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Before ‘it gets better:’ Study links bullying to long term negative mental health


A popular anti-bullying campaign has been telling bullied teens “it gets better” — but the effects of past bullying often linger, according to new research.

The study, released Monday (May 16) in the May 2011 issue of the peer-reviewed Journal of School Health, reports that anti-LGBT bullying at school “is strongly linked” to negative mental health for its victims.

Among those risks are an increased frequency of suicide attempts and increased risk for engaging in behaviors that can lead to infection with STDs and HIV. The increased risks exist not only while the victim is in adolescence, but also in young adulthood.

It should come as no surprise that there is a link between the bullying of LGBT students and negative mental health consequences.

Several suicides of LGBT teens in the past year, motivated at least in part by relentless bullying because they are or were perceived to be LGBT, have made headlines and prompted an outpouring of support for LGBT youth from individuals, corporations, and politicians. Syndicated columnist Dan Savage created the “It Gets Better Project” last September to provide youth with videos of LGBT adults and allies who reassure them that life does get better and encourage them to seek help from an adult.

But, until now, there have been no formal studies of the long-term effects of such bullying on LGBT people in the United States.

The new research, by Dr. Stephen T. Russell, distinguished professor at the University of Arizona, and Dr. Caitlin Ryan, director of the Family Acceptance Project at San Francisco State University, found that youth victimized in school because of their LGBT identity reported much greater problems with health and social adjustment in young adulthood than those experiencing low or moderate levels of school victimization.

Ryan said the research provides important empirical evidence about the relationship between bullying and its impact and that this evidence will “help us do something about it.”

Ryan and Russell surveyed 245 LGBT young adults (white and non-white Latino/a) ages 21 to 25. They asked them about their experiences during adolescence with bullying and harassment based on their known or perceived LGBT identity.

The researchers asked each participant to indicate the number of times he or she had experienced each of 10 different actions—such as being hit by a fellow student—because the other person knew or assumed him/her to be LGBT.

The responses to each item were assigned scores as follows: 0=never, 1=once or twice, 2=a few times, 3=many times. The researchers categorized those having total scores between 0 and 2 as having “low” levels of victimization; those between 3 and 10 as having “moderate” levels, and those between 10 and 28 as having “high” levels.

Thirty-seven percent of students (91 participants) had “low” levels of being bullied; 31 percent (75 participants) had “moderate” levels, and 32 percent (79 participants) had “high” levels.

Participants who reported high frequencies of victimization during adolescence were, compared to those with low frequencies:

  • 2.6 times more likely to report clinical levels of depression as young adults,
  • 5.6 times more likely to report having attempted suicide at least once,
  • 5.6 times more likely to have had a suicide attempt that required medical attention,
  • more than twice as likely to report having had an STD diagnosis, and
  • more than twice as likely to report having put themselves at risk for HIV infection in the last six months.

Explaining the latter phenomenon, Ryan said, “When you have a reason to value your own life, you’re going to be much more likely to engage in safer sex.”

Females reported less LGBT victimization in general than males and transgender young adults (both male-to-female and female-to-male) and had lower levels of depression in young adulthood. But those females who did experience higher levels of victimization reported levels of depression comparable to males.

Ryan said that the results will help show school administrators and others that bullying is not just “part of being an adolescent.”

“Now we can show that these effects with high levels of victimization are very serious,” she explained. And if victimization is linked “with serious health problems, such as suicide attempts that required medical care, sexual health risks, and risks for HIV,” she said, schools have “an issue in terms of liability.”

Ryan and Russell conclude that reducing the victimization of LGBT youth “should be an educational and public health priority.” The relationship between bullying and HIV risk, they wrote, “is especially important for school health programs that are funded by HIV funding streams.”

And now that they have shown anti-LGBT bullying to have effects later in life, efforts to prevent such bullying can also “play an important role in helping mitigate the well-documented adult health disparities that exist for LGBT adults in the United States.”

Reducing health disparities between LGBT people and the general population is one of the stated goals of Healthy People 2020, a decennial document created by the U.S. Department of Health and Human Services to set national goals for health.

There are currently several bills in Congress that would address anti-LGBT bullying, including the Safe Schools Improvement Act and the Student Nondiscrimination Act. Ryan said that this legislation is “absolutely essential” to address the “patchwork of approaches” to anti-LGBT bullying across the states. But that legislation alone isn’t enough, said Ryan.

“Schools are embedded in neighborhoods and in communities,” she said, and advocates for LGBT youth “need to do community engagement . . . and to reach out to families and do public education.”

The authors note several limitations of their study. The first is that it relied on LGBT young adults’ memories of experiences during their teenage years. The researchers tried to minimize errors in recollection by asking about very specific actions, e.g., “During my middle or high school years, while at school, I had mean rumors or lies spread about me.”

Also, the study recruited LGBT young adults from a wide range of sites in California, but did not use a sample fully representative of the population. The research covered only LGBT Latino and non-Latino White young adults. These are the two largest ethnic groups in California—but the authors hope that future research will include “greater ethnic diversity to assess potential differences related to ethnicity.”

Still, Ryan said, their results are “an important first step.”

And while the results have implications for school administrators and policy makers, Ryan said they also have implications for families.

“Once parents understand the stakes for their children,” said Ryan, “they’re much more motivated to get involved, to advocate for their kids.”

Previous research Ryan has done has found that acceptance of LGBT youth by parents and caregivers can help protect them against depression, substance abuse, and suicide attempts in early adulthood. Conversely, LGBT young adults whose families rejected them were more than three times as likely to have suicidal thoughts and to report suicide attempts.

Ryan said she shared those results with the staff of U.S. Senator John Kerry (D-Mass.), who on May 12 introduced the Reconnecting Youth to Prevent Homelessness Act to reduce youth homelessness and establish programs specifically for LGBT teens.

Those programs would include ones aimed at reducing rejecting behaviors and increasing supporting behaviors and understanding among families to improve the chances of LGBT youth remaining at home.

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