physical, and sexual abuse. These experiences are related to increased substance use (see below), mental health problems, and sexual risk-taking behavior (Birkett et al., 2009).

School-based harassment, bullying, and peer victimization are the most common topics in the literature on LGB youth. This emphasis may be due to the role of schools in child and adolescent socialization and development and the increasing focus over the past 20 years on schools as a primary site of conflict, victimization, and activism for young people who are known or perceived to be LGBT.

School victimization based on known or perceived sexual orientation and gender identity has been documented consistently in studies of LGB and, more recently, transgender adolescents. A community-based study of LGB youth aged 21 or younger (n = 350) (D’Augelli et al., 2002) found that school-based victimization was widespread for LGB youth and that an association existed between this victimization and mental health and posttraumatic stress symptoms. The study results showed that earlier recognition of same-sex feelings, self-identification as LGB, and disclosure of sexual orientation were correlated with increased high school victimization. Similarly, youth who were open about their sexual orientation or exhibited gender-atypical behavior were targets for victimization. Likewise, a series of community school climate surveys conducted since 1999 has documented extensive verbal and physical harassment and discrimination among LGBT students in schools (Kosciw et al., 2007, 2008).

Population-based surveys of high school students have shown that those with same-sex sexual experience (DuRant et al., 1998; Faulkner and Cranston, 1998; Robin et al., 2002) and those who identify as LGB (Garofalo et al., 1998) are more likely than their heterosexual peers to be threatened or injured with a weapon at school and to skip school because they feel unsafe. (Few population-based studies have assessed risk factors affecting the health of LGBT youth beyond violence. Those that have [Garofalo et al., 1998; O’Shaughnessy et al., 2004] have found significantly higher rates of health problems among LGB youth compared with their heterosexual peers.)

Concerns about their safety have consequences for the academic achievement of LGBT youth. O’Shaughnessy and colleagues (2004) examined data from the 2002 California Healthy Kids Survey (n = 237,544) and the 2003 Preventing School Harassment Survey (n = 634) and found that, compared with other students, LGBT students and students perceived to be sexual minorities were more likely to report low grades, to miss school because they felt unsafe, and to report less support from teachers and other adults. Similarly, using data from the 1995 wave of the National Longitudinal Study of Adolescent Health, Russell and colleagues (2001) found that, compared with heterosexual girls, sexual-minority girls as identified

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