LGBTQ Youth Remain at High Risk for Mental Health Issues but Also Envision a More Inclusive Future

LGBTQ kids are tapped into news and current events more than any other generation before them. Because of that, they are experiencing significant mental health upheaval. According to the 2023 survey from The Trevor Project, LGBTQ kids are worried about anti-LGBTQ legislation making its way through states. The Trevor Project releases its survey annually that takes a hard look at the mental health and well-being of LGBTQ kids across America.

But it's not all bad: LGBTQ young people also weighed in on what they think an ideal future would look like and offered guidance on how parents and caregivers can best support them in the years to come. We spoke to The Trevor Project's vice president of research, and an LGBTQ young person, so you can understand the unique and sometimes challenging environment for kids right now.

Trevor Project Survey Shows What Life Is Like for LGBTQ Youth

This year's annual National survey findings are even more important, as anti-LGBTQ legislation makes its appearance across America. Dr. Ronita Nath, vice president of research at The Trevor Project, explains these surveys help parents, caretakers, lawmakers, and allies understand the landscape of LGBTQ young people's mental health.

"We don't know a lot about LGBTQ kids and suicide risk. Surveys like this help us leverage the data to make an impact on legislation," Dr. Nath explains. Making LGBTQ youth safer isn't just a nebulous concept; for many LGBTQ young people, living in or going to school in an unsafe environment is a dangerous reality.

Many LGBTQ youth reported having negative mental and physical health experiences in school. The study shows some alarming trends: 41% of LGBTQ young people seriously considered suicide in the past year. This staggering number is perhaps related to access to mental health care. In the past year, 56% of LGBTQ young people were not able to access mental health care when they needed it most.

Ty Smith*, an LGBTQ young person who graduated in 2016, explained that the structural difficulties of accessing mental health care in public schools run deep. "The guidance counselors seemed to have a massive workload and seemed better prepared for academic advisement than mental health or disciplinary issues that they were also expected to handle," he explains.

Teachers often have a lot on their plates—too much indeed to also become de facto mental health care counselors for at-risk youth.

Schools can be a difficult environment even for straight and cis kids. But for LGBTQ kids, they can be an obstacle course of mental health challenges. About half of transgender and nonbinary youth found their school was gender-affirming, but a majority of LGBTQ young people reported being verbally harassed at school.

In his experience, Ty explains that "f-slurs" were commonplace, and though he himself didn't experience any direct LGBTQ discrimination at his public school, he had to transfer from a smaller private school because of bullying. "The administration sent me to counseling but thankfully did not out me to my parents before I transferred out due to other bullying issues," he says.

The problems aren't just at school, unfortunately. Fewer than 40% of LGBTQ young people found their home to be affirming of their gender and sexuality.

However concerning these numbers might be, they are actually lower than 2022's numbers. In that year, the Trevor Project reported 45% of LGBTQ youth considered suicide, 60% were unable to receive mental health care when they wanted it, and less than one in three transgender and nonbinary youth felt supported and affirmed in their homes.

"LGBTQ young people who live in gender-affirming homes report lower suicide risk," Dr. Nath explains. But, "a lot needs to be done to help both school and home be more affirming."

Racial and Gender Disparities

Mental health is an intersectional field, where gender identity, sexuality, location, and race come into play. The Trevor Project Survey shows some troubling disparities based on both racial and gender identities.

For example, White and Asian American/Pacific Islander (AAPI) youth have the lowest suicidality among LGBTQ people. White youth considered suicide at a rate of 37% and attempted suicide at a rate of 11%. AAPI youth were at 34% and 10% respectively. However, Native/Indigenous LGBTQ young people considered suicide at the highest rate (53%), and attempted suicide at a staggering rate of 22%. It bears underscoring: more than half of Native/Indigenous LGBTQ youth considered suicide, and almost a quarter made an attempt to end their lives.

The second highest in suicidality were mixed race and Middle Eastern/North African youth, who considered suicide at a rate of 47% percent, and attempted suicide at 17% and 18% respectively.

"People of color are at a much higher risk of suicide. These risks remain quite high, year over year. They report high rates of discrimination," Dr. Nath says.

The picture gets even more complicated with the relationship to suicidality based on gender. Transgender men (56%) and women (48%), as well as nonbinary/genderqueer folks (48%) considered suicide at the highest rates. The numbers actually attempting suicide were 23%, 16%, and 17% respectively. The lowest rates were among cisgender men and women.

Dr. Nath explains it was important to have granular information because it helps lawmakers and mental health professionals see the data in "new and unique ways." This helps to fight back against policies that can be harmful to LGBTQ youth, especially the lack of access to mental health care.

But Dr. Nath wants to underscore something fundamental: kids are kids, no matter their orientation. At-risk LGBTQ youth are only at risk because of the environment they're in.

"LGBTQ people are not inherently at higher risk of suicide because of their sexuality or gender orientations; we place them at risk" by contributing to anti-LGBTQ behaviors, Dr. Nath says.

