Counseling Issues Research Articles

Intersectionality Pedagogy in the Classroom: Experiences of Counselor Educators

The role of intersectionality in counselor education and supervision has not been formally addressed by researchers in the preparation of counselors in training. Traditional ways of teaching multicultural and diversity issues in counseling include compartmentalized discussions about social identities, but do not incorporate intersectionality despite its significance in describing how individuals move through the world. The method of inquiry used to collect and analyze data was heuristic in nature due to the focus on contextual experiences of the participants as well as the researcher. The results showed how seven CES faculty members’ personal and professional experiences influenced their incorporation of intersectionality in their multicultural pedagogy. The extent to which intersectionality plays a role in understanding multicultural counseling education and experiences of faculty members is explored in this article.

Prenatally diagnosed de novo segmental amplification or deletion by microarray-based comparative genomic hybridization: A retrospective study

ObjectivePrenatal diagnosis of de novo segmental amplification or deletion by microarray-based comparative genomic hybridization (array CGH) is uncommon. The study aimed to know about the incidence, abnormal ultrasound findings, and pregnancy outcomes of prenatally diagnosed de novo segmental amplification or deletion by array CGH. Materials and methodsBetween January 2014 and December 2017, we analyzed pregnant women who received prenatal array CGH (SurePrint G3 Human CGH Microarray Kit, 8 × 60K) at Chang Gung Memorial Hospital, Taiwan. Clinical data on maternal age, reason for fetal karyotyping, sonographic findings, gestational age at delivery, newborn birth weight, and associated anomalies, if any, were obtained by chart review. ResultsA total of 836 specimens (814 amniotic fluid samples, 4 cord blood samples, 18 chorionic villi samples) were analyzed by array CGH during the study period. Of the 56 cases with abnormal array CGH results, 40 had segmental amplification or deletion, 12 had trisomy, three had monosomy, and one had sex chromosome aneuploidy. Of these 40 cases with segmental amplification or deletion, 30 were inherited and 10 were de novo occurrences. The incidence of de novo segmental amplification or deletion was 1.2% (10/836). Abnormal prenatal ultrasound findings occurred in 40% (4/10) of de novo segmental amplification or deletion cases. Among these 10 pregnancies, nine were voluntarily terminated between 22 and 26 weeks of gestation and one was delivered at term. ConclusionsPrenatal diagnosis of de novo segmental amplification or deletion by array CGH raises important genetic counseling issues. In our series, the incidence of de novo segmental amplification or deletion in prenatal samples was 1.2%. Abnormal prenatal sonographic findings occurred in 40% of these de novo segmental amplification or deletion cases. Of these de novo segmental amplification or deletion pregnancies, 90% were voluntarily terminated.

Ethical dilemmas and legal aspects in contraceptive counselling for women with intellectual disability—Focus group interviews among midwives in Sweden

Few studies have explored ethical and legal issues in contraceptive counselling among women with intellectual disability (ID). This study aimed to gain a deeper understanding of these issues during midwifery contraceptive counselling. The present authors interviewed 19 midwives in five focus groups in Sweden 2016 - 2017 and analysed data with content analysis. The participants expressed that women with intellectual disability have equal right to relationships and sexual expressions, but feared exposure to sexual exploitation/abuse. They experienced ethical dilemmas related to principles of fairness and autonomy, but strived to provide assistance in spite of the women's cognitive impairment, presence of supporting persons and uncertainty of optimal counselling. Organizational support was insufficient. The midwives experienced ambivalence, uncertainty and ethical dilemmas in their counselling. They were, however, aware of legal aspects and strived for the women's best interest, right to self-determination and autonomous choices. The participants wanted better professional teamwork and support.

Calls to a Major Teratogen Information Service Regarding Exposures During Breastfeeding.

