Workplace Harassment, Cyber Incivility, and Climate in Academic Medicine.

Importance: The culture of academic medicine may foster mistreatment that disproportionately affects individuals who have been marginalized within a given society (minoritized groups) and compromises workforce vitality. Existing research has been limited by a lack of comprehensive, validated measures, low response rates, and narrow samples as well as comparisons limited to the binary gender categories of male or female assigned at birth (cisgender). Objective: To evaluate academic medical culture, faculty mental health, and their relationship. Design, Setting, and Participants: A total of 830 faculty members in the US received National Institutes of Health career development awards from 2006-2009, remained in academia, and responded to a 2021 survey that had a response rate of 64%. Experiences were compared by gender, race and ethnicity (using the categories of Asian, underrepresented in medicine [defined as race and ethnicity other than Asian or non-Hispanic White], and White), and lesbian, gay, bisexual, transgender, queer (LGBTQ+) status. Multivariable models were used to explore associations between experiences of culture (climate, sexual harassment, and cyber incivility) with mental health. Exposures: Minoritized identity based on gender, race and ethnicity, and LGBTQ+ status. Main Outcomes and Measures: Three aspects of culture were measured as the primary outcomes: organizational climate, sexual harassment, and cyber incivility using previously developed instruments. The 5-item Mental Health Inventory (scored from 0 to 100 points with higher values indicating better mental health) was used to evaluate the secondary outcome of mental health. Results: Of the 830 faculty members, there were 422 men, 385 women, 2 in nonbinary gender category, and 21 who did not identify gender; there were 169 Asian respondents, 66 respondents underrepresented in medicine, 572 White respondents, and 23 respondents who did not report their race and ethnicity; and there were 774 respondents who identified as cisgender and heterosexual, 31 as having LGBTQ+ status, and 25 who did not identify status. Women rated general climate (5-point scale) more negatively than men (mean, 3.68 [95% CI, 3.59-3.77] vs 3.96 [95% CI, 3.88-4.04], respectively, P < .001). Diversity climate ratings differed significantly by gender (mean, 3.72 [95% CI, 3.64-3.80] for women vs 4.16 [95% CI, 4.09-4.23] for men, P < .001) and by race and ethnicity (mean, 4.0 [95% CI, 3.88-4.12] for Asian respondents, 3.71 [95% CI, 3.50-3.92] for respondents underrepresented in medicine, and 3.96 [95% CI, 3.90-4.02] for White respondents, P = .04). Women were more likely than men to report experiencing gender harassment (sexist remarks and crude behaviors) (71.9% [95% CI, 67.1%-76.4%] vs 44.9% [95% CI, 40.1%-49.8%], respectively, P < .001). Respondents with LGBTQ+ status were more likely to report experiencing sexual harassment than cisgender and heterosexual respondents when using social media professionally (13.3% [95% CI, 1.7%-40.5%] vs 2.5% [95% CI, 1.2%-4.6%], respectively, P = .01). Each of the 3 aspects of culture and gender were significantly associated with the secondary outcome of mental health in the multivariable analysis. Conclusions and Relevance: High rates of sexual harassment, cyber incivility, and negative organizational climate exist in academic medicine, disproportionately affecting minoritized groups and affecting mental health. Ongoing efforts to transform culture are necessary.

Expectativas y realización profesional en Cirugía General y subespecialidades quirúrgicas: situación actual de los cirujanos jóvenes en Córdoba / Expectations and professional fulfillment in general surgery and surgical sub-specialties: current situation of young surgeons in Cordoba

RESUMEN Antecedentes: en la Argentina, la especialidad Cirugía General se encuentra en crisis y esta situación alarmante se halla vinculada a las malas condiciones laborales del cirujano general. Objetivo: describir la percepción que el cirujano joven tiene al terminar su programa de formación, en relación con su perspectiva laboral, actividad quirúrgica y académica. Material y métodos: estudio transversal basado en una encuesta dirigida a cirujanos jóvenes en Córdoba, Argentina. Resultados: participaron 53 encuestados. El 58% eran hombres y la mediana de edad fue 32 años. El 72% ejercía Cirugía General y el 55% trabajaba en el sector privado. El 34% pertenecía a la Asociación de Cirugía de Córdoba y el 23% a la Asociación Argentina de Cirugía. En cuanto a la experiencia profesional, el 53,1% eran cirujanos junior y el 64% eran competentes para realizar procedimientos de baja o mediana complejidad. En relación con la perspectiva laboral, el 89% consideró que el cirujano joven no consigue salida laboral rápida y el 96,2% refirió que sus prácticas no eran bien remuneradas. Respecto de la calidad de vida personal y laboral, el 57% manifestó frustración e incertidumbre económica. En cuanto a las cirujanas, la tasa de inequidades de género y hostigamiento sexual en el ámbito laboral fue del 73% y 50%, respectivamente. Conclusión: encontramos la percepción de un bajo nivel de competencia para las cirugías de mayor complejidad y una baja tasa de adherencia a sociedades quirúrgicas. Debido a la escasa oferta laboral existe gran frustración e incertidumbre económica. Actualmente, predomina y persiste el maltrato y hostigamiento hacia las cirujanas.

