Mental Health Advocacy

School-based mental health providers – counselors, psychologists, and social workers – can often be some of the first adults that young people connect with regarding their LGBTQ identity. In fact, in the GLSEN’s National School Climate Survey shows that over half of LGBTQ students reported that they would feel most comfortable talking with school based mental health professionals about LGBTQ issues. Unfortunately, a recent study shows that 76% of school mental health professionals received little to no preparation on working with LGBTQ youth (Supporting Safe and Healthy Schools). 

GLSEN recommends the following best practices to support LGBTQ students’ mental health:

  1. Advocate with other teachers and administrators

LGBTQ students need to know that there is at least one adult who is supportive of them. This is, very importantly, a “show don’t tell” version of allyship. It’s important that this be done through actions and advocacy. Here are several suggestions of visible actions that you can take to show LGBTQ support:

  1. Have pronoun buttons available in an obvious location in your office. Also, wearing your own pronoun button models this practice and can invite students to share theirs. 
  2. Display LGBTQ-affirming materials and signs while you work with youth. This can be done with books, safe space stickers, or posters to promote an inclusive space, or with notebooks or lanyards if you travel between spaces or schools.
  3. Support or start a GSA (Gender & Sexuality Alliance) group. Use our 10 Tips for GSA Advisors to get started. 
  4. If a teacher or administrator is using anti-LGBTQ language (whether in front of students or not), respectfully but firmly let them know that the language they are using is inappropriate.
  5. If an adult or student in the school is using the wrong name or pronouns for a student who is out publicly, correct them. Don’t make a big deal of it, as that can draw uncomfortable attention to the student. Instead, simply say the correct name or pronoun and then let the person continue speaking.
  6. Find out from your school regarding their policies regarding bathroom use, and advocate strongly that your students can use the bathroom that matches their identity, or for them to be able to use the gender-neutral staff bathroom. Refer to and share GLSEN’s Trans Model Policy for support.
  7. For school trips and overnights, review the policies around rooming to be more gender inclusive and safe for students.
  1. Explore LGBTQ-Community Resources

Take some time to do research in your own area regarding therapists and clinics that are LGBTQ-friendly, and compile a list of referrals for students who are looking for therapy outside of school. Follow up with students who have outside experiences with therapists and clinics and ask about their experiences. Keep track and note if the students had positive experiences, and continue to refer students to outside resources and supports that have received positive reviews by your students. Be mindful of student identities and ensure that queer and trans youth of color find outside supports and resouces that feel affirming to them. Granted, depending on where you are, those resources may be slim, but there are multiple vetted online support groups as well as national helplines for young people to be able to get support outside of school. 

This need for referrals holds particularly true if you only have time to meet with students infrequently, or for short periods of time. Forgive yourself if you can’t be “The Person” that this student goes to for support regarding their LGBTQ identity. It is an honorable thing to recognize your limits. You can still have a positive impact, even if your primary role is connecting that student to an outside provider and being a safe space in the school environment for the time that you are able to give them.

  1. Be transparent with your students about what you can (or cannot) hold confidential

It is crucial when working with LGBTQ youth to be forthcoming regarding the obligations of mental health providers with regards to confidentiality. Every school is different in terms of what is expected of their counselors in regards to sharing what a student has shared, be it with teachers, interns, administrators, or the student’s family members. In addition, it is important to be aware of how note-taking may happen after you see a student and of who might have legal access to those notes.

Unless safety is a concern in any way, it is imperative for counselors not to share any information about a student’s sexual orientation, gender identity, or curiosity and exploration of gender expression., It is so important for young people to have a safe space, and have access to adults who value their privacy and respect their need to take their time with self-discovery. Remember that public school students have a right to privacy. If this confidentiality is not possible due to the particular expectations in your school, you need to make that clear to any student who might want to share personal information with you regarding anything along the LGBTQ spectrum.

As LGBTQ youth are more likely to experience mental health concerns regarding suicide (YRBS, Trevor Project), be very transparent with your students that you will have to break confidentiality if you are concerned about their safety either due to potential self-harm or harm from someone else. Depending on the situation, even with this necessary break of confidentiality, you may be able to keep the person’s LGBTQ identity out of the conversation if the student wants to keep that part of their identity private for the time being.

  1. Follow their lead with their coming out path

When we’re working in a school setting, mental health providers often have dual relationships with students: privately in offices as well as other settings, such as in a group session, in mediation, in an Individualized Education Program (IEP) meeting, or even in classrooms. This can make it feel tricky to know how to keep confidentiality for a student while also respecting what they may have shared with you about their identity.

Ask students whether the names and pronouns they claim can be used with other teachers, with parents/families, and in front of the class/group.For example, let’s say a student comes out as being a transgender girl. Ask her how she would like for you to address her in public settings. It’s possible that she may, for now, ask you to continue to use her legal name or “deadname” and he/him pronouns in public, as she does not yet want others to know. When you are meeting with her alone, use her chosen name and her chosen pronouns. Furthermore, offer to help her facilitate conversations with her parents and/or the administration should she decide she is ready to come out publicly. Share GLSEN’s Coming Out Resource to help the student consider different aspects of this ongoing process.

There are myriad factors that play into a young person’s decision to come out or not, and potentially a student may feel that due to their individual circumstances it may not be safe for them to be out. Allow them to safely explore their thoughts and feelings about their gender or sexual identity with you, without the pressure of feeling obligated to have to take everything to the next step of coming out. Be mindful that coming out is a multi-step process, and use careful word choice to not pressure the young people you’re working with in any way to share parts of their identity with anyone before they are ready. For more information on supporting students in their coming out process, use GLSEN’s Safe Space Kit. 

  1. Remember that we will never be experts

In order to approach and truly support LGBTQ youth, we need to understand that it is a continual learning process. Language and terminology is ever-changing, and if our approach is to master this language we will always be disappointed as it shifts. We have to allow our students to correct us, and not become defensive if we have made assumptions that are challenged. Instead, it’s best to adopt an attitude of excitement and affirmation when learning new identity terms, or what these terms mean to a particular person. Years of experience and even our own identities can’t make us experts on a particular student’s experience. We have to do our own continuing education to learn how the language is changing, and we have to do it enthusiastically. Remember that in this situation, the student you are working with is the expert and teacher, and our role is to listen and learn from them. 

What makes someone truly a professional is confidence in the acceptance of being wrong, and a genuine willingness to learn. You are here, reading this, which means that you already are on a solid path toward being the person that an LGBTQ student may need. 

Adapted from a blog by Kit McCann, LMFT, they/them, is a queer/gender therapist.