LGBTQ+ Youth Are Facing A Mental Health Crisis

Photographed by Nicolas Bloise.
Suicide is the second leading cause of death among people ages 10 to 34, and those in the LGBTQ+ community are disproportionately affected. Right now, the burden being placed on the mental health of queer people is particularly high. That's evident in the Trevor Project’s 2020 National Survey on LGBTQ Youth Mental Health, which was released on Wednesday.
The survey was conducted over four months and included 40,000 respondents in the US, ranging from age 13 to 24. It delves into the topics affecting the mental health of LGBTQ+ youth, including discrimination, housing instability, barriers to affirming health care, and prevalence of conversion therapy.
The information revealed by the survey is critical, because it reinforces the importance of having safe spaces for queer communities, especially for its younger members. Nearly half of LGBTQ+ youth who wanted psychological or emotional counselling from a mental health professional were unable to receive it in the past 12 months, the survey found. Devastatingly, nearly 15% of LGBTQ+ respondents attempted suicide in the past twelve months; if you look at transgender and nonbinary youth, the stat rises to over 20%. And 48% of LGBTQ+ youth, and over 60% of transgender and nonbinary youth, reported engaging in self-harm in the past 12 months.
Compared to The Trevor Project's 2019 survey, these numbers are pretty comparable — but appear to have dropped a little. Last year, over 18% of LGBTQ respondents attempted suicide in the past twelve months and 29% of transgender and non-binary youth respondents have attempted suicide.
"These surveys reflect snapshots in time, and the characteristics of the youth who take it differ," Amy Green, PhD, director of research at The Trevor Project, tells Refinery29. "When samples differ in this way, researchers wouldn't examine changes over time using just this data. However, the CDC will be releasing probability-based data on US high school students later this year, and we will be looking to see whether they have also found decreases in suicide attempt rates for LGBTQ youth in their sample." 
Either way, the numbers are still troubling — and worth looking into. We spoke to Dr Green about the findings, and what she hopes people will take away from this year's report.
Refinery29: How did The Trevor Project go about conducting this survey?
Amy Green, PhD: "This is the largest existing survey of LGBTQ youth mental health. One of the reasons why we obtained such a large sample was because we know that our LGBTQ community is diverse. In order to ensure that we were capturing the perspectives of various intersections of identities within the LGBTQ community, we created this large sampling pool primarily using ads on social media, such as Facebook and Instagram that you saw over a four month period, from December 2019 to March 2020, that allowed them to complete the survey and provide us with their data so that we could really capture a wide diverse range of LGBTQ youth."

"There are a good number of LGBTQ youth who seriously consider suicide each year. We know that this is not something inherent to being LGBTQ, but is about the way LGBTQ youth are treated."

Amy Green
Are there any drastic differences between this year's survey and last years? Or similarities?
"There are similarities that we see in terms of the overarching findings, which are that there are a good number of LGBTQ youth who seriously consider suicide each year. We know that this is not something inherent to being LGBTQ, but is about the way LGBTQ youth are treated. So in both years, some of the strongest predictors of suicide attempts were things like experiences of discrimination due to their LGBTQ identity, experiences of victimisation due to their LGBTQ identity, as well as the harmful practice of conversion therapy.
"Both years, we also had questions and measures that looked at positive assets that LGBTQ youth may have in their life, such as accepting adults, having consistent use of the correct pronouns, having supportive LGBTQ spaces, and those types of supportive environments, people, and places really reduce the risk for suicide among LGBTQ youth.
"Some of our most powerful results this year related to the impact that affirming a transgender or nonbinary gender identity can have. Things like using the pronouns that the youth uses, having those gender affirming shape wears and clothing, and providing spaces for youth to be accepted and affirmed really reduce the risk [of death by suicide].
"LGBTQ youth who reported having their pronouns respected by all or most of the people in their life attempted suicide at half the rate of those who did not. I think this finding is extremely powerful, because it highlights how these types of affirming actions and using our words carefully and affirmatively can really save lives."
The Trevor Project has said that the study comes at a critical time as the country grapples with the implications of COVID-19 and national demonstrations around racial justice, which unfortunately affect Black LGBTQ+ people. Were any findings specific to Black LGBTQ+ people that you found eye opening or important?
"We know from last year's survey data that Black LGBTQ youth experience rates of attempting suicide that are similar to all LGBTQ youth. We also know on a national level that for Black youth, they are one of the populations for whom suicide rates are rising the fastest, particularly among the younger ages. We also know from our data that Black LGBTQ youth are the least likely to receive mental health care, including when they're experiencing thoughts of suicide and feelings of depression. That's really a manifestation of that systemic racism in terms of a system of care that is not working for Black LGBTQ youth in need."
What were the core findings of this survey, and why are they important?
"The core findings really fit in three areas. The first is the disparity, which is that even with changes and progress that's been made over the years for LGBTQ equality, we still see experiences of depression, anxiety, suicide, thoughts, and suicide attempts that are much higher for LGBTQ youth than what we know are the rates for their straight, cisgender peers. That disparity is there — it exists and it's large, and it's particularly impactful for transgender and nonbinary youth who have higher rates of suicide and mental health conditions and challenges.
"The second part is that the experiences of victimisation and discrimination are also common, and have an extremely negative impact on LGBTQ mental health and suicide. The third one is the findings on how impactful support and affirmation are for LGBTQ youth. I think with those three points... that this is related to discrimination and victimisation, which can be prevented. There are these positive affirming actions that can happen for youth that can really support them, and they're powerful because they provide us a plan for the future and a plan for a way to improve things so that we don't continue to see those high rates of depression, anxiety, and suicide attempts among LGBTQ youth year after year."

