Mental Health

Preventing Suicide in LGBTQ+ Teens

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.

Mental Health

Supporting LGBTQ+ Youth Mental Health During Pride Month and Beyond

As discussions surrounding discrimination reach peak relevancy this Pride Month, it’s important to be aware of the inequality that has been a primary issue for teens and young adults in the LGBTQ+ community for decades, and continues to be a pressing issue over 50 years after the Stonewall riots.

LGBTQ+ youth have been on the receiving end of underreported suicides and fatal harassment, denial of medical care, discrimination at school and in the workplace, and vicious bullying for years and years. Organizations like the American Civil Liberties Union and Lamdba Legal have made a huge impact on helping non-LGBTQ+ Americans recognize the legitimacy of our LGBTQ+ youth and shine a light on these issues.

Yet we are far from reaching a point of equality and understanding. Just a few days ago, the current administration reversed key health protections for transgender people. A recent National Survey on LGBTQ Youth Mental Health in 2021 found 42% of LGBTQ youth seriously considered attempting suicide. Higher rates of anxiety, depression, and suicidal ideation continue to be linked to rejection by family members, negative bias, discrimination, and serious barriers to access for mental and physical healthcare.

As educators, parents, friends, and allies, our role in helping our loved ones in the LGBTQ+ community is and always has been vital. Here are some of the ways you can continue to support the mental health condition of LGBTQ+ teens and loved ones.

Supporting and Affirming LGBTQ+ Youth

GLAAD’s annual survey on acceptance shows the number of Americans between ages 18 and 34 who are comfortable around LGBTQ+ individuals has decreased from 63 percent in 2016 and 53 percent in 2017 to 45 percent in 2018. Meanwhile, the number of young people who feel uncomfortable with the idea of having an LGBTQ+ relative has increased (from 29 percent to 36 percent), and more feel uncomfortable with the idea that their child had a school lesson on LGBTQ+ history (39 percent) than the previous year (30 percent).

The slow erosion of tolerance, particularly among young people, is surprising – and some speculate it might be tied to the “newness” of LGBTQ+ identities for teens and young people who had not previously been aware of non-binary gender identities and sexual orientations other than homosexuality and heterosexuality. Nevertheless, it hints at the need for more information and understanding on the topic of LGBTQ+ identity, particularly for teens and adults who feel confused by the concepts of distinguishing between biological sex, gender, and orientation.

Spreading LGBTQ+ Youth Mental Health Awareness

Aside from a rise in hate and discrimination, especially against trans people of color, another startling issue demanding attention is the lack of access to critical care for LGBTQ+ youth, as well as a lack of LGBTQ+ sex education, and general health care disparities among lesbian, gay, bisexual, and transgender youth. A report published by Human Rights Watch details how members of the LGBTQ+ community face discrimination leading to delays in critical care, leaving LGBTQ+ youth more vulnerable to mental health issues such as depression and substance abuse, as well as physical conditions like cancer and chronic pain.

The Affordable Care Act had previously prohibited discrimination in healthcare on the basis of sexual orientation and gender identity, yet even then issues of discrimination continued to occur. Prior to roll backs issued by the current administration that further puts LGBTQ+ youth at risk, surveys from 2017 already showed discrimination actively discouraged teens and adults in the LGBTQ+ community from seeking care when they needed it, and LGBTQ+ community members often had trouble finding alternatives after being turned away.

    • 9 percent of LGBTQ+ respondents reported that their healthcare provider used abusive language when treating them
    • 8 percent reported refusal of service
    • 7 percent reported unwanted physical contact (including sexual assault and fondling)

Among transgender respondents, the discrimination was even worse. 29 percent said they experienced refusal of service, 29 percent reported unwanted physical contact, and 21 percent reported abusive language. Nearly one in four transgender individuals refused to seek out healthcare out of fear of discrimination in 2015. Spreading awareness on these issues and highlighting the need to fight against discrimination in healthcare, both mental and physical, is critical if we wish to reduce the rate at which LGBTQ+ youth experience negative healthcare outcomes and complications related to poor healthcare, or none at all.

Speaking Out Against LGBTQ+ Discrimination and Bullying at School

A report on the effects of school bullying on LGBTQ+ youth, 85 percent reported being verbally harassed for their sexual orientation, and 44 percent were physically harassed for their sexual orientation. Compared to peers who reported low levels of school victimization, a survey of 245 LGBTQ+ individuals found higher levels of school victimization led to:

    • 2.6 times greater likelihood of depression
    • 5.6 times greater likelihood of attempted suicide
    • 2 times greater likelihood of an STD diagnosis

Across the board, higher levels of bullying and victimization led to significantly higher instances of depression, suicidal thoughts and attempts, and STD diagnoses later in life. If you have noticed that your loved one has experienced discrimination or bullying at school because of their nonconforming gender identity or sexual orientation, bring it up with the teachers and those in charge.

If the school does not already have a policy on anti-LGBTQ+ bullying and discrimination, petition for them to make one. And if the school does not have a student-run Genders & Sexualities Alliance (GSA), consider looking into organizing one, as GSAs can play a critical role in disseminating information and helping middle and high school students educate themselves on the topics of gender identity, sexual orientation, bullying, and suicide prevention.

Helping LGBTQ+ Loved Ones Seek Access to Mental and Physical Healthcare

Ultimately, public health recourse for teens experiencing victimization because of their LGBTQ+ identity is limited. It is important to encourage them to seek outside help for mental illness treatment and support, via LGBTQ+ mental health services, providers and therapists. Advocate for your loved one’s access to mental and physical healthcare and seek out local resources to help you identify LGBTQ+ friendly therapists, and specialists.

The best way to be an ally to a loved one is to help defend their basic human rights to exist, express themselves, and seek care and support from you and others. Many teens and youth are confused about who they are and lack the access to information they might be able to use to better understand themselves, which is why helping them seek information out can be vital as well. By expressing your support for them, you also empower them to find out who they are without judgment and bias.