Background: MotherSafe is a free telephone-based counseling service for Australian consumers and health care providers concerned about drug exposures during pregnancy and breastfeeding. Calls relating to breastfeeding are relatively common and a source of significant distress to the breastfeeding mother, particularly if there is a lack of clarity regarding possible adverse effects of drug exposure on the infant. This study seeks to identify the medication exposures of concern for breastfeeding mothers and the information available to address these concerns. Aims: To review calls to MotherSafe about breastfeeding drug exposures during the 19-year period from 2000 to 2018 and to highlight drugs of concern and counseling issues. Materials and Methods: A retrospective descriptive assessment of a prospectively collected Access database was undertaken. Phone counseling records identified the medication (and other) exposures of concern regarding breastfeeding. The information about medication exposures via breastfeeding provided in consumer and product information (PI) was also reviewed. Results: Of a total of 315,158 calls received at MotherSafe between 2000 and 2018, 116,876 (37.1%) were regarding drug exposure via breastfeeding; 30% of these calls related to nonsteroidal anti-inflammatory drugs, antihistamines, antidepressants, simple analgesics, and antibiotics, and 5% were regarding an exposure specifically contraindicated when breastfeeding. Conclusions: Queries about medication exposures via breastfeeding represent a significant proportion of all the counseling calls to MotherSafe. This study demonstrates the inconsistent and often misleading information about breastfeeding exposures found in consumer and PI sheets and online and highlights the important role of Teratogen Information Services like MotherSafe in providing evidence-based information to both consumers and health care providers.

PRIMARY CARE: HOW TO INCREASE PHYSICAL ACTIVITY IN YOUR PATIENTS

Sedentary lifestyle, being a behavioral risk factor for chronic non-communicable diseases, is relevant for preventive medicine. A key role in the correction of behavioral risk factors for chronic non-communicable diseases is occupied by general medical practice, where the patient is continuously observed for many years. Increased physical activity reduces the risk of atherosclerosis, diseases of the musculoskeletal system, malignant tumors, has a positive effect on the psychological state of patients and reduces the overall morbidity and mortality. Increasing the reserves of the cardiorespiratory system of the body, physical activity improves the quality of life of patients and reduces the cost of medical care.To effectively combat sedentary lifestyle, it is necessary to adequately motivate patients that can be achieved through routine counseling to enhance physical activity. The method of such consultation should take into account limited time of outpatient admission and all personal characteristics of patients (starting level of physical activity, health group and risk of disease).The article presents a summary of modern scientific views in the field of increasing physical activity of patients, discusses current issues of counseling. The groups of patients with or without chronic diseases and the high risk of cardiovascular complications were discussed. The variant of rational outpatient counseling with the help of the algorithm of organization of physical activity mode, providing stratification of patients, planning, optimization and control of personal motor activity was presented. The proposed method of optimization of counseling successfully solves the problems of motivation, increase of physical activity and individual approach in outpatient practice.

Counseling Twins: A Family Counseling Issue

Although twins belong to the same family, they experience unique challenges throughout their life span. If counselors recognize the family issues involved in the unique concerns of twins, counselor...

PBI8 COST SAVING OPPORTUNITY TO A HEALTH-SYSTEM ADALIMUMAB BIOSIMILAR TRANSITION PROGRAMME ACCOUNT WITHIN THE UK

To determine the overall potential twelve-month savings opportunity when accounting for both drug acquisition cost savings and operational cost incurred in a theoretical UK account transition programme setting. A simulated UK health system account was devised based on a cohort of 250 adult patients with a total annual usage volume of 6,500 units of the 40mg reference adalimumab biologic. Operational costs incurred for an individual patient transition were assumed to be £62.40 based on current NHS guidance. The reference adalimumab biologic price was assumed to be at list price with no further discounting with other biosimilar formulations at a discount of 50% and 65%. The account scenario was based on an immediate transition programme (assuming full patient consent for change in formulation had previously been obtained). At a discount of 50%, a potential full year effect saving of £1.14m could be achieved increasing to £1.49m at a 65% discount. Allowing for the operational transition costs of £15,600 (staff time, counselling, training and other related issues) for this cohort, savings could be expected to be similar after operational cost outlay. Operational costs are an important factor to consider when planning a transition programme. These costs will invariably be required to be an upfront cost impact but the longer-term savings through competitive pricing outweigh this initial investment. To maximise these savings, mechanisms between the payer and the clinical account need to be in place to allow for rapid adoption.

Secondary actionable findings identified by exome sequencing: expected impact on the organisation of care from the study of 700 consecutive tests.

