Meet Upstander Debra Houry

An interview with Director of the National Center for Injury Prevention and Control (NCIPC) from the Center for Disease Control (CDC).

Debra Houry
How do you define bullying?
CDC defines bullying as any unwanted aggressive behavior(s) by another youth or group of youths, who are not siblings or current dating partners, involving an observed or perceived power imbalance and is repeated multiple times or is highly likely to be repeated. Bullying may inflict harm or distress on the targeted youth including physical, psychological, social, or educational harm.1 A young person can be a perpetrator, a victim, or both (also known as a “bully/victim”).

Bullying can occur in-person and through technology. Electronic aggression, or “cyber-bullying,” is bullying that happens through email, chat rooms, instant message, a website, text message, or social media.2

Why does the CDC see bullying as a public health issue?

Bullying is widespread in the United States. In a 2015 nationwide survey, 20% of high school students reported being bullied on school property in the 12 months preceding the survey, and an estimated 16% of high school students reported in 2015 that they were bullied electronically in the 12 months before the survey.3

How would you describe the impact that bullying has on individuals? On communities?

Bullying can result in physical injury, social and emotional distress, and even death. Victimized youth are at increased risk for depression, anxiety, sleep difficulties, and poor school adjustment. Youth who bully others are at increased risk for substance use, academic problems, and violence later in adolescence and adulthood.4

Youth who both bully others and are bullied themselves (i.e., “bully-victims”) suffer the most serious consequences and are at greater risk for both mental health and behavior problems than those who only bully others or are bullied by other.5

What kind of response has the CDC’s report received?

CDC’s August 11 Sexual Minority Youth MMWR report was received with gratitude and excitement by the vast majority of external stakeholders, LGBTQ organizations, and researchers who worked with CDC to make this data collection a reality. The health disparities noted in the report were described as heartbreaking, horrifying, shocking, and unacceptable. Many expressed that the report is ground-breaking, long overdue, and a land-mark that will hopefully motivate much needed changes to help gay, lesbian, and bisexual students not only survive, but actually thrive.

Our work is certainly not done and the need for health risk data on transgender youth is critical, as is highlighted by feedback about this report. CDC has been working on multiple fronts to determine how this can be accomplished with the Youth Risk Behavior Survey (YRBS) and/or other data systems. CDC will be piloting a gender identity question next year on selected state and local YRBS’s and will continue to evaluate whether the number of positive respondents is large enough to capture reliable data on transgender youth or if other research formats are needed.

There were so many important findings from this study that may impact LGB youth and as well as their parents and teachers. Can you draw any inferences to other minority youth from these findings?

The 2015 National YRBS report did not have enough responses to develop data on lesbian, gay, and bisexual youth by race/ethnicity, but for all youth:

  • 18.4 percent of white students reported being electronically bullied, versus 8.6 percent of black students and 12.4 percent of Hispanic students
  • 23.5 percent of white students reported being bulled on school property, versus 13.2 percent of black students and 16.5 percent of Hispanic students

We can’t make any clear inferences but we do need more of an understanding of how bullying differs by children with disabilities or special needs, by racial or ethnic groups, and by children with various religions and faiths.

The study included results factoring in online bullying. Can you describe the environment that exists online for LGB youth and how parents and teachers might approach creating safer space for their children who may identify as LGBT (or non-gender identified)?

Cyber-bullying is an emerging issue that needs further exploration. In the 2015 national YRBS, approximately 16% of all high school students reported experiencing cyber-bullying and unfortunately this estimate has not changed significantly since the question was first asked in 2011. Unfortunately, for lesbian, gay, and bisexual students and students who have sex with their same sex or both sexes, rates are almost double (i.e., close to 30%). We don’t have specific resources for parents and teachers of youth who identify as LGBT, but we have general tips for parents/caregivers and teachers:

For educators:

  • Explore current bullying prevention policies
  • Work collaboratively to develop policies
  • Explore current programs to prevent bullying and youth violence
  • Offer training on electronic aggression for educators and administrators
  • Talk to teens
  • Work with IT and support staff
  • Create a positive school atmosphere
  • Have a plan in place for what should happen if an incident is brought to the attention of school officials

For parents/caregivers:

  • Talk to your child
  • Develop rules
  • Explore the internet
  • Talk with other parents/caregivers
  • Encourage your school or school district to conduct a class for caregivers about electronic aggression
  • Keep current

The study’s implications can be seen as validation of what so many working with LGB (and T) youth have been saying for many years. Why is the CDC issuing this now?

