 LGBT adolescents had lost friends due to their sexual orientation. D’Augelli et al. (2005) found a relatively even split between positive and negative parental reactions to disclosure. Depending on parent and child gender, 27 to 39% of participants described a parent’s reaction as “negative;” 12 to 18% reported “very negative” responses. Anxiety disorders in LGBT populations. The lifetime prevalence rate for Generalized Anxiety Disorder in the general population has been estimated at 5.7% (Kessler, Berglund, Demler, Jin, & Walters, 2005). Results from the National Comorbidity Study (1994) found that the lifetime prevalence rate for social anxiety disorder was 13.3% (Kessler et al.). In their study of LGB and heterosexual adolescents between the ages of 16 and 21, Safren and Pantalone (2006) found that LGB youths reported greater social anxiety than did their heterosexual peers. Other studies have also suggested a higher incidence of anxiety disorders and anxiety-related symptoms among LGBTQ populations than in the general population or strictly heterosexual populations (e.g., Cochran, Sullivan & Mays, 2003; Gilman et al., 2001; Pachankis & Goldfried, 2006; Sandfort, de Graaf, Bijl & Schnabel, 2001). In their 2008 review, King et al. concluded that the lifetime

LGBTQ SCHOOL-BASED SUPPORT prevalence of any anxiety disorder among LGB men and women was twice that of heterosexual

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men and women, and that the 12-month prevalence among LGB individuals was approximately 1.5 times higher. Significance of the Present Study To date, there has been little research on the potential role of school-based psychoeducational interventions as protective factors for LGBTQ youth. In addition to GSAs and other general school supports for LGBTQ students, interventions aimed at the development of effective coping responses may (a) help youth to confront the uncertainty of decisions related to disclosure, and (b) help to buffer the potentially negative effects of disclosure-related rejection on the manifestation of anxiety and other mental health concerns. However, the complex relationships between disclosure, acceptance, rejection, coping responses, anxiety, and school-based support remain unknown. This study seeks to inform current school practices regarding the provision of resources and support to LGBTQ students. It will examine the relationships between LGBTQ individuals’ experiences of disclosure-related acceptance and rejection, school-based support, current coping responses, and current level of generalized and social anxiety. Specifically, the study will attempt to discern which elements of school-based support are perceived by LGBTQ young adults as most helpful, as well as those elements that are associated with more effective coping skills and lower levels of anxiety in that population. In addition, the results will suggest whether school-based support and positive coping responses might serve as protective factors against the effects of disclosure-related rejection and the manifestation of anxiety among LGBTQ young adults.

LGBTQ SCHOOL-BASED SUPPORT Organization of this Study The present study seeks to examine the relationship between LGBTQ individuals’

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experiences of disclosure-related acceptance and rejection, school-based support, current coping responses, and current level of generalized and social anxiety. Young adult participants were recruited to complete a web-based survey through nationwide LGBTQ-related email lists, online discussion boards, and LGBTQ community organizations. The survey included the following measures: the Disclosure and School-Based Support Questionnaire, a researcher-constructed qualitative measure of demographic information, experiences related to disclosure of sexual orientation, and school-based support; the Brief COPE, a measure 14 conceptually differentiable coping reactions (Carver, 1997); the Brief Fear of Negative Evaluation Scale, Version 2 (BFNE-II; Carleton, McCreary, Norton & Asmundson, 2006), a measure of social anxiety; and the Spielberger State-Trait Anxiety Inventory- Trait Version (STAI-T; Spielberger, 1983), a measure of the stable propensity to experience anxiety. Definition of Terms Sexual Orientation Sexual orientation refers to an enduring pattern of emotional, romantic, and/or sexual attractions to men, women, or both sexes. Sexual orientation also refers to a person’s sense of identity based on those attractions, related behaviors, and membership in a community of others who share those attractions (American Psychological Association, 2008). Transgender Transgender is an umbrella term used to describe people whose gender identity (sense of themselves as male or female) or gender expression differs from that usually associated with their birth sex (American Psychological Association, 2006).

LGBTQ SCHOOL-BASED SUPPORT Genderqueer

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Genderqueer refers to individuals who do not solidly identify with one particular gender. Transgender Heterosexual This term is used to describe the sexual orientation of a transgender person whose primary sexual attraction is to individuals of the “opposite” gender identity (e.g., a trans person who identifies as female and is attracted to individuals, both trans- and cisgender, who identify as male). Pansexual Pansexual refers to sexual orientation and describes an individual who is attracted to others without regard for gender identity or biological sex (i.e., is attracted to people of all genders and sexes). Queer Some members of the LGBTQ community have reclaimed the term queer as a synonym for LGBTQ. It describes a non-heterosexual orientation and is often associated with activism and rejection of strict categorical labels. Questioning Individuals who are just beginning to explore the possibility of a non-heterosexual orientation as well as those who are uncertain of their sexual orientation are often described as questioning. Coming Out Coming out refers to the disclosure of one’s sexual orientation and/or gender identity to others.

LGBTQ SCHOOL-BASED SUPPORT Degree of Disclosure

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Also referred to in the literature as outness, a person’s degree of disclosure indicates the extent to which the individual has told others of his or her LGBTQ identity. The term degree takes into account a variety of factors, including the number of people to whom one has disclosed, the relational groups to whom one has disclosed (e.g., LGBTQ friends, heterosexual friends, parents, siblings, extended family, teachers, religious community, etc.), the amount of information disclosed (e.g., LGBTQ identity only, feelings about one’s identity, information about relationships and partners, etc.), the settings in which one has disclosed (e.g., home, school, work, neighborhood, etc.), and the extent to which one has integrated the open expression of his or her LGBTQ identity into daily interactions with others (e.g., mentioning one’s partner in casual conversation, bringing partner to social events, displaying a photo of partner, etc.). Disclosure-Related Rejection Disclosure-related rejection is defined as interpersonal rejection experienced by a LGBTQ individual in response to his or her disclosure of sexual orientation and/or gender identity. School Climate According to Freiberg and Stein (1999), school climate is defined as “that quality of a school that helps each individual feel personal worth, dignity, and importance, while simultaneously helping create a sense of belonging to something beyond ourselves” (p. 11). School-based support School-based support for LGBTQ students refers to any of the following: LGBTQinclusive policies, curricula, activities, and resources; supportive and responsive teachers and staff; a LGBTQ-safe school climate; a Gay-Straight Alliance or similar student club, etc.

LGBTQ SCHOOL-BASED SUPPORT Gay-Straight Alliance

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A Gay-Straight Alliance (GSA) is a student-led club that aims to provide a safe place for LGBTQ students and straight allies to come together to discuss their shared experiences, plan activities and events, address name-calling and harassment, and promote respect for all students (GLSEN, 2006). Comprehensive Anti-Harassment Policy A school policy designed to protect students and staff by explicitly prohibiting harassment. A comprehensive policy specifically includes harassment based on sexual orientation or gender identity/ expression in addition to race, color, gender, religion, age, national origin, ethnicity, disability, veteran or military status, marital status, citizenship status, or any other legally protected status (New York University Office of Equal Opportunity, 2006). Comprehensive Non-Discrimination Policy A school policy designed to protect students and staff by explicitly prohibiting discrimination. A comprehensive policy specifically includes discrimination based on sexual orientation or gender identity/ expression in addition to race, color, gender, religion, age, national origin, ethnicity, disability, veteran or military status, marital status, citizenship status, or any other legally protected status (New York University Office of Equal Opportunity, 2006). Coping Coping has been defined by Lazarus and Folkman (1984) as “constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person” (p. 141).

LGBTQ SCHOOL-BASED SUPPORT Fear of Negative Evaluation

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Fear of negative evaluation is a latent construct believed to promote the development of more general fears, anxiety and psychopathologies (Carleton, Collimore & Asmundson, 2007). Research findings and several cognitive models support the idea that social anxiety is derived in part from fears of perceived negative evaluation (e.g., Clark & Wells, 1995; Rapee & Heimberg, 1997). Social Anxiety Social anxiety refers to the perception of one’s environment as threatening, along with the fear of social interactions (Safren & Pantalone, 2006). Trait Anxiety Trait anxiety refers to a stable propensity to experience anxiety, and tendencies to perceive stressful situations as threatening. Trait anxiety implies differences between people in the disposition to respond to stressful situations with varying amounts of state anxiety (Spielberger, 1983). Generalized Anxiety Generalized Anxiety Disorder (GAD) is characterized by long-term, intense and excessive worry, and is a chronic, relatively common disorder with high rates of comorbidity (Brown & Barlow, 1992). GAD has been conceptualized by Mennin, Turk, Heimberg and Carmin (2004) as being characterized by the experience of intense emotion, limited understanding of the emotional experience, poor ability to adaptively modulate emotions, and an aversive response to emotions. Overview of Chapters Chapter I defines the problem of negative mental health outcomes (i.e., anxiety symptoms) as they relate to sexual orientation disclosure-related rejection and individual coping responses. The

LGBTQ SCHOOL-BASED SUPPORT need for additional school-based supports in the form of psychoeducational interventions to

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develop and strengthen effective coping skills is also discussed. Additionally, the organization of the study is described and key terms are defined. Chapter II will provide an extensive review of the literature related to LGBT identity development, challenges faced by LGBT youth and the correlates of these challenges, anxiety disorders in LGBT populations, and evidence-based protective factors such as positive coping responses and school-based support for LGBT students. Chapter III outlines the methods and procedures related to the present study. The sample, recruiting process, survey measures, and procedures for data collection and data analysis are described. Chapter IV will report the results of the present study and answer the research questions. Chapter V will include a discussion of the implications of the findings, limitations of the study, and suggestions for future research.

LGBTQ SCHOOL-BASED SUPPORT Chapter II Review of the Literature

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The National Association of School Psychologists’ (NASP) Position Statement on Gay, Lesbian, Bisexual, Transgender, and Questioning Youth supports equal access to education and mental health services for gay, lesbian, bisexual, transgender and questioning (GLBTQ) youth within public and private schools (NASP, 2006). The Statement asserts that education and advocacy must be used to reduce discrimination and harassment against GLBTQ youth by students and staff. As the major social context for school-aged individuals, schools are in a position to strongly influence outcomes for LGBTQ youth. LGBT Identity Development Creating Identity: A Critical Process Recognition and acceptance of their LGBTQ identity is a major developmental process for LGBTQ adolescents (Malyon, 1981) and may serve as an important protective factor. Studies have shown that a positive sexual identity can serve as a buffer against the negative effects of stress (Meyer, 2003; Hershberger & D’Augelli, 1995). Several models of identity development locate self-acceptance as central to psychological health (e.g., Cass, 1984; Jordan& Deluty, 1998; Luhtanen, 2003), and there is evidence that a positive LGBTQ identity predicts psychological wellbeing and positive self-perception (Crawford, Allison, Zamboni, & Soto, 2002; Frable, Wortman, & Joseph, 1997; Kertzner, 2001). It has been established that LGBTQ youth must contend with an array of unique challenges in the world as they know it (e.g., D’Augelli, Pilkington & Hershberger, 2002; Elze, 2003; Kosciw, Diaz & Greytak, 2008). Such obstacles may interfere with the development of a healthy and selfaffirmative LGBTQ identity, with further effects on psychological well-being. Developmental

LGBTQ SCHOOL-BASED SUPPORT supports to encourage positive identity formation may be an important area of focus for intervention with LGBTQ adolescents. Self-Concept and Identity Formation The construction of a clear and relatively stable self-concept is one of the major

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developmental tasks of adolescence (Erikson, 1968). For a variety of reasons, LGBTQ adolescents often find it difficult to positively integrate their sexual orientation and/or gender identity (SI/GI) into their self-concept and identity (Radkowski & Siegel, 1997). It has been suggested that only those aspects of the self that an individual values affect his or her self-esteem (Salmivalli, 1998). Interestingly, LGBTQ adolescents tend to assign a more global relevance to their sexual orientation than it warrants (Hammersmith, 1987). Self-concept is constructed partly through social interaction, as feedback confirms or disconfirms an individual’s beliefs about him- or herself (Epstein, 1973). For LGB adolescents, this feedback system may work somewhat differently. Hammersmith (1987) proposed the notion that a lack of congruence between the normative heterosexual identity all adolescents are prepared for and an emerging LGB identity creates a state of cognitive dissonance. This internal conflict can complicate and impede the formation of a positive identity and selfconcept. Additionally, internalized homophobia, or non-conscious negative thoughts, feelings, and attitudes held by LGBTQ people about homosexuality, often plays a considerable role in the identity formation of LGBTQ adolescents (Radkowski & Siegel, 1997). Internalized homophobia triggers feelings of shame about one’s identity and can be difficult to combat due to its unconscious nature and often subtle perpetuation by established social policies, laws, family traditions and expectations, religious beliefs, and negative images in the media (Radkowski & Siegel). Taken together, this cumulative understanding of self-concept and identity development supports the

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notion that negative feelings about one’s sexual orientation or gender identity plays a significant role in a LGBTQ adolescent’s developing sense of self. Theories of LGBTQ Identity Development Stage-sequential models. A number of researchers have described sexual orientation identity formation using stage-sequential models, which specify a standard set of experiences occurring in an expected sequence (e.g., Cass, 1979; Troiden, 198; Coleman, 1982). These models typically refer to early awareness of same-sex attraction followed by exploration of a lesbian or gay identity. To illustrate, The Cass Model (1979, 1984) consists of six non-age-specific stages: identity awareness, in which individuals become conscious of their difference; identity comparison, in which the individual thinks he or she may be lesbian or gay but tries to act heterosexual; identity tolerance, in which the individual realizes that he or she is lesbian or gay; identity acceptance, in which the individual begins to explore the lesbian and/or gay community; identity pride, in which the individual becomes an active member of the lesbian and/or gay community; and finally, synthesis, in which the individual fully accepts him- or herself as well as others. Troiden’s (1989) model consists of four age-specific stages: before puberty, sensitization occurs, in which the individual has lesbian or gay feelings or experiences without understanding the implications for his or her identity; during adolescence, identity confusion occurs, during which the individual realizes that he or she may be lesbian or gay; identity assumption, in which the individual comes out as being lesbian or gay; and commitment, in which the individual lives as a lesbian or gay person. Coleman (1982) proposed five stages: pre-coming out in which the individual knows that something is different about him- or herself, but does not have same-sex feelings; coming out, in which the individual has admitted to him- or herself that he or she has same-sex feelings but may still lack a clear understanding of his or her sexuality; exploration, in

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which the individual begins to experiment with his or her new sexual identity; first relationships, in which the individual learns same-sex relationship skills; and identity integration, in which the individual combines both the private and public selves into an integrated identity. Life-course developmental models. In contrast to the assumed universality and sexcentered pattern of stage-sequential models, recent studies have identified multiple trajectories for the timing and sequencing of milestone events (e.g., D’Augelli, 1994; Diamond, 1998; Dube, 2000; Floyd & Stein, 2002; Savin-Williams & Diamond, 2000). These authors have acknowledged an identity-centered process of development that centers around an internal sense of identity over sexual practices (Dube, 2000). Savin-Williams and Diamond (2000) found that among their sample of 164 LGB individuals aged 16 to 27, the identity-centered pattern (i.e., a “label first” sequence) occurred for 80% of women, whereas for men, the sex-centered pattern (i.e., “sex first” sequence) was reported 51% of the time. In her study of 89 self-described lesbian, bisexual, and unlabeled women aged 16 to 23, Diamond (1998) learned that a majority of women denied at least one of the following: childhood indicators of sexual orientation, stability in same-sex attractions, or awareness of same-sex attractions prior to the conscious process of sexual questioning. There is some evidence to suggest that women tend to reach milestones related to awareness and selfidentification at later ages than do men (e.g., Diamond; Savin-Williams & Diamond; Schneider, 2001). Multi-faceted model. An inclusive model of sexual identity formation was developed by Fassinger (1998) to reflect a simultaneous progression through both individual and group membership aspects of sexual identity. Fassinger’s multi-faceted model is stage-based and includes four phases of individual sexual identity development as well as four parallel phases of group membership identity development. However, individuals do not necessarily progress through the

LGBTQ SCHOOL-BASED SUPPORT individual and group phases concurrently (i.e., one may be at individual identity phase “x” and group membership identity phase “y” at any given time). Within this multi-faceted model, the

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individual sexual identity and group membership identity phases include: Awareness, Exploration, Deepening/Commitment, and Internalization/Synthesis. A final consideration concerns the “differential developmental trajectories” described by Savin-Williams (1998). LGBQ identity formation is a complex individual process such that no two people will share the same developmental course. Not only do LGBQ individuals differ among themselves in terms of developmental experiences, but they also share many developmental characteristics and experiences with their heterosexual peers (Savin-Williams & Diamond, 2000). Savin-Williams and Diamond note that lesbian and bisexual women may be more similar in their developmental trajectories to heterosexual women than they are to gay or bisexual men. Established models of sexual identity development may not reflect the effects of race and ethnicity on milestone experiences and will require modification if they are to apply to non-White youth (Dube & Savin-Williams, 1999). It is also important to note that LGBQ youth are increasingly likely to use “queer” or another nongender-based label, or to reject labeling their identities at all. This choice reflects a philosophy of nongender-based models of sexuality that transcend the convention of categorization (Savin-Williams, 2005). Stress and Resilience: A Minority Stress Framework Minority Stress Social stress theory posits that in addition to personal events, conditions in the social environment are also sources of stress that may negatively affect mental and physical health (e.g., Allison, 1998; Clark, Anderson, Clark & Williams, 1999; Meyer, 1995). Minority stress refers to the idea that stigma, prejudice, and discrimination create a hostile and stressful social environment

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that may lead to mental health problems among members of a stigmatized minority group (Meyer, 1995; 2003). The minority stress model is rooted in sociological and social psychological theories related to the harmful effects of adverse social conditions (i.e., prejudice, stigma) on individuals and groups (e.g., Allport, 1954; Crocker, Major & Steele, 1998). Stress Processes The assumptions underlying the concept of minority stress are as follows: (a) minority stress is unique, in that it is additive to general stressors experienced by all people and requires additional adaptation efforts; (b) minority stress is chronic, or related to relatively stable underlying social and cultural structures; and (c) minority stress is socially based, stemming from social processes, institutions, and structures beyond the individual (Meyer, 2003). Meyer suggests a distinction between distal and proximal stressors, and explains that distal social attitudes gain psychological importance through cognitive appraisal and become proximal concepts with psychological importance to the individual. He identifies four processes of minority stress relevant to LGB individuals (Note: transgender individuals were not included in this theoretical review): (a) external, objective stressful events and conditions (chronic and acute), (b) expectations of such events and the vigilance this expectation requires, (c) concealment of one’s sexual orientation, and (d) the internalization of negative societal attitudes. He also describes stress processes specific to LGB individuals, including the experience of prejudice events, expectations of rejection, concealment of one’s sexual orientation and internalized homophobia. Coping Processes In addition to stress processes, Meyer’s model also includes ameliorative coping processes as they relate to the mental health of LGB individuals. There is a wealth of evidence to suggest that individual members of stigmatized groups respond to prejudice with coping and resilience (e.g.,

LGBTQ SCHOOL-BASED SUPPORT Allport, 1954; Clark, Anderson, Clark, & Williams, 1999). Stigmatized individuals use both

