At a time when lesbian, gay, bisexual, and transgender individuals—often referred to under the umbrella acronym LGBT—are becoming more visible in society and more socially acknowledged, clinicians and researchers are faced with incomplete information about their health status. While LGBT populations often are combined as a single entity for research and advocacy purposes, each is a distinct population group with its own specific health needs. Furthermore, the experiences of LGBT individuals are not uniform and are shaped by factors of race, ethnicity, socioeconomic status, geographical location, and age, any of which can have an effect on health-related concerns and needs. While some research about the health of LGBT populations has been conducted, researchers still have a great deal to learn. To help assess the state of the science, the National Institutes of Health (NIH) asked the Institute of Medicine (IOM) to assess current knowledge of the health status of lesbian, gay, bisexual, and transgender populations; to identify research gaps and opportunities; and to outline a research agenda to help NIH focus its research in this area. A committee of experts was convened by the IOM to consider this task, and its findings are presented in its report, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding.

The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding

For more than a century, there has been a growing interest in school climate. Recently, the U.S. Department of Education, Center for Disease Control and Prevention, Institute for Educational Sciences, a growing number of State Departments of Education, foreign educational ministries, and UNICEF have focused on school climate reform as an evidence-based school improvement strategy that supports students, parents/guardians, and school personnel learning and working together to create ever safer, more supportive and engaging K–12 schools. This work presents an integrative review on school climate research. The 206 citations used in this review include experimental studies, correlational studies, literature reviews, and other descriptive studies. The review focuses on five essential dimensions of school climate: Safety, Relationships, Teaching and Learning, Institutional Environment, and the School Improvement Process. We conclude with a critique of the field and a series of recommendations for school climate...

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A Review of School Climate Research

Global health burden and needs of transgender populations: a review

BACKGROUND: In recent years, puberty suppression by means of gonadotropin-releasing hormone analogs has become accepted in clinical management of adolescents who have gender dysphoria (GD). The current study is the first longer-term longitudinal evaluation of the effectiveness of this approach. METHODS: A total of 55 young transgender adults (22 transwomen and 33 transmen) who had received puberty suppression during adolescence were assessed 3 times: before the start of puberty suppression (mean age, 13.6 years), when cross-sex hormones were introduced (mean age, 16.7 years), and at least 1 year after gender reassignment surgery (mean age, 20.7 years). Psychological functioning (GD, body image, global functioning, depression, anxiety, emotional and behavioral problems) and objective (social and educational/professional functioning) and subjective (quality of life, satisfaction with life and happiness) well-being were investigated. RESULTS: After gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Well-being was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being. CONCLUSIONS: A clinical protocol of a multidisciplinary team with mental health professionals, physicians, and surgeons, including puberty suppression, followed by cross-sex hormones and gender reassignment surgery, provides gender dysphoric youth who seek gender reassignment from early puberty on, the opportunity to develop into well-functioning young adults.

Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment

The construct of school climate has received attention as a way to enhance student achievement and reduce problem behaviors. The purpose of this article is to evaluate the existing literature on school climate and to bring to light the strengths, weakness, and gaps in the ways researchers have approached the construct. The central information in this article is organized into five sections. In the first, we describe the theoretical frameworks to support the multidimensionality of school climate and how school climate impacts student outcomes. In the second, we provide a breakdown of the four domains that make up school climate, including academic, community, safety, and institutional environment. In the third, we examine research on the outcomes of school climate. In the fourth, we outline the measurement and analytic methods of the construct of school climate. Finally, we summarize the strengths and limitations of the current work on school climate and make suggestions for future research directions.

School Climate: A Review of the Construct, Measurement, and Impact on Student Outcomes.

Transgender youth experience negative school environments and may not benefit directly from interventions defined to support Lesbian, Gay and Bisexual (LGB) youth. This study utilized a multi-method approach to consider the issues that transgender students encounter in school environments. Using data from two studies, survey data (total n = 2260, 68 transgender youth) from study 1 and focus groups (n = 35) from study 2, we examine transgender youth’s experience of school harassment, school strategies implemented to reduce harassment, the protective role of supportive school personnel, and individual responses to harassment, including dropping out and changing schools. In both studies, we found that school harassment due to transgender identity was pervasive, and this harassment was negatively associated with feelings of safety. When schools took action to reduce harassment, students reported greater connections to school personnel. Those connections were associated with greater feelings of safety. The indirect effects of school strategies to reduce harassment on feelings of safety through connection to adults were also significant. Focus group data illuminate specific processes schools can engage in to benefit youth, and how the youth experience those interventions.

Charles R. Anderson

Papers

School climate for transgender youth: a mixed method investigation of student experiences and school responses.