ABSTRACT Background: In Argentina, the specialty of general surgery is in crisis, and this alarming situation is associated with the poor working conditions of general surgeons. Objective: The aim of this study is to describe the perception of young surgeons at the end of their training program, in relation to their job prospects, surgical and academic activity. Material and methods: We conducted a cross-sectional study based on a survey responded by young surgeons in Cordoba, Argentina. Results: The survey was responded by 53 young surgeons; 58% were men and median age was 32 years. Seventy-two percent practiced general surgery and 55% worked in the private setting. Thirtyfour percent were members of Asociación de Cirugía de Córdoba and 23% belonged to Asociación Argentina de Cirugía. As for professional experience, 53.1% were junior surgeons and 64% were capable of performing low or medium complexity procedures. Eighty-nine percent considered that young surgeons do not get a job quickly and 96.2% reported that they were not well paid for their practice. When asked about their personal and professional quality of life, 57% expressed frustration and economic uncertainty. Among women surgeons, 73% reported gender inequities and 50% reported sexual harassment in the workplace. Conclusion: Young surgeons perceived they had low level of competencies for high complexity surgical procedures and reported low rate of membership in surgical societies. Most of them feel frustrated due to scarce job opportunities and expressed economic uncertainty. Nowadays, abuse and harassment of women surgeons still prevails and persists.

Sexual harassment by peers in Chilean schools.

BACKGROUND: Although a significant amount of literature has explored peer sexual harassment in higher education, little is known about peer sexual harassment in primary and middle school. Among existing studies, most have examined individual student characteristics that predict peer sexual harassment without considering the importance of the classroom and school context, which may prevent or promote such harassment. OBJECTIVE: The purpose of this study was to identify individual and school-related factors predicting sexual harassment victimization. METHODS: A sample of 17,364 Chilean students from Grades 5 through 8 in 405 schools with low socioeconomic status answered instruments concerning peer sexual harassment, other types of peer victimization and discrimination, and perceptions of classroom and school climate and norms against sexual harassment. Data were analyzed through hierarchical multivariate regression. RESULTS: Experiences of being sexual harassed by other students were reported by 13.5 % of students, with higher frequencies in male students, students from Grades 5 and 6, and students with lower individual socioeconomic status. School-related experiences of being discriminated against due to sexual orientation, ethnic origin, and disability were the strongest predictors of sexual harassment victimization. CONCLUSION: We discuss how peer sexual harassment might be understood as a consequence of peer social discrimination based on sexism, racism, and ableism. We also discuss the need to provide inclusive school climate policies that allow all students to feel safe and included.

Understanding, Experience and Response to Sexual Harassment among the Female Students: A Mixed Method Study.

BACKGROUND: Sexual harassment has received global attention and has been recognized as a public health problem with increased physical and mental health risks among the victims. This study attempted to assess understanding, experience, response and effect of sexual harassment among the secondary school female students in Kathmandu, Nepal. METHODS: It was a mixed method study conducted among 441 secondary level female students. In quantitative component, a structured questionnaire was used to collect information relating to socio-demographic characteristics, and understanding, experience, response and effect of sexual harassment from 441 participants from three clusters (schools) of Tokha Municipality, Kathmandu. For qualitative method, two focused group discussions were conducted to assess the understanding of and response to sexual harassment. Quantitative and qualitative data were analyzed using Chi square test and thematic analysis method respectively. RESULTS: Around 76% of the participants had experienced some forms of sexual harassment in their life. Sexual harassment was significantly associated with religion and parental occupation. Majority of participants who faced sexual harassment reported that the perpetrators were strangers and they either ignored it or did nothing at the time of events. School, roads and public places were the most common settings where participants encountered sexual harassment. CONCLUSIONS: Sexual harassment is prevalent among female secondary students in Kathmandu. However, they lacked a clear understating of and ways to respond to sexual harassment. Raising awareness to recognize and respond to different forms of harassment and to change the victim-blaming attitudes can be a potential strategy for tackling the problem in Nepalese society.

Gender Differences in Veterans' Perceptions of Harassment on Veterans Health Administration Grounds.

PURPOSE: Stranger harassment at Veterans Health Administration (VA) facilities is prevalent, affecting one in four women veteran VA primary care users. Harassment interferes with health care quality and may result in veterans forgoing or delaying needed care. To better understand this phenomenon, gender-stratified discussion groups were held with men and women veterans. This article examines gender differences in veterans' perceptions and experiences of harassment on VA grounds. METHODS: We conducted a total of 15 discussion groups at four VA medical centers, eight with men (n = 57) and seven with women (n = 38). Transcripts were coded using the constant comparative method and analyzed for overarching themes. RESULTS: Awareness of harassment was not uniformly high among participants. Although women voiced clear understandings and experiences of specific behaviors constituting harassment (e.g., cat-calls, sexual comments), many men expressed confusion about how to differentiate between harassment, "harmless flirting," and general friendliness; they were unsure which behaviors "cross a line." Furthermore, men placed the onus on women for setting boundaries, whereas women indicated it was not their responsibility to "train" men about acceptable behavior. Men and women agreed that VA staff hold primary responsibility for preventing and managing harassment. CONCLUSIONS: Substantive gender differences in understandings of harassment exist among veteran VA users. To minimize harassment, veterans recommend education of men veteran VA users, and staff-oriented trainings. Privacy, safety, dignity, and security are the cornerstones of women veterans' health care, per VA policy. Harassment undermines these standards, impeding women's access to VA care and compromising both their health outcomes and health care experiences. Understanding harassment through a gendered lens is a critical step in designing comprehensive initiatives that respond to diverse viewpoints and experiences.

Health disparities between genderqueer, transgender, and cisgender individuals: An extension of minority stress theory.

Interpersonal, social, and structural stressors have been identified as key elements that explain health disparities between transgender and cisgender individuals. However, most of this research has focused on binary transgender individuals or has not differentiated between binary and nonbinary individuals; little research has examined the experiences of minority stress or health of those identifying outside the gender binary. Guided by intersectionality and drawing on a sample of 3,568 college students from the Center for Collegiate Mental Health's 2012-2016 database-of whom 892 identified outside the gender binary-we conducted analyses of demographic and outcome measures administered in participants' 1st counseling appointment, examining differences between cisgender, transgender, and genderqueer individuals. We found that genderqueer individuals were harassed, sexually abused, and subjected to traumatic events at higher rates than were either cisgender or binary transgender individuals, with approximately 50% of genderqueer individuals reporting one of these experiences. We found that genderqueer individuals experienced more anxiety, depression, psychological distress, and eating concerns than did binary transgender and cisgender individuals and more social anxiety than did cisgender individuals. Genderqueer individuals more frequently reported self-harm and suicidality than did any other group, with approximately 2/3 of participants' having contemplated and nearly 50% making a suicide attempt. We extend current theorizing about minority stress (Hendricks & Testa, 2012; Meyer, 2003) to include genderqueer individuals and delineate several structural aspects of genderqueer experiences that may be responsible for these trends, including others' lack of knowledge about genderqueer experiences and pronouns, poor access to legal and medical resources, and systemic discrimination. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Poly-Victimization and Peer Harassment Involvement in a Technological World.

This article explores the ways poly-victimized youth (those experiencing multiple different types of victimization over the course of 1 year) use technology to interact with peers. Particular attention is given to the peer harassment victimization and perpetration experiences of poly-victimized youth compared with less victimized and non-victimized youth-both overall and through technology. Data were collected as part of the Technology Harassment Victimization (THV) study; a national survey of 791 youth, ages 10 to 20 across the United States. Study results document the heightened risks that poly-victimized youth experience when interacting with peers. Low and high poly-victimized youth were both at significantly greater risk of being dual victims and perpetrators of peer harassment when compared with non-victimized youth even after taking into account other potentially explanatory factors. This was not found to be the case for less victimized youth. This was true for high poly-victims and technology-involved harassment risk as well. There were indications that poly-victimized youth were interacting with peers in more intense and risky ways in general using new technology. The increase in attention to poly-victimization in recent years has importantly identified the detrimental role that experiencing different forms of victimization have on youth. This study not only adds to that literature but suggests that there is an opportunity to interrupt additional victimization by understanding how poly-victimized youth interact with peers before and during adolescence. Although preliminary, the differences in technology use by poly-victimized youth versus others suggest that more information is needed to understand how they are relating to peers in both positive and risky ways in this environment.

A non-randomised pragmatic trial of a school-based group cognitive-behavioural programme for preventing depression in girls.

The aim of this study was to investigate the effectiveness of the DISA-programme in preventing depressive symptoms (DS) in adolescent girls, as implemented in a real-world school setting, accounting for baseline socioeconomic and psychosocial factors, and to investigate whether the effects of these baseline variables on DS differed between intervention participants and non-participants. In this non-randomised pragmatic trial, an electronic questionnaire was disseminated in 2011 (baseline) and 2012 (follow-up) in schools in one municipality in northern Sweden. Pupils (total n=275; intervention participants identified in the questionnaire: n=53; non-participants: n=222) were 14-15 years old at baseline. The groups were compared by means of SEM. DISA could not predict differences in DS at follow-up in this real-life setting. In the overall sample, sexual harassment victimisation (SH) at baseline was associated with DS at follow-up and the estimate for SH increased in the DISA-participants compared to the overall sample.

Increased Health Care Utilization and Costs Among Veterans With a Positive Screen for Military Sexual Trauma.

BACKGROUND: The effects of sexual trauma on long-term health care utilization and costs are not well understood due to infrequent documentation of sexual trauma history in health care systems. The Veteran's Health Administration provides a unique opportunity to address this constraint as sexual trauma is actively screened for as part of routine care. METHODS: We used a retrospective cohort design to analyze Veteran's Health Administration mental health and medical service utilization and costs as a function of a positive screen for exposure to military sexual trauma (MST) among Veterans of recent conflicts in Iraq and Afghanistan. We computed adjusted 5-year estimates of overall utilization and costs, and utilization and costs determined not to be related to MST. RESULTS: The cohort included 426,223 men and 59,611 women. A positive MST screen was associated with 50% higher health care utilization and costs relative to a negative screen. Overall, a positive relative to negative MST screen was associated with a 5-year incremental difference of 34.6 encounters and $10,734 among women, and 33.5 encounters and $11,484 among men. After accounting for MST-related treatment, positive MST screen was associated with 11.9 encounters and $4803 among women, and 19.5 encounters and $8001 among men. CONCLUSIONS: Results demonstrate significant and consistent differences in health care utilization and costs between Veterans with a positive relative to negative MST screen. Even after accounting for MST-related care, a positive screen was associated with significantly higher utilization and costs. MST-related needs may be more readily recognized in women relative to men.

'Even though a man takes the major role, he has no right to abuse': future male leaders' views on gender-based violence in Sri Lanka.

BACKGROUND: Distinct gender roles influence gender inequality and build the foundation for gender-based violence. Violence against women is a major public health problem in all societies, and a violation of human rights. Prevalence surveys on gender-based violence have been published from Sri Lanka, but qualitative studies on men's perceptions are lacking. OBJECTIVES: The aim of this study was to explore young educated Sri Lankan men's perceptions of violence against women. METHODS: Seven focus-group discussions were held. Men at the end of their university studies were purposefully selected. A topic guide was used, covering various scenarios of violence against women. Qualitative content analysis was carried out. RESULTS: Four categories were developed through the analytic process: fixed gender roles - patriarchal values are accepted in society, female mobility control, and slowly changing attitudes; violence not accepted but still exists - sexual harassment exists everywhere, different laws for different people, female tolerance of violence, and men's right to punish; multiple factors cause violence - alcohol, violent behavior is inherited, violence culturally accepted, low education, and lack of communication; and prevention of violence against women - both parents must engage and socialize girls and boys equally, life skills education, premarital counselling, working places value clarification, and more women in politics and boards are suggested. CONCLUSIONS: Medical and management students, possible future male leaders of the country, have suggestions of prevention strategies in life skills to reduce gender-based violence and to increase knowledge of health consequences with the aim of changing attitudes.

Determinants of Intimate Partner Violence in Europe: The Role of Socioeconomic Status, Inequality, and Partner Behavior.

This article presents an analysis of determinants of intimate partner violence (IPV) in the European Union (EU). Based on an EU-wide survey with 42,000 women that examined women's diverse experiences of violence-from violence by strangers to sexual harassment-this article looks specifically at the survey's research with respect to the occurrence of IPV in current partnerships. The analysis explores selected determinants of IPV by focusing on specific indicators in relation to a couple's socioeconomic status, and analyzes inequalities in the sense of unequal distribution of resources. In addition, a partner's behavior outside a relationship, as captured through specific survey questions, is looked at as providing additional evidence of factors that strongly indicate IPV. The results of the article show that, when averaging across the EU Member States, among couples with lower socioeconomic status, there is higher prevalence of violence. In particular, women reporting problems with their household income also report higher rates of IPV. Furthermore, women suffer more often from violence if they do not have an equal say about household income. While reported inequality in income between partners, in the sense of a partner earning more or less than a woman, does not show a consistent result, a woman who reports having less say about the family income is more likely to experience IPV. This result points to the importance of "norm" related inequality compared with actual inequality with respect to IPV, which holds true across all EU Member States. Finally, a partner's behavior-in terms of being violent outside a relationship and frequently getting drunk-shows a strong influence on women reporting incidents of IPV across all countries in the survey.

Breaking the Silence: Sexual Harassment of Mexican Women Farmworkers.

The purpose of this study was to understand Mexican women farmworkers' perceptions of workplace sexual harassment, its related factors and consequences, and potential points of intervention. This community-based participatory research study conducted focus groups with 20 women farmworkers in rural Washington. Four coders analyzed and gleaned interpretations from verbatim transcripts. Three main themes were identified. It was learned that women farmworkers: (1) frequently experienced both quid pro quo and hostile work environment forms of sexual harassment; (2) faced employment and health consequences due to the harassment; and (3) felt that both individual- and industry-level changes could prevent the harassment. Based on these findings, the authors identified three sets of risk factors contributing to workplace sexual harassment and recommend using a multilevel approach to prevent future harassment in the agriculture industry.

[Violence and discrimination in the workplace. The effects on health and setting-related approaches to prevention and rehabilitation]. / Gewalt und Diskriminierung am Arbeitsplatz. Gesundheitliche Folgen und settingbezogene Ansätze zur Prävention und Rehabilitation.

Violence in the workplace is a widespread problem that manifests itself in very different forms. The consequences for victims and companies are equally diverse. Sexual harassment is a special form of violence at the workplace. Violence may come from external perpetrators (attacks on cashiers) or from persons inside a company or establishment (colleagues, patients, people in care). Statutory accident insurance institutions in Germany (UV, "Unfallversicherungsträger") receive approximately 16,000 occupational injury reports per year that resulted from violence and led to extended incapacity to work. The numbers are increasing steadily. Particularly affected by violence are people working in healthcare and social welfare. Both psychological and physical violence can lead to severe disorders such as post-traumatic stress disorder (PTSD). To avoid violence, technical, organisational, and personal protective measures are needed. The training of de-escalation officers in the areas affected can be helpful. For victims of psychological and physical violence in the workplace, the UV offers special psychotherapeutic support and recommends the training of first-aiders.

The Trauma of Sexual Harassment and its Mental Health Consequences Among Nurses.

OBJECTIVE: To determine the prevalence of sexual harassment in nurses and to observe its correlation with negative mental health (depression, anxiety and stress). Further to examine the role of sexual harassment as a predictor of negative mental health in nurses and to explore the differences in the experience of sexual harassment, depression, anxiety and stress between junior and senior nurses. STUDY DESIGN: Cross-sectional descriptive study. PLACE AND DURATION OF STUDY: Public Sector Hospitals in Lahore, from December 2011 to March 2012. METHODOLOGY: Asample of 200 nurses with age range 23 to 46 years was obtained. Assessment tools used in the study were Sexual Harassment Experience Questionnaire (SHEQ) by Kamal, and Depression, Anxiety and Stress Scale (DASS) by Lovibond and Lovibond. RESULTS: Mean age of the nurses was 29.80 ±7.10 years. Among these 63% were married and 37% unmarried. The mean working experience of nurses was 13.7 ±3. 52 years and their mean monthly income was 27820 ±13687.32 rupees. Their working hours ranged from 8 to 16 hours (M = 8.32, SD = 2.12). The mean prevalence of sexual harassment was 71.66 ±19.01. A significant positive correlation of sexual harassment with depression, anxiety, stress and combined effect of them (DASS) was found. Multiple regression analysis showed sexual harassment as significant predictor of depression (ß= 0.47, p < .001), anxiety (ß= 0.43, p < .001) and stress (ß= 0.45, p < .001) in nurses. CONCLUSION: Sexual harassment was found to be a predictor of negative mental health in the form of depression, anxiety and stress in nurses of public hospitals.

The social ecology of girls' bullying practices: exploratory research in two London schools.

This exploratory study adopts a socio-ecological approach to examine the context of school bullying. It asks: (1) what are students' accounts of bullying practices?; (2) how are these enabled and constrained by the school-environment?; (3) how is gender implicated? Qualitative data were collected from girls in two schools in London via focus groups (one in each school; students aged 12-15) and seven semi-structured interviews (in one school; students aged 16-18); and from school policy documents. Our interpretation of girls' accounts, informed by Giddens' structuration theory, suggests that bullying practices were spatially patterned in the schools and often characterised by the regulation of girls' sexuality and sexual-harassment. Repeated acts of aggression were fluid with regard to the bully and victim role, challenging the dominant view of bullying as characterised by consistent disparities in power between individuals. Schools structured bullying behaviour via policies and practices that ignored these forms of abuse and which focused on and may have been complicit in the making of stable 'bully' and 'victim' roles, thus indirectly contributing to the reproduction of unhealthy relationships between students. In terms of gender, traditional gendered and sexual discourses appear to structure the identities of the schools and girls in our study.

"They Talk Like That, But We Keep Working": Sexual Harassment and Sexual Assault Experiences Among Mexican Indigenous Farmworker Women in Oregon.

In order to examine the experiences of sexual harassment and sexual assault among indigenous and non-indigenous Mexican immigrant farmworkers in Oregon's Willamette Valley, a community-academic participatory research partnership initiated a study, which included focus groups, conducted and analyzed by skilled practitioners and researchers. The themes that emerged from the focus groups included direct and indirect effects of sexual harassment and sexual assault on women and risk factors associated with the farmworker workplace environment, and the increased vulnerability of non-Spanish-speaking indigenous women due to low social status, poverty, cultural and linguistic issues, and isolation. Recommendations for prevention and improved services for vulnerable women will be discussed as well as limitations and future research directions.

Unit support protects against sexual harassment and assault among national guard soldiers.

OBJECTIVE: Despite concerns about increased sexual harassment and assault after the 2013 legislation repealing the ban on women in combat, little research has examined military factors that could prevent sexual harassment and assault during deployment. This study examined whether unit support, which reflects the quality of service members' relationships within their unit, protects against sexual harassment and assault during deployment. METHODS: Participants were 1,674 Ohio Army National Guard service members who reported at least one deployment during a telephone survey conducted in 2008 and 2009. Participants completed measures of sexual harassment/assault, unit support, and psychosocial support. Logistic regression was used to model odds of sexual harassment/assault. RESULTS: Approximately 13.2% of men (n = 198) and 43.5% of women (n = 74) reported sexual harassment, and 1.1% of men (n = 17) and 18.8% of women (n = 32) reported sexual assault during their most recent deployment. Greater unit support was associated with decreased odds of sexual harassment and assault. CONCLUSIONS: A substantial proportion of men and women reported sexual harassment/assault. Greater unit support was associated with diminished odds of sexual harassment/assault during deployment. Programming designed to improve unit cohesion has the potential to reduce sexual harassment and assault.

Is there an emotional cost of completing high school? Ecological factors and psychological distress among LGBT homeless youth.

This study explored the nexus of home and school climate on the psychological distress of lesbian, gay, bisexual, and transgender (LGBT) homeless youth, as well as their experiences during high school. Of the LGBT homeless youth (N = 89) surveyed, 39.3% reported not completing high school. Most participants did not seek support from school staff nor did they report attending a school with a Gay-Straight Alliance. Significantly higher levels of psychological distress were found among high school graduates and those reporting LGBT harassment at home; however, harassment experienced at school was not statistically related to psychological distress. Findings are discussed.