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personal- and group-level resources to cope with negative experiences (Branscombe & Ellemers, 1998). Minority coping refers to a group-level resource related to the group’s ability to create selfenhancing structures to offset stigma (Meyer, 2003). However, environmental and personality factors affect an individual’s ability to access and use group-level resources (Meyer). When even otherwise-resourceful individuals are unable to access group-level resources, their capacity to cope will be limited (Meyer). Group solidarity and cohesiveness are important resources that serve to protect members from the potential effects of minority stress (Clark et al., 1999: Crocker & Major, 1989; Meyer). Minority group affiliation is a crucial group-level coping resource that: (a) allows stigmatized individuals to experience social environments in which they are not stigmatized; (b) provides support for negative evaluation of the stigmatized group; and (c) encourages reappraisal of prejudicial and discriminatory experiences, thus reducing their effects on psychological well-being (Meyer). In these ways, group members may be able to adopt some of the group’s self-enhancing attitudes, values and structures (Meyer). This conceptualization of individual coping in the context of group coping resources highlights the clear need for accessible school-based group-level resources for LGBTQ youth. Daily Challenges as Minority Stress LGBTQ youth are confronted with a variety of unique stressors related to their sexual orientation and/or gender identity not experienced by their heterosexual peers (e.g., Bontempo & D’Augelli, 2002; D’Augelli, Pilkington, & Hershberger, 2002; Kosciw & Diaz, 2006; Kosciw, Diaz, & Greytak, 2008; Murdock & Bolch, 2005; Pearson, Muller, & Wilkinson, 2007; Rivers, 2001). Since 1999, the Gay, Lesbian, and Straight Education Network (GLSEN) has conducted a

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comprehensive survey every two years to document the experiences of LGBTQ students. The 2007 National School Climate Survey (NSCS; Kosciw et al., 2008) describes the experiences of 6,209 LGBTQ students aged 13 to 21 (M=15.9) from all 50 states and the District of Columbia (22.2% Northeast, 30.1% South, 22.6% Midwest, 25.1% West). Students were largely in 10th or 11th grade, but ranged from grade 6 through 12. They attended urban (32.4%), suburban (42%) and small town/rural (25.6%) schools. Most attended public schools (92.5%). Approximately 64% of their sample was White, 5.8% was African American or Black, 13% was Hispanic or Latino/a, 4.1% was Asian or Pacific Islander, 6.2% was Native American, American Indian or Alaska Native, and 5.4% was Multiracial. The sample was 57.7% female, 33.4% male, 4.8% transgender, and 4% other gender identity (e.g., genderqueer, androgynous). Gay and lesbian students comprised 53.6% of the sample, 42% identified as bisexual, and 4.6% reported another sexual orientation (e.g., queer, asexual). Notably, the researchers took steps to increase representation of transgender youth and youth of color by recruiting from organizations that serve those populations. To address a previous sampling limitation, they reached youth who were not connected to the LGBTQ community (e.g., those from Southern states and small town or rural areas, middle school students) via MySpace, a popular social networking website. According to the 2007 NSCS (Kosciw et al., 2008), LGBTQ youth are prone to verbal and physical harassment, physical assault, and lack of staff intervention and support. They are likely to feel unsafe in their schools, are at greater risk for absenteeism, and face academic consequences. Sexual minority youth must also navigate the disclosure of their LGBTQ identity to others and cope with related consequences (D’Augelli, Hershberger, & Pilkington, 1998; Floyd & Stein, 2002; Savin-Williams, 1998). As a result of these challenges, LGBTQ youth may be at risk for a variety of mental health and behavioral concerns (Bontempo & D’Augelli, 2002; Busseri, Willoughby,

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Chalmers, & Bogaert, 2008; D’Augelli, 2002; D’Augelli, et al., 2005; D’Augelli, Pilkington, & Hershberger, 2002; Rivers, 2001). Most studies have not adequately examined school experiences that may be unique to transgender students. Studies have typically excluded transgender youth or folded them into the larger “LGBTQ” identity without asking questions specific to their gender identity- and presentation-related experiences. A relatively small number of studies dedicated to transgender youth and their school experiences have been published in recent years. A recent focus-group study in New York City found that transgender youth did not feel safe or supported in their schools (Grossman & D’Augelli, 2006). Also, in a study conducted in Philadelphia, approximately 75% of transgender youth also reported that their schools did not provide them with a safe environment (Sausa, 2005). Hostile School Climate The GLSEN 2007 NSCS found that many LGBT students are subject to verbal and physical harassment and assault because of their sexual orientation or gender identity (Kosciw et al, 2008). Nearly three-fourths (73.6%) of student respondents heard homophobic remarks frequently or often at school, and nine out of ten students heard “gay” used in a negative way often or frequently. More than half (60.8%) of respondents reported that they felt unsafe in school because of their sexual orientation, and more than a third (38.4%) felt unsafe because of their gender expression. The majority (60.8%) of students who were harassed or assaulted in school did not report the incident to school staff, believing little or no action would be taken or the situation could become worse if reported. Alarmingly, nearly a third (31.1%) of the students who did report an incident said that school staff did nothing in response.

LGBTQ SCHOOL-BASED SUPPORT Verbal Harassment

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Verbal harassment is an emotionally damaging reality for many LGBTQ students. Nearly nine out of ten students (86.2%) who responded to the GLSEN 2007 NSCS reported being verbally harassed (i.e., called names or threatened) at school because of their sexual orientation, and twothirds (66.5%) of students were verbally harassed because of their gender expression (Kosciw et al., 2008). In their study on the impacts of sexual orientation victimization on mental health, D’Augelli, Pilkington, and Hershberger (2002) found that high school victimization correlated with mental health symptoms, and especially with post-traumatic stress symptoms. Physical Harassment and Assault There is evidence that attacks based on one’s sexual orientation tend to affect victims more negatively than do crimes in general (Herek, Cogan, Gillis, & Glint, 1997). Heightened risk of physical assault based on their sexual orientation and/or gender identity is a critical reality for LGBTQ youth (Bontempo & D’Augelli, 2002; D’Augelli, Pilkington, & Hershberger, 2002). Of students responding to the GLSEN 2007 NSCS, almost half (44.1%) had been physically harassed (i.e., pushed or shoved) at school in the past year because of their sexual orientation and three out of ten students (30.4%) because of their gender expression (Kosciw et al., 2008). The 2007 NSCS also found that 22.1% of students reported being physically assaulted (i.e., punched, kicked, or injured with a weapon) because of their sexual orientation and 14.2% because of their gender expression. Identity Concealment and the Self as a Limited Resource Baumeister, Bratslavsky, Muraven, and Tice (1998) examined ego depletion and the active self as a limited resource. Their results suggest that an individual’s capacity for active volition is limited, and that a variety of seemingly unrelated acts share a common resource. Specifically, they

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reported that decision making, self-control, and active responding share a common resource and cause ego depletion (i.e., after one initial act of volition, less of this resource remains available for subsequent acts). In a related investigation, Smart and Wegner (1999) studied concealable stigma and mental control. Results indicated that individuals who concealed their stigmas became preoccupied with the control of stigma-relevant thoughts, and exhibited more secrecy, suppression, intrusive thoughts, and projection of stigma-related thoughts. The authors also considered potential benefits of “passing,” in which a socially stigmatized individual is able to conceal his or her stigma, thereby minimizing its impact on social interactions. Identified benefits included social acceptance, avoidance of discrimination, and escaping the burden of disclosure. However, concealment requires sustained mental effort during interactions, and can distract the individual from important relational aspects of social interactions (Smart & Wegner). While this research was conducted in the context of eating disorders, the findings are relevant to LGBTQ identities. To varying degrees, LGBTQ individuals move through their daily lives in a constant cognitive and emotional multitasking state. They must simultaneously decide whether or not to disclose their sexual orientation or gender identity to those they encounter while controlling their emotional responses to experiences of victimization and rejection (Crocker, et al., 1998; Smart & Wegner, 2000). For LGBTQ youth, this can leave few internal resources for active responding in the classroom or social situations. Disclosure: If, When, How, and to Whom? Correlates of disclosure. An individual’s degree of sexual orientation/gender identity disclosure has been linked to a range of both person-centered and contextual factors. Some studies have associated outness with positive identity development and mental health (cf., Jordan & Deluty, 1998; Miranda & Storms, 2001). Internalized homophobia has also been shown to

LGBTQ SCHOOL-BASED SUPPORT negatively correlate with disclosure of sexual orientation (Herek et al., 1997; Jellison &

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McConnell, 2003). Others such as McCarn and Fassinger (1996) have suggested that a person’s degree of disclosure may be more a reflection of a particular social context (i.e., whether there are visible LGBTQ role models; whether the context is LGBTQ affirming). As noted, there has been a trend in recent years toward disclosure at a younger age (Floyd & Bakeman, 2006). In their study of 767 LGB individuals aged 18 to 74, Floyd and Bakeman examined the effects of age and the calendar year (i.e., historical context) when individuals first self-identified as LGB on their sexual orientation identity development. Specifically, they examined the timing and sequencing of seven coming out experiences: first awareness of same-sex attraction; first sexual experiences with opposite-sex partners; first sexual experiences with same-sex partners; self-identification as LGB; disclosure to someone other than a parent; disclosure to mother; and disclosure to father. Their data revealed trends toward earlier disclosure of sexual orientation to others, with an average age at disclosure of younger than 18 years. D’Augelli, Grossman, and Starks (2005) examined data from a longitudinal study of LGB youth (aged 15 to 19) in New York City and surrounding suburbs. Their sample consisted of 293 adolescents who lived with one or both parents who had raised them. Regression analysis revealed that gay self-identification (based on Kinsey rating), greater childhood gender atypicality, less internalized homophobia, more family support, and less fear of parental harassment or rejection were related to parental awareness of sexual orientation. Gender, age of first disclosure, and years of awareness were not significant predictors of parental awareness. The model explained 58% of the variance and correctly classified 86% of the cases. A variety of additional factors associated with disclosure also have been offered by researchers. In their study of 2,401 lesbian and bisexual women, Morris, Waldo, and Rothblum

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(2001) learned that differences in individual identity development may also be related to disclosure. Their data suggested that the longer women self-identified as lesbian or bisexual, the more likely they were to self-disclose. Floyd and Bakeman’s (2006) results also suggested that individuals who self-identified during adolescence (as opposed to adulthood) were more likely to demonstrate identity-centered sequences in which self-identification preceded same-sex sexual experiences. In terms of community involvement, Morris, Waldo, and Rothblum reported that among lesbian and bisexual women, greater involvement in the LGBTQ community was associated with an increased likelihood of disclosure of sexual orientation. Complex choices: Disclosure vs. identity concealment. Many LGBTQ youth experience significant challenges related to the emerging awareness of their sexual orientation and gender identity for the first time during early adolescence (e.g., Floyd & Bakeman, 2006; Mosher, 2001). In addition to their own developing identity as a LGBTQ person, these youth are often faced with decisions related to the disclosure of their sexual orientation or gender identity to others (i.e., “coming out”). In some cases, disclosure of one’s sexual orientation or gender identity is not a choice; an individual may be “outed” by someone else, or their gender expression may lead others to draw conclusions about their sexual orientation and gender identity (Carragher & Rivers, 2002). In recent years, LGBTQ individuals have been coming out at younger ages than ever before (Floyd & Bakeman, 2006). Research findings related to early disclosure have been inconsistent. Several studies have identified coming out at a young age as a risk factor (e.g., D’Augelli, Pilkington, & Hershberger, 2002), perhaps due to poor access to resources and the absence of important coping skills among younger adolescents. Other studies have suggested that early disclosure can serve as a protective factor (Floyd & Stein, 2002), citing the possibility that earlier disclosure may in fact encourage positive identity development if resources are provided early on in the process. As such,

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schools must be prepared to support LGBTQ adolescents as they navigate this complicated, and sometimes turbulent, process. Decisions regarding if, when, how, and to whom one might disclose are complicated by a variety of interconnected factors including religious and cultural beliefs, the anticipated reaction, real or perceived safety, relationship factors, and subjective distress about concealment (Corrigan & Matthews, 2003; D’Augelli et al., 2005; Mosher, 2001; Savin-Williams & Ream, 2003). LGB youth cite a variety of reasons for not disclosing to their parents, including fears of harassment, rejection, or eviction; fear of relationship deterioration; and not having close relationships with parents (D’Augelli et al., 2005). Predicting the potential impact of disclosure can be quite complex. To illustrate, a study of 2401 lesbian and bisexual women found that an individual’s degree of disclosure predicted lower psychological distress (Morris, Waldo, & Rothblum, 2001). However, other studies have proposed different findings. For example, in their study of 350 LGB youth aged 14 to 21, D’Augelli, Pilkington, and Hershberger (2002) discovered that the earlier young individuals came out to themselves and others, the more they were victimized in high school. LGBTQ youth who disclose their sexual orientation or gender identity, by choice or through the assumptions of others, are often met with rejection (Cohen & Savin-Williams, 1996; D’Augelli, Hershberger, & Pilkington, 1998; Ryan, Huebner, Diaz, & Sanchez, 2009; Savin-Williams, & Ream, 2003). Unlike members of many other minority groups, LGBTQ youth often do not have the support of their families, places of worship, or other cultural organizations to provide an identity framework or to serve as a buffer against the hostility that they face (Taylor, 2000). In their study of 156 LGB youths (ages 14 to 21), Rosario, Schrimshaw, and Hunter (2009) found that a greater number of rejecting reactions from important individuals was associated with more concurrent and subsequent substance use and abuse. Accepting reactions were found to moderate the negative

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association of rejection with alcohol use, but not with tobacco or marijuana use or substance abuse symptoms. These findings suggest that it may be the number of accepting and rejecting reactions that influence outcomes rather than the number of disclosures per se; however, more research is needed to examine other outcomes of interest. Family reaction. Family support may play an important protective role for LGBTQ adolescents. To illustrate, in their study of LGB youth aged 15 to 21, Hershberger and D’Augelli (1995) found partial evidence for the mediating role of family support and self-acceptance in the relationship between victimization, mental health and suicidality. Specifically, their analyses revealed that family support buffered against the effects of victimization when the level of victimization was low. Unfortunately, in cases of moderate or high victimization, family support was not protective. LGB youth cite a variety of reasons for not disclosing to their parents, including fears of harassment, rejection, or eviction; fear of relationship deterioration; and not having close relationships with parents (D’Augelli et al., 2005). Parents’ reactions to a child’s disclosure of his or her sexual orientation or gender identity can be negative (Cohen & Savin-Williams, 1996; D’Augelli, Hershberger, & Pilkington, 1998; Ryan, Huebner, Diaz, & Sanchez, 2009; SavinWilliams, & Ream, 2003). A variety of factors may influence a parent’s negative reaction to disclosure, including feelings of guilt related to a belief that they caused their child to be LGBTQ or experiencing conflict between love for their child and anger or resentment over the perceived loss of their heterosexual child (Goldfried & Goldfried, 2001). Some recent studies have suggested greater parental acceptance of a child’s sexual orientation. For example, Garofalo, Mustanski, and Donenberg (2008) found that among their sample of 302 urban gay and bisexual young men, 82.7% of those with a mother or stepmother reported that she definitely knew their sexual orientation.

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Further, most of these mothers were described as accepting (53.4%) or tolerant (30.3%). Among participants with a father or stepfather, 70.4% reported that their father definitely knew about their sexual orientation, with the majority of these fathers accepting (48.9%) or tolerant (25.3%). Peer reaction. The disclosure of one’s sexual orientation may result in an interruption or loss of social supports (D’Augelli et al., 1998). Although greater disclosure has been associated with larger peer networks, outness may also be also related to loss of friendships and friendship-related worry among sexual minority youth (Diamond & Lucas, 2004). In their 1995 study, D’Augelli and Hershberger found that LGB adolescents reported a fear of rejection by peers following disclosure of their sexual identity. In his study of 542 LGBT adolescents, D’Augelli (2002) found that more than one third had lost friends due to their sexual orientation. In addition, he found that those individuals who had lost friends reported more mental health problems and more past suicide attempts than those who did not lose friends. Obstacles to Academic Success Negative school experiences can have serious implications for LGBTQ students’ academic success. According to the GLSEN 2007 NSCS (Kosciw et al., 2008), LGBTQ youth are prone to verbal and physical harassment, physical assault, and lack of staff intervention and support. As a result, they are likely to feel unsafe in their schools, are at greater risk for absenteeism, and face academic consequences. More than half (60.8%) of respondents reported that they felt unsafe in school because of their sexual orientation, and more than a third (38.4%) felt unsafe because of how they expressed their gender (Kosciw et al.). This pervasive fear can be a significant distraction for some LGBTQ students and may have serious implications for their academic success. Absenteeism. The 2007 NSCS found that LGBTQ students were more than five times more likely to have skipped school in the last month because of feeling unsafe than the general

LGBTQ SCHOOL-BASED SUPPORT population of secondary school students (Kosciw et al., 2008). In addition, experiences of

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harassment were related to absenteeism among respondents. Students who had experienced high frequencies of verbal harassment related to their sexual orientation or gender expression were twice as likely to have missed school in the past month than those who had not experienced frequent harassment. Students who had experienced high frequencies of physical harassment because of their LGBTQ identity were almost three times more likely than other students to have missed school in the past month due to feeling unsafe (physical harassment based on sexual orientation: 68.9% versus 25.4%, physical harassment based on gender expression: 70.8% versus 28.4%). Results from a biennial California survey of adolescent risk behaviors found that students who were victimized in school because they were gay or lesbian – or simply perceived to be – were more than three times as likely as students who were not harassed for this reason to have missed school because they felt unsafe (Russell et al., 2006). Academic achievement and goals. The GLSEN 2007 NSCS found that a higher frequency of harassment was related to lower academic achievement among LGBTQ students (Kosciw et al., 2008). The average grade point average of students who experienced frequent physical harassment because of their sexual orientation or gender expression was almost half a grade lower than that of LGBTQ students experiencing less harassment. In addition, LGBTQ students who endorsed more frequent physical harassment were also less likely to report plans to attend college. Specifically, 41.5% of students who experienced high frequencies of physical harassment did not plan to go to college compared to 30.1% of those who had not experienced high frequencies of physical harassment. Overall, LGBTQ students were almost twice as likely as the general population of students to report that they were not planning to pursue any post-secondary education (i.e., obtaining a high school diploma only or not finishing high school). A recent study using data from

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The National Longitudinal Study of Adolescent Health, which has followed into young adulthood a nationally representative sample of young people who were in grades 7-12 during the 1994-95 school year, suggested that sexual minority youth felt less connected and engaged with their school community than their heterosexual peers (Pearson, Muller, & Wilkinson, 2007). These youth, particularly gay and bisexual young men, performed worse academically and were less prepared for postsecondary education (Pearson et al.). Mental Health and Wellness The majority of research has supported the conclusion that LGBTQ individuals experience a higher prevalence of mental health concerns than do heterosexuals (see King et al., 2008 for a review and meta-analysis; Meyer, 2003). Methodologically, early studies examining risk (e.g., suicide) among LGB youth were often not representative of LGB youth as a group because participants were typically recruited from service providers. These young people were already seeking mental health services, which created biased samples (Mustanski, 2008). Ecological models of human development (Bronfenbrenner, 1979) describe interactions between multiple individuals, contexts, and “spheres of influence” that shape an individual’s development. Until recently, most studies have examined only single variables in the prediction of mental health outcomes among LGBT youth as opposed to the use of a multivariate approach (Mustanski, 2008). Historically, research with LGBTQ youth has typically focused on risks directly related to sexual orientation and/or gender identity (e.g., victimization, age at self-labeling), often ignoring risk factors identified among general adolescent samples such as personality variables, mental and addictive disorders, impulsivity, hopelessness, lack of a peer social network, and early puberty (Elze, 2002; Mustanski, 2008; Safren & Heimberg, 1999).

