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For children, teens, and young adults aged 10 to 24, the second leading cause of death is suicide. Teens and young adults who belong to the LGBTQ+ community experience suicidal ideation (seriously contemplating a suicide attempt) three times as often as their heterosexual/cisgender peers. LGBTQ+ youth attempt suicide five times at the rate of their heterosexual/cisgender peers.

These are self-reported numbers. The actual suicide rate among LGBTQ+ youth remains unknown because sexual orientation and gender identity are not reported in death records, and there is little research attempting to shed light on the issue. That is partly why it is difficult to determine how many LGBTQ+ youth completed suicide, despite the evidence that the suicide risk is massively higher among LBGTQ+ youth than other demographics.

However, research shows that LGBTQ+ youth are by large well-adjusted and mentally healthy. Studies show that LGB as well as transgender youth do not report mental health issues as a majority. Why are LGBTQ+ so much more likely to try to commit suicide, then? The answer lies in a series of unique risk factors that the LGBTQ+ community deals with.

Risk Factors for LGBTQ+ Teens

LGBTQ+ teens remain statistically more likely to report depressive symptoms, as well as substance abuse, and anxiety. But their increased risk of suicidal ideation cannot be explained by depression alone. Even when controlling for mental health issues and diagnosed instances of depression, LGBTQ+ teens remain more likely to attempt suicide.

Two risk factors that are unique to teens in the LGBTQ+ community are family rejection and a far higher likelihood of adolescent victimization (i.e. bullying). Both family rejection and adolescent victimization directly correlated with greater risk of suicide attempts, and suicides that required medical attention. Studies also made note of the increased risks of depression and suicide among transgender teens in particular.

Aside from LGBTQ+-specific risk factors like increased victimization and family rejection, LGBTQ+ youth also remain more at-risk for body image disorders and eating disorders, as well as reports of very low self-esteem. These tend to correlate with the risk of suicide. Notable risk factors to watch out for in teens in the LGBTQ+ community include:

    • Alcohol use
    • Other drug use
    • Signs of depression (including persistent low mood, a sudden change in sleeping habits, lack of motivation for old hobbies)
    • Signs of self-destructive behavior or maladaptive coping (including self-harm, binge eating, risky behavior)
    • Frequently talking about suicide, joking about suicide

On the other hand, research makes note of protective factors that may help reduce or prevent suicide attempts and help improve mental health outcomes among LGBTQ+ youth. These include:

    • Affirming relationships with peers and family
    • Family support
    • More legislation that protects LGBTQ+ youth
    • Changing policies and mindsets that discriminate against LGBTQ+ youth at school and in healthcare
    • Increased community awareness and tolerance for LGBTQ+ youth
    • Better access to mental healthcare

Suicide prevention is critical for LGBTQ+ youth, due to their disproportionate risk of attempting suicide. Another way to help reduce suicidal ideation is to directly target and treat the co-occurring risk factors, including mental health issues like depression and anxiety, as well as codependent substance abuse.

Suicide, Depression, and Substance Use in LGBTQ+ Teens

Substance use also plays a role in LGBTQ+ rates of suicidal ideation among youth, as LGB adolescents are shown to be at a higher risk of substance use and substance use disorders. While substance use describes the non-medical use of drugs and alcohol, substance use disorders are instances where substance use reaches a point wherein it becomes compulsive and severely self-destructive.

In many cases, LGBTQ+ youth resort to substance use to cope with associated risk factors, including stress and depressive symptoms. Drugs like alcohol, nicotine, marijuana, and different forms of prescription medication can help induce short-term euphoria, but at the cost of both an increased likelihood of using the drug again (and again), and long-term consequences related to excessive drug use (including cognitive decline, memory loss, greater risk of cancer, and more).

Treatment for teens with mental health issues and a codependent substance use disorder differ from treatment for just mental health issues. LGBTQ-specific dual diagnosis treatment aims to address substance use disorder and a co-occurring mental health issue within the context of nonconforming gender identity and sexual orientation.

Why Access to Mental Healthcare Is Critical

LGBTQ+ youth struggle with diminished access to mental as well as physical healthcare. Barriers to access include denial of service and other forms of negative bias and discrimination, including a greater risk of sexual assault from medical professionals, and delayed or inadequate care. Advocating for your loved ones and ensuring that they get access to the proper care they deserve is critical.

Mental health treatment for LGBTQ+ teens does not typically differ from treatment for their heterosexual peers with the same disorders. Mental healthcare professionals do account for the unique context of each teen’s experiences and issues, including instances of physical or verbal victimization, cyberbullying, and family rejection.

Among transgender teens who are experiencing symptoms of gender dysphoria, proper “treatment” will involve coordinating with the teen’s parents to help create an affirmative environment to help them explore their gender identity naturally and impartially, without fear of judgment. Carefully selected teens may undergo other forms of treatment depending on how their gender identity evolves, including puberty suppression and cross-sex hormones.

When seeking to reduce the suicide risk among LGBTQ+ teens, it helps to be aware of the factors that contribute to that risk, and aware of the protective factors that help diminish it. Some of the facts and science surrounding the LGBTQ+ community may be unknown or new to many parents, which is why continuing education is always critically important.

If you believe your teen or loved one is at risk of attempting suicide, it is important to get in touch with a mental health professional and consider how you can approach the topic in conversation. It is infinitely more important to address your worries than to shy away from the idea due to its controversial nature. No, talking to a teen about suicide does not plant suicidal ideas in their head. Instead, you might be able to give them the opportunity to make themselves heard and seek a solution for their issues together.