LGBTQ youth are not inherently prone to suicide risk because of their sexual orientation or gender identity but rather placed at higher risk because of how they are mistreated and stigmatized in society.
- Suicide is the second leading cause of death among young people aged 10 to 24 (Hedegaard, Curtin, & Warner, 2018) — and lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth are at significantly increased risk
- LGBTQ youth are more than four times as likely to attempt suicide than their peers (Johns et al., 2019; Johns et al., 2020).
- Experts estimate that more than 1.8 million LGBTQ youth (13-24) seriously consider suicide each year in the U.S. — and at least one attempts suicide every 45 seconds.
- 2021 National Survey on LGBTQ Youth Mental Health found that 42% of LGBTQ youth seriously considered attempting suicide in the past year, including more than half of transgender and nonbinary youth.
The Importance of Intersectionality
- Intersectionality is a framework for understanding how interdependent and multidimensional social identities at the individual level, such as race/ethnicity, gender, and sexuality, are shaped by interlocking systems of privilege and oppression at the societal level, such as heterosexism, cisgenderism, and racism (Crenshaw, 1991).
- This intersection of identities may, in turn, present distinct stressors for some LGBTQ youth compared to others, and minority stress may be most persistent and problematic for youth who occupy multiple marginalized social positions (Cyrus, 2017).
- That said, largely due to sample size limitations, researchers often fail to examine within-group differences among LGBTQ youth, limiting our understanding of within-group disparities in suicidal thoughts and behaviors.
- However, existing research points to increased disparities for bisexual youth, transgender and nonbinary youth, and LGBTQ youth of color.
Mental Health Disparities Across Social Identities
- Data shows that bisexual youth, or those who have the capacity to form attraction and/or relationships to more than one gender, report higher rates of depressed mood, bullying, sexual assault, and physical harm
- Almost half (48%) of bi young people seriously considered attempting suicide in the past year, and 27% attempted suicide. Among gay or lesbian youth, 37% seriously considered suicide and 19% attempted. And among straight youth, 14% seriously considered suicide and 6% attempted suicide.
- These suicide risk disparities among bi youth also remain constant across gender identity and race/ethnicity.
- Transgender and Nonbinary Youth
- Transgender and nonbinary youth face elevated risk for depression, thoughts of suicide, and attempting suicide compared to youth who are cisgender and straight, including cisgender members of the LGBTQ community.
- A 2020 peer-reviewed study published in the Journal of Adolescent Health, found that transgender and nonbinary youth were 2 to 2.5 times as likely to experience depressive symptoms, seriously consider suicide, and attempt suicide compared to their cisgender LGBQ peers.
- LGBTQ Youth of Color
- 2021 National Survey found that LGBTQ youth of color reported higher rates of attempting suicide than their white peers in the past year. Among the nearly 35,000 LGBTQ youth surveyed, 12% of white youth attempted suicide compared to 31% of Native/Indigenous youth, 21% of Black youth, 21% of multiracial youth, 18% of Latinx youth, and 12% of Asian/Pacific Islander youth.
Some Key Risk Factors for LGBTQ Youth Suicide
- The Minority Stress Model, one of the most predominant theories used to explain mental health disparities experienced by LGBTQ individuals, suggests that experiences of LGBTQ-based victimization — and the internalization of these experiences and anti-LGBTQ messages — can compound and produce negative mental health outcomes and increase suicide risk among LGBTQ individuals (Meyer, 2003).
- A 2021 peer-reviewed study published in the American Journal of Community Psychology, found that greater experiences of minority stress experiences are associated with increased odds of attempting suicide. LGBTQ youth who reported experiencing four types of minority stress — LGBTQ-based physical harm, discrimination, housing instability, and change attempts by parents — were 12 times at greater odds of attempting suicide compared to youth who experienced none.
- 75% of LGBTQ youth report that they had experienced discrimination based on their sexual orientation or gender identity at least once in their lifetime, and more than half said they experienced this discrimination in the past year. Those who experienced discrimination in the past year attempted suicide at more than twice the rate of those who did not.
- A 2020 peer-reviewed study published in the Journal of Adolescent Health, found that transgender and nonbinary youth who report experiencing discrimination based on their gender identity had more than double the odds of attempting suicide in the past year compared to those who did not experience discrimination based on their gender identity.
- A 2020 peer-reviewed study published in the American Journal of Public Health, found that youth who reported undergoing conversion therapy were more than twice as likely to report having attempted suicide and more than 2.5 times as likely to report multiple suicide attempts in the past year.
- According to The Trevor Project’s 2021 National Survey of nearly 35,000 diverse LGBTQ youth ages 13-24 across the U.S., 13% reported being subjected to conversion therapy, with 83% reporting it occurred when they were under age 18.
Some Key Protective Factors for LGBTQ Youth Suicide
Social Support and Acceptance from Adults and Peers
- Having at least one accepting adult can reduce the risk of a suicide attempt among LGBTQ young people by 40 percent.
- A 2021 peer-reviewed study published in Transgender Health, found that transgender and nonbinary youth who reported gender identity acceptance from adults and peers had significantly lower odds of attempting suicide in the past year.
- LGBTQ youth who report high levels of social support from family and friends are significantly less likely to attempt suicide compared to those with lower levels of social support.
- Affirming Spaces and Activities, Especially at School
- Research has found that LGBTQ youth who reported having at least one LGBTQ-affirming space had 35% reduced odds of reporting a suicide attempt in the past year — the strongest association being with LGBTQ-affirming schools.
- LGBTQ youth who report the presence of trusted adults in their school have higher levels of self-esteem (Dessel et al., 2017) and access to supportive peers is protective against anxiety and depression, including among those who lack support from their family (Parra et al., 2018).
- Schools also offer youth the ability to participate in extracurricular activities and clubs, which have been found to promote positive youth development (Eccles et al., 2003). The presence of Gender and Sexualities Alliances (GSAs) has been found to significantly reduce the risk for depression and increase well-being among LGBTQ youth and young adults (Toomey et al., 2011).
Policies and Practices that Support Transgender and Nonbinary Youth
- Transgender and nonbinary youth attempt suicide less when their pronouns are respected, when they are allowed to officially change the gender marker on their legal documents, and when they have access to spaces (online, at school, and home) that affirm their gender identity.
- Transgender and nonbinary youth who reported having pronouns respected by all or most people in their lives attempted suicide at half the rate of those who did not have their pronouns respected.
- Gender-affirming medical care, such as hormone therapy, is associated with positive mental health outcomes including showing promise for reducing suicide risk. A 2021 peer-reviewed study by The Trevor Project’s researchers, published in the Journal of Adolescent Health, found that gender-affirming hormone therapy is significantly related to lower rates of depression, suicidal thoughts, and suicide attempts among transgender and nonbinary youth.
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