Share Your Experience to Help Protect LGBTQ+ Students

GLAD Law has heard about an increase in bullying and harassment of LGBTQ+ students. By sharing your story, you can help us understand what’s happening and take action.

If you are an LGBTQ+ student who has faced bullying or harassment at school, or an adult supporting a student who has, please let us know below.

Your response helps us identify patterns, push back against mistreatment, and strengthen protections for LGBTQ+ students. In some cases, we may also be able to provide legal information or referrals.

Your responses are confidential. We will not share names or identifying information without your permission.

This form should take around 5-10 minutes to complete. If you need immediate resources or prefer to share by email or phone, please contact GLAD Law Answers.

Please select the option that describes you:

I am a student experiencing bullyingI am filling out this form on behalf of a student who's experiencing bullying

Students

Your First Name

Your Last Name

Your Pronouns

Your Age

How can we reach you? (select all that apply)

Call/VoicemailText MessageEmail

Your phone number

Your personal email

Where did the school bullying happen?

Your school district (optional)

In what grade(s) did you experience the bullying? Please let us know if it is still happening.

Does the bullying or harassment relate to your:

Sexual orientation	Gender identity or expression
Race/ethnicity	National origin
Disability	Other

Please specify:

How would you describe your sexual orientation? (select all that apply)

Asexual	Bisexual
Gay or lesbian	Pansexual
Queer	Straight or heterosexual
Unsure	Other
Prefer not to answer

Optional: Please specify

How would you describe your gender? (select all that apply)

Gender non-conforming/genderqueer	Man (cisgender or transgender)
Non-binary	Woman (cisgender or transgender)
Transgender/trans	Two-Spirit
Unsure	Other
Prefer not to answer

Optional: Please specify

Your race/ethnicity (select all that apply)

Asian/Pacific Islander	Black/African American
Latina/Latino/Latine	Middle Eastern/North African
Native American/Indigenous	White/European
Other	Prefer not to answer

Optional: Please specify

Student Experience

Please briefly describe your situation and what kind of bullying you experienced in the past and/or are experiencing now.

Is there anything else about your school experience that you think we should know?

Can you answer some additional demographic questions to better help us support students and school communities?

YesNo

Your first name

Your last name

The student's first name

The student's last name

The student's pronouns

The student's age

What is your relationship to the student?

How can we reach you? (select all that apply)

Call/VoicemailText MessageEmail

Your personal email

Your phone number

Adult: When and Where

Where did the school bullying happen?

School district (optional)

In what grade(s) did the student experience bullying? Please let us know if it is still happening.

Does the bullying relate to the student's:

Sexual orientation	Gender identity or expression
Race/ethnicity	National origin
Disability	Other

Please specify:

How does the student identify their sexual orientation? (select all that apply)

Asexual	Bisexual
Gay or lesbian	Pansexual
Queer	Straight or heterosexual
Unsure	Other
Prefer not to answer

Optional: Please specify

How does the student identify their gender? (select all that apply)

Gender non-conforming/genderqueer	Man (cisgender or transgender)
Non-binary	Woman (cisgender or transgender)
Transgender/trans	Two-Spirit
Unsure	Other
Prefer not to answer

Optional: Please specify

The student's race/ethnicity (select all that apply)

Asian/Pacific Islander	Black/African American
Latina/Latino/Latine	Middle Eastern/North African
Native American/Indigenous	White/European
Other	Prefer not to answer

Optional: Please specify

Please briefly describe the situation and the type of bullying the student has experienced or is experiencing.

Is there anything else about the student’s experience that you think we should know?

Can you answer some additional demographic questions to better help us support students and school communities?

YesNo

If you already answered any of these questions above, feel free to skip them below.

Reminder: Click the "Submit" button at the bottom of this form for your answers to be sent to GLAD Law.

How would you describe your sexual orientation? (select all that apply)

Asexual	Bisexual
Gay or lesbian	Pansexual
Queer	Straight or heterosexual
Unsure	Other
Prefer not to answer

Optional: Please specify

How would you describe your gender? (select all that apply)

Gender non-conforming/genderqueer	Man (cisgender or transgender)
Non-binary	Woman (cisgender or transgender)
Transgender/trans	Two-Spirit
Unsure	Other
Prefer not to answer

Optional: Please specify

Your race/ethnicity (select all that apply)

Asian/Pacific Islander	Black/African American
Latina/Latino/Latine	Middle Eastern/North African
Native American/Indigenous	White/European
Other	Prefer not to answer

Optional: Please specify

If you already answered any of these questions above, feel free to skip them below.

REMINDER: Click the "Submit" button at the bottom of this form for your answers to be sent to GLAD Law.

How does the student identify their sexual orientation? (select all that apply)

Asexual	Bisexual
Gay or lesbian	Pansexual
Queer	Straight or heterosexual
Unsure	Other
Prefer not to answer

Optional: Please specify

How does the student identify their gender? (select all that apply)

Gender non-conforming/genderqueer	Man (cisgender or transgender)
Non-binary	Woman (cisgender or transgender)
Transgender/trans	Two-Spirit
Unsure	Other
Prefer not to answer

Optional: Please specify

The student's race/ethnicity (select all that apply)

Asian/Pacific Islander	Black/African American
Latina/Latino/Latine	Middle Eastern/North African
Native American/Indigenous	White/European
Other	Prefer not to answer

Optional: Please specify