Supporting Delaware’s LGBT+ Youth

National Coming Out Day continues to be a reminder that LGBTQ+ individuals make a brave decision to disclose their identities to family, friends and community members. Many LGBTQ+ people experience mental health symptoms due to ongoing discrimination, and Delaware adolescents are especially at risk.

In one of the first studies of its kind to use state-level data collected after the COVID-19 pandemic-when mental health challenges among youth were acutely severe-University of Delaware Assistant Professor Eric Layland and his UD co-authors August X. Wei, Natalie M. Maurer, Rochelle Brittingham and Ronet Bachman examined the mental health symptoms and underage substance use among more than 17,000 Delaware adolescents with data from the 2022 to 2024 Delaware School Surveys. They found that approximately one in every four students identified as LGBT+ and that rates of lifetime mental health symptoms and underage substance use were substantially elevated among LGBT+ youth.

"The study showed us that by eighth grade when most adolescents are only 13 or 14 years old, LGBT+ youth are already using alcohol and other drugs at higher rates than their peers," said Eric Layland, who specializes in LGBTQ+ development and affirmative interventions in the College of Education and Human Development's (CEHD) Department of Human Development and Family Sciences. "Unfortunately, around 50% of adolescents in Delaware were reporting current mental health challenges, and alarmingly, these rates were at or above 75% for LGBT+ youth."

Elevated risks for LGBT+ youth

Through the state-administered Delaware School Surveys, eighth and eleventh grade students (ages 12 to 17) in participating public, private, charter and alternative schools were asked about their gender identity, sexual orientation, mental health symptoms and substance use. For example, the survey asked students if they ever felt "sad, empty, hopeless, angry or anxious" and to indicate how often they experienced these feelings over the past two weeks. Similarly, the survey asked students to report how often they drank alcohol, smoked e-cigarettes or vaped, used marajuna or took prescription drugs without a prescription or differently from prescribed.

Among cisgender, heterosexual youth, Layland and his team found alarming rates of mental health symptoms. Half of this group reported feelings of anxiety in the two weeks before taking the survey. But the rates of psychological distress were even higher among LGBT+ youth, with 75% to 80% of these students experiencing anxiety at the time of the survey. In fact, Layland and his team found that the rates of lifetime mental health symptoms and underage substance use were elevated among LGBT+ youth for every health outcome in comparison to their cisgender, heterosexual peers.

For example, LGBT+ eighth graders were:

• 269% more likely to report psychological distress,
• 276% more likely to report anxiety,
• 91% more likely to report drinking,
• 141% more likely to report cigarette smoking,
• 121% more likely to report vaping,
• 98% more likely to report marijuana use, and
• 86% more likely to report prescription drug misuse.

Similarly, LGBT+ eleventh graders were:

• 228% more likely to report psychological distress,
• 240% more likely to report anxiety,
• 33% more likely to report drinking,
• 71% more likely to report cigarette smoking,
• 51% more likely to report vaping,
• 57% to report marijuana use, and
• 70% more likely to report prescription drug misuse.

"Adolescence is a time when spikes in mental health symptoms and early experiences with alcohol and drugs are common, but what we find especially concerning is the evidence that these high levels of mental health symptoms and behaviors are so widespread for LGBT+ youth," Layland said. "The most common explanation is the extra stress that LGBT+ youth navigate and the real or expected rejection related to their identities."

Schools as sites for support

While these results are distressing, Layland and his co-author note that Delaware schools can be important sites of support for LGBT+ youth. Many intervention studies have shown that schools can effectively reduce these mental health burdens especially when they take a "whole school approach" in challenging the discrimination and marginalization of LGBT+ youth.

When schools adopt this whole-school approach-implementing inclusive policies and curricula, training staff to serve as active allies and fostering a supportive school climate through everyday interactions-they send a powerful message to LGBTQ+ students that they are valued and safe," said Brittany Zakszeski, who specializes in school psychology in CEHD's School of Education. "That sense of belonging can significantly buffer against the mental health risks these youth so often face."

Beyond changes at the school or district levels, Layland also encourages policymakers to consider policy changes that would help protect LGBT+ students. Although Delaware has some policies in place to protect the well-being of LGBT+ youth, it is ranked lower than neighboring states in school- and youth-based policies protecting LGBT+ students. For example, Delaware does not have a state-level policy that includes sexual orientation and gender identity in anti-bullying laws and does not require state school curriculum to be LGBT+ inclusive. States with more policies that protect LGBT+ youth rights and fewer policies that restrict LGBT+ youth rights tend to exhibit better youth mental health outcomes.

State-level policies that prohibit LGBT+ bullying or regulate inclusive curriculum are important, but as Layland reminds us, they are not the only solution.

"School and district level policies and programs can also have a meaningful impact," Layland said. "School-based Gender and Sexuality Alliances provide a social resource with ties to mental health, sense of safety, belonging and school attendance. Mentoring relationships--including with teachers and school staff--can also provide LGBT+ youth with skills for navigating discrimination and finding hope for the future."

To learn more about CEHD research on the social determinants of health, visit its research page.