TABLE 1.

Key Recommendations for Future Directions

Recommendations
Clinical care
• Foster inclusive and affirming health care environments wherein LGBTQ youth feel comfortable discussing their identities and experiences
• Establish and safeguard confidentiality with LGBTQ youth
• Educate parents and youth about bullying
• Identify youth experiencing LGBTQ bullying, who often do not report it to teachers and parents
• Prevent the negative health consequences of bullying by referring LGBTQ youth experiencing bullying to mental health services when appropriate
Research
• Expand investigation into aspects of school, neighborhood, state, and national contexts to better understand structural-level drivers of LGBTQ bullying (eg, relevant laws and policies)
• Attend to how multiple identities and characteristics (including sexual orientation, gender identity, and others [eg, race, disability, socioeconomic status, and religion]) affect experiences and outcomes of bullying among LGBTQ youth
• Collect sexual orientation and gender identity data in EHRs to facilitate research on LGBTQ bullying in clinical settings
• Employ community-engaged research methods to collaborate with youth, parents, school staff, and community leaders
Intervention
• Develop multicomponent approaches to prevent bullying, including education, skills training, dialogue, and creation of GSAs
• Expand intervention efforts to settings outside of schools, including in clinical settings
Policy
• Advocate for evidence-based, antibullying policies that prohibit bullying on the basis of sexual orientation and gender identity
• Work with multiple stakeholders to secure administrative and community support of policies