Mental health issues among youth are on the rise, as highlighted by the CDC (2023) and the U.S. Surgeon General (2021). One of the most urgent concerns is the mental well-being of gender-diverse students, including those who identify as transgender, genderqueer, gender non-conforming, or non-binary. These students are at higher risk for mental health issues, discrimination, and even suicide (Cicero & Wesp, 2017). Fortunately, schools can provide protective factors to support students’ mental health. One such protective factor that’s well-established in research is a sense of belonging in school, including having at least one adult a student can talk to for emotional support.
A Pulse on Mental Health
In our work at Challenge Success, a nonprofit school reform organization affiliated with the Stanford Graduate School of Education, we found further evidence of gender-diverse high school students’ mental health struggles. The Challenge Success-Stanford Survey of Student Experiences was administered to 40,000 students at 59 high schools during the 2021–22 and 2022–23 school years and measured well-being, belonging, and student-adult connections. Students could choose whether to identify their gender identity, and six percent of all respondents identified as gender-diverse. Students were not asked to answer questions about sexual orientation. In our analysis of the data, three main issues emerged:
Higher stress levels: About 25 percent of gender-diverse students indicated that a major source of stress is identity-based discrimination, harassment, or bullying, compared with fewer than 5 percent of students who don’t identify as gender-diverse. Gender-diverse students are also more likely to report mental health as a major stressor (68 percent) compared with 46 percent of non-gender-diverse girls and 23 percent of non-gender-diverse boys.
Lower levels of adult support: Only 65 percent of gender-diverse students reported that they have a trusted adult to whom they could go with a personal problem, compared with 71 percent of non-gender-diverse boys and 73 percent of non-gender-diverse girls.
Lower sense of school belonging: Using Goodenow and Grady’s Psychological Sense of School Belonging scale, which asks students to rate their agreement with statements on a scale of 1-5, we found that almost 30 percent of students disagree or strongly disagree that they belong at their school. Gender-diverse students were more likely to disagree (mean=2.97) compared with boys (mean=3.52) and girls (mean=3.34).
Stronger Support for Students
To help mitigate mental health challenges for gender-diverse students, we recommend increasing feelings of connection and reducing stigma around seeking help for any mental health problems. For example, schools can initiate relationship mapping. As described in the book Overloaded and Underprepared (John Wiley, 2015) which two of us co-authored, relationship mapping tracks student-teacher connections so schools can identify students who may not have an adult at school to go to for support. Educators might implement an “I Wish” Campaign, where students complete sentence stems such as “I wish my teachers knew . . .” or support the formation of identity-based clubs (such as Gender and Sexuality Alliances).
School leaders can explore professional development resources from organizations that support gender-diverse youth, such as the Human Rights Campaign’s Welcoming Schools initiative or The Trevor Project’s resource guides. They can also examine the inclusivity of campus spaces, such as bathrooms and locker areas, and review and amend dress codes that may negatively impact gender-diverse students.
The insight and expertise of gender-diverse youth can be an excellent resource for educators considering more inclusive practices. For example, students we interviewed suggested strategies to help teachers get pronoun use right: have adults share their pronouns, default to using they/them pronouns, and include a place for pronouns on name tags and school documents.
Students who identify as gender-diverse are struggling significantly more than other students are. We realize some of the recommendations described here may not be consistent with state and local laws where LGBTQ+ rights are limited. But we urge educators to check in on LGBTQ+ students regularly—particularly in states with such laws in effect. Improving conditions for gender-diverse students can lead to a caring community for all students.