With exome/genome sequencing (ES/GS) integrated into the practice of medicine, there is some potential for reporting incidental/secondary findings (IFs/SFs). The issue of IFs/SFs has been studied extensively over the last 4 years. In order to evaluate their implications in care organisation, we retrospectively evaluated, in a cohort of 700 consecutive probands, the frequency and burden of introducing the search for variants in a maximum list of 244 medically actionable genes (genes that predispose carriers to a preventable or treatable disease in childhood/adulthood and genes for genetic counselling issues). We also focused on the 59 PharmGKB class IA/IB pharmacogenetic variants. We also compared the results in different gene lists. We identified variants (likely) affecting protein function in genes for care in 26 cases (3.7%) and heterozygous variants in genes for genetic counselling in 29 cases (3.8%). Mean time for the 700 patients was about 6.3 min/patient for medically actionable genes and 1.3 min/patient for genes for genetic counselling, and a mean time of 37 min/patients for the reinterpreted variants. These results would lead to all 700 pre-test counselling sessions being longer, to 55 post-test genetic consultations and to 27 secondary specialised medical evaluations. ES also detected 42/59 pharmacogenetic variants or combinations of variants in the majority of cases. An extremely low metabolizer status in genes relevant for neurodevelopmental disorders (CYP2C9 and CYP2C19) was found in 57/700 cases. This study provides information regarding the need to anticipate the implementation of genomic medicine, notably the work overload at various steps of the process.

Incorporating Multicultural Couple and Family Therapy Into Incarcerated Settings.

Incarceration rates have increased significantly since the 1990s, with more than two million adults in federal, state, and local facilities. More than half of the offenders report a history of mental health issues, highlighting the importance of offenders having access to effective therapeutic approaches, including individual, couples, and family counseling. Traditionally, the focus of mental health services has been individual treatment; however, family members are also significantly impacted by the offender's absence during incarceration. Incorporating family members into treatment can serve to improve relationships, leading to better outcomes at reentry and reductions in recidivism rates. Given the preponderance of persons of color in the incarcerated population, diversity issues in counseling must also be addressed. The purpose of the underlined article is to explore the implications of incorporating multicultural family therapy into incarcerated settings.

Mental health counsellors’ perceptions on use of technology in counselling

The objectives of the study were: (a) to explore the self-reported knowledge of counsellors about technology in counselling. (b) to understand the flexibility, usage, and openness to integrating the technology services in their practice, and (c) to identify the problems associated with using technology as a process in counselling. Semi-structured interviews of eleven practising counsellors in Bangalore and Chennai, India, recruited through snowball sampling, were used for data collection. The deductive content analysis of the interview transcripts generated seven concepts, each comprising of several categories. The seven concepts were 'attitude', 'strengths', 'weakness', 'suitability', 'skills and training', 'therapeutic alliance', and 'theoretical approaches'. The analysis revealed that the counsellors preferred face-to-face counselling and were not using technology for their mainstream practice, but all were quite aware of the process, the benefits and costs of using different forms of technology. The study revealed that the counsellors were also aware about the target population and mental health issues for online counselling. This study has strong implications for building additional skills and enhancing training for counsellors to use technology in their counselling practice, along with the formulation of legal and ethical policies, certification and licensing, in order to protect both the clients and counsellors.

Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling’s Best Practices in Addressing Conscience Clause Legislation in Counselor Education and Supervision

The amount of various, state-level legislation allowing the denial of counseling services to individuals with values that conflict with those of the professional counselor continues to increase. Such laws are in direct conflict with the values, principles, and ethical standards of the counseling profession. These “conscience clause” legislations are of concern due to the ability of the counseling profession to safeguard and protect the welfare of clients seeking counseling services. Potently, however, much of the focus of conscience clause legislation centers around the legal sanctioning of bias and refusal to provide services to affectional and gender minority clients, and the intersection of sexual/affectional orientation to spiritual and religious values. Provided is a review of these laws and the way they clash with the counseling profession. To assist profession counselors in navigating appropriate ethical behavior, specific counseling-appropriate and lesbian, gay, bisexual, trans, and queer affirming recommendations are provided. Each layer of professional counseling, direct work with clients, supervision, and counselor education, is addressed.

Beyond the Brochure: Innovations in Clinical Counseling Practices for Prenatal Genetic Testing Options.

