‘It’s our job to create a safe environment’: Mark Schuster on the bullying of gay youth

Mark Schuster, MD, PhD, chief of General Pediatrics at Boston Children’s Hospital, led a first-of-its-kind longitudinal study on the bullying of gay, lesbian and bisexual young people.

Fourteen-year-old Kenneth Weishuhn, 15-year-old Jadin Bell and 18-year-old Tyler Clementi were all teenagers who committed suicide after being bullied for being gay. There have been many similar stories reported around the country, but until now, little research has existed to help understand the backdrop to tragic outcomes like these.

A new study, published today in the New England Journal of Medicine and led by Mark Schuster, MD, PhD, chief of General Pediatrics at Boston Children’s Hospital, who is also the William Berenberg Professor of Pediatrics at Harvard Medical School, sheds light on the bullying and victimization experiences of sexual minority youth (that is, youth who are lesbian, gay or bisexual) from elementary school to high school. Bullying is generally defined as the intentional and repeated perpetration of aggression over time by a more powerful person against a less powerful person. The study, the only one on this topic to follow a representative sample of young people in the United States over several years, surveyed 4,268 students in Birmingham, Houston and Los Angeles in fifth grade and again in seventh and tenth grades.

Schuster and his colleagues found that girls and boys who were identified in tenth grade as sexual minorities were more likely than their peers to be bullied or victimized as early as fifth grade, and this pattern continued into high school.

We sat down with Dr. Schuster to discuss this important study and its implications.


What was the most significant finding from the study?

What really stands out is that we found that kids who are classified as sexual minorities in tenth grade are bullied and victimized more than their peers not only in tenth grade but also in fifth and seventh grades. The differences are persistent and striking.

We would think that in fifth grade, most kids don’t recognize themselves or peers as sexual minorities, yet those who will later identify as sexual minorities are already being bullied more than other kids.

How do you explain this finding? How is it that fifth graders who haven’t yet identified as sexual minorities are already being bullied more than other kids?

We don’t yet fully know what’s going on. It’s possible that there are ways in which they are identified by other kids as different. For example, even though fifth graders may not have a clear concept of sexual orientation among their peers, they might be aware that some kids don’t fit the image they’ve learned for how boys and girls are supposed to act. They might think that a boy seems “girlish” or a girl seems “boyish,” and feel that this is a reason to bully another child, especially if they’ve heard adults or peers similarly torment others. Not all kids who are bullied for being different from how kids think someone of their gender should act turn out to be gay, just as not all gay kids are identified by their peers as being gay.

Many gay adults say that they felt like they were different from other kids in elementary school. Some say they didn’t know why, and some say they knew they were gay. Others sensed they were similar to adults they saw being ridiculed—perhaps their father rolled his eyes or held his wrist limp in mockery when a certain man’s name came up in conversation. Whatever made these adults feel different when they were younger—and any fear they had about what it might mean to be different—might also have been noticed by peers.


Why should we be concerned about bullying?

We no longer brush off bullying with a mindset that kids will be kids. Studies have found that bullying has serious short- and long-term consequences, not only physical injury but also anxiety, low self-esteem, depression, suicidal ideation, post-traumatic stress and negative school performance. It has also been found that bullying targeted at sexual minorities has even more severe negative effects.

The American Academy of Pediatrics, the American Medical Association and the American Psychological Association, among others, have all made statements about bullying. They have called on clinicians to take an active role to address bullying among youth and to partner with parents, educators and community organizations in doing so. And almost every state has enacted anti-bullying laws.


You’re a pediatrician in addition to being a researcher. What should pediatricians and other primary care physicians take away from these results?

This is a really important issue in pediatrics. It’s our job as pediatricians to create a safe environment in which kids will be open with us and comfortable talking about their sexuality, or about being confused and unsure about it. We also need to be alert to whether a kid is being bullied—whether a kid is socially isolated, avoiding school, coming home with unexplained cuts and bruises, or experiencing symptoms of anxiety or depression. We have a role to play in educating parents, who can learn to notice if their child is showing evidence of being bullied. We also can support kids, helping them deal with being bullied. And we can help prevent bullying as well.


And what about parents? What can parents learn from this study?

Parents can play a big role in creating an open environment in which kids understand and appreciate the diversity of the world around them, in which kids who are sexual minorities are not afraid of rejection and kids who are not sexual minorities don’t look down on peers who are.

The language we often use as parents can tell our children early on that we expect them to be heterosexual. Parents who want their kids—gay or not—to feel safe and appreciate diversity should be aware of what they say to their kids. If they make snide comments about someone they assume to be gay, their children hear these statements and learn from them. It can be quite damaging to recognize that you are the subject of your parent’s scorn.

Parents also should recognize that their assumptions can send powerful messages. Parents convey expectations for their daughter with “What kind of boy do you want to marry when you grow up?” They can convey a more open message with “If you marry a boy or girl when you grow up, I’ve saved the veil from my wedding in case you want to use it.” It’s similar to the way holiday greetings have changed over time. It used to be common to say Merry Christmas to everyone; now people say Happy Holidays or just Happy New Year when they don’t know people well because they recognize that they are surrounded by people with a variety of religious backgrounds.


This longitudinal study began in 2004. Do you feel the changes in society since then — regarding same-sex marriage, say — have had an impact on the type of bullying you looked at in this study?

In 2004, Massachusetts became the first state to approve same-sex marriages, and sexual minorities weren’t as visible on TV as they are now. Since then, there has been a dramatic generational shift in comfort with sexual minorities and attitudes, with more and more schools having gay-straight alliances, which are organizations that provide support to gay youth and youth who are uncertain about their orientation.

There may be a transition period during which kids are coming out younger, and their peers haven’t fully learned a new way of understanding sexual orientation, and so bullying could increase. Or it could be that as kids come out more, there are more people around them protecting them and standing up for them. Ultimately, I would think that greater awareness and visibility of sexual orientation would lead to less bullying over time. I hope that it’s not too far off that bullying a gay kid will be as outdated as bullying a kid for being left-handed. Of course, I’d rather see bullying disappear altogether.


Learn more about General Pediatrics at Boston Children’s.