Access to care is built on national policies supporting young people both in school and at home, and unfortunately, the landscape of anti-LGBTQ policies is shifting at a rapid rate.

The Effect of Anti-LGBTQ Legislation

Among the key findings of The Trevor Project Survey is the effects censorship of LGBTQ content has had on trans and nonbinary young people. Not to mention the hundreds of laws and policies being passed in states across the country.

"There are over 400 anti-LGBTQ bills circulating right now," Dr. Nath says. "This negatively affects the mental health of LGBTQ people. For example, more than a dozen states have banned transgender health care."

Nearly 1 in 3 LGBTQ youth said their mental health was poor most of the time or always due to anti-LGBTQ policies and legislation. Nearly 2 in 3 young people said hearing about state or local laws banning people from discussing LGBTQ folks made their mental health "a lot worse."

These policies have a real-life impact on the LGBTQ youth in America. It's not just about access to accepting and affirming communities, but physical and emotional safety.

This year's survey paints a bleak picture: LGBTQ young people who experienced anti-LGBTQ victimization say it has strongly affected their mental health, resulting in a doubled rate of suicide attempts. In fact, 27% of LGBTQ people who attempted suicide in the past year experienced physical threat or harm because of their sexual orientation or gender identity. Only 9% of those who made an attempt on their lives did not experience threat or harm on their lives because of their orientation and gender presentation.

A Brighter Future for LGBTQ Youth

LGBTQ youth have expectations of their straight and cisgender peers in their lives. Overwhelmingly they want people to support and accept them (82%), understand gender identity (78%) and sexual orientations (77%), make an attempt to use proper pronouns (74%), and create safe spaces (68%). These are common-sense ways to support LGBTQ youth and their mental health.

The numbers underscore the importance of providing young people with supportive and accepting homes. According to the survey, the rate of suicidal ideation and attempts were much lower among trans and nonbinary youth who resided in gender-affirming homes with family members who respected their pronouns.

Where are some gender-affirming places LGBTQ youth feel safest? Online is far and away the safest for LGBTQ young people (68%), specifically for trans and nonbinary folx (70%). School came in as a close second.

Notably, home (38%) and community events (16%) were the least affirming and safe for LGBTQ youth. The numbers were similar for transgender and nonbinary youth. Dr. Nath says, unfortunately, while online communities may be safer and more affirming, but they don't move the dial for suicide risk.

Smith weighs in about a positive experience in school that helped him to feel affirmed. "In my junior year of high school, I recall my health teacher being very queer-positive when it came to sex education and gender segments," he says. In this same school, he didn't think of himself as physically safe, though he did feel more mentally protected. "I don't talk to anyone from those days, but I'm grateful for the experience. Teacher support definitely made it feel a lot more open."

Everyone deserves to feel safe and affirmed in their identities—it shouldn't be a rare experience.

Dr. Nath says there are a few common sense things parents and caretakers can do—whether they have LGBTQ children or not. "Learn the basics," she says. "Help kids be allies, so they don't think there's nothing they can do; kids can intervene if they see anti-LGBTQ situations, identifying microaggressions or bullying in school." Parents can also refrain from assuming that their child fits into the gender binary, and can ask about pronouns.

"Something as simple as using the right pronouns can be lifesaving," Dr. Nath says.

Legislators can also change the future for LGBTQ youth. "We need culturally-competent providers and health care," Dr. Nath explains. "So that kids can talk to someone safely and without stigma."

Investing in support services both at the legislative level and at the school level to address suicide risk is also important—as well as instituting intersectional and gender-affirming practices and a zero-tolerance policy for anti-LGBTQ bullying. Protecting kids from anti-LGBTQ legislation such as conversion therapy is also key.

Envisioning a More Inclusive World for LGBTQ Youth

This year, the Trevor Project also asked LGBTQ youth to describe what a world where all LGBTQ people are accepted would look like. Here's a summary of the descriptors used:

• better
• peaceful
• happy
• happier
• normal
• free
• able
• perfect
• beautiful

In the world they described, "people ask pronouns," there are "gender-neutral bathrooms," folks can "be who they want to be," and others "mind their own business." "People are able to express themselves" and have "basic human rights." Indeed, in this world where they "feel like people would be happier and kinder," and "people just exist."

Dr. Nath says this gathering of LGBTQ young people's thoughts for a brighter future helps give readers of the survey opportunity to help. "A lot of people say they don't know how to help, or even if they can," she continues. "But it's okay to not be an expert. You don't need to be an expert to be an ally."

Dr. Nath suggests checking out The Trevor Project. There, you'll find common sense ways to be an ally, including this guide to being an ally for transgender and nonbinary youth.

The Trevor Project Survey each year opens our eyes to the challenges, risks, and potential rewards and avenues of expansion and affirmation for LGBTQ young people. This year, though the numbers are alarming, they are important for every parent to see—not just those with LGBTQ kids, but for everyone.