Remarkable advancements related to preconception and prenatal genetic screening have emerged in recent years. While technology and testing options are more numerous and complex; fundamental genetic counseling issues remain the same. It is essential that with any prenatal genetic testing, women have an opportunity to make informed and autonomous decisions that are consistent with their personal needs and values. Opportunities to discuss testing options, including potential benefits and limitations, are often limited in obstetric visits due to time constraints or lack of sufficient provider education. As genetic testing is not considered a routine component of antepartum care, review of information regarding testing options is imperative so women can decide which, if any, testing to pursue. Developing new strategies to address the growing complexity of prenatal testing while ensuring provider education is accurate is crucial in imparting evidence-based care. This article will arm providers with the knowledge needed to educate women about currently available prenatal genetic screening and diagnostic tests along with guidance on the essential elements and importance of genetic counseling.

SU46 - PSYCHIATRIC GENETIC COUNSELING: CHALLENGES IN AUTISM SPECTRUM DISORDERS

Autism Spectrum Disorders (ASD) have one of the highest estimates of heritability among psychiatric conditions. Genetic testing is now considered standard of care for diagnosis of ASD etiology, and is increasingly available, affordable, and offered to patients and their families. The 2013 American College of Medical Genetics Practice Guidelines estimates a genetic diagnostic yield of 30–40% in ASD cases, recommending Chromosome Microarray (CMA), single gene testing such as FMR1, as well as other testing such as metabolic studies. As of 2017, more than 20 academic and commercial laboratories have developed clinical genetic tests specific for ASD, which are being marketed as diagnostic testing to clinicians worldwide. However, these gene panels often have low clinical validity, and often include genes where the associations between the loci and ASD are unclear. Little is known regarding the practical experience of individuals with ASD undergoing genetic testing. Here, we present five illustrative cases and suggest standardized approaches for genetic counseling in ASD. Since 2013, clinical genetic testing has been routinely offered to individuals with ASD in our Genetics clinic. The most common test offered was CMA, followed by FMR1 and whole exome sequencing. Through retrospective chart review, five representative cases were selected to highlight the diagnostic and counseling complexities. From 2013 to 2016, we provided genetic counseling to 29 individuals with ASD, resulting in at least a partial genetic diagnosis in 34% of cases, a variant of unknown significance in 10% of cases, and incidental findings in 7% of cases. We present five cases of nonsyndromic ASD with variable genetic testing results (1q21.1 deletion, 16p11.2 duplication, 15q13.3 duplication, AUTS2, 47, XYY) and discuss the genetic counseling issues for each. In our collective experience with these and other cases, we have found that diagnostic challenges include phenotypic and locus heterogeneity, variable expressivity, reduced penetrance, causative versus risk alleles, and changing genetic associations as research progresses. Psychosocial challenges include misleading information online, illness representation beliefs of patients and families, stigma, guilt and shame, and family communication. It is not enough to know that certain genetic factors are associated with ASD. Translating this information in a meaningful way for patients and families is the ultimate goal of all clinically-directed research. The reactions of the families described in this case series illustrate these challenges. We recommend standardizing informed consent for genetic testing in ASD, especially regarding the inherent uncertainties, and to include referral to a clinical genetic specialist if available. Careful and informed genetic counseling is crucial and may lead to improved coping and adaptation, and may reduce negative consequences of stigma and discrimination.

Message from the Editor

It is a great honour for us to publish Volume 8, Issue 3, of the Global Journal of Guidance and Counseling: Current Perspectives. The journal welcomes original empirical investigations and literature review articles on current issues in guidance and counseling. The journal is published quarterly and serves as an international platform for discussing new developments in guidance and counselling. The journal focuses on, but is not limited to, the following major fields as they relate to guidance and counseling: child and adolescent counseling, adult and elder counseling, family counseling, school counseling, health counseling, crisis and risk counseling, occupational counseling, industrial counseling, cyber counseling, psychology education, inter-disciplinary approaches to psychology, counseling and guidance, rehabilitation counseling, technology usage in psychology, counseling and guidance, and special education.
 A total number of twenty-two (22) manuscripts were submitted for this issue and each paper has been subjected to double-blind peer review process by the reviewers specialized in the related field. At the end of the review process, a total number of eight (8) high quality research papers were selected and accepted for publication.
 Aim of this issue is to give the researchers an opportunity to share the results of their academic studies. There are different research topics discussed in the articles. For example, Comparison effectiveness of cognitive-behavioural therapy and relaxation technique on curing premenstrual syndrome Farah Mahmoud. The practice and guidance and counseling in Amhara region Ethiopia. Alebachew Mohammed Legas, Antehun Atanaw Mengistu. A Content Analysis of the Research Articles Written on online-counseling, Eser Ceker. Factors contributing to effective guidance and counselling services at university of Eswatini, Alfred Fana Tsikati. Study upon the Postgraduate Dissertations the Subject of which are Family Involvement in Pre-School Education in Turkey, Nur Demirbaş Çelik, Aycem Birand. A comparative study of the effectiveness of cognitive-behavioural and common method of family education on the psychological well-being of parents and girl students in secondary programme at western region of Isfahan Province, Iran, Mansour Abdi, Aliasghar Abbasi. Relationship between father’s emotional intelligence and marital satisfaction with adolescent self-esteem and mental health, Ali Rasouli, Hassan Heydari, Seyed Ali Alyasin, Mansour Abdi. Causes of bullying in the workplace among primary school teachers of your paper, Tomas Cech, Jana Kvintová, Simona Dobešová Cakirpaloglu
 The topics of the next issue will be different. You can make sure that we will be try ing to serve you with our journal to provide a rich knowledge of the field.
 We present many thanks to all the contributors who helped us to publish this issue.
 Kind regards,

