High Gay Teen Suicide Rate: How We’re Still Failing Our Vulnerable Youth

While recent headlines on NPR screamed, “Nearly half of LGBTQ youth seriously considered suicide,” in Austin, protesters rallied at the Texas State Capitol on May 4, 2021, to stop proposed medical care ban legislation that would criminalize gender-affirming care. 

“The Trevor Project estimates that at least one LGBTQ youth between the ages of 13–24 attempts suicide every 45 seconds in the U.S.” 

What's wrong with the people we elected for, among many reasons, to protect our children from harm? They are either being killed by mass shootings due to a system that is adamant about letting an 18-year-old buy an assault weapon the moment he turns 18 - or killing themselves because of enacted laws that deem them not worth protecting.

Suicide is the second leading cause of death among young people (Centers for Disease Control and Prevention, 2020), with LGBTQ youth being four times more likely to seriously consider suicide, to make a plan for suicide, and to attempt suicide than their peers (Johns et al., 2019; Johns et al., 2020). Understanding the number of LGBTQ youth who seriously consider and attempt suicide, as well as how often suicide risk occurs, improves our ability to serve and advocate for LGBTQ Youth. 

The Trevor Project published its annual survey, which found rising rates of suicidal thoughts, as well as significant disparities among trans youth and LGBTQ youth of color. It demonstrated that suicidal thoughts have trended upward among LGBTQ young people over the last three years, making our life-saving work all the more important.

 "The impact of the COVID-19 pandemic and relentless political attacks during this time period cannot be understated."

Aimed at estimating the Number of LGBTQ youth who attempted suicide in the past year, The Trevor Project’s 2021 National Survey of LGBTQ Youth Mental Health found that 19.0% of LGBTQ youth ages 13–18 and 8.3% of LGBTQ youth ages 19–24 reported attempting suicide in the past year. Applying these rates to the estimates of LGBTQ youth living in the U.S. results in an estimated 503,073 LGBTQ youth between the ages of 13–18 and 209,917 between the ages of 19–24 who attempted suicide in the past year, for a total of 712,990 LGBTQ youth between the ages of 13–24.

Laws targeting LGBTQ youth have emerged across the country this year. In March, For example. Florida Gov. Ron DeSantis signed what opponents have called the "Don't Say Gay" bill while Alabama's state legislature voted to ban gender-affirming medical care for trans youth. 

According to the survey, 45% of LGBTQ youth seriously considered attempting suicide in the past year. Additionally, nearly 1 in 5 transgender and nonbinary youth attempted suicide.

More than 60% of LGBTQ youth said their home wasn't affirming, the survey found. Nearly 2 in 5 LGBTQ youth said they lived in a community that wasn't accepting of LGBTQ people.

Because many LGBTQ youth report attempting suicide multiple times in a given year, this estimate likely underrepresents the extent of how often LGBTQ youth attempt suicide in the U.S. Additionally, The Trevor Project’s past-year attempted suicide rates are based on non-probability data that trend slightly slower than rates among national probability datasets

This estimation does not account for the fact that many LGBTQ youth report multiple suicide attempts each year. Further suicide attempts are not distributed across time in an even and consistent pattern. Thus, this estimate only serves as an approximation of how often LGBTQ youth attempt suicide. Although the data on frequency of suicide attempts is based on our National Survey (which is not a probability survey)

Consider this:

Rates of suicide attempts were generally higher among LGBTQ youth of color, and particularly among Native/Indigenous LGBTQ youth — 21% say they attempted suicide in the past year.

• 60% of LGBTQ youth who wanted mental health care in the past year were unable to get it.

• 73% of LGBTQ youth reported experiencing symptoms of anxiety and 58% reported experiencing depression symptoms.

• LGBTQ youth are not inherently prone to suicide risk because of their sexual orientation or gender identity but 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  - and lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth are at significantly increased risk.

• LGBTQ youth are four times more likely to attempt suicide than their peers (Johns et al., 2019; Johns et al., 2020).

• The Trevor Project estimates that more than 1.8 million LGBTQ youth, ages 13-24 seriously consider suicide each year in the U.S. — and at least one attempts suicide every 45 seconds

• These numbers point to distinct stressors for some LGBTQ youth compared to others, and minority stress may be most persistent and