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More recent research efforts have revealed that when other factors are controlled, many of the differences between LGBTQ youth and their heterosexual peers on indices of mental health disappear (cf., Busseri, Willoughby, Chalmers, & Bogaert, 2008; Elze, 2002; Safren & Heimberg, 1999). To illustrate, in their study of 56 LGB youth and 48 heterosexual youth, Safren and Heimberg discovered that when other psychosocial predictors of present distress were controlled (i.e., stress, social support, and coping), significant differences between LGB and heterosexual youth in depression, hopelessness, and present suicidality disappeared. The authors suggest that based on their findings, environmental factors associated with sexual orientation, which can be targeted and changed through prevention and intervention efforts, play a major role in predicting distress in this population. It has been reported in the literature that LGBTQ youth experience an elevated risk of suicidality. LGBTQ adolescents are particularly vulnerable to victimization because it often occurs before they have developed sufficient self-protective resources. It may be that existing in a homophobic environment while lacking the personal resources with which to deal with harassment and marginalization contributes to the elevated prevalence of suicidal behavior among LGBT youth (McFarland, 1998). In his 2001 investigation, Sadowski concluded that the suicide rate among LGBT youth was four times that of their heterosexual peers. It also has been reported that LGBT youth are the victims of 30% of all completed teen suicides, yet they comprise only 5 to 10% of the total youth population (Todd, 2001). In a sample of gay and bisexual male adolescents, substance use, feminine gender presentation, age at the time of self-labeling, and gay-related stressors (e.g., disclosure of sexual orientation) were identified as risk factors for suicide attempts (Remafedi, Farrow, & Deisher, 1991). Another study found that loss of friends, low self-esteem, hostility, feminine gender presentation, and age at the time of self-labeling were associated with suicide

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attempts among gay and bisexual young men (D’Augelli & Hershberger, 1993). Among gay and bisexual young women in that sample, loss of friends and more frequent visits to gay bars were associated with suicide attempts. LGBT youth may be more likely than their heterosexual peers to abuse drugs and/or alcohol (Jordan, 2000). In their 1995 study, Rotheram-Borus, Rosario, Van Rossem, Reid, and Gillis found that LGBT youth may also use substances as a method of rationalizing their same-sex feelings, or as a way to reduce the anxiety they feel when in a gay or lesbian situation. They also reported that frequent unprotected sexual encounters and suicide attempts have been found to increase with substance use. LGBT youth may become sexually active at an earlier age than their straight peers in an effort to prove that they are “normal,” which presents a greater risk of sexually transmitted infections and pregnancy (Rotheram-Borus et al., 1995). They may also use substances as a result of the lack of age-appropriate social outlets such as parties or dances (Jordan, 2000). Anxiety in LGBTQ Populations Etiology and Prevalence From a learning theory perspective, an individual’s early learning history and temperamental vulnerabilities together affect the emotional consequences of adverse and stressful life events (Mineka & Zinbarg, 1996). Individual differences in these factors may affect one’s susceptibility to the development of problematic anxiety. A number of intervening psychosocial factors and life experiences have been associated with the manifestation of anxiety, including the family environment, peer relationships, information processing styles and conditioning experiences (Hudson & Rapee, 2000). More generally, demographic risk factors for the development of anxiety disorders in children and adolescents include sex, age, socioeconomic status, race and familial factors (i.e., environmental and genetic; Merikangas, 2005). Individual and contextual

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vulnerabilities include temperament and personality (e.g., behavioral inhibition, anxiety sensitivity, vigilance to threat); comorbid psychiatric and medical disorders; biological factors (e.g., autonomic reactivity, respiratory sensitivity, neurobiologic factors); life events and stressors; drug use; and parenting (for a thorough discussion of these factors, see Merikangas, 2005). The present study is concerned with two specific manifestations of anxiety: (1) generalized (or trait) anxiety and (2) social anxiety, known at clinical levels as social phobia. Etiology of generalized anxiety disorder. Generalized anxiety disorder (GAD) is primarily characterized by chronic excessive worry about a number of events or activities that is difficult to control (Mineka & Zinbarg, 2006). It is generally agreed that worry is the central feature of GAD and serves as a self-reinforcing cognitive avoidance response (Mineka & Zinbarg). It has been suggested that uncontrollable and unpredictable adverse events may play an important role in the development of generalized anxiety (e.g., Barlow, 2002; Mineka & Zinbarg, 1996). There is limited evidence that individuals with GAD may be more likely to have a history of childhood trauma than are those with a number of other anxiety disorders (Borkovec, Alcaine & Behar, 2004). Individuals most prone to developing GAD may lack safety signals or indicators telling them when negative events are unlikely to occur, causing a constant state of vigilance and tension (Mineka & Zinbarg, 1996; Rapee, 2001). Etiology of social anxiety disorder. Social anxiety is defined as fear and avoidance of situations that may involve evaluation by others (Safren & Pantalone, 2006). Individuals who have social anxiety disorder (SAD) or social phobia show excessive fears of situations in which they might be evaluated or judged by others and either attempt to avoid such situations or endure them with distress (Mineka & Zinbarg, 2006). Fear of negative evaluation is a latent construct believed to promote the development of more general fears, anxiety and psychopathologies (Carleton,

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Collimore, & Asmundson, 2007). Research findings and several cognitive models support the idea that social anxiety is derived in part from fears of perceived negative evaluation (e.g., Clark & Wells, 1995; Rapee & Heimberg, 1997). It has been postulated that social phobia may, in some cases, develop through an aversive conditioning experience, such as being severely teased (Barlow, 1988; Hofmann & Barlow, 2002). A cluster of cognitive biases known as the “cognitive signature” (p. 757) of socially anxious individuals has been described by a number of researchers and includes attentional bias, memory bias, and judgment or interpretation bias (Ledley & Heimberg, 2006). Research has suggested that these biases are rooted in temperamental factors, early attachment patterns, family modeling, peer relations, and a number of other life events (Ledley & Heimberg, 2006). Adolescents are particularly vulnerable to risk factors from ages 13 to 18, an identified period of onset of social anxiety symptoms (Last, Perrin, Hersen, & Kazden, 1992). In their longitudinal study of 185 adolescents followed from age 13 through 18, Teachman and Allen (2007) reported that a lack of perceived social acceptance predicted later social anxiety and fear of negative evaluation. In their 2003 study of adults, McCabe, Antony, Sumerfeldt, Liss, and Swinson found that 92% of their sample with SAD reported a history of severe teasing in childhood, compared to 50% of those with panic disorder and 35% in their obsessive-compulsive disorder groups. Other studies have suggested that for vulnerable individuals, social learning may be sufficiently distressing to lead to the manifestation of SAD. For example, in a study of 106 adults with SAD, animal phobia, and claustrophobia, 17% recalled vicarious experiences that may have led to the onset of their symptoms (Ost & Hughdahl, 1981). Prevalence of anxiety disorders. The lifetime prevalence rate for GAD in the general population has been estimated at 5.7% (Kessler, Berglund, Demler, Jin & Walters, 2005). Results

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from the national Comorbidity Study found that the lifetime prevalence rate for SAD was 13.3% (Kessler et al., 1994). In their study of LGB and heterosexual adolescents between the ages of 16 and 21, Safren and Pantalone (2006) found that LGB participants reported greater social anxiety than did their heterosexual peers. Quite a few studies have revealed a higher incidence of anxiety disorders and anxiety-related symptoms among LGBT populations than in the general population or strictly heterosexual populations (e.g., Cochran, Sullivan & Mays, 2003; Gilman et al., 2001; Pachankis & Goldfried, 2006; Sandfort, de Graaf, Bijl & Schnabel, 2001). Anxiety in LGBT Youth and Young Adults The specific etiology of anxiety disorders and anxiety symptomatology in LGBTQ youth and adults is not well understood. However, theorists and researchers suggest that issues such as victimization, pressures to conform to heterosexual developmental parameters, and familial stressors may be contributing factors. For example, in their 2002 study on the impact of sexual orientation victimization on mental health, D’Augelli, Pilkington, and Hershberger found that high school victimization correlated with mental health symptoms and especially with posttraumatic stress symptoms. A study of 104 LGB and heterosexual youths (mean age = 18.2) suggest that social anxiety may be a barrier to obtaining social support and engaging in positive events, over and above the effects of sexual orientation (Safren & Pantalone, 2006). The authors explain that during adolescence, young people typically experience social pressure to conform to heterosexual social and dating behaviors. In response to this pressure, many LGB adolescents make efforts to hide their sexual orientation. Toward that end, they may avoid participation in the social situations that typically provide access to supportive peer networks. Social anxiety (i.e., fear and avoidance of social interactions) can inhibit the ability to attain satisfactory social support from peers and engage in positive, competence-building activities.

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In addition, this constant self-monitoring has been found to impair functioning in individuals with social anxiety (Hope, Heimberg & Klein, 1990). In their study of 87 gay and 87 heterosexual men between the ages of 18 and 24, Pachankis and Goldfried (2006) found that young gay men reported greater fear of negative evaluation and social interaction anxiety, and lower self-esteem than heterosexual men. Their study revealed that relatively innocuous situations for heterosexual men can be anxiety-provoking for gay men (e.g., being in a locker room with other men, watching the Super Bowl with other men). Results also indicated that gay men who were less comfortable with their sexual orientation and who were less open about being gay were more likely to experience social anxiety. Specifically, 75% of gay participants reported having changed their behavior because of fears of being identified as gay or harassed or attacked because of their sexual orientation. Pachankis and Goldfried’s (2006) findings may have significant implications for intervention with young gay and bisexual men, as social anxiety has been linked to risky sexual behaviors among men who have sex with men. To illustrate, a study of 100 gay and bisexual men (aged 16 to 21) found that social anxiety predicted increased probability of having engaged in unprotected sexual intercourse in the past six months (Hart & Heimberg, 2005). In their study of 80 young gay and bisexual men (aged 14 to 21), Rosario, Schrimshaw, and Hunter (2006) found a relationship between lower self-esteem, anxious symptoms, and more unprotected sex indirectly through more substance abuse symptoms and more sexual partners and encounters. The authors underscore the clear need for service providers to consider the impact of social fears and other symptoms of anxiety when designing interventions for this population that target sexual risk behaviors.

LGBTQ SCHOOL-BASED SUPPORT Examining the Response of Schools Lack of Formal and Informal Support Although the need for LGBTQ-specific school-based support has been established (see Hansen, 2007 for a review), many schools continue to ignore the safety, developmental, and

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academic needs of their LGBTQ students. Despite their increased struggle and risk, LGBTQ youth are faced with a lack of resources in their schools, communities, and homes. Unlike members of other minority groups, LGBT youth often do not have the support of their families, places of worship, or other cultural organizations to provide an identity framework or to serve as a buffer against the hostility they face (Taylor, 2000). Forming a Gay-Straight Alliance Gay-Straight Alliances (GSAs) are student-led, school-based clubs open to all students regardless of sexual orientation that work to improve school climate (GLSEN, 2008). The benefits of such student groups have been well documented (e.g., Garcia-Alonzo, 2004; Horowitz & Loehnig, 2003; Kosciw et al., 2008; Lee, 2001). To illustrate, the GLSEN 2007 NSCS (Kosciw et al.) found that students in schools with a GSA reported hearing fewer homophobic remarks, experienced less harassment and assault because of their sexual orientation and gender expression, were more likely to report incidents of harassment and assault to school staff, were less likely to feel unsafe because of their sexual orientation or gender expression, were less likely to miss school because of safety concerns and reported a greater sense of belonging to their school community. Nonetheless, just 36.3% of LGBTQ students reported having a GSA at their school (Kosciw et al.). Despite the steadily increasing prevalence of GSAs and other LGBTQ-supportive student groups in schools, most districts still lack such social opportunities for LGBTQ students. The GLSEN 2007 NSCS also revealed that LGBTQ African American students were less likely to report having a

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GSA in their school than other students of color, particularly those in schools where the student population is predominantly African American. LGBTQ students in the South and in small towns or rural areas were least likely to have a GSA in their school. Staff Response The GLSEN 2007 NSCS found that the presence of supportive staff contributed to a range of positive indicators among LGBTQ adolescents, including fewer reports of missing school, greater academic achievement, higher educational aspirations and a greater sense of belonging to their school community (Kosciw et al., 2008). However, the survey also found that the majority (60.8%) of students who were harassed or assaulted in school did not report the incident to school staff, believing little or no action would be taken or the situation could become worse if reported. Almost a third (31.1%) of the students who did report an incident said that school staff did nothing in response (Kosciw et al., 2008). In their 2001 report, the Sexuality Information and Education Council of the United States (SEICUS) found that 25% of students surveyed perceived that teachers exhibited significant prejudice against LGBT students, and 38.2% reported not feeling comfortable speaking about LGBT issues to teachers or staff in class. In another study, 80% of prospective teachers and 67% of guidance counselors surveyed reported at least some negative attitudes toward LGBT people (Todd, 2001). The same study also found that less than 20% of teachers surveyed had received training on LGBT students and the unique issues they face. School Culture: What Does “Inclusive” Really Mean? LGBTQ students experience systematic exclusion (Macgillivray, 2000) at school in the form of social and curricular omission. Unlike their straight peers who have ample role models for healthy heterosexual relationships and are openly encouraged to date, LGBTQ adolescents do not typically see their identities reflected or affirmed. The National Association of School

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Psychologists (NASP) supports equal access to education and mental health services for LGBTQ youth within public and private schools. Their Position Statement on Gay, Lesbian, Bisexual, Transgender, and Questioning Youth asserts that violence and intimidation as either direct harassment of individual students or hostile statements and biases toward LGBTQ people as a group violate the right of LGBTQ students to receive equal educational opportunities (NASP, 2006). The Statement establishes that failure to address harassment and intimidation in the school setting perpetuates an unsafe environment that is not supportive of academic or social achievement. NASP believes that school psychologists are “ethically obligated to ensure that all students have an equal opportunity for the development and expression of their personal identity in an environment free from discrimination, harassment, violence and abuse” (NASP, 2006). This Position Statement establishes the Association’s expectation that school psychologists will make efforts to reduce discrimination and harassment against LGBTQ youth by students and staff through education and advocacy. Typical school curricula rarely include positive mention of LGBT people or issues. The GLSEN 2007 NSCS (Kosciw et al., 2008) found that only 10.5% of students were exposed to positive representations of LGBT people, history or events in their classes. In their 2001 study, SEICUS reported that 80.6% of LGBT students surveyed indicated that there were no positive portrayals of LGBT people, history, or events in any of their classes. According to the GLSEN 2007 NSCS, students whose schools had a safe school policy that included protections based on sexual orientation and/or gender identity/expression heard fewer homophobic remarks, experienced lower levels of victimization related to their sexual orientation, were more likely to report that staff intervened when hearing homophobic remarks and were more likely to report incidents of harassment and assault to school staff (Kosciw et al., 2008). However,

LGBTQ SCHOOL-BASED SUPPORT less than one in five or 18.7% of students attended a school with a comprehensive policy for

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reporting harassment and assault that specifically mentioned sexual orientation (37.6% reported a generic policy). Almost half of students surveyed reported that their schools did not have any type of safe school policy in place. Most school districts lack policies to protect the rights of LGBT students (GLSEN, 2008). Some school districts have even gone as far as to uphold “No Promo Homo” policies, which restrict or eliminate any school-based instruction or activity that could be interpreted as positive about homosexuality (Bonauto, 2001). Non-discrimination and anti-harassment policies designed to protect students usually include race, religion, and sex, but exclude sexual orientation and gender identity or expression. With no firm policies to back them, teachers often have little support in disciplining students when homophobic or harassing behavior occurs. School-Wide Interventions: Cultivating Respect through Education School climate has been defined as “that quality of a school that helps each individual feel personal worth, dignity, and importance, while simultaneously helping create a sense of belonging to something beyond ourselves” (Freiberg & Stein, 1999, p. 11). A positive school climate can foster resilience, while a hostile climate can be a risk factor for harassment, dropping out, and violence (Szalacha, 2003). Specific school-based supports have the potential to mitigate the damaging effects of the compounded stressors experienced by LGBTQ youth. School-based support in the form of GSAs, comprehensive anti-harassment policies, supportive school staff, and LGBT-related resources and curricula appear to alleviate some of the difficulties faced by LGBTQ students (e.g., Hansen, 2007; Kosciw & Diaz, 2006, Kosciw et al., 2008). A critical factor in the prevention of bullying and harassment is peer behavior. There is evidence that the behavioral responses of peer bystanders can effectively halt or encourage bullying

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behavior (Craig, Pepler, & Atlas, 2000; Espelage, Holt, & Henkel, 2003; Salmivalli, 1999). This finding underscores the need for intervention efforts to target normative beliefs that support and maintain bullying behavior (Henry et al., 2000; Olweus, 1993; Swearer & Espelage, 2004). Meyer (2000) notes that in order to cultivate a change in school climate, relevant interventions must be directed at both the individual and structural levels. He delineates two pathways of intervention: (1) the subjective view, which targets processes within the LGBT individual, aims to influence coping and appraisal; and (2) the objective view, which targets the stressors, aims to effect changes in the stress-inducing environment and reduce exposure to stressors. Supporting Resilience in LGBTQ Adolescents Meyer (2003) asserts that along with our developing understanding of the risk for mental health disorders due to social stress among LGB individuals, we also require an understanding of the factors that ameliorate stress and contribute to mental health if we are to design effective prevention and intervention programs. The social environment provides individuals with ways to attach meaning to their world and organization to their experiences (Stryker & Statham, 1985); therefore, social interactions are crucial for the development of a sense of self and well-being (Meyer). This phenomenon operates in the opposite direction as well; given the relevance of the social environment, negative regard from others will lead to negative self-regard (Meyer). A mismatch between an individual and his or her experience of society has been described as the core of all social stress (Lazarus & Folkman, 1984). Coping as a Protective Factor It may be useful to conceptualize disclosure-related rejection within a stress and coping framework, as rejection is typically described as a stressful experience (Sandstrom, 2004). Individual differences in coping response have been shown to affect mental health outcomes (e.g.,

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Szymanski & Owens, 2008). The ways in which children and adolescents cope with stress may affect the impact of that stress on their current and future mental health (Compas, et al., 2001). Further, the development of characteristic adaptive or maladaptive coping responses during childhood and adolescence may influence coping styles into adulthood (Compas et al., 2001). Because individual differences in coping responses to disclosure-related rejection as a stressor may have important implications for mental health outcomes, the development of effective coping skills may be an area of particular interest for school-based intervention. This is not to say that LGBT youth should bear the responsibility of overcoming the potentially negative effects of rejection, discrimination, or victimization. Meyer (2003) cautions against the conceptualization of prejudice as a subjective stressor rather than an objective societal ill; to do so would place an unjust burden on the stigmatized individual. Rather, interventions intended to develop protective coping skills in LGBT youth should be viewed as a transitional intervention as work is being done to create safe environments via social, political and structural changes. Consistent Social Support For all youth, healthy identity development depends on the stability and supportiveness of their environment (Pringle & Mallon, 2003). As Cohen (2004) suggests, social relationships may be related to health outcomes in that social factors can promote health by providing psychological and material resources needed to cope with stress, as well as through main effects such as peer pressures that influence normative health behaviors. He advocates for interventions that occur in natural social networks to facilitate social integration and support as opposed to the temporary social connections of an assigned group. Gay-Straight Alliances and similar school-based clubs may be one way of providing an identity-affirming group to which LGBT youth may belong.

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Social support in the form of a support group for LGBT youth has been shown to positively impact identity formation and self-esteem (Martin & Hetrick, 1988). In their study of LGBTQ adolescent clients of a social service agency, Martin & Hetrick (1988) found that those entering support groups with signs of depression and low self-esteem showed a dramatic reduction in such symptoms when given the opportunity to interact with other LGBT youth. Radkowsky (1994) found that LGBT adolescents who spent more time attending LGBT youth groups displayed higher levels of self-esteem and fewer symptoms of depression (as cited by Radkowsky & Siegel, 1997). Further, he reported that the more helpful and supportive LGBT youth found their social environments, the less likely they were to experience internalized homophobia. Gay-Straight Alliances, or GSAs, are student-led, school-based clubs open to all members of the student body regardless of sexual orientation (GLSEN, 2007). They aim to provide safe, supportive environments for LGBTQ and straight-ally youth to meet; to encourage discussions about how to end sexual prejudice and heterosexism in schools; and to create positive change by making schools welcoming, supportive, and safe places for all students, regardless of sexual orientation (Szalacha, 2003; GLSEN, 2007). Based on the work of Shelton and Richeson (2005) on the role of pluralistic ignorance in intergroup contact, it seems that this bias regarding an individual’s explanation for their own inaction versus that of an out-group member may be another area for intervention. Lack of intergroup contact contributes to ignorance and unfounded negative biases against out-group members. Interventions designed to educate adolescents regarding this tendency may be useful in promoting mutual understanding and intergroup contact between heterosexual and LGBT youth. Shelton and Richeson discuss the Extended Contact Hypothesis, which posits that being aware that an in-group member has a close relationship with an out-group member can lead to more positive

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intergroup attitudes, as a potential method of increasing intergroup contact. The involvement of heterosexual peer allies in Gay-Straight Alliances (GSAs) and similar groups is one way to achieve this goal. In their study of 202 LGBTQ youth from 52 schools in Massachusetts with and without GSAs, Goodenow, Szalacha, and Westheimer (2006) found that LGBTQ students who attended schools with GSAs reported lower rates of victimization and suicide attempts than those in other schools. Three times as many students in schools with GSAs report that they can be open about their orientation at school, are less likely to hear homophobic slurs, and receive more support from faculty and staff (Sadowski, 2001). GSAs have been shown to improve school climate and schoolrelated experiences (e.g., academic performance, social relationships, feelings of belongingness) for LGBT students (Kosciw & Diaz, 2006; Lee, 2002; Todd, 2001). In her qualitative study of seven youth, Lee found evidence suggesting that GSAs positively impact academic performance; support school, social and family relationships; improve comfort level with one’s sexual orientation; encourage development of strategies to handle assumptions of heterosexuality; provide a sense of physical safety; increase students’ perceived ability to contribute to society; and enhance students’ sense of belonging to their school community.

LGBTQ SCHOOL-BASED SUPPORT Chapter III Method and Procedures Participants

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LGBTQ young adults were chosen for the present study because LGBTQ young adults are in a position to both recall their high school experiences and reflect upon how those experiences may have affected them at the time. In addition, LGBTQ individuals are an invaluable source of authentic information regarding best practices for the provision of support to LGBTQ high school students. Respondents were limited to individuals who attended high school between 1994 and 2009. This limit was intended to keep data within a reasonable time span in terms of cultural changes and attitudes (i.e., 15 years). Those under the age of 18 were not permitted to participate in the survey research because they were not at the age of consent. Demographic information is presented in Table 1 (Appendix I). The sample consisted of 184 LGBTQ young adults aged 18 to 33 (M=25.23; SD=3.98). The sample was largely Caucasian (84.2%; n=155), 7.6% multiracial (n=14), 4.3% Asian or Asian-American (n=8), 1.6% Latino/a (n=3), and 1.1% African American or Black (n=2). Slightly more than half of participants identified as female (54.9%; n=101), 19.6% as male (n=36), 17.4% as transgender (n=32), and 8.2% as genderqueer (n=15). About half the sample identified as lesbian or gay (54.9%; n=101); 32.1% queer, questioning, pansexual or transgender heterosexual (n=59); and 13.0% bisexual (n=24). Characteristics of the high schools described by participants are presented in Table 2 (Appendix I). The majority of participants attended high school in the Northeastern U.S. (n=131; 71.2%); 12% (n=22) in Western states; 6% (n=11) in the Midwest; 5.4% (n=10) in Southeastern states; 1.1% (n=2) in the Southwest; 1.1% (n=2) in Australia; 0.5% (n=1) in the UK and 0.5% (n=1) in Montreal, Canada. The majority of participants described their high schools as suburban

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(67.9%; n=125), 18.5% rural (n=34), and 13.6% urban (n=25). About half of participants reported middle- and mixed-SES student populations (52.2%; n=96). Eighty four percent (n=154) of participants attended public high schools. Procedures Approval to conduct the present investigation was obtained from the University at Buffalo Social and Behavioral Sciences Institutional Review Board (IRB). The study employed a webbased survey. The online consent form indicated that completion and submission of the web-based survey would constitute consent. In the event that a participant did not agree to the terms of the informed consent document, he or she was asked to exit the online survey. Participants were able to withdraw from the study at any point up until the submission of their completed survey. Once submitted, there was no way to identify an individual’s response. LGBTQ young adults were recruited through LGBTQ-related email list-servs, LGBTQrelated online groups and forums, and student email list-servs. Participants were asked to complete four separate measures. The Disclosure and School-Based Support Questionnaire is a qualitative researcher-constructed measure of demographic information, experiences related to disclosure of sexual orientation, and school-based support. The Brief COPE is a measure of 14 conceptually differentiable coping reactions (Carver, 1997). The Brief Fear of Negative Evaluation Scale, Version 2 (BFNE-II) has been widely used as a measure of social anxiety (Carleton, McCreary, Norton & Asmundson, 2006). The Spielberger State-Trait Anxiety Inventory- Trait Version (STAIT) is a measure of the more general and long-standing quality of “trait anxiety” (Spielberger, 1983). The online survey concluded with a list of LGBTQ-related services and resources that may have been of interest to participants.

LGBTQ SCHOOL-BASED SUPPORT Instruments The Disclosure and School-Based Support Questionnaire

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Description. The Disclosure and School-Based Support Questionnaire (DSBSQ; Appendix A) is a qualitative investigator-constructed measure of several aspects of LGBTQ individuals’ school experiences. The Demographic section of the DSBSQ collects information about the individual’s personal characteristics as well as characteristics of the high school he or she attended. The Disclosure and School Based Support section asks respondents to indicate their age at the time they first (a) considered, (b) self-identified, and (c) disclosed to others their sexual orientation and/or gender identity. They are also asked to identify their age at the time of their first same-sex sexual activity. Respondents are then asked to describe some of their experiences related to the disclosure of their sexual orientation and/or gender identity (i.e., “coming out”) to family members, friends/peers, and school staff. Respondents indicate their age at the time of disclosure and their relationship to the individual they disclosed to, and rate each individual’s response to their disclosure on four dimensions (i.e., Initial Reaction, Degree of Effect on Respondent, Change Over Time, and Current Relationship). Each dimension is rated on a unique 3- or 4-point scale. Response choices for the Initial Reaction dimension range from 1 (very accepting) to 4 (very rejecting). Responses for the Degree of Effect on Respondent dimension range from 1 (not at all) to 4 (a lot). Response choices for the Change Over Time dimension include 1 (became less accepting), 2 (no change), and 3 (became more accepting). Responses for the Current Relationship dimension range from 1 (very negative) to 4 (very positive). This section also assesses the presence and perceived helpfulness of interpersonal support from family members, peers, school staff, service providers and other community members, and

LGBTQ SCHOOL-BASED SUPPORT LGBTQ-specific school-based supports (e.g., presence of a GSA or similar group, safe-zone

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initiative, inclusive curricula, LGBTQ resources, supportive staff, non-discrimination policies that include sexual orientation and gender identity). Respondents first indicate the presence or absence of each type of school-based support. Those who did have access to a specific support were then asked to rate the value or helpfulness of each on a 4-point scale, ranging from 0 (not at all helpful) to 3 (very helpful). Scoring and variable construction: Disclosure-related rejection and acceptance. Using a 4-point Likert-type scale, respondents were asked to rate the initial reactions of several relevant individuals in response to their disclosure of sexual orientation or gender identity. Respondents were given the opportunity to rate up to four individuals from each of three relationship types: immediate family members, friends, and high school staff. The Total Rejection Index score was computed as the sum of all very rejecting (four points) or somewhat rejecting (three points) responses. The Total Acceptance Index score was computed as the sum of all very accepting (one point) or somewhat accepting (two points) responses. Higher Total Rejection Index scores indicate a greater degree or frequency of disclosure-related rejection experiences; lower Total Acceptance Index scores reflect a greater degree or frequency of acceptance. Scoring and variable construction: LGBTQ-related school-based support. The School Support Index is an indicator of the perceived helpfulness of a number of specific school-based supports for LGBTQ students. It is the sum of an individual’s helpfulness ratings for each available school-based support. If such supports were not available, a score of zero was assigned. Brief COPE Description. The Brief COPE (Carver, 1997; Appendix B) is an abbreviated form of a previously published measure of coping called the COPE Inventory (Carver, Schier & Weintraub,

LGBTQ SCHOOL-BASED SUPPORT 1989). It consists of 14 scales with two items each. These 28 items measure 14 conceptually

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differentiable coping reactions (Self-Distraction, Active Coping, Denial, Substance Use, Use of Emotional Support, Use of Instrumental Support, Behavioral Disengagement, Venting, Positive Reframing, Planning, Humor, Acceptance, Religion, and Self-Blame). Response options include: 0 (I don’t usually do this at all), 1 (I usually do this a little bit), 2 (I usually do this a medium amount), and 3 (I usually do this a lot). Reliability and validity data for the Brief COPE were collected from 168 participants (Carver, 1997). In terms of internal structure, an exploratory factor analysis revealed a factor structure similar to that of the full COPE Inventory (Carver et al., 1989). The analysis yielded nine factors that together accounted for 72.4% of the variance in responding. Specifically, the Substance Use, Religion, Humor and Behavioral Disengagement scales each formed distinct factors; Use of Emotional Support and Use of Instrumental Support formed a single factor; Active Coping, Planning and Positive Reframing loaded onto a single factor; Venting and Self-Distraction formed a single factor; and Denial and Self-Blame formed a single factor. The items of the Acceptance scale loaded on separate factors; one item formed its own factor, while the other item loaded onto the Active Coping factor (.52) with a strong secondary loading (.47) on the Acceptance factor. The scales range in internal consistency (.50 < α <.90); however, each meets or exceeds the value regarded as minimally acceptable (α = .50; Nunnally, 1978). Therefore, the Brief COPE has adequate internal reliability. Scoring and variable construction: Coping behavior. The 14 subscales of the Brief COPE were combined into two higher-order factors: Disengaged Coping and Active Coping. Descriptive statistics for the Brief COPE subscales are presented in Table 4 (Appendix I). David

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and Knight (2008) examined the adequacy of this two-factor structure using confirmatory factor analysis and demonstrated a reasonable fit. State-Trait Anxiety Inventory, Trait Version Description. The State-Trait Anxiety Inventory, Trait Version (STAI-T; Appendix C) was designed to measure a stable propensity to experience anxiety, and tendencies to perceive stressful situations as threatening (Spielberger, 1983). Trait anxiety implies differences between people in the disposition to respond to stressful situations with varying amounts of state anxiety. The trait scale consists of 20 statements that require individuals to rate how they generally feel on a four point scale, ranging from 1 (almost never) to 4 (almost always). Total scores range from 20 to 80. Internal consistency is reported as α=.91 (Spielberger). Reported test-retest reliabilities for the trait scale are high, ranging from 0.73 to 0.86 (Spielberger). Concurrent validity with other measures of anxiety ranges from 0.73 to 0.85 (Spielberger). Scoring and variable construction: Trait anxiety. Trait anxiety was measured by the Total STAI-T score. Higher scores suggest an increasingly stable propensity to experience anxiety as well as tendencies to perceive stressful situations as threatening (Spielberger, 1983). Brief Fear of Negative Evaluation Scale, Version 2 Description. The Brief Fear of Negative Evaluation Scale, Version 2 (BFNE-II; Carleton, McCreary, Norton, & Asmundson, 2006; Appendix D) is a revised version of the original BFNE developed by Leary in 1983. The BFNE-II is a measure of a person’s tolerance for the possibility s/he may be judged disparagingly or hostilely by others (Leary, 1983). Previous research supports the notion that social anxiety is derived in part from fears of perceived negative evaluation (e.g., Clark & Wells, 1995; Rapee & Heimberg, 1997). The BFNE-II consists of 8 items, each rated on a

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5-point Likert scale ranging from 0 (not at all characteristic of me) to 4 (extremely characteristic of me). Total scores range from 0 to 32. Carleton, Collimore and Asmundson (2007) conducted an investigation to confirm the unitary factor structure of the BFNE-II, demonstrate convergent validity with measures related to social anxiety, and demonstrate discriminant validity with construct-independent measures of other fundamental fears. Factor analysis supported a unitary factor structure (i.e., fear of negative evaluation). Adequate convergent validity was demonstrated through moderate correlations (0.50 < r < 0.69; Westgard, 1999) with other measures of social anxiety; the Social Concerns Subscale of the Anxiety Sensitivity Index (ASI; Peterson & Reiss, 1992), the Social Phobia Scale (SPS; Mattick & Clarke, 1998), and the Social Interaction Anxiety Scale (SIAS; Mattick & Clarke, 1998). Discriminant validity was also demonstrated through weak correlations (r < 0.30; Westgard, 1999) with measures of other fundamental fears, including the Illness/Injury Sensitivity Index – Revised (ISI-R; Carleton, Park & Asmundson, 2006) and the Somatic subscales of the ASI (Peterson & Reiss, 1992). Internal consistency is excellent (α = 0.96; Carleton, Collimore & Asmundson, 2007). Carleton and colleagues (2007) also established non-clinical norms for the BFNE-II using a sample of 322 undergraduate students (73% female, 88% Caucasian). Specifically, the mean score for males in the normative sample was 12.18 (S.D. = 8.94) and the mean score for females was 15.63 (S.D. = 8.55). Scoring and variable construction: Social anxiety. Social Anxiety was measured by the Total BFNE-II score. Higher scores reflect greater fear of negative evaluation, a characteristic feature of social anxiety disorders (Carleton, Collimore & Asmundson, 2007; Leary, 1983).

LGBTQ SCHOOL-BASED SUPPORT Research Questions and Statistical Analysis Research Question One

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How prevalent are experiences of disclosure-related rejection and generalized and social anxiety among LGBTQ young adults? This question was answered by calculating descriptive statistics for the Total Rejection Index, Total Acceptance Index, STAI-T scores, and BFNE-II scores. Mean scores on these dimensions were compared across race/ ethnicity, gender identity and sexual orientation using factorial analyses of variance (ANOVAs). Research Question Two How prevalent are the identified types of LGBTQ-specific school-based support? This question was answered by calculating descriptive statistics for each type of school-based support. The relative prevalence of the various types of school-based support were also compared across demographic groups (i.e., U.S. region, SES of the high school community, community type) while controlling for age using a Multivariate Analyses of Covariance (MANCOVA). Research Question Three Which school-based supports did LGBTQ young adults perceive as most helpful? To answer this question, mean perceived helpfulness scores were calculated and compared for each type of school-based support (as measured by the DSBSQ). Higher scores indicated that a support was rated more helpful; lower scores, less helpful. Research Question Four Do an individual’s experiences of disclosure-related rejection and acceptance (as measured by the Total Rejection and Total Acceptance Indices), perceived helpfulness of LGBTQ-specific school-based support (as measured by the School Support Index), coping behaviors (as measured by the Active and Disengaged Coping scores derived from the Brief COPE), and/or gender predict

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the development of trait anxiety (as measured by the STAI-T) and/or social anxiety (as measured by the BFNE-II)? This question was answered by examining the intercorrelations of potential predictor variables (i.e., Total Rejection Index, Total Acceptance Index, School Support Index, Disengaged Coping score, Active Coping score) and criterion variables (i.e., STAI-T score, BFNEII score), followed by two standard multiple regression analyses. The first regression analysis tested the relationships between each potential predictor variable (i.e., disclosure-related rejection and acceptance; disengaged and active coping styles; helpfulness of school-based support) and trait anxiety. The second tested the relationships between each predictor variable and social anxiety. Research Question Five Which components of school-based support best predict active coping skills? This question was answered using a hierarchical multiple regression analysis to predict coping behaviors by examining the variance in Active Coping scores uniquely explained by potential predictor variables after controlling for participant age. Age and helpfulness ratings of each type of school-based support were the potential predictor variables and the Active Coping score was the criterion variable. Research Question Six Which components of school-based support best predict low levels of trait- and social anxiety? This question was answered using two hierarchical multiple regression analyses to predict trait- and social anxiety by examining the variance in STAI-T and BFNE-II scores uniquely explained by potential predictor variables after controlling for participant age. Age and helpfulness ratings of each type of school-based support were the potential predictor variables and anxiety scores were the criterion variables.