"LGBTQ youth who reported having their pronouns respected by all or most of the people in their life attempted suicide at half the rate of those who did not."

Amy Green
What are the most interesting, impactful, or necessary stats that have come out of the survey?
"Particularly now, the conversation nationwide is really focused more so on the importance of mental wellness and mental health care — and yet we're seeing the data that LGBTQ youth are not receiving the mental health care they desire. [Editor's note: The survey revealed that 46% of LGBTQ youth reported they wanted psychological or emotional counselling from a mental health professional, but were unable to receive it in the past 12 months.] The reasons range from not having LGBTQ-competent providers, to concerns with parents allowing them to have therapy. I think that now there is a need to look at the way that we provide mental health services to all youth, and LGBTQ youth in particular, so that we can start addressing some of those gaps.
"There's no reason why an LGBTQ youth should not be able to have the mental healthcare that they need. Our data shows that that that's an issue that's ongoing. Now, when we're physically distant and able to access services through online mechanisms and telehealth, is a time to start looking at ways to change things for the better."
How can we move forward with this information? How is the Trevor Project moving forward?
"The first thing we need to do is put policies into place that protect LGBTQ youth from victimisation, harm, and discrimination. That includes policies on the national and state level. The Trevor Project's advocacy team is actively working towards policies that are supportive of LGBTQ and stopping policies that may harm them, as well as at the community level — things like school policies that support LGBTQ youth.
"We also need to improve LGBTQ access to quality mental health care and reducing those barriers the LGBT youth experience related to getting mental health care. Finally, the results show how powerful the role of acceptance and support are. And this is an act that anyone can do to show LGBTQ youth that they are valued and accepted just as they are.
"At The Trevor Project, 24 hours a day, seven days a week, our crisis counsellors are on the phone to be there and show that affirmation and acceptance to LGBTQ youth. But this is also something that anyone who wants to support youth wellbeing can do by accepting, listening, using the correct pronouns, and being someone who shows LGBT youth that they care and that they are valued. The Trevor Project is working through our advocacy and our crisis services and our education to do this. There are also things that the rest of the community can really do as well to support and improve things for LGBTQ youth."

"The simple act of telling someone that you accept them, that you care, can really make a big difference."

Amy Green
What should readers take away from this information?
"I think we're starting to put together a picture of the factors that place LGBT youth at greater risk for suicide. We know that there's no one risk factor that causes an individual to attempt suicide, and there's also not going to be one factor that will prevent it. We need to invest in policies and programs and practices that support LGBTQ youth, and each one of us can do something to show youth that they are valued and that they are supported.
"That could be the simple act of telling someone, 'I see you, I accept you, I support you, I care.' Not everyone has to go out and be a crisis counsellor or do things that are time-intensive. The simple act of telling someone that you accept them, that you care, can really make a big difference. And if we all start doing that, we can make the world a better place for LGBTQ youth."
If you are thinking about suicide, please contact Samaritans on 116 123. All calls are free and will be answered in confidence.

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