To understand more about behaviors that can contribute to negative health outcomes among lesbian, gay, and bisexual students, a question to ascertain sexual identity and a question to ascertain sex of sexual contacts was added for the first time to the 2015 national and standard Youth Risk Behavior Survey or YRBS. Thus, the report released in August 2016 is the first time we’ve been able to estimate the health risks of U.S. lesbian, gay, and bisexual high school students with a nationally representative sample. This research is critical for understanding and addressing the disparities in risk among lesbian, gay, and bisexual high school students—a population at elevated risk for a number of health concerns. These data are also important to assess trends in risk behaviors over time and the information is important to help policymakers at all levels plan and evaluate prevention programs and policies.

You said, “All of us can help to position lesbian, gay, and bisexual youth to survive and thrive in their environments, and it’s critical that we take action.” Tyler Clementi Foundation has been working with schools and colleges with our #Day1 Program, for example, to establish safe space in workplaces, classrooms and organizations. What key messages do you recommend are present in what the study says are “comprehensive, community-wide prevention efforts [that] can reduce the risk of multiple types of violence for these and other vulnerable youth”?

All of us, including parents, schools and communities, can and must take action to ensure lesbian, gay, and bisexual youth survive and thrive:

  • Ensure comprehensive, community-wide support systems that reduce risk and promote protective factors for lesbian, gay, and bisexual youth
    • Parents: foster resiliency by providing strong family support; teach all children non-violent problem solving skills
    • Schools: build environment that provides a sense of safety and connectedness for all students, including gay, lesbian, and bisexual youth
    • Communities: reduce stressors for gay, lesbian, and bisexual youth by reducing discrimination and forms of victimization that contribute to vulnerability
  • Connectedness is key to protecting health of these adolescents — to parents, to peers, to teachers, and to schools and other community organizations
    • Students are more likely to thrive in their schools and communities if they know they matter – that they have adults, teachers, and friends who care about their safety and success

We also know that the sexual violence and bullying experienced by transgender youth and adults cannot be ignored and requires a nationwide response. CDC is committed to working, in collaboration with key partners and the community, to improve health and safety for transgender individuals.

How will the CDC be contributing in the coming years to end bullying and harassment?

CDC is committed to understanding and preventing bullying before it starts by using a population-based approach and developing a rigorous science base. Developing a rigorous science base is particularly needed in the area of bullying prevention, as there is limited information about the different forms of bullying, the factors that place youth at risk for or protect youth from experiencing bullying, and effective prevention strategies for schools and communities to implement. CDC’s approach to bullying prevention includes:

  • Defining the problem and monitoring trends through surveillance;
  • Using research to identify risk and protective factors;
  • Developing and evaluating comprehensive, community‐based prevention programs; and
  • Disseminating research to ensure widespread adoption of evidence‐based strategies.

In addition, CDC’s Division of Violence Prevention works closely with our funded partners to implement and evaluate programs to prevent bullying. For example, our staff collaborate with the Youth Violence Prevention Centers and STRYVE sites to prevent violence and bullying in individuals, families, schools, and communities by implementing evidence-based programs, including Positive Behavioral Interventions and Supports (PBIS), Promoting Alternative Thinking Strategies (PATHS), Positive Action, and Second Step: Student Success Through Prevention. We also fund partners to implement a data-driven approach to prevent all forms of violence called Communities That Care.

Finally, we collaborate with other federal agencies to spread awareness of bullying and help link youth, parents, and communities to resources on bullying via the Federal Partners in Bullying Prevention Working Group and

Debra Houry, MD, MPH, is the Director of the National Center for Injury Prevention and Control (NCIPC) at CDC. In this role, she leads innovative research and science-based programs to prevent injuries and violence and to reduce their consequences. Follow her on Facebook and Twitter.


The views or experiences expressed are solely those of the contributor or interview subject and do not represent the views of the Tyler Clementi Foundation, its staff or board. If you have any questions or concerns regarding the material, please contact the Tyler Clementi Foundation, and we appreciate your support and commitment to end bullying starting on #Day1.