LGBTQ SCHOOL-BASED SUPPORT Chapter IV Results

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The present study sought to examine the relationships between disclosure-related rejection and acceptance, individual coping behaviors, the presence of LGBTQ-specific school-based supports during high school, and symptoms of anxiety in LGBTQ young adults. This chapter describes the statistical analyses used to evaluate the research questions outlined in the preceding chapter. A total of 236 surveys were submitted. Forty six of these were not included in the analyses due to large amounts of missing data (i.e., <50% completed). Six surveys were excluded because the respondents did not meet the minimum age requirement of 18. The remaining 184 surveys were included in the study. Reearch Question One: How Prevalent are Experiences of Disclosure-Related Rejection and Generalized and Social Anxiety among LGBT Young Adults? Descriptive statistics for the Total Rejection Index, Total Acceptance Index, STAI-T scores, and BFNE-II scores are presented in Table 5 (Appendix I). The STAI-T normative sample mean score is 34.79 (SD=9.22); the mean score for this sample was 47.91 (SD=10.98). This reflects an elevation of approximately 1.5 standard deviations. The BFNE-II normative sample mean score for women is 15.63 (SD=8.55) and the mean score for men is 12.18 (SD=8.94). The BFNE-II mean score for this sample as a whole was 16.59 (SD=8.26). The mean BFNE-II score for cisgender (i.e., non-transgender) female participants was 16.41 (SD=8.32); the mean score for cisgender males was 18.14 (SD=7.92); and the mean score for transgender participants was 15.79 (SD=8.41). Mean scores on these dimensions were compared across race/ethnicity, gender identity and sexual orientation using factorial ANOVAs. People of color were not well represented in the study

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sample. Therefore, for this and all subsequent comparisons involving race/ethnicity, groups were collapsed into two categories to represent (1) Caucasian participants and (2) participants of all other races/ ethnicities. No significant differences were observed by race or sexual orientation on any of the study variables. There was a significant main effect found for gender and Total Rejection score [F (2, 160) = 9.486, p<.01] with a moderate to large effect size (η2= .11). Post-hoc comparisons using the Tukey HSD test indicated that that the mean Total Rejection score for transgender participants (M=7.91, SD=6.99) was significantly different from that of both cisgender female (M=3.81, SD=4.09) and male (M=4.75, SD=4.61) participants. Cisgender female and male participants did not differ significantly from one another on mean Total Rejection scores. Research Question Two: How Prevalent are the Identified Types of School-Based Support? Descriptive statistics for each type of school-based support are presented in Table 6 (Appendix I). The most frequently reported support was a school staff member who let students know that s/he was safe to talk to about LGBTQ-related issues (38.6% of respondents). The presence of a Gay-Straight Alliance was reported by 37% of participants. Just under one third of participants indicated that their high schools had non-discrimination/ anti-harassment policies that explicitly included sexual orientation in its language, but only 10.9% reported similar policies that included gender identity and expression. The relative prevalence of the various types of school-based support were compared across demographic groups (i.e., U.S. region, community type, SES of the high school community) using a Multivariate Analyses of Covariance (MANCOVA) with demographic variables as IVs and presence of each school support as DVs. An examination of Pearson product moment correlations revealed that there were significant negative correlations between a respondent’s age and the presence of each type of school-based support, ranging from weak to moderate in strength (-.16 < r

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< -.49, p < .01; Table 7, Appendix I). Therefore, age was included as a covariate in this analysis to control for potential effects of changes over time in societal attitudes toward LGBTQ individuals. Due to the large number of comparisons being made, a more stringent alpha level of .01 was used to test significance. Because it is considered robust to violations of the homogeneity of covariance matrices assumption, Pillai’s Trace was chosen in place of Wilks’ Lambda. MANCOVA results indicate that after adjusting for participant age, there was a significant difference between U.S. regions on the combined dependent variables (presence of specific school supports), F (48, 444) = 1.73, p < .01; Pillai’s Trace = .631; partial eta squared = .158. When the results for each school support were considered separately, the only difference to reach statistical significance using a Bonferroni adjusted alpha level of p = .004 was LGBTQ-inclusive curricula, F (4, 119) = 7.67, p < .004, partial eta squared = .205. An inspection of the mean scores indicated that participants from Midwestern states reported LGBTQ-inclusive curricula (M=.45, SD=.52) more often than other regions (range of M = 0 to .07). These results are reported here to describe demographic variations. However, the numbers of participants in each cell were unequal and small. As a result, these findings must be interpreted with caution. Research Question Three: Which School-Based Supports Did LGBTQ Young Adults Perceive as Most Helpful? To answer this question, mean perceived helpfulness scores were calculated and compared for each type of school-based support (as measured by the DSBSQ). Participants who indicated that a given support was present at their high schools rated each support on a scale of 0 (not at all helpful) to 3 (very helpful). Higher scores indicate that a support was rated more helpful; lower scores, less helpful. The overall mean perceived helpfulness rating was 2.04. Results are presented in Table 6 (Appendix I). Diversity training for students that included LGBTQ issues was perceived

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as most helpful (M=2.47, SD=.70), followed by LGBTQ adult role models (M=2.35, SD=.86). The experience of an LGBT-inclusive prom was also rated highly by participants (M=2.26, SD=.95), as were LGBTQ-inclusive curricula (M=2.23, SD=1.01) and faculty or staff who communicated to students that they were safe to talk to about LGBTQ-related issues and concerns (M=2.18, SD=.95). Non-discrimination/ harassment policies that included sexual orientation (M=2.06, SD=1.00), policies that included gender expression (M=2.11, .90), and the availability of LGBTQ-themed books (M=2.05, SD=.92) were also rated to be more helpful than average. Research Question Four. Do an Individual’s Experiences of Disclosure-Related Rejection and Acceptance, LGBTQ-Related School-Based Support, and Coping Behaviors Predict the Development of Trait Anxiety and/or Social Anxiety? This question was answered by first examining the intercorrelations of potential predictor variables (i.e., Total Rejection Index, Total Acceptance Index, School Support Index, Disengaged Coping score, Active Coping score) and criterion variables (i.e., STAI-T score, BFNE-II score), followed by two multiple regression analyses. Pearson product moment correlation coefficients were calculated to examine the bivariate relationships between the study variables (Table 8, Appendix I), and partial correlations were calculated to examine those relationships while controlling for participant age (Table 9, Appendix I). As would be expected, there was a significant, strong bivariate correlation between the two criterion variables as measured by STAI-T and BFNE-II scores (r=.62, p<.01). A significant, strong correlation was also found between Disengaged Coping and STAI-T scores (r=.55, p<.01). A significant, weak correlation was found between Disengaged Coping and BFNE-II scores (r=.29, p<.01). Controlling for age did not influence the strength or significance of these correlations.

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The first multiple regression analysis tested the relationships between potential predictor variables (i.e., Total Rejection score, Total Acceptance score; Disengaged Coping score, Active Coping score; School Support Index) and trait anxiety (as measured by STAI-T score) . The second tested the relationships between each predictor variable and social anxiety (as measured by BFNEII score). Summaries of the regression analyses are presented in Tables 10 and 11 (Appendix I). A standard multiple regression analysis with simultaneous entry of all potential predictor variables revealed that the full model was significant, Adjusted R Square = .30 (R Square = .33), F (5, 151) = 14.59, p < .01. The model accounted for 30.1% of the variance in STAI-T scores. Of the predictor variables, only Disengaged Coping made a significant, unique contribution to the prediction of STAI-T scores after the shared variance of all other predictors in the model was controlled for (Table 10, Appendix I). Specifically, higher Disengaged Coping scores were strongly associated with higher STAI-T scores (t = 7.84, p < .01). A standard multiple regression analysis with simultaneous entry of all potential predictor variables was also conducted with BFNE-II score as the criterion variable. This analysis indicated that the full model was significant, Adjusted R Square = .08 (R Square = .11), F (5, 151) = 3.53, p < .01. The model accounted for 8.0% of the variance in BFNE-II scores. Of the predictor variables, only Disengaged Coping made a significant, unique contribution to the prediction of BFNE-II scores after the shared variance of all other predictors in the model was controlled for (Table 11, Appendix I). Specifically, there was a weak to moderate association between greater Disengaged Coping scores and higher BFNE-II scores (t = 3.46, p < .01). Research Question Five: Which Components of School-Based Support Best Predict Active Coping Skills?

LGBTQ SCHOOL-BASED SUPPORT This question was answered using a hierarchical multiple regression analysis to predict coping behavior by examining the variance in Active Coping scores uniquely explained by

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potential predictor variables after controlling for participant age. Age and Perceived Helpfulness ratings of each type of school-based support are the potential predictor variables and the Active Coping score is the criterion variable. An examination of Pearson product moment correlations revealed that there were significant, negative, bivariate correlations between a respondent’s age and the presence of each type of school-based support, ranging from weak to moderate in strength (-.16 < r < -.49, p < .01; Table 7, Appendix I). Therefore, age was included in this analysis to control for its potential effects on the predictor variables. Intercorrelations of relevant variables were first examined, followed by a hierarchical multiple regression analysis. Pearson product moment correlation coefficients were calculated to examine the bivariate relationships between variables (Table 8, Appendix I), and partial correlations were calculated to examine those relationships while controlling for participant age (Table 9, Appendix I). Active Coping was not significantly associated with Perceived Helpfulness ratings of any of the school-based supports. Participant age and Perceived Helpfulness ratings for each school-based support were then entered into a hierarchical regression model as potential predictors of Active Coping. Participant age was entered at Step 1 and the Perceived Helpfulness ratings were entered as a block at Step 2. This analysis indicated that the model was not significant [Step 1: F (1, 177) = 1.21, p = .27; R Square = .007; Adjusted R Square = .001. Step 2: F(12, 165) = .93, p = .51; R Square = .07; Adjusted R Square = -.003; R Square Change = .06, p = .51]. Therefore, Perceived Helpfulness ratings of these LGBTQ-specific school-based supports were not found to be significant predictors of Active Coping (Table 12, Appendix I).

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Research Question Six: Which Components of School-Based Support During High School Best Predict Levels of Trait- and Social Anxiety in Young Adulthood? This question was answered using two hierarchical multiple regression analyses to predict trait- and social anxiety by examining the variance in STAI-T and BFNE-II scores uniquely explained by potential predictor variables after controlling for participant age. Age and Perceived Helpfulness ratings are the predictor variables and the anxiety scores are the criterion variables. Intercorrelations of relevant variables were first examined, followed by hierarchical multiple regression analyses. As noted in previous analyses, Pearson product moment correlations revealed that there were significant negative correlations between a respondent’s age and the presence of each type of school-based support (Table 7, Appendix I). Therefore, age was included in this analysis to control for its potential effects on the predictor variables. Pearson product moment correlation coefficients were calculated to examine the bivariate relationships between variables (Table 8, Appendix I), and partial correlations were calculated to examine those relationships while controlling for participant age (Table 9, Appendix I). A significant, weak bivariate correlation was found between Perceived Helpfulness of LGBTQ-safe school staff and STAI-T scores (r = .20, p<.05). The strength of that relationship was slightly reduced after controlling for age, but the partial correlation remained significant at the .05 level (r = .18, p < .05). STAI-T scores were not significantly associated with Perceived Helpfulness ratings of the other types of school-based support. BFNE-II scores were not significantly associated with Perceived Helpfulness ratings of any of the school-based supports examined. Two hierarchical multiple regression analyses were conducted with STAI-T and BFNE-II scores as the criterion variables and participant age and Perceived Helpfulness ratings for each type of school-based support as predictors (Tables 13 & 14, Appendix I). For each regression analysis,

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participant age was entered at Step 1 and Perceived Helpfulness ratings were entered as a block at Step 2. The first regression analysis indicated that Perceived Helpfulness of LGBTQ-related school-based supports were not significant predictors of STAI-T scores (Table 13, Appendix I). The model was not significant at either step [Step 1: F (1, 171) = 1.13, p = .29; R Square = .007; Adjusted R Square = .001. Step 2: F(13, 159) = .89, p = .56; R Square = .07; Adjusted R Square = .008; R Square Change = .06, p = .58]. Therefore, Perceived Helpfulness ratings of LGBTQspecific school-based supports did not significantly contribute to the variance in STAI-T scores. The second regression analysis indicated that Perceived Helpfulness of LGBTQ-related school-based supports were not significant predictors of BFNE-II scores (Table 14, Appendix I). The model was not significant [Step 1: F (1, 179) = 1.64, p = .20; R Square = .01; Adjusted R Square = .004. Step 2: F(13, 167) = .55, p = .89; R Square = .04; Adjusted R Square = -.03; R Square Change = .03, p = .93]. Therefore, Perceived Helpfulness ratings of LGBTQ-specific school-based supports did not significantly contribute to the variance in BFNE-II scores. Based on the non-significant correlations between BFNE-II scores and Perceived Helpfulness of schoolbased supports (Table 9, Appendix I), this result would be expected.

LGBTQ SCHOOL-BASED SUPPORT Chapter V Discussion The present study investigated the contributions of LGBTQ individuals’ experiences of

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disclosure-related acceptance and rejection, school-based support and current coping behavior in predicting current levels of trait and social anxiety. Specifically, it examined which elements of school-based support LGBTQ young adults perceived as having been most helpful during high school, as well as whether specific elements of support were associated with active coping skills and lower levels of anxiety during young adulthood. Results will be discussed in the context of previous research and theory, and implications for theory and practice will be explored. Limitations of the study will be reviewed, followed by implications for future research. Findings and Implications Prevalence of Anxiety and Disclosure-Related Rejection Consistent with previous studies (e.g., Cochran, Sullivan & Mays, 2003; Gilman et al., 2001; Pachankis & Goldfried, 2006; Sandfort, de Graaf, Bijl & Schnabel, 2001), elevated levels of trait anxiety were found in this sample of LGBTQ young adults. Specifically, the mean STAI-T score for this sample fell approximately 1.5 standard deviations above the established norm (Spielberger, 1983). Inconsistent with expectations, the mean BFNE-II scores for this sample, calculated by gender, were within the average range when compared to BFNE-II normative sample means (Carleton et al., 2007). Previous research has suggested elevated levels of social anxiety among LGBTQ individuals (Pachankis & Goldfried, 2006; Safren & Pantelone, 2006; Sandfort et al., 2001). A significant difference was found in experiences of rejection, with a moderate to large effect size. Specifically, transgender participants reported more disclosure related-rejection than did

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cisgender (i.e., non-transgender) females or males. Cisgender female and male participants did not differ significantly from one another in their experiences of rejection. This finding is consistent with other studies suggesting that transgender individuals experience higher levels of rejection than do cisgender LGBs (Burgess, 1999; Grossman, D’Augelli, Howell & Hubbard, 2005). No significant differences were observed by race or sexual orientation on any of the study variables. Risk and Protective Factors A primary purpose of this study was to evaluate whether school-based support and adaptive coping responses might serve as protective factors against the effects of disclosure-related rejection on the manifestation of anxiety among LGBT young adults. Initial examination of the bivariate relationships between study variables revealed that trait anxiety and social anxiety were strongly associated with one another, as would be expected. There was not a significant relationship between disclosure-related rejection and trait or social anxiety. This finding is inconsistent with previous studies linking social anxiety with experiences of rejection (McCabe, Antony, Summerfeldt, Liss, & Swinson, 2003; Teachman & Allen, 2007). Disengaged coping behaviors were strongly associated with trait anxiety. This finding is consistent with results of a study conducted by the authors of the instrument used to measure coping in the present study (Brief COPE). In their sample of undergraduates, Carver, Scheier & Weintraub (1989) found moderate associations (.21 < r < .37; p < .01) between STAI-T scores and several of the Brief COPE Disengaged Coping subscales. In other words, high levels of trait anxiety were related to avoidance of active coping and disengagement from goals (Carver, et al., 1989). In the current sample, active coping behavior was not significantly associated with anxiety or any other predictor variables. This result is inconsistent with a number of previous studies that

LGBTQ SCHOOL-BASED SUPPORT have evidenced a relationship between active coping and mental health. There is evidence to suggest that the use of active coping strategies is related to lower levels of distress in general (Aldwin & Revenson, 1987; Aspinwall &Taylor, 1992; Glyshaw, Cohen, & Towbes, 1989).

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Several studies have also examined coping behavior in LGB individuals specifically. For example, Miranda and Storms (1989) found that active coping styles in lesbians and gay men lead to a positive sense of sexual identity, which then led to positive psychological adjustment. In another study of 106 Latina/o lesbians and gay men ages 20 to 53, active coping styles were associated with lower levels of depression (Zea, Reisen, & Poppen, 1999). Results of the current study suggested that disengaged coping behavior was the only factor among those tested that uniquely contributed to the variance in either trait anxiety or social anxiety. Disengaged coping behaviors include self-distraction, denial, substance use, behavioral disengagement, venting and self-blame (David & Knight, 2008). Disengaged and active coping behaviors, experiences of acceptance and rejection, and perceived helpfulness of school-based supports together accounted for 30% of the variance in trait anxiety; however, disengaged coping was the strongest contributor and made the only unique contribution. The aforementioned set of predictors explained 7.7% of the variance in social anxiety. Disengaged coping was again the only unique predictor; however, its association with social anxiety was not as strong as it was with trait anxiety. A key distinction between trait and social anxiety may account for this difference. Specifically, trait anxiety refers to a stable tendency to respond to stressful situations with an elevated level of state anxiety (Spielberger, 1983). Whereas trait anxiety suggests a global tendency to perceive situations as threatening, social anxiety is specific to situations that may involve evaluation by others. Disengaged coping behaviors such as

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self-distraction, denial, substance use, behavioral disengagement, venting, and self-blame are less applicable to situations that would elicit social anxiety. In terms of identifying risk and protective factors related to anxiety, the current data suggest that disengaged coping behaviors may be uniquely related to trait anxiety and, to a somewhat lesser degree, social anxiety. This finding is consistent with previous research supporting a relationship between disengaged or avoidant coping strategies and psychological distress (for a review, see Compas, Connor-Smith, Saltzman, Thomsen, & Wadsworth, 2001; Penedo et al., 2003; Stanton & Snider, 1993). Current findings also suggest that experiences of disclosure-related rejection may not in and of themselves contribute to the development of trait or social anxiety in this population. The results do not provide evidence that either disclosure-related acceptance or active coping behaviors alone predict trait or social anxiety in LGBTQ young adults. Regression analyses failed to provide evidence that perceived helpfulness of specific school-based supports predicts active coping responses or anxiety levels. The current findings point to a potential focus of intervention with LGBTQ youth and young adults. Disengaged coping behaviors such as self-distraction, denial, substance use, behavioral disengagement, venting and self-blame appear to predict trait anxiety and, to a lesser degree, social anxiety. Minority stress theory suggests that in addition to social support, individual coping can be protective against the negative effects of stress (Meyer, 2003). Interventions aimed at reducing disengaged and avoidant coping responses and replacing them with more adaptive behaviors may prove effective in reducing anxiety in LGBTQ young people. School-Based Supports for LGBTQ Students A secondary purpose of this study was to measure the prevalence and perceived helpfulness of specific school-based supports for LGBTQ students. The most frequently reported support was a

LGBTQ SCHOOL-BASED SUPPORT school staff member who let students know that s/he was safe to talk to about LGBTQ-related

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issues (38.6% of respondents), followed by the presence of a GSA (37% of participants). In their 2007 report on the growing number of GSAs in the United States, GLSEN found that 47% of LGBT high school students across the country reported having a GSA. This rate is somewhat higher than our sample, very likely because some of our participants attended high school a number of years ago, when school-based supports for LGBTQ students were much less common. Just under one third of participants in the current study indicated that their high schools had nondiscrimination/ anti-harassment policies that explicitly included sexual orientation in its language, and only 10.9% reported similar policies that included gender identity and expression. This rate is somewhat higher than that reported in GLSEN’s 2007 National School Climate Survey (NSCS; Kosciw et al., 2008). That study reported that less than one in five or 18.7% of students attended a school with a comprehensive policy for reporting harassment and assault that specifically mentioned sexual orientation. Participants also reported their perceptions of how helpful each available school-based support was during high school. The overall mean helpfulness rating indicated that in general, participants viewed school-based supports as being “somewhat helpful.” Diversity training for students that included LGBTQ issues was perceived as most helpful, followed by LGBTQ adult role models. The experience of an LGBT-inclusive prom was also rated highly by participants, as were LGBTQ-inclusive curricula and faculty or staff who communicated to students that they were safe to talk to about LGBTQ-related issues and concerns. Non-discrimination/ harassment policies that included sexual orientation, policies that included gender expression, and the availability of LGBTQ-themed books were also rated to be more helpful than average.

