09 Aug The Trevor Project National Survey on LGBTQ Youth Mental Health 2021

40% of LGBTQ youth have seriously considered suicide in the past year. Over half of transgender and non-binary youth have considered suicide, and 20% have attempted it.

The Trevor Project provides evidence-based support for LGBTQ youth through crisis services, peer support, advocacy and education. The organization recently released new data from their third annual National Survey on LGBTQ Youth Mental Health. The survey calls attention to severe mental health challenges and suicide risks, especially among transgender and non-binary youth and young adults. This year, the survey also included questions regarding the impact of the COVID-19 pandemic.

Survey Demographics 

Researchers surveyed nearly 35,000 lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) adolescents and young adults between the ages of 13-24, across the United States. Targeted recruitment for the survey via social media ads ensured a cross-sectional sample with respect to geography, gender identity, race, and ethnicity. Of the 35,000 participants, 37% self-identified as bisexual, 28% gay or lesbian, 19% pansexual, 12% queer, 4% questioning, and 1% heterosexual. In terms of gender identity,  38% of respondents identified as “transgender or non-binary,” which The Trevor Project uses as an umbrella term for non-cisgender participants.

Impacts of the Pandemic on LGBTQ Mental Heath

80% of the respondents said COVID-19 negatively impacted their mental health and added more stress to their living situation. Additionally, mental health was rated poor “most of the time” or “always” for 70% of LGBTQ youth. Nearly 40% of employed respondents lost their job during the pandemic. 

We know that there is a direct correlation between high stress situations like the pandemic and an increase in depression, anxiety, and suicide. Still, clinicians are only beginning to understand the complex effects of COVID-19 on mental health. For instance, mandatory lockdowns and school closures reduced some students‘ access to safe places. According to the survey, LGBTQ youth find their affirming spaces more often in school than at home. Those with no access to these types of spaces have higher rates of attempted suicide than those with access. Clinicians will need to consider the effects of lockdown for LGBTQ youth living in a home environment that does not affirm their sexual orientation or gender identity.

Risk Factors for Suicidal Ideation Among LGBTQ Youth 

Suicide prevention is a critical component of treating LGBTQ adolescents and young adults, who are far more likely to attempt suicide than their heterosexual peers. According to the survey, 40% of all LGBTQ youth have seriously considered suicide in the past year. However, specific sub-groups are more likely to consider and attempt suicide. Data from the survey gives clinicians a deeper look at the risk factors for suicidal thoughts and behaviors among LGBTQ youth in America. 

• Race/Ethnicity: Indigenous, Black, Hispanic, and multi-racial respondents reported higher rates of suicidal ideation and attempts than Whites and Asians.
• Age: Suicidal thoughts and behaviors are more common among LGBTQ adolescents (ages 13-17) than young adults (18-24). 
• Affirming Spaces: LGBTQ youth with no access to supportive environments online, at school, or at home have higher rates of attempting suicide than those who have access to places that affirm their orientation and gender identity.
• Transgender or Non-binary: Over half of gender non-conforming youth have considered suicide, and 20% have attempted it.
• Conversation Therapy: Of LGBTQ youth who attempted suicide in the past year, 27% had some form of conversion therapy, 12% did not. 
• Food Insecurity: A quarter of participants who attempted suicide in the past year had trouble affording food, compared to 11% who did not have to worry about food insecurity.
• Discrimination: The more discrimination a person faced, the more likely they were to attempt suicide. Among those respondents who attempted suicide, 36% experienced three types of discrimination—race/ethnicity, orientation, and gender identity; whereas, 13% encountered only one type, and 7% experienced none.

 
Special Considerations for Transgender and Non-binary Youth

Clinicians need to pay particular attention to transgender clients due to the high rate of suicide among this population. Oftentimes, these youth experience rejection by their families and harassment in their communities. These experiences can lead to shame–making them feel like they are a burden or don’t belong. However, the Trevor Project survey reveals certain factors that reduce suicide risks. Specifically, affirming transgender identity by respecting pronouns and allowing for changes in legal documents correlate with lower rates of attempted suicide.

Transgender youth who are able to alter legal documents, such as birth certificates and driver’s licenses, are half as likely to attempt suicide compared to those who cannot. Additionally, trans and non-binary respondents reported far fewer suicide attempts when members of their household use the individual’s preferred pronouns. This data suggests that gender-identity affirming environments can reduce the risk of suicidal thoughts and behaviors in this population. 

Increase in GAD and MDD Among LGBTQ Youth

Most LGBTQ youth experience symptoms of Generalized Anxiety Disorder (GAD) and Major Depressive Disorder (MDD). Overall, 72% of respondents reported having GAD symptoms in the past two weeks, up from 68% the previous year. 62% of participants had symptoms of MDD, compared to 55% of participants who reported this symptom in the year prior. The increase in anxiety and depression is consistent with an overall rise in these disorders among all adolescents and young adults during the COVID-19 pandemic.

Key Insights and Takeaways 

The Trevor Project 2021 National Survey calls attention to the serious mental health challenges facing LGBTQ youth in the United States. While these problems have increased for all youth during the pandemic, LGBTQ individuals are at particular risk, especially those who live in a non-affirming home environment.

High rates of anxiety, depression, and suicide among LGBTQ youth point to the need for early prevention. In the past year, nearly half of LGBTQ youth have wanted counseling from a mental health professional, but did not receive it. Programs such as the Trevor Project provide crisis support with a specific focus on LGBTQ youth, but more needs to be done. Young people may benefit from more school-based counseling and suicide prevention geared toward the LGBTQ community. Clinicians can use Electronic Health Records (EHR) to track demographic information and symptoms to watch for suicide risks in their clients, and plan their therapy accordingly. Ultimately, supporting and accepting LGBTQ youth can build the strength and resilience needed to save lives. 

Additional Resources 

• The Trevor Project Crisis line 1-866-488-7386
• It Gets Better Project
• Q Chat Space: A community for LGBTQ teens
• Parents, Families, and Friends of Lesbians and Gays (PFLAG)
• Helping Families to Support Their LGBT Children: A Practitioner’s Resource Guide
• Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth