Linking inclusive school practices and mental health in sexual and gender minority youth in Europe.

Sexual and gender minority (SGM) youth often face stressors such as stigma and discrimination, leading to high rates of depression, anxiety, and suicidal ideation. There is a need to identify effective school practices across different countries to reduce these minority stressors and the resulting mental health disparities. A total of 17,733 SGM high school students (aged 14+) across 13 European countries completed an online survey between September 2020 and January 2022. Participants reported on school inclusivity practices (i.e., inclusive sex education, SGM representation in classroom, and teacher inclusivity), minority stressors (i.e., perceived unsafety at school, experiences of bias-based bullying, and internalized stigma) and mental health (i.e., depression, anxiety, and suicidal ideation). SGM-inclusive sex education and teacher inclusiveness were associated with lower odds of depression, anxiety, and suicidal ideation. A positive representation of SGM issues in classrooms was associated with low odds of depression and suicidal ideation, whereas negative representation was associated with increased odds of depression, anxiety, and suicidal ideation. The associations between such practices and the mental health outcomes were partially mediated by perceived unsafety at school, experiences of bias-based bullying, and internalized stigma. Across European countries, incorporating positive representations of LGBTQI + topics in the classroom, providing inclusive sex education, and fostering inclusive attitudes and behaviors among teachers can create a more supportive and affirming educational environment for SGM youth. By addressing issues of perceived unsafety, bias-based bullying, and internalized stigma, these practices can play a critical role in reducing mental health disparities and promoting well-being among SGM students.