LGBTQ SCHOOL-BASED SUPPORT These results are consistent with the GLSEN 2007 NSCS finding that the presence of supportive staff contributed to a range of positive indicators including fewer reports of missing school, greater academic achievement, higher educational aspirations and a greater sense of

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belonging to their school community (Kosciw et al., 2008). The GLSEN survey also reported that students whose schools had a safe school policy that included protections based on sexual orientation and/or gender identity/expression heard fewer homophobic remarks, experienced lower levels of victimization related to their sexual orientation, were more likely to report that staff intervened when hearing homophobic remarks and were more likely to report incidents of harassment and assault to school staff. Limitations and Implications for Future Research Several limitations of the present study should be considered. Although participants were recruited nationwide, the sample is not random and representative of LGBTQ young adults. There were distinct geographic clusters of participation (i.e., Western NY, Washington state), most likely due to snowball sampling effects through various LGBTQ organizations and informal social networks. To have received an invitation to participate in the study implies some type of connection to the LGBTQ community; it is unlikely that socially isolated or highly non-disclosed individuals were included in the sample. Participants were primarily White and most were either current college students or held Bachelor’s or post-graduate degrees. Unequal demographic group sizes limited the ability to interpret comparisons across groups. Future studies should investigate a larger and more diverse sample. In addition, a heterosexual comparison group was not included in the present study, limiting the ability to clearly attribute findings to a given predictor variable. The inherent limitations of self-report measures should be considered, including the potential for response sets, social desirability, and recall difficulties. The retrospective nature of the

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study may have resulted in memory distortions or biases, potentially limiting the accuracy of the data. Future studies could employ a longitudinal design to avoid this issue. Reliance on a single instrument for each outcome variable may have limited the validity of results. The use of a researcher-constructed measure without established psychometric properties also introduces questions of reliability and validity. It also remains unclear which components of school-based support contributed to coping and/or anxiety. Although research trends support the positive correlates of school-based supports for LGBTQ students, it is difficult to identify the specific experiences and support components that influence outcomes. A larger sample size would allow interpretation of specific supports with effective power. More research is needed as we move toward an understanding of protective factors for these students.

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Lindzey (Eds.), The handbook of social psychology, Vols. 1 and 2 (4th ed.). (pp. 504-553). New York, NY US: McGraw-Hill. D'Augelli, A. R. (2002). Mental health problems among lesbian, gay, and bisexual youths ages 14 to 21. Clinical Child Psychology and Psychiatry, 7(3), 433-456. D'Augelli, A. R., Grossman, A. H., & Starks, M. T. (2008). Families of gay, lesbian, and bisexual youth: What do parents and siblings know and how do they react? Journal of GLBT Family Studies, 4(1), 95-115. D'Augelli, A. R., Grossman, A. H., & Starks, M. T. (2005). Parents' Awareness of Lesbian, Gay, and Bisexual Youths' Sexual Orientation. Journal of Marriage and Family, 67(2), 474-482. D'Augelli, A. R., Hershberger, S. L., & Pilkington, N. W. (1998). Lesbian, gay, and bisexual youth and their families: Disclosure of sexual orientation and its consequences. American Journal of Orthopsychiatry, 68(3), 361-371. D'Augelli, A. R., Pilkington, N. W., & Hershberger, S. L. (2002). Incidence and mental health impact of sexual orientation victimization of lesbian, gay, and bisexual youths in high school. School Psychology Quarterly, 17(2), 148-167. David, S., & Knight, B. G. (2008). Stress and coping among gay men: Age and ethnic differences. Psychology and Aging, 23(1), 62-69. Decker, M. L., Turk, C. L., Hess, B., & Murray, C. E. (2008). Emotion regulation among individuals classified with and without generalized anxiety disorder. Journal of Anxiety Disorders, 22(3), 485-494. Diamond, L. M. (1998). Development of sexual orientation among adolescent and young adult women. Developmental Psychology, 34(5), 1085-1095. Diamond, L. M., & Lucas, S. (2004). Sexual-minority and heterosexual youths' peer relationships: Experiences, expectations, and implications for well-being. Journal of Research on Adolescence, 14(3), 313-340. Dubé, E. M., & Savin-Williams, R. C. (1999). Sexual identity development among ethnic sexualminority male youths. Developmental Psychology, 35(6), 1389-1398. Dundas, S., & Kaufman, M. (2000). The Toronto Lesbian Family Study. Journal of Homosexuality, 40(2), 65-79. Espelage, D. L., Holt, M. K., & Henkel, R. R. (2003). Examination of peer-group contextual effects on aggression during early adolescence. Child Development, 74, 205–220. Gilman, S. E., Cochran, S. D., Mays, V. M., Hughes, M., Ostrow, D., & Kessler, R. C. (2001). Risk

LGBTQ SCHOOL-BASED SUPPORT of psychiatric disorders among individuals reporting same-sex sexual partners in the National Comorbidity Survey. American Journal of Public Health, 91(6), 933-939.

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GLSEN (2007). Gay-Straight Alliances: Creating safer schools for LGBT students and their allies. (GLSEN Research Brief). New York: Gay, Lesbian and Straight Education Network. Glyshaw, K., Cohen, L. H., & Towbes, L. C. (1989). Coping strategies and psychological distress: Prospective analyses of early and middle adolescents. American Journal of Community Psychology, 17, 607-623. Gomez, R., & McLaren, S. (2006). The association of avoidance coping style, and perceived mother and father support with anxiety/depression among late adolescents: Applicability of resiliency models. Personality and Individual Differences, 40(6), 1165-1176. Grossman, A. & D’Augelli, A. (2006). Transgender youth: Invisible and vulnerable. Journal of Homosexuality, 51(1), 111–128. Hansen, A. L. (2007). School-based support for GLBT students: A review of three levels of research. Psychology in the Schools, 44(8), 839-848. Harper, G. W., & Schneider, M. (2003). Oppression and discrimination among lesbian, gay, bisexual, and transgendered people and communities: A challenge for community psychology. American Journal of Community Psychology, 31(3), 243-252. Hatzenbuehler, M. L., McLaughlin, K. A., & Nolen-Hoeksema, S. (2008). Emotion regulation and internalizing symptoms in a longitudinal study of sexual minority and heterosexual adolescents. Journal of Child Psychology and Psychiatry, 49, 1270-1278. Henry, D., Guerra, N. G., Huesmann, L. R., Tolan, P., Van Acker, R., & Eron, L. (2000). Normative influences on aggression in urban elementary school classrooms. American Journal of Community Psychology, 28, 59–81. Herek, G. M., & Garnets, L. D. (2007). Sexual orientation and mental health. Annual Review of Clinical Psychology, 3, 353-375. Holmbeck, G. N. (1997). Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: Examples from the child-clinical and pediatric psychology literatures. Journal of Consulting and Clinical Psychology, 65(4), 599-610. Jordan, K. M., & Deluty, R. H. (1998). Coming out for lesbian women: Its relation to anxiety, positive affectivity, self-esteem and social support. Journal of Homosexuality, 35(2), 41-63. King, M., Semlyen, J., Tai, S. S., Killaspy, H., Osborn, D., Popelyuk, D., et al. (2008). A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry, 8.

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Kosciw, J. G. and Diaz, E. M. (2006). The 2005 National School Climate Survey: The experiences of lesbian, gay, bisexual and transgender youth in our nation's schools. New York: GLSEN. Kosciw, J. G., Diaz, E. M., and Greytak, E. A. (2008). 2007 National School Climate Survey: The experiences of lesbian, gay, bisexual and transgender youth in our nation’s schools. New York: GLSEN. Kosciw, J. G., Diaz, E. M., & Greytak, E. A. (2009). Who, what, where, when, and why: Demographic and ecological factors contributing to hostile school climate for lesbian, gay, bisexual, and transgender youth. Journal of youth and adolescence, 38(7), 976-88. Mallon, G. P. (1997). Entering into a collaborative search for meaning with gay and lesbian youth in out-of-home care: An empowerment-based model for training child welfare professionals. Child & Adolescent Social Work Journal, 14(6), 427-444. Marinoble, R. M. (1998). Homosexuality: A blind spot in the school mirror. Professional School Counseling, 1(3), 4-7. Mattick, R. P. & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455-470. McCabe, R. E., Antony, M. M., Summerfeldt, L. J., Liss, A., & Swinson, R. P. (2003). Preliminary examination of the relationship between anxiety disorders in adults and self-reported history of teasing or bullying experiences. Cognitive Behaviour Therapy, 32(4), 187-193. Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674697. Morris, J. F., Waldo, C. R., & Rothblum, E. D. (2001). A model of predictors and outcomes of outness among lesbian and bisexual women. American Journal of Orthopsychiatry, 71(1), 61-71. Mosher, C. M. (2001). The social implications of sexual identity formation and the coming-out process: A review of the theoretical and empirical literature. The Family Journal, 9(2), 164173. Mustanski, B. (2008) Suicide risk and prevention among LGBT youth: "Webinar" for the American Foundation for suicide prevention. Accessed September 4, 2008. New York University Office of Equal Opportunity. (2006). New York University Anti-Harassment Policy and Complaint Procedures [Retrieved from www.nyu.edu/eo/AHP-definition.htm]

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Nichols, S. L. (1999). Gay, lesbian, and bisexual youth: Understanding diversity and promoting tolerance in schools. The Elementary School Journal, 99(5), 505-519. Olweus, D. (1993). Bullying at school: What we know and what we can do. Oxford, England Blackwell. Otis, M. D., & Skinner, W. F. (1996). The prevalence of victimization and its effect on mental well-being among lesbian and gay people. Journal of Homosexuality, 30(3), 93-121. Pachankis, J. E., & Goldfried, M. R. (2006). Social anxiety in young gay men. Journal of Anxiety Disorders, 20, 996–1015. Pearson, J., Muller, C., & Wilkinson, L. (2007). Adolescent same-sex attraction and academic outcomes: The role of school attachment and engagement. Social Problems, 54(4), 523– 542. Peterson, R. A. & Reiss, S. (1992). Anxiety Sensitivity Index manual (2nd ed.). Worthington, OH: International Diagnostic Systems. Ream, G. L., & Savin-Williams, R. C. (2005). Reciprocal Associations Between Adolescent Sexual Activity and Quality of Youth-Parent Interactions. Journal of Family Psychology, 19(2), 171-179. Remafedi, G., Farrow, J. A., Deisher, R. W. (1991). Risk factors for attempted suicide in gay and bisexual youth. Pediatrics, 87(6), 869-75. Rosario, Schrimshaw, & Hunter (2006). A model of sexual risk behaviors among young gay and bisexual men: Longitudinal associations of mental health, substance abuse, sexual abuse, and the coming out process. AIDS Education and Prevention, 18, 444-460. Rosario, M., Schrimshaw, E. W., Hunter, J., & Gwadz, M. (2002). Gay-related stress and emotional distress among gay, lesbian and bisexual youths: A longitudinal examination. Journal of Consulting and Clinical Psychology, 70(4), 967-975. Ruscio, A. M., Chiu, W. T., Roy-Byrne, P., Stang, P. E., Stein, D. J., Wittchen, H.-U., et al. (2007). Broadening the definition of generalized anxiety disorder: Effects on prevalence and associations with other disorders in the National Comorbidity Survey Replication. Journal of Anxiety Disorders, 21(5), 662-676. Russell, S.T., McGuire, J.K., Laub, C., Manke, E., O’Shaughnessy, M., Heck, K., & Calhoun, C. (2006). Harassment in school based on actual or perceived sexual orientation: Prevalence and consequences. California Safe Schools Coalition Research Brief No. 2. San Francisco, CA: California Safe Schools Coalition. Ryan, C., Huebner, D., Diaz, R. M., & Sanchez, J. (2009). Family rejection as a predictor of

LGBTQ SCHOOL-BASED SUPPORT negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics, 123(1), 346-352.

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Safren, S. A., & Heimberg, R. G. (1999). Depression, hopelessness, suicidality, and related factors in sexual minority and heterosexual adolescents. Journal of Consulting and Clinical Psychology, 67(6), 859-866. Safren S. & Pantalone D. (2006). Social anxiety and barriers to resilience among lesbian gay and bisexual adolescents. In A. Omoto & H. Kurtzman (Eds.) Sexual Orientation and Mental Health: Examining Identity and Development in Lesbian Gay and Bisexual People (pp. 5571). Washington DC: American Psychological Association. Salmivalli, C. (1999). Participant role approach to bullying: Implications for intervention. Journal of Adolescence, 22, 453–459. Sandfort, T. G. M., de Graaf, R., Bijl, R. V., & Schnabel, P. (2001). Same-sex sexual behavior and psychiatric disorders: Findings from the Netherlands mental health survey and incidence study (NEMESIS). Archives of General Psychiatry, 58(1), 85-91. Sandstrom, M. J. (2004). Pitfalls of the peer world: How children cope with common rejection experiences. Journal of Abnormal Child Psychology, 32(1), 67-81. Sausa, L. (2005). Translating research into practice: Trans youth recommendations for improving school systems. Journal of Gay & Lesbian Issues in Education, 3(1), 15–28. Savin-Williams, R. C. (1998). The disclosure to families of same-sex attractions by lesbian, gay, and bisexual youths. Journal of Research on Adolescence, 8(1), 49-68. Savin-Williams, R. C., & Diamond, L. M. (2000). Sexual identity trajectories among sexualminority youths: gender comparisons. Archives Of Sexual Behavior, 29(6), 607-627. Savin-Williams, R. C., & Dube, E. M. (1998). Parental reactions to their child's disclosure of a gay/lesbian identity. Family Relations, 47(1), 7-13. Savin-Williams, R. C., & Ream, G. L. (2003). Sex variations in the disclosure to parents of same-sex attractions. Journal of Family Psychology, 17(3), 429-438. Smart, L., & Wegner, D. M. (1999). Covering up what can't be seen: Concealable stigma and mental control. Journal of Personality and Social Psychology, 77(3), 474-486. Smith, J. D., Schneider, B. H., Smith, P. K., & Ananiadou, K. (2004). The effectiveness of wholeschool antibullying programs: A synthesis of evaluation research. School Psychology Review, 33, 547–560. Smith, G. W., & Smith, D. E. (1998). The ideology of 'fag': The school experience of gay

LGBTQ SCHOOL-BASED SUPPORT students. Sociological Quarterly, 39(2), 309-335.

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Swearer, S. M., & Espelage, D. L. (2004). A social– ecological framework of bullying among youth. In D. L. Espelage & S. M. Swearer (Eds.), Bullying in American schools: A social– ecological perspective on prevention and intervention (pp. 1–12). Mahwah, NJ: Erlbaum. Szymanski, D. M., & Owens, G. P. (2008). Do coping styles moderate or mediate the relationship between internalized heterosexism and sexual minority women's psychological distress? Psychology of Women Quarterly, 32(1), 95-104. Telljohann, S. K., Price, J. H., Poureslami, M., & Easton, A. (1995). Teaching about sexual orientation by secondary health teachers. The Journal of School Health, 65(1), 18-22. Turk, C. L., Heimberg, R. G., Luterek, J. A., Mennin, D. S., & Fresco, D. M. (2005). Emotion Dysregulation in Generalized Anxiety Disorder: A Comparison with Social Anxiety Disorder. Cognitive Therapy and Research, 29(1), 89-106. Vassilopoulos, S. P. (2008). Coping strategies and anticipatory processing in high and low socially anxious individuals. Journal of Anxiety Disorders, 22(1), 98-107. Volker, M. A. (2006). Reporting effect size estimates in school psychology. Psychology in the Schools, 43(6), 653-672. Westgard, J. O. (1999). Basic method validation. Madison, WI: Westgard QC Inc. Zea, M. C., Reisen, C. A., & Poppen, P. J. (1999). Psychological well-being among Latino lesbians and gay men. Cultural Diversity and Ethnic Minority Psychology, 5(4), 371-379.

LGBTQ SCHOOL-BASED SUPPORT Appendix A Informed Consent Document
UNIVERSITY AT BUFFALO, STATE UNIVERSITY OF NEW YORK High School Experiences of Lesbian, Gay, Bisexual and Transgender Young Adults FOR QUESTIONS ABOUT THIS RESEARCH, CONTACT:

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This study is being conducted by Jennifer Piccolo (jpiccolo@buffalo.edu) under the supervision of Dr. Catherine Cook-Cottone (cpcook@buffalo.edu). Ms. Piccolo and Dr. Cook-Cottone can be reached through the Department of Counseling, School, and Educational Psychology, University at Buffalo, Amherst NY 14260 or by telephone at (716) 645-2484. If you have any questions about your rights as a participant in a research project, you should contact (anonymously, if you wish) the Social and Behavioral Sciences Institutional Review Board, 515 Capen, University at Buffalo, Buffalo, NY 14260, e-mail SBSIRB@research.buffalo.edu, phone (716) 645-6474 PURPOSE: You are invited to participate in a research project that examines some of the experiences of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) young adults during high school. The results of this study should help to further our understanding of the best ways for schools to provide positive environments for LGBTQ students. This understanding will help school professionals to develop more effective resources and policies to support LGBTQ students during high school. Approximately 200 participants will be involved in the study. PROCEDURES: If you agree to be a part of this study, you will first be asked to fill out three online surveys. The surveys ask about your ways of dealing with stress, as well as your feelings of anxiety. You will then be asked to provide some demographic information and complete a fourth survey about some of your experiences related to your sexual orientation and/or gender identity. Filling out the online surveys should take about 30 minutes. You are free not to answer any questions you do not wish to answer. You may

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withdraw from the study at any time prior to submission of your surveys. Withdrawal after this point will not be possible because the surveys are anonymous and once submitted, will be unidentifiable. Withdrawing would have no foreseeable negative effects. CONFIDENTIALITY: The information you provide by filling out the survey is completely anonymous and therefore no one will be able to identify your responses. The data from your survey will become part of a database and stored in a locked file in 415 Baldy Hall for 3 years upon completion of the manuscript. Your identity will in no way be related to the study and will not be made a part of any published findings resulting from this study. RISKS: The known risks associated with this study include the possibility that you might become upset thinking about some of the questions or topics in this study. If this occurs, you should notify the interviewer (by email if completing the web-based survey) and you will be provided with an appropriate referral for assistance. In addition, phone numbers for national help lines will provided before you begin the survey. Any significant new findings developed during the course of this research that uncover new risks, which may affect your willingness to continue participation, will be provided to you in writing. BENEFITS: There are no anticipated direct benefits to you for participating in this study. However, results of the study may be used to inform school professionals of a best-practices model for the provision of effective school-based resources, policies, and support for LGBTQ high school students. COSTS and COMPENSATION: There is no cost to you to participate in this study. If you decide to participate, you will be given the opportunity to enter into a random drawing to win one of four $25 Amazon.com gift certificates. If you choose to enter this drawing, you will be asked to email the investigator with a password provided at the

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beginning of the online survey. Your email address will in no way be linked to your survey data; your responses will remain anonymous. JOINING OF YOUR OWN FREE WILL (VOLUNTEERING FOR THE STUDY):

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Your participation is voluntary. Your refusal to participate will involve no penalty or loss of benefits to which you are otherwise entitled. You do not have to answer every question and may refuse to answer any questions that you do not want to answer. You may withdraw from the study at any time prior to submitting your survey to the investigator. SUBJECT STATEMENT: By participating in this study, I assert that I have read the explanation provided to me. I have had all my questions answered to my satisfaction, and I voluntarily agree to participate in this study.

LGBTQ SCHOOL-BASED SUPPORT Appendix B Debriefing Script

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Thank you for participating in this research. The purpose of this study is to learn what experiences were helpful to you in dealing with issues related to your sexual orientation and/or gender identity during high school, and to understand how some of your high school experiences may have affected you. Previous research has looked at some of these issues, but the interactions between school-based support, level of disclosure, coping responses and their long-term effects on anxiety-related outcomes have not been specifically evaluated. Perhaps most importantly, this study seeks to understand the complex experiences of LGBTQ students by inviting LGBTQ young adults to reflect upon their own experiences and to share their unique perspectives. It is our hope that we will discover some experiences that many of you found helpful during high school. We plan to share your knowledge with schools so that they may better serve their LGBT students in the future. Some of the experiences discussed in these surveys may have been sensitive for some people. In the event that you would like support, we encourage you to contact a community mental health provider. The results of this study will be available for you at your request after the research is completed. If you have any questions or would like more information about this study, please contact me, Jen Piccolo (645-2484), or my faculty advisor, Dr. Catherine Cook-Cottone (Department of Counseling, School, and Educational Psychology; 645-2484 ext. 1073). For further reading on these topics: Hansen, A. L. (2007). School-based support for GLBT students: A review of three levels of research. Psychology in the Schools, 44(8), 839-848. Herek, G. M., & Garnets, L. D. (2007). Sexual orientation and mental health. Annual Review of Clinical Psychology, 3, 353-375. Savin-Williams, R. C., & Ream, G. L. (2003). Sex variations in the disclosure to parents of same-sex attractions. Journal of Family Psychology, 17(3), 429-438.

LGBTQ SCHOOL-BASED SUPPORT Appendix C Resources for Participants

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The National Suicide Prevention Lifeline is a 24-hour, toll-free suicide prevention service available to anyone in suicidal crisis. If you need help, please dial 1-800-273-TALK (8255). You will be routed to the closest possible crisis center in your area. Why should I call the Lifeline? From immediate suicidal crisis to information about mental health, crisis centers in our network are equipped to take a wide range of calls. Some of the reasons to call 1-800-273TALK are: Call to speak with someone who cares, Call if you feel you might be in danger of hurting yourself, Call to find referrals to mental health services in your area.

GLBT National Help Center Toll-free 1-888-THE-GLNH (1-888-843-4564) Email: glnh@GLBTNationalHelpCenter.org

HOURS: Monday thru Friday from 1pm to 9pm, Pacific Time, Saturday from 9am to 2pm, Pacific Time (Monday thru Friday from 4pm to midnight, Eastern Time, Saturday from Noon to 5pm, Eastern Time) The Gay, Lesbian, Bisexual and Transgender National Hotline provides telephone and email peer-counseling, as well as factual information and local resources for cities and towns across the United States. All of our services are free and confidential.

GLBT National Youth Talkline CONTACT INFO: Toll-free 1-800-246-PRIDE (1-800-246-7743) youth@GLBTNationalHelpCenter.org HOURS: Monday - Friday from 5pm to 9pm, Pacific Time (Mon - Fri 8pm to Midnight, Eastern Time) The GLBT National Youth Talkline provides telephone and email peer-counseling, as well as factual information and local resources for cities and towns across the United States. All of our services are free and confidential. Our telephone volunteers are in their teens and early twenties, and we speak with teens and young adults up to age 25 about coming-out issues, relationship concerns, parent issues, school problems, HIV/AIDS anxiety and safer-sex information, and lots more.

LGBTQ SCHOOL-BASED SUPPORT Appendix D Brief COPE - Part 1: Now

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These items deal with ways you've been coping with the stress in your life. There are many ways to try to deal with problems, and different people deal with things in different ways. We are interested in how YOU have tried to deal with stress. Each item says something about a particular way of coping. We would like to know to what extent you've been doing what the item says. Don't answer on the basis of whether it seems to be working or not—just whether or not you're doing it. Use these response choices. Try to rate each item separately in your mind from the others. Make your answers as true FOR YOU as you can. 1 = I haven't been doing this at all 2 = I've been doing this a little bit 3 = I've been doing this a medium amount 4 = I've been doing this a lot 1. I've been turning to work or other activities to take my mind off things. 2. I've been concentrating my efforts on doing something about the situation I'm in. 3. I've been saying to myself "this isn't real." 4. I've been using alcohol or other drugs to make myself feel better. 5. I've been getting emotional support from others. 6. I've been giving up trying to deal with it. 7. I've been taking action to try to make the situation better. 8. I've been refusing to believe that it has happened. 9. I've been saying things to let my unpleasant feelings escape. 10. I’ve been getting help and advice from other people.

LGBTQ SCHOOL-BASED SUPPORT 11. I've been using alcohol or other drugs to help me get through it. 12. I've been trying to see it in a different light, to make it seem more positive. 13. I’ve been criticizing myself. 14. I've been trying to come up with a strategy about what to do. 15. I've been getting comfort and understanding from someone. 16. I've been giving up the attempt to cope. 17. I've been looking for something good in what is happening. 18. I've been making jokes about it. 19. I've been doing something to think about it less, such as going to movies, watching TV, reading, daydreaming, sleeping, or shopping. 20. I've been accepting the reality of the fact that it has happened. 21. I've been expressing my negative feelings. 22. I've been trying to find comfort in my religion or spiritual beliefs. 23. I’ve been trying to get advice or help from other people about what to do. 24. I've been learning to live with it. 25. I've been thinking hard about what steps to take. 26. I’ve been blaming myself for things that happened. 27. I've been praying or meditating. 28. I've been making fun of the situation.

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LGBTQ SCHOOL-BASED SUPPORT Appendix E Brief COPE - Part 2: During High School

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Please rate the following items based on how you coped with your coming out experiences during high school. Try to rate each item separately in your mind from the others. Make your answers as true FOR YOU as you can. 1 = I did not do this at all 2 = I did this a little bit 3 = I did this a medium amount 4 = I did this a lot 1. I turned to work or other activities to take my mind off things. 2. I concentrated my efforts on doing something about the situation I'm in. 3. I said to myself "this isn't real." 4. I used alcohol or other drugs to make myself feel better. 5. I got emotional support from others. 6. I gave up trying to deal with it. 7. I took action to try to make the situation better. 8. I refused to believe that it has happened. 9. I said things to let my unpleasant feelings escape. 10. I got help and advice from other people. 11. I used alcohol or other drugs to help me get through it. 12. I tried to see it in a different light, to make it seem more positive. 13. I criticized myself. 14. I tried to come up with a strategy about what to do.

LGBTQ SCHOOL-BASED SUPPORT 15. I got comfort and understanding from someone. 16. I gave up the attempt to cope. 17. I looked for something good in what was happening. 18. I made jokes about it. 19. I did something to think about it less, such as going to movies, watching TV, reading, daydreaming, sleeping, or shopping. 20. I accepted the reality of the fact that it had happened. 21. I expressed my negative feelings. 22. I tried to find comfort in my religion or spiritual beliefs. 23. I tried to get advice or help from other people about what to do. 24. I learned to live with it. 25. I thought hard about what steps to take. 26. I blamed myself for things that happened. 27. I prayed or meditated. 28. I made fun of the situation.

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LGBTQ SCHOOL-BASED SUPPORT Appendix F State-Trait Anxiety Inventory (Trait Scale)

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A number of statements which people have used to describe themselves are given below. Read each statement and then select the appropriate circle to indicate how you GENERALLY feel. There are no right or wrong answers. Do not spend too much time on any one statement, but give the answer which describes how you GENERALLY feel. Almost Almost Sometimes Often never always 1. I feel pleasant 2. I feel nervous and restless 3. I feel satisfied with myself 4. I wish I could be as happy as others seem to be 5. I feel like a failure 6. I feel rested 7. I am "calm, cool, and collected" 8. I feel that difficulties are piling up so that I cannot overcome them 9. I worry too much over something that really doesn't matter 10. I am happy 11. I have disturbing thoughts 12. I lack self confidence 13. I feel secure 14. I make decisions easily 15. I feel inadequate 16. I am content 17. Some unimportant thought runs through my mind and bothers me 18. I take disappointments so keenly that I can't put them out of my mind 19. I am a steady person 20. I get in a state of tension or turmoil as I think over my recent concerns and interests

LGBTQ SCHOOL-BASED SUPPORT Appendix G Brief Fear of Negative Evaluation Scale – Version II

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Read each of the following statements carefully and indicate how characteristic it is of you according to the following scale: 1 = Not at all characteristic of me 2 = Slightly characteristic of me 3 = Moderately characteristic of me 4 = Very characteristic of me 5 = Extremely characteristic of me 1. I worry about what other people will think of me even when I know it doesn’t make any difference. 2. It bothers me when people form an unfavorable impression of me. 3. I am frequently afraid of other people noticing my shortcomings. 4. I worry about what kind of impression I make on people. 5. I am afraid that others will not approve of me. 7. I am concerned about other people’s opinions of me. 8. When I am talking to someone, I worry about what they may be thinking about me. 9. I am usually worried about what kind of impression I make. 10. If I know someone is judging me, it tends to bother me. 11. Sometimes I think I am too concerned with what other people think of me. 12. I often worry that I will say or do wrong things.

LGBTQ SCHOOL-BASED SUPPORT Appendix H Disclosure and School-Based Support Questionnaire Demographic Information: Date of Birth: __________________ Gender: Current Date: _________________

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o Female o Male o Transgender – Male to Female o Intersex o Other

o Transgender – Female to Male

Sexual Orientation: o Lesbian o Gay o Bisexual o Questioning o Other (Please describe) Location of high school from which you graduated (Zip Code): Was your high school: Socioeconomic status of school community: o Urban o Suburban o Rural

o High Income o High-Middle Income o Middle Income o Low-Middle Income o Low Income o Mixed/Other (Please describe)______ o Public o Private o Religious o Single-gender o Other: _____________

Type of High School: (check all that apply)

Number of students in high school graduating class: o 1 to 25 o 26 to 99 o 100 to 199 o 200 to 399 o 400 or more

Highest Educational Level Completed (please check the most appropriate box): o o o o o Did not complete HS GED HS Diploma Freshman Year (College) Sophomore Year (College)

o o o o

Junior Year (College) Senior Year (College) Masters Degree Doctoral/Law/Medical Degree

High School GPA (approximate; can report as a % or GPA out of 4.0): Current employment status: seeking work, other employed full-time, employed part-time, student, unemployed

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Race/Ethnicity (please check all that apply): o o o o African American Native American Middle Eastern Euro American/Caucasian o Asian or Asian American o Pacific Islander o Latino/Latina o Other ______________________

Disclosure and School-Based Support Please estimate age to the best of your ability: 1. How old were you when you first considered your sexual orientation? 2. How old were you when you first self-identified or acknowledged your sexual orientation? 3. How old were you when you first engaged in same-sex sexual activity? 4. How old were you when you first came out, or disclosed your sexual orientation, to another person? Please answer questions 5 through 7 if they apply to your gender-related experience: 5. How old were you when you first considered your transgender identity? 6. How old were you when you first self-identified or acknowledged your transgender identity? 7. How old were you when you first came out, or disclosed your transgender identity, to another person? 8. Who was the first person you came out to? (Please do not include names. Indicate role, e.g. friend, teacher, etc.) Please describe that person's reaction: 9. Please describe the context of your disclosure. Did you initiate this process? (e.g., Did you decide to tell someone? Did someone else disclose your sexual orientation without your consent? Were you pressured to disclose?) 10. If you did not disclose your sexual orientation or transgender identity during high school, why didn’t you? (e.g., not yet aware of lesbian, gay, bisexual or transgender (LGBT) identity, lack of support, threats or fear of consequences, etc.)

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11. If you have disclosed your sexual orientation or gender identity to family members, please describe how they reacted when you told them. In addition, please describe how you felt about their reactions.

Your Age (at disclosure)

Family Member ( e.g., mother, sister)

Family Member’s Initial Reaction (Please rate using scale and describe) 1 2 3 4 Very Somewhat Somewhat Very Rejecting Rejecting Accepting Accepting

How did this person’s initial reaction affect you? (Please rate and describe) 1 2 3 4 Not A little A fair A lot at all amount

Did this person’s reaction change over time? (Please rate and describe) 1 2 3 Became No Became Less Change More Accepting Accepting

What is your relationship like now? (Please rate and describe) 1 2 3 4 Very Somewhat Somewhat Very Negative Negative Positive Positive (or indicate “no contact”)

LGBTQ SCHOOL-BASED SUPPORT

94

Friend Disclosure

12. If you have disclosed your sexual orientation or gender identity to friends, please describe how they reacted when you told them. In addition, please describe how you felt about their reactions.

Your Age (at disclosure)

Friend’s Initial Reaction (Please rate using scale and describe) 1 2 3 4 Very Somewhat Somewhat Very Rejecting Rejecting Accepting Accepting

How did this person’s initial reaction affect you? (Please rate and describe) 1 2 3 4 Not A little A fair A lot at all amount

Relationshi p (e.g., best friend, LGBT friend, childhood friend)

Did this person’s reaction change over time? (Please rate and describe) 1 2 3 Became No Became Less Change More Accepting Accepting

What is your relationship like now? (Please rate and describe) 1 2 3 4 Very Somewhat Somewhat Very Negative Negative Positive Positive (or indicate “no contact”)

LGBTQ SCHOOL-BASED SUPPORT

95

High School Staff Disclosure

13. If you have disclosed your sexual orientation or gender identity to high school staff, please describe how they reacted when you told them. In addition, please describe how you felt about their reactions.

Your Age (at disclosure)

Staff Member ( e.g., teacher, coach)

Staff Person’s Initial Reaction (Please rate using scale and describe) 1 2 3 4 Very Somewhat Somewhat Very Rejecting Rejecting Accepting Accepting

How did this person’s initial reaction affect you? (Please rate and describe) 1 2 3 4 Not A little A fair A lot at all amount

Did this person’s reaction change over time? (Please rate and describe) 1 2 3 Became No Became Less Change More Accepting Accepting

LGBTQ SCHOOL-BASED SUPPORT

96

14. Who do you feel was helpful to you in dealing with issues related to your sexual orientation and/or gender identity? (Check as many as apply, please comment on each below - Why was support from that person helpful or important to you?) Please note: LGBTQ= Lesbian, Gay, Bisexual, Transgender, or Questioning o Mother o Father o Other Guardian: _______________ o Sibling o Other Relative: Comments: 15. Of those people who helped you (as indicated in question 9), please rank the five who were the most supportive (1= most supportive), list their role (e.g., friend, parent, teacher, etc.), and describe the type of support you received from them. o o o o o o LGBTQ Friends non-LGBTQ Friends Teacher School Principal LGBT Adult Religious leader o o o o o o School Psychologist School Counselor School Social Worker Private Counselor Medical Provider Other individual(s), list below:

Rank

Person (e.g., teacher, LGBTQ friend, etc.)

Type of Support (what they said or did that was helpful)

1 2 3 4 5 16. Given your experiences, who do you think might be helpful to kids who are struggling with issues related to their sexual orientation and/or gender identity? (Check as many as apply, please comment on each below - Why is support from that person helpful or important?) Please note: LGBTQ= Lesbian, Gay, Bisexual, Transgender, or Questioning o Mother o Father o Other Guardian: _______________ o Sibling o Other Relative: Comments: o LGBTQ Friends o non-LGBTQ Friends o Teacher o School Principal o LGBT Adult o Religious leader o o o o o o School Psychologist School Counselor School Social Worker Private Counselor Medical Provider Other individual(s), list below:

LGBTQ SCHOOL-BASED SUPPORT

97

17. Please indicate below if any of the supports listed were available at your high school by checking yes or no. Then, for each one of the supports, please indicate how helpful you believe the support was, or might be (circle level of helpfulness), and explain your answer.
a) Gay-Straight Alliance or similar group 3 = Very helpful 2 = Somewhat helpful Yes o No o 0 = Not helpful at all

1 = Slightly helpful

I answered this way because: Yes No o o 1 = Slightly helpful 0 = Not helpful at all

b) Group Counseling 3 = Very helpful

2 = Somewhat helpful

I answered this way because: Yes No o o 1 = Slightly helpful 0 = Not helpful at all

c) Peer Support Group 3 = Very helpful

2 = Somewhat helpful

I answered this way because: Yes No o o

d) School staff member who was safe to talk to about LGBT issues 3 = Very helpful 2 = Somewhat helpful 1 = Slightly helpful

0 = Not helpful at all

I answered this way because: Yes o No o

e) Safe Zone Project (stickers displayed in offices/classrooms indicating that it was safe to talk about LGBT issues in that space) 3 = Very helpful 2 = Somewhat helpful 1 = Slightly helpful

0 = Not helpful at all

I answered this way because: Yes o No o 0 = Not helpful at all

f) LGBT-themed posters 3 = Very helpful 2 = Somewhat helpful

1 = Slightly helpful

I answered this way because: Yes o No o 0 = Not helpful at all

g) LGBT-themed books available 3 = Very helpful 2 = Somewhat helpful

1 = Slightly helpful

I answered this way because:

LGBTQ SCHOOL-BASED SUPPORT
Yes h) Inclusion of LGBT history in school curriculum o 3 = Very helpful 2 = Somewhat helpful 1 = Slightly helpful No o 0 = Not helpful at all

98

I answered this way because: Yes o No o

i) Inclusion of LGBT-related current events in school curriculum 3 = Very helpful 2 = Somewhat helpful 1 = Slightly helpful

0 = Not helpful at all

I answered this way because: Yes o No o

j) Anti-discrimination policy that included sexual orientation 3 = Very helpful 2 = Somewhat helpful 1 = Slightly helpful

0 = Not helpful at all

I answered this way because: Yes o No o

k) Anti-discrimination policy that included gender identity 3 = Very helpful 2 = Somewhat helpful 1 = Slightly helpful

0 = Not helpful at all

I answered this way because: Yes o No o

l) Anti-bullying/ Anti-harassment policy that included sexual orientation in its language 3 = Very helpful 2 = Somewhat helpful 1 = Slightly helpful 0 = Not helpful at all

I answered this way because: Yes o No o

m) Anti-bullying/ Anti-harassment policy that included gender identity in its language 3 = Very helpful 2 = Somewhat helpful 1 = Slightly helpful 0 = Not helpful at all

I answered this way because: Yes o No o

n) LGBT adult role models (teachers, counselors, coaches, school staff, etc.) 3 = Very helpful 2 = Somewhat helpful 1 = Slightly helpful

0 = Not helpful at all

I answered this way because: Yes o No o 1 = Slightly helpful 0 = Not helpful at all

o) LGBT-inclusive Prom 3 = Very helpful

2 = Somewhat helpful

LGBTQ SCHOOL-BASED SUPPORT
I answered this way because: p) Other (Please describe): 3 = Very helpful 2 = Somewhat helpful 1 = Slightly helpful 0 = Not helpful at all

99

I answered this way because: q) Other (Please describe): 3 = Very helpful 2 = Somewhat helpful 1 = Slightly helpful 0 = Not helpful at all

I answered this way because:

18. Do you believe that your high school experiences related to sexual orientation and/or gender identity were important or formative? Please explain why or why not. 19. Is there any additional information you would like educators and other school professionals to know about helping students with issues relate to sexual orientation and/or gender identity? What are the best ways to help LGBTQ students?

