Multilevel Factors Impacting U.S. School Nurses’ Support of LGBTQ+ Youth: A Qualitative Analysis
School nurses (SNs) can play important roles in supporting LGBTQ+ youth. Prior research has emphasized individual and interpersonal factors influencing SNs’ interactions with LGBTQ+ youth, showing mixed results regarding cultural competency, knowledge, and youth satisfaction. However, higher-level factors (e.g., structural and political) shaping these interactions remain underexplored in the United States at a national level. To address this gap, we analyzed open-ended responses from a survey distributed by the National Association of School Nurses in May 2023, receiving responses from 672 nurses (49 states and one U.S. territory). Analysis revealed five key themes: (1) personal stake and the SN role; (2) perspectives on school and community climate; (3) policies as supportive versus challenging; (4) LGBTQ+ resources and education; and (5) barriers and facilitators to learning. Findings illustrate the interconnectedness of policy, leadership, school culture, and education, highlighting areas for targeted improvements to enhance SNs’ capacity to effectively support LGBTQ+ youth health.