“We all know this. It’s intuitive, but the data is there to support it.”
Emily Greytak, research director at the Gay, Lesbian & Straight Education Network  (GLSEN), one of the nation’s leading advocacy and policy organizations for LGBTQ students in K-12 schools, is assessing the startling data about school experience. Greytak’s able to reel off one number after another reflecting, in stark detail, the stunning disparities between LGBTQ youth and their peers when it comes to their school experience.
LGBTQ students nationwide face higher levels of depression and lower levels of self-esteem, lower grade point averages, higher truancy rates and staggeringly high rates of physical violence.
More than 36 percent of students report being physically harassed because of their sexual orientation, and more than 16 percent said they were physically assaulted in school.
This discriminatory treatment and stigmatization, so-called “minority stress,” yields even more troubling numbers. According to the National Alliance on Mental Illness (NAMI), LGBTQ youth are four times more likely to attempt suicide.  Among LGBTQ people between the ages of 10 and 24, suicide is one of the leading causes of death.
For the transgender population, it’s even worse. NAMI reports between 38 and 65 percent of transgender individuals experience suicidal thoughts.
It’s why experts like Greytak say no one should be surprised by recent reports of spiking crisis line calls for LGBTQ residents of North Carolina  following the March 23 passage of House Bill 2, sweeping legislation that, among its many tenets, axes local nondiscrimination protections for gay and transgender residents.
It’s a set of reforms that could wreak havoc in the state’s K-12 facilities  as they continue to address myriad LGBTQ inequalities, some say.
“When students are not allowed to be who they are, or they can’t dress like they want to, or they’re even forbidden from saying they’re gay or lesbian or transgender, that in itself has an impact on their mental health,” Greytak says.
Every two years, her organization conducts its nationwide survey of school climate for LGBTQ students . This fall, GLSEN will release its latest numbers, but in this moment, Greytak is questioning an over-arching system of laws, school policies and attitudes—including those spurring House Bill 2—that would allow such stunning disparities between LGBTQ youth and their peers when it comes to mental health.
In North Carolina, the problems for LGBTQ youth are particularly potent , GLSEN reports. About 95 percent of students reported hearing “gay” in a negative way, the 2013 survey found, and more than 60 percent heard slurs aimed specifically at transgender students. About 30 percent said they were “physically harassed” in North Carolina schools—all conditions that could spur or exacerbate mental illness.
For both mental health and LGBTQ advocates, this is one of the greatest concerns about the impacts of House Bill 2, a concern reaffirmed by reports last week from Trans Lifeline —a national suicide hotline—that phone calls from North Carolina doubled in the wake of the legislation’s passage.
And this week, Barry Bryant, executive director of HopeLine , one of North Carolina’s more prominent crisis hotlines, told Policy Watch that his organization has seen calls balloon by about 20 percent in March and April, compared to every other month in 2015 and 2016.
Although Bryant says he can’t say why crisis phone calls are up in the state—typically, callers do not broach their sexual orientation or gender identity when ringing in—advocates say it’s another sign that the mental health of this chronically underserved population could be most at stake.
“I’m really worried about where this could take us,” says Jack Register, executive director of the state NAMI chapter.
He’s not the only one. As of this week, an alliance of Democratic lawmakers had filed legislation to repeal House Bill 2 , although the chances of success seemed unlikely.
Republican leaders in the House and Senate were dismissive of calls for repeal in recent weeks, and on Tuesday, one of the state’s most powerful Republicans, Hendersonville Sen. Tom Apodaca, issued a call for a statewide referendum on the mega-controversial bill. 
Rep. Bobbie Richardson, a former educator from Franklin County, is one of the Democrats sponsoring repeal legislation. Richardson told Policy Watch that most of the feedback she’s received from constituents since the repeal bill was filed has been positive.
And while she acknowledges the minutiae of House Bill 2’s various points caused her to overlook the mental health dangers associated with the controversial bill, Richardson said she was stunned when she learned of the spike in crisis line phone calls from North Carolina.
