Identity-based bullying linked to poorer health outcomes


Bullying due to a marginalized identity is a sad fact of life for far too many children and teenagers. A study examines how such bullying can lead to poorer health.

Bullying is something that many children are subjected to on a daily basis, and for many of those children it’s based on a minority race/ethnicity/national origin as well as other marginalized identities. An investigation in JAMA Network Open examined how those experiences are linked to physical health and mental health outcomes in adolescents.1

The investigators looked at responses from an anonymous survey that had been performed at 13 public high schools in the Pittsburgh, Pennsylvania area. The survey was given to students in the 9th through 12th grade. Students were asked questions about bullying, harassment, gender identity, sexual orientation, racial/ethnic identity, and access to well-child care. The Centers for Disease Control and Prevention Youth Risk Behavior Survey was used to assess health, mental health, and violence involvement.

There were 3939 participants with an average age of 15.7 years. Among these participants, 1380 indicated they were Black; 2086 had been assigned a female gender at birth; 1021 stated that they were part of a sexual minority group; and 313 were gender diverse. When looking at reported social identities, the investigators found that race/ethnicity-based experiences of bullying and bullying perpetration were the most common, occurring in 375 students (9.5%) and bullying perpetration 209 students (5.8%), respectively. Teenagers who had multiple identities that were stigmatized were found to experience even higher rates of identity-based bullying and identity-based bullying perpetration. Overall, the highest rates of identity-based bullying were seen in gender diverse Black and Hispanic adolescents. Experiencing identity-based bullying due to a number of stigmatize identities was linked to a variety of negative outcomes including delayed well care (adjusted odds ratio [aOR], 1.41; 95% CI, 1.20-1.65), forgone medical care (aOR, 1.64; 95% CI, 1.44-1.87), nonsuicidal self-injury (aOR, 2.86; 95% CI, 2.53-3.24), suicidal ideation (aOR, 2.49; 95% CI, 2.20-2.83), and greater violence involvement (experiencing violence: aOR, 2.90; 95% CI, 2.45-3.43; homicide survivorship: aOR, 1.19; 95% CI, 1.06-1.33).

The investigators concluded that identity-based bullying leads to negative outcomes, especially when a person has more than 1 marginalized identity. The results indicate that bullying prevention programs should work on addressing systemic racism and be empathetic to the experiences of minority teenagers to improve outcomes.


1. Galán C, Stokes L, Szoko N, Abebe K, Culyba A. Exploration of experiences and perpetration of identity-based bullying among adolescents by race/ethnicity and other marginalized identities. JAMA Netw Open. 2021;4(7):e2116364. doi:10.1001/jamanetworkopen.2021.16364

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