What We Know About LGBTQ Youth Mental Health and Suicide Prevention

We are pleased to share this guest blog, courtesy of our friends at The Trevor Project, the world’s largest suicide prevention and crisis intervention organization for LGBTQ youth.

Suicide is a public health crisis. It is the second leading cause of death among young people — and lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth are at significantly increased risk. According to CDC data, LGBTQ youth are more than four times as likely to attempt suicide than their peers.

As the world’s largest suicide prevention and crisis intervention organization for LGBTQ young people, The Trevor Project dedicates itself to supporting LGBTQ youth in crisis 24/7 and advocating for LGBTQ-inclusive policies, programs, and practices to end this crisis.

One way we do this is by conducting and publishing original research, which we use to help inform our life-saving crisis services, as well as to expand the general knowledge base on LGBTQ youth mental health, given the lack of LGBTQ-inclusive data nationwide.

Representing the experiences of over 40,000 LGBTQ youth, The Trevor Project’s 2020 National Survey on LGBTQ Youth Mental Health is the largest survey of LGBTQ youth ever conducted. And the data provides new insights into the unique challenges that LGBTQ youth face every day. For one, our survey found that 40% of LGBTQ youth seriously considered attempting suicide in the past year, including more than half of transgender and nonbinary youth.

The disparate rate of suicide attempts among LGBTQ youth is staggering. But these findings should also not be interpreted to suggest that LGBTQ youth are inherently prone to suicide because of their sexual orientation or gender identity. LGBTQ youth are at a higher risk of suicide because of increased experiences of internalized stigma, discrimination, violence, and rejection from others. And we see this in our data.

According to our national survey, 1 in 3 LGBTQ youth reported that they had been physically threatened or harmed in their lifetime due to their LGBTQ identity. 10% of LGBTQ youth reported undergoing the dangerous and discredited practice of conversion therapy, and they reported more than twice the rate of attempting suicide in the past year compared to those who did not undergo conversion therapy. Alarmingly, 29% of respondents had experienced homelessness, been kicked out, or run away.

Based on the minority stress model, we know that harmful experiences like these can compound and produce negative mental health outcomes like anxiety, depression, and suicide thoughts, plans, and attempts. So when we find that 68% of LGBTQ youth reported symptoms of generalized anxiety disorder in the past two weeks and 48% of LGBTQ youth reported engaging in self-harm in the past year — including over 60% of transgender and nonbinary youth — we must keep in mind the unique stressors in play here and the potential impacts of victimization.

To make matters worse, we also found that LGBTQ youth who want and need mental health care are having trouble getting it. 46% of LGBTQ youth wanted psychological or emotional counseling from a mental health professional but were unable to receive it in the past year. And youth reported numerous barriers to explain why they couldn’t get the mental health care they wanted, ranging from difficulties with insurance and affordability to concerns around parental permission and the availability and LGBTQ-competence of providers.

These startling statistics are often the ones that lead the news, and for good reason: this is a public health crisis that demands urgent action, including comprehensive policy solutions and investment from the top down. But focusing entirely on doom and gloom is unhelpful. It paints a pessimistic picture for the young people we serve and most often leaves out the most critical point of all — that suicide is preventable!

Data from our national survey reaffirms that support systems work to save lives. LGBTQ youth who reported high levels of social support from family and friends were significantly less likely to attempt suicide. And LGBTQ youth with access to just one LGBTQ-affirming space were significantly less likely to attempt suicide than those who do not have access to any. It is abundantly clear that LGBTQ allies can positively impact how youth feel about being LGBTQ.

Furthermore, our findings around affirming gender identity among transgender and nonbinary youth are remarkable. Transgender and nonbinary youth who reported having their pronouns respected by all or most of the people in their lives attempted suicide at half the rate of those who did not have their pronouns respected. And trans youth with access to tools such as binders, shapewear, and gender-affirming clothing reported lower rates of attempting suicide in the past year compared to those without access.

The data we have on protective factors for suicide should command as much attention as the risk factors. We must recognize that suicide prevention efforts are working in many areas, and we should continue to offer messages of hope and positive guidance on how to enable young people to not only survive but to also thrive.

We hope this report provides valuable insights that can be used by researchers, policymakers, and the many organizations working alongside The Trevor Project to support LGBTQ young people everywhere. And further, we hope it will inspire people to consider the impact of their day-to-day interactions. A little support can go a long way.