The isolation experienced by LGBTQ youth, who are closeted in all or parts of their lives, leads to a higher rate of alcohol and drug use, smoking, mental health issues, and suicide. National studies in the United States and Canada show that LGBTQ youth are three to six times more likely to commit suicide than their straight counterparts and that 30 percent of all completed youth suicides are related to issues of sexual identity. The good news is that students in schools with Gay-Straight Alliances (GSAs) reported hearing fewer homophobic remarks, experienced less harassment and assault because of their sexual and gender orientation, and were more likely to report incidents of harassment and assault to school staff. They were also less likely to feel unsafe because of their sexual orientation or gender expression, were less likely to miss school because of safety concerns, and reported a greater sense of belonging to their school community. (Contains 2 endnotes.)