LGBTQ SCHOOL-BASED SUPPORT Appendix I Table 1 Demographic Characteristics of the Study Sample Variable Race/Ethnicity (N=182) African American or Black Asian or Asian American Latino/a White Multi-racial Not reported Sexual Orientation (N=184) Lesbian Gay Bisexual Queer Questioning Pansexual Heterosexual (Transgender) Gender Identity (N=184) Female Male Queer/ Genderqueer FtM Transgender MtF Transgender Education level (N=184) Currently in HS Did Not Complete High School High School Diploma 5 9 13 2.7 4.9 7.1 101 36 15 30 2 54.9 19.6 8.2 16.3 1.1 65 36 24 47 4 6 2 35.3 19.6 13.0 25.5 2.2 3.3 1.1 2 8 3 155 14 2 1.1 4.3 1.6 84.2 7.6 1.1 n %

100

LGBTQ SCHOOL-BASED SUPPORT Some College Associate's Degree Bachelor's Degree Master's Degree Doctoral Degree Employment Status (N=182) Employed FT or PT Student Student and Employed Unemployed 87 44 36 15 47.3 23.9 19.6 8.2 50 6 66 31 4 27.2 3.3 35.9 16.8 2.2

101

LGBTQ SCHOOL-BASED SUPPORT Table 2 Sexual Orientation and Gender Identity of the Study Sample Lesbian Female Male Genderqueer FtM MtF Total 61 0 2 1 1 65 Gay 4 27 0 4 1 36 Bisexual 17 4 0 3 0 24 Queer 15 3 12 17 0 47 Questioning Pansexual 2 1 1 0 0 4 2 1 0 3 0 6 Trans Hetero 0 0 0 2 0 2

102

Total 101 36 15 30 2 184

LGBTQ SCHOOL-BASED SUPPORT Table 3 Characteristics of High Schools

103

Variable Region (N=180) Northeastern US Southeastern US Southwestern US Western US Midwestern US Australia UK Canada (Montreal) Community (N=184) Urban Suburban Rural School Size (N=183) 1 to 25 26 to 99 100 to 199 200 to 399 400 or more SES of district (N=183) Low and low-middle Middle and mixed High and high-middle School Type (N=183) Public Private

n

%

131 10 2 22 11 2 1 1

71.2 5.4 1.1 12.0 6.0 1.1 .5 .5

25 125 34

13.6 67.9 18.5

7 27 34 56 59

3.8 14.7 18.5 30.4 32.1

33 96 54

17.9 52.2 29.3

154 29

84.2 15.9

LGBTQ SCHOOL-BASED SUPPORT Table 4 Descriptive Statistics for Brief COPE Subscales Subscale Active Coping Index Use of Instrumental Support Use of Emotional Support Active Coping Planning Positive Reframing Acceptance Humor Religion Disengaged Coping Index Self Distraction Denial Substance Use Behavioral Disengagement Venting Self Blame Note. N=179 Min 8 0 0 0 1 0 0 0 0 2 0 0 0 0 0 0 Max 41 6 6 6 6 6 6 6 6 27 6 6 6 6 6 6 Mean 24.64 3.15 3.46 3.52 3.73 3.20 3.72 2.96 0.91 12.59 3.53 0.84 1.41 1.02 2.72 3.06 SD 7.34 1.75 1.66 1.54 1.51 1.50 1.46 1.86 1.48 5.32 1.58 1.25 1.59 1.25 1.47 1.95

104

LGBTQ SCHOOL-BASED SUPPORT Table 5 Descriptive Statistics for STAI-T, BFNE-II, Total Rejection, Total Acceptance, Disengaged Coping, Active Coping, and School Support Index
Total Sample (N=184) Female (n=101) Male (n=36) Transgender (n=47)

105

Scale (Possible Score Range) STAI-T (20-80) M SD Range BFNE-II (0-32) M SD Range Total Rejection (0-48) M SD Range Total Acceptance (0-24) M SD Range Disengaged Coping (0-36) M SD Range Active Coping (0-48) M SD Range School Support Index (0-36) M SD Range

47.91 10.98 24-74

47.15 11.58 25-74

47.73 10.51 24-71

49.74 9.94 29-68

16.59 8.26 0-32

16.41 8.32 2-32

18.14 7.92 2-30

15.79 8.41 0-32

5.13 5.41 0-28

3.81 4.09 0-21

4.75 4.61 0-17

7.91 6.99 0-28

6.72 3.30 1-16

6.71 3.25 1-16

6.53 2.74 1-15

6.91 3.81 1-16

12.59 5.32 2-27 24.64 7.34 8-41 5.00 6.38 0-30

12.33 5.39 2-26 25.18 7.75 8-40

12.54 5.88 3-27 22.83 6.41 10-38

13.18 4.75 5-22 24.98 7.04 11-41

STAI-T: State-Trait Anxiety Inventory, Trait version; BFNE-II: Brief Fear of Negative Evaluation Scale, 2nd Ed.

LGBTQ SCHOOL-BASED SUPPORT Table 6 School Based Supports: Prevalence and Perceived Helpfulness
Had Support Type of Support n (%)

106

Helpfulness* Mean (SD)

Diversity training for students that included LGBTQ issues LGBTQ adult role model

21 (11.4) 46 (25.0)

2.47 2.35

(.70) (.86)

LGBTQ-inclusive prom

40 (21.7)

2.26

(.95)

LGBTQ history, current events, etc. included in curricula LGBTQ-safe staff

15 (8.2)

2.23

(1.01)

71 (38.6)

2.18

(.95)

Non-discrimination/ harassment policy that included gender expression Non-discrimination/ harassment policy that included sexual orientation LGBTQ-themed books available

20 (10.9)

2.11

(.90)

58 (31.5)

2.06

(1.00)

44 (23.9)

2.05

(.92)

LGBTQ-themed posters, displays, etc.

23 (12.5)

1.81

(.93)

Gay-Straight Alliance

68 (37.0)

1.80

(1.12)

Diversity training for staff that included LGBTQ issues Safe Zone Project

17 (9.2)

1.71

(.99)

36 (19.6)

1.53

(.86)

*Helpfulness rated on a scale of 0 to 3 with 0 being not at all helpful and 3 being very helpful.

LGBTQ SCHOOL-BASED SUPPORT Table 7 Bivariate Correlations between Current Age and Presence of Individual School Supports Variable Age Gay-Straight Alliance LGBTQ-safe staff Safe Zone Project LGBTQ adult role model LGBTQ-themed posters, displays, etc. LGBTQ-themed books available LGBTQ history, current events, etc. included in curricula Non-discrimination/harassment policy that included sexual orientation Non-discrimination/harassment policy that included gender expression Diversity training for students that included LGBTQ issues Diversity training for staff that included LGBTQ issues LGBTQ-inclusive prom Age 1 -.49 -.35 -.24 -.20 -.29 -.37 -.25 -.32 -.28 -.16* -.22 -.29

107

*All correlations are significant at the p < .01 level, with the exception of diversity training for students (p < .05)

LGBTQ SCHOOL-BASED SUPPORT

108

Table 8

Bivariate Correlations between Age, Total Rejection, Total Acceptance, Disengaged Coping, Active Coping, Number of School

Supports, School Support Index, Perceived Helpfulness of Each Support, STAI-T and BFNE-II Scores
Tot Sch Spt # of GSA Reject Indx Supports Staff 0.20* 0.10 -0.13 0.19* 0.17* 0.11 0.12 0.03 0.00 -0.13 0.11 0.14 0.02 0.22** 0.11 0.10 0.13 0.04 0.09 0.17* -0.08 -0.09 -0.01 -0.08 -0.06 0.11 0.01 -0.02 0.14 0.05 0.06 0.05 0.04 0.02 -0.05 -0.01 0.06 0.05 0.08 0.07 0.10 -0.01 -0.07 -0.10 0.05 -0.02 0.08 -0.07 Sf Zn Posters Books 0.12 0.13 0.08 0.11 -0.34** 0.34** 0.35** 0.10 0.00 1.00 1.00 1.00 1.00 1.00 1.00 -0.06 -0.10 0.08 0.09 0.06 -0.11 -0.11 -0.14 0.01 0.03 0.10 0.15 0.14 0.06 Role Mod Curric SO Pol Gnd Pol DvTrStu DvTrStf Prom 0.07 0.01 -0.06 0.02 0.26** 0.02 0.09 -0.01 -0.04 -0.08 0.00 -0.02 0.04 0.02 -0.06 0.11 Age -0.09 -0.10 0.09 -0.13 0.33** -0.34** -0.14 0.12

STAI-T BFNE-II 0.04 0.04 -0.13 0.08 1.00

Actv Diseng Tot Cope Cope Accept

STAI-T

1.00

0.62** -0.08 0.55**

BFNE-II 0.07 1.00

1.00

-0.02 0.29**

Active Cope

1.00

Diseng Cope

Acceptance

Rejection

SchSpt Index

0.88** 0.58** 0.60** 0.43** 0.47** 0.61** 0.67** 0.45** 0.60** 0.44** 0.43** 0.46** 0.67** -0.36** 0.48** 0.52** 0.37** 0.40** 0.52** 0.58** 0.37** 0.50** 0.34** 0.37** 0.44** 0.57** -0.47** 0.54** 0.39** 0.28** 0.43** 0.49** 0.17* 0.46** 0.23** 0.22** 0.15 0.16 1.00 0.38** 0.29** 1.00 0.21* 0.28** 0.27** -0.06 0.09 0.25** 0.12 0.29** 0.12 0.15 -0.05 0.18* 0.29** -0.27** 0.21* -0.29** 0.17* 0.18* -0.12 -0.05 0.56** 0.34** 0.39** 0.28** 0.34** 0.26** 0.32** -0.11 1.00 0.48** 0.49** 0.42** 0.21** 1.00 0.20* 1.00 0.23** 0.29** 0.62** 0.22** 1.00 0.19* 1.00 0.18* 0.42** -0.24** 0.16 0.36** -0.08 0.20* 0.42** -0.12 0.17* 0.34** -0.17* 0.17* 0.39** 1.00 0.00 0.30** -0.12 1.00 -0.27** 1.00

# of Supports

GSA

Safe Staff

0.50** 0.45** 0.40** 0.55** 0.25** 0.36** 0.24** 0.37** 0.39**

Safe Zone

Role Model

Posters

Books

Curricula

SO Policy

Gndr Policy

Div Tr Stud

Div Tr Staff

Incl Prom

Age

* p< 0.05; ** p< 0.01

LGBTQ SCHOOL-BASED SUPPORT

109

Table 9

Partial Correlations between Total Rejection, Total Acceptance, Disengaged Coping, Active Coping, Number of School Supports,

School Support Index, Perceived Helpfulness of Each Support, STAI-T and BFNE-II Scores (Controlling for Age)
Actv Diseng Cope cope Staff 0.18* 0.08 -0.11 0.16 0.08 0.15 0.55** 0.45** 0.50** 1.00 1.00 0.49** 0.38** 0.28** 0.46** 0.24** 1.00 0.36** 0.43** 0.42** 0.49** 0.62** 0.54** 0.42** 0.38** 0.36** 0.38** 1.00 0.14 0.04 0.00 0.08 0.13 -0.02 0.15 -0.10 0.65** 0.54** 0.46** 0.52** 0.37** 0.28** 0.56** 1.00 0.10 0.10 0.12 0.01 -0.08 0.00 -0.07 -0.04 0.12 0.08 0.15 -0.07 0.45** 0.37** 0.16 0.24** 0.15 0.21* 0.34** 0.48** 1.00 0.05 0.04 0.03 0.00 -0.05 0.05 0.05 0.07 0.05 0.10 -0.02 -0.02 0.02 -0.03 0.11 0.07 0.61** 0.50** 0.45** 0.34** 0.27** 0.27** 0.39** 0.47** 0.19* 1.00 Sf Zn Posters Books Curric -0.07 0.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0.42** 0.86** 0.54** -0.02 -0.05 0.03 -0.32** 0.25** 0.23** 0.00 0.04 0.13 0.04 0.04 0.02 0.08 -0.11 0.07 -0.09 -0.08 -0.12 0.29** 0.01 0.15 -0.02 -0.01 0.08 0.54** 0.01 0.13 0.12 0.11 0.03 Tot Accept Tot Reject Sch Spt # of GSA Index Supports Role Mod SO Pol Gnd Pol DvTrStu DvTrStf Prom -0.09 -0.12 0.07 -0.04 0.03 -0.05 0.41** 0.29** 0.19* 0.10 -0.08 0.08 0.26** 0.39** 0.22** 0.62** 1.00 0.07 0.01 -0.06 0.02 0.27** 0.02 0.46** 0.42** 0.22** 0.26** 0.12 0.29** 0.34** 0.22** 0.30** 0.22** 0.20* 1.00 0.08 -0.03 -0.03 -0.10 -0.04 0.00 0.02 0.00 -0.04 0.08 0.26** -0.12 0.45** 0.63** 0.44** 0.52** 0.09 0.12 -0.07 0.17* 0.24** 0.14 0.15 0.17* 0.25** 0.31** 0.16 0.15 0.18* 0.16 0.17* 1.00 0.38** 0.36** 0.41** 0.30** 0.41** 0.28** 1.00

STAI-T BFNE-II

STAI-T

1.00

0.62**

BFNE-II

1.00

Active Cope

Diseng Cope

Acceptance

Rejection

SchSpt Index

# of Supports

GSA

Safe Staff

Safe Zone

Role Model

Posters

Books

Curricula

SO Policy

Gndr Policy

Div Tr Stud

Div Tr Staff

Incl Prom

* p< 0.05; ** p< 0.01

LGBTQ SCHOOL-BASED SUPPORT Table 10

110

Regression Analysis for the Prediction of Trait Anxiety from Disclosure-Related Rejection and Acceptance, Coping Responses, and School Support Index
Variable B S.E. B Beta p

Disengaged Coping Active Coping Total Rejection Total Acceptance School Support Index

1.09 -.20 .14 -.02 .19

.14 .10 .15 .25 .12

.53 -.13 .07 -.01 .11

.00 .05 .35 .95 .12

Note. R Square = .33; Adjusted R Square = .30

LGBTQ SCHOOL-BASED SUPPORT Table 11

111

Regression Analysis for the Prediction of Social Anxiety from Disclosure-Related Rejection and Acceptance, Coping Responses, and School Support Index
Variable B S.E. B Beta p

Disengaged Coping Active Coping Total Rejection Total Acceptance School Support Index

.42 -.06 .22 .20 -.01

.12 .09 .13 .22 .12

.27 -.05 .15 .08 -.01

.01 .50 .08 .35 .92

Note. R Square = .11; Adjusted R Square = .08

LGBTQ SCHOOL-BASED SUPPORT Table 12 Regression Analysis for the Prediction of Active Coping Responses from Age and Perceived Helpfulness of Particular School-Based Supports
Variable Step 1 Age Step 2 Age Gay Straight Alliance LGBTQ-safe staff Safe Zone Project LGBTQ adult role model LGBTQ-themed posters, displays, etc. LGBTQ-themed books available LGBTQ history, current events, etc. included in curricula Non-discrimination/ harassment policy that included sexual orientation Non-discrimination/ harassment policy that included gender expression Diversity training for students that included LGBTQ Issues Diversity training for staff that included LGBTQ Issues LGBTQ-inclusive prom Note. .05 -.97 -.67 -.24 .33 -.85 .02 1.85 .15 .73 .69 1.02 .67 1.23 .92 1.10 .03 -.14 -.11 -.02 .04 -.07 .00 .15 .15 .14 .08 B S.E. B Beta

112

p

.27

.73 .19 .33 .82 .63 .49 .98 .09

.95 .50 -.33 .34 -.72

.87 1.15 .94 1.14 .70

.12 .04 -.03 .02 -.10

.28 .67 .73 .77 .31

Step 1 R Square = .007; Adjusted R Square = .001 Step 2 R Square = .07; Adjusted R Square = -.003; R Square Change = .06 (n.s.)

LGBTQ SCHOOL-BASED SUPPORT

113

Table 13 Regression Analysis for the Prediction of Trait Anxiety from Age and Perceived Helpfulness of Particular School-Based Supports
Variable Step 1 Age Step 2 Age Gay Straight Alliance LGBTQ-safe staff Safe Zone Project LGBTQ adult role model LGBTQ-themed posters, displays, etc. LGBTQ-themed books available LGBTQ history, current events, etc. included in curricula Non-discrimination/ harassment policy that included sexual orientation Non-discrimination/ harassment policy that included gender expression Diversity training for students that included LGBTQ Issues Diversity training for staff that included LGBTQ Issues LGBTQ-inclusive prom Note. -0.11 -0.56 2.61 -0.72 -0.51 0.76 -0.78 1.15 0.23 1.12 1.05 1.55 1.03 1.88 1.41 1.67 -0.04 -0.05 0.27 -0.04 -0.05 0.04 -0.06 0.06 0.62 0.62 0.01 0.65 0.62 0.69 0.58 0.49 -0.22 0.21 -0.08 0.29 B S.E. B Beta p

-0.21 -1.66 0.35 0.97 0.26

1.33 1.75 1.43 1.73 1.07

-0.02 -0.10 0.02 0.05 0.02

0.88 0.34 0.81 0.58 0.81

Step 1: R Square = .007; Adjusted R Square = .001 Step 2: R Square = .07; Adjusted R Square = -.008; R Square Change = .06 (n.s.)

LGBTQ SCHOOL-BASED SUPPORT

114

Table 14 Regression Analysis for the Prediction of Social Anxiety from Age and Perceived Helpfulness of Particular School-Based Supports
Variable Step 1 Age Step 2 Age GSA LGBTQ-safe staff Safe Zone Project LGBTQ adult role model LGBTQ-themed posters, displays, etc. LGBTQ-themed books available LGBTQ history, current events, etc. included in curricula Non-discrimination/ harassment policy that included sexual orientation Non-discrimination/ harassment policy that included gender expression Diversity training for students that included LGBTQ Issues Diversity training for staff that included LGBTQ Issues LGBTQ-inclusive prom Note. -0.15 0.39 0.92 -0.72 -0.16 0.71 -0.19 -1.21 0.17 0.83 0.78 1.16 0.77 1.40 1.05 1.25 -0.07 0.05 0.13 -0.06 -0.02 0.05 -0.02 -0.09 0.39 0.64 0.24 0.54 0.84 0.61 0.86 0.33 -0.20 0.154 -0.10 0.20 B S.E. B Beta p

-0.11 -1.43 0.38 -0.13 0.37

0.99 1.31 1.06 1.29 0.80

-0.01 -0.11 0.03 0.00 0.04

0.91 0.28 0.72 0.92 0.64

Step 1: R Square = .01; Adjusted R Square = .004 Step 2: R Square = .04; Adjusted R Square = -.03; R Square Change = .03 (n.s.)

LGBTQ SCHOOL-BASED SUPPORT

115

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