“It made me think about how this impacts students in this community to hear this from the people who are elected to protect and legislate bills beneficial to all citizens of North Carolina,” said Richardson. “I just wonder how these students see us. I can imagine it is a disappointment. They take it very personally, as an indictment on who they are as people.”
Richardson says she has family members in the LGBT community, and that state lawmakers should be wary of the repercussions for such youth in North Carolina.
“We should not be creating climates where students feel unvalued and unprotected, or that they’re being judged for their way of life,” she said.
Shortly after state lawmakers approved House Bill 2 last month, Register’s state NAMI chapter was one of the most outspoken in condemning the legislation. And, although NAMI’s national organization has yet to weigh in, Register’s group said in a statement that it opposes legislation that “alienates or discriminates against any person.”
“From our point of view, any sort of exclusion is not ok for vulnerable people,” Register said this week in an exclusive interview with Policy Watch.
In a population disproportionately impacted by mental illness, Register says North Carolinians need to be especially tuned in following the passage of House Bill 2.
Still, mental health has been a relatively overlooked component of the controversy, experts say, even after a coalition of physicians publicly blasted lawmakers  in March for speeding a bill they deemed “deplorable and utterly irresponsible.”
Register says he expects physicians, particularly mental health professionals, to more aggressively delineate the mental health risks in the coming weeks as lawmakers reconvene in Raleigh and potentially discuss tweaks to the bill lobbed by Gov. Pat McCrory amidst the firestorm of controversy.
In addition to sweeping away local nondiscrimination ordinances that protect the LGBTQ community, House Bill 2 also forces facilities such as public schools to demand that transgender students use the bathroom of their birth sex, despite the well-documented concerns.
Bathrooms and locker rooms are a source of great anxiety for transgender residents, researchers say. Nearly 60 percent of K-12 students in GLSEN’s nationwide school survey reported being forced to use a bathroom corresponding to their legal sex, feeding increased risk of bullying or harassment.
Last week, Hunter Schafer, a transgender teen from Raleigh from who’s joined an ACLU-led legal challenge to House Bill 2, told Policy Watch that she feared going into the boy’s restroom when she began transitioning in the ninth grade.
Since the law’s approval, Schafer, a 17-year-old at N.C. School of the Arts in Winston-Salem, has been using a private restroom at the school rather than the girls’ or the boys’ restroom, the latter of which made her feel “uncomfortable.”
“I have to choose between putting myself in that position or breaking the law,” Schafer said.
Some of this is to be expected says Greytak. GLSEN’s 2013 report on school climate noted nationwide that there seems to be improvement in LGBTQ school life, with reports of experiencing homophobic remarks dwindling from 80 percent in 2001 to about 60 percent.
Such progress tends to spur a backlash, she said.
“It’s a cultural shift where LGBT issues are coming more into the mainstream,” she says. “We’re seeing a new generation that doesn’t think of it as a big deal. It’s just a part of their life, but there’s the inevitable backlash of people so ingrained in their bigotry. They’re scared. Two steps forward, one step back.”
In the meantime, GLSEN is recommending a broad set of policy changes for North Carolina, including increased professional development for school staff on LGBTQ issues, the formation of more school clubs like the Gay-Straight Alliance, which has been found to improve the school climate for such students, and “comprehensive” anti-bullying or harassment policies that include sexual orientation or gender identity.
The last recommendation is particularly key in North Carolina, where just 8 percent of K-12 students reported to GLSEN that they attended a school with such all-encompassing bullying protections.
Such policies send a welcoming message to LGBTQ residents and youth, experts say, yet legislation like House Bill 2 does the opposite.
“At the bare minimum, they’re sending the message to LGBTQ youth that they are not supported by their government, that they’re not supported by their schools,” says Greytak.
That must change, says Richardson. Because, with crisis calls mounting, North Carolina needs to begin preparing for the results.
“This legislation could be the vehicle by which someone would devalue themselves that it could lead to consequences I’m not able to foresee,” she said. “I can’t look in a crystal ball, but if it does (risk lives) we should take note of that and be prepared to provide support for people in that position.”