Psychological Counseling for Adult Clients

The article analyzes methodological and practical approaches of psychological counseling for adult clients. General psychological problems of this age group are generalized; the concept of restoration of balance between the image of the world and the image of the “I” of clients as the main internal mechanism of mental equilibrium is substantiated; the aspects of professional training of a psychologist to advisory practice with adults are considered.The urgent problem of psychological counseling for adult clients is to help them to solve such problems as negative behaviors, disadaptation, loss of the meaning of life, addictive behavior, depression, etc. Psychological help should be carried out in the direction of qualitative transformations of the image of the world and the image of “I”, which envisage the expansion of knowledge about the world, its positive emotional experience, the realism of ideological beliefs. The general trend in the development of the worldview is the lack of realism in the image of the world, which affects the formation of a false system of values, the development of distorted moral ideas, and as a consequence, problems of health, self-realization, professional adaptation, and behavior deviations.The purpose of the article is to substantiate the methodology and methods of psychological counseling for clients of the adult age group. Specialization of practical activity of a psychologist with this age category requires special knowledge, skills, and skills from a specialist that qualitatively differ from the provision of psychological services to other age groups (children, adolescents, etc.). The success of solving the psychological problems of clients entirely depends on the introduction of the correct, in other words, “more objective”, realistic methodology of counseling. The task of the article is to describe specific aspects of advisory psychological counseling for adults.Summarizing the issue of adult counseling, we note that this type of activity requires from a psychologist to continuously improve the theoretical knowledge and practical skills, as well as to rethink the life experience. The presence of only one of the components of this activity provokes unprofessionality – it often manifests as the behavior in the style of a teacher, a teacher of higher education, in which there is a somewhat superficial, authoritarian attitude to students. Consequently, effective counseling for adult clients is stimulated by professional introspection and qualification in order to avoid professional deviation. Therefore, it is advisable for a psychologist to gain experience with clients (patients) of the adult age group to practice in a counseling center under the guidance of a specialist, and if this is a medical institution – a doctor or therapist.

EDITORIAL

Message from Editor
 Dear Readers,
 It is the great honor for us to publish sixth issue of Global Journal of Guidance and Counseling: Current Perspectives.
 Global Journal of Guidance and Counseling: Current Perspectives welcomes original empirical investigations and comprehensive literature review articles focusing on current issues related with the area of guidance and counselling. The journal is published quarterly and it is devoted to be a joint platform for presenting and discussing the emerging developments on guidance and counseling in an international arena.
 The scope of the journal includes, but is not limited to the following major areas as they relate to guidance and counseling; child and adolescent counseling, adult and elder counseling, family counseling, school counseling, higher education counseling, health counseling, crisis and risk counseling, occupational counseling, industrial counseling, cyber counseling, psychology education and occupational issues, inter- disciplinary approaches to psychology, counseling and guidance, rehabilitation counseling, technology usage in psychology, counseling and guidance and special education.
 Investigating the effect of social capital on delinquency of 15-to-19-year-old juveniles in shiraz, The relationship between happiness and vocation burnout teachers, Social integration of the autistic child through physical activity, Scale of remembered relationship with parents: Evaluation of psychometric properties on university students have been included into this issue. The topics of the next issue will be different. You can make sure that we will be trying to serve you with our journal with a rich knowledge in which different kinds of topics are discussed in 2015 Volume.
 A total number of nine (9) manuscripts were submitted for this issue and each paper has been subjected to double-blind peer review process by the reviewers specialized in the related field. At the end of the review process, a total number of four (4) high quality research papers were selected and accepted for publication.
 We present many thanks to all the contributors who helped us to publish this issue.
 Best regards,

