This study examined Indiana public middle school principals' perceptions of school conditions and stakeholders' attitudes regarding middle-grade lesbian, gay, bisexual, transgender, and questioning (LGBTQ) students. Principals' responses revealed that inclusive school environments and caring faculty members were prominent factors in successfully providing support to middle-grade LGBTQ students, while the negative attitudes of some parents, community members, and school staff members were barriers to supporting LGBTQ youth. Principals' self-reported attitudes toward LGBTQ students were favorable and were found to be statistically significant in predicting their reports of school stakeholders' attitudes, especially teachers. Implications for principal preparation programs and recommendations for school leadership practice are discussed.