Population-based survey data from 10 state and nine urban school districts found that an average of 1.8% of high school students identify as transgender. Transgender students were more likely than were cisgender students to report violence victimization, substance use, and suicide risk, and, although generally more likely to report sexual risk behaviors, were also more likely to report having been tested for human immunodeficiency virus.

Esbian, gay, and bisexual youths experience more violence victimization and report more suicide risk behaviors than heterosexual youths.

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) adolescents face well-documented health disparities in suicide risk, substance use, and sexual health. These disparities are known to stem, in part, from stigma directed toward LGBTQ youth in the form of minority stressors such as violence, discrimination, and harassment. Given the proportion of time that LGBTQ students spend in school, schools provide a critical context within which protective factors may be developed and leveraged to improve the health and well-being of these populations. This article provides a summary of key findings from a discussion among researchers, practitioners, and community members who participated in “The State of LGBTQ Youth Health and Wellbeing: Strengthening Schools and Families to Build Resilience,” a public symposium held in June 2017. We detail emerging science on and future priorities for school-based research with LGBTQ youth which were identified by attendees at this meeting, with a particular focus on intersectionality, supportive adults in schools, and in-school programs. We call for more school-based research on priority gaps such as how LGBTQ students' intersecting identities affect their in-school experiences, how to design professional development programs that cultivate supportive educators, and how to leverage gay–straight alliances/gender and sexuality alliances as sites of health programming for LGBTQ students.

Youths identifying as lesbian, gay, bisexual, or another nonheterosexual identity report more violence victimization, substance use, and suicide risk than do heterosexual youths.

Adolescents’ health behaviors and experiences contribute to many outcomes, including risks for HIV, other sexually transmitted diseases (STDs), and unintended pregnancy. Public health interventions and approaches addressing risk behaviors or experiences in adolescence have the potential for wide-reaching impacts on sexual health and other related outcomes across the lifespan, and schools are a critical venue for such interventions. This paper describes a school-based program model developed by the Center for Disease Control and Prevention’s (CDC) Division of Adolescent and School Health (DASH) for preventing HIV/STDs, unintended pregnancy, and related health risk behaviors and experiences among middle and high school students. This includes a summary of the theoretical and evidence base that inform the model, and a description of the model’s activities, organized into three key strategies (sexual health education, sexual health services, and safe and supportive environments) and across three cross-cutting domains (strengthening staff capacity, increasing student access to programs and services, and engaging parent and community partners). The paper also outlines implications for adolescent health professionals and organizations working across schools, clinics, and communities, to address and promote adolescent sexual health and well-being.