EDITORIAL

Dear Readers,
 It is the great honor for us to publish fifty issue of Global Journal of Guidance and Counseling: Current Perspectives.
 Global Journal of Guidance and Counseling: Current Perspectives welcomes original empirical investigations and comprehensive literature review articles focusing on current issues related with the area of guidance and counselling. The journal is published quarterly and it is devoted to be a joint platform for presenting and discussing the emerging developments on guidance and counseling in an international arena.
 The scope of the journal includes, but is not limited to the following major areas as they relate to guidance and counseling; child and adolescent counseling, adult and elder counseling, family counseling, school counseling, higher education counseling, health counseling, crisis and risk counseling, occupational counseling, industrial counseling, cyber counseling, psychology education and occupational issues, inter- disciplinary approaches to psychology, counseling and guidance, rehabilitation counseling, technology usage in psychology, counseling and guidance and special education.
 Bilingualism, identity and social tolerance, Awareness levels of teachers regarding the physical abuse in children, Emotional intellengence in university students have been included into this issue. The topics of the next issue will be different. You can make sure that we will be trying to serve you with our journal with a rich knowledge in which different kinds of topics are discussed in 2015 Volume.
 A total number of nine (9) manuscripts were submitted for this issue and each paper has been subjected to double-blind peer review process by the reviewers specialized in the related field. At the end of the review process, a total number of six (3) high quality research papers were selected and accepted for publication.
 We present many thanks to all the contributors who helped us to publish this issue.
 Best regards,
 Prof. Dr. Kobus Maree Editor – in Chief

Addressing cultural issues in grief counseling with immigrants: The case of a bereaved Filipino family following homicide

This article discusses cultural considerations and approaches to working with bereaved immigrants who cope with traumatic loss. A clinical case is used to elaborate on issues related to cultural identity, level of acculturation as well as religious beliefs and rituals among Filipinos living in Greece. Considerations for clinicians, who provide services to culturally diverse families that experience traumatic deaths, are discussed.

Possibilities of preservation and realization of reproductive function in girls with Turner syndrome (analytical review)

Turner syndrome (TS) is the most common chromosomal abnormality in females. TS is associated with partial or complete loss of the second X-chromosome in phenotypic females and is associated with increased morbidity and mortality. There are many controversial issues of monitoring, management and counseling of patients with TS. This review emphasizes the need for a multidisciplinary approach to the study of this pathology to enable the realization of reproductive function in patients with TS.

Three strikes and you’re out: culture, facilities, and participation among LGBTQ youth in sports

ABSTRACTSchool-based sports and physical education play an important role in the development of youth (Jones, Edwards, et al., 2017), but participation in athletics is unequal for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth compared to their straight/cisgender peers [Greenspan, S. B., Griffith, C., & Murtagh, E. F. (2017). LGBTQ youths’ school athletic experiences: A 40-year content analysis in nine flagship journals. Journal of LGBT Issues in Counseling, 11(3), 190–200]. Sport cultures, generally, recreate dynamics of exclusion for marginalized youth. However, there are opportunities to transform these spaces into more inclusive and positive environments to support positive growth for all young people [Newman, T., Alvarez, A., & Kim, M. (2017). An experiential approach to sport-based positive youth development. Journal of Experiential Education, 40(3), 308–322]. Our study uses a data set of adolescents, collected as part of a community-based participatory action research project led by high school students in southeast Michigan, USA. Respondents reported their sexual and gender identities, as well as experiences in youth sport, as well as safety using sex-segregated facilities (i.e., bathrooms and locker-rooms). Using mediation models based on linear regression, we found evidence that LGBQ high school students play sports at a significantly lower rate compared to straight students, and among those who play sports, LGBTQ respondents felt significantly less safe compared to straight and cisgender students. Opposite to the LGBQ and trans youth in this study, straight/cisgender youth also reported feeling safer using all facilities. The mediation models suggest that these inequalities help to explain disparities in rates of sports participation and feelings of safety while participating. These findings have important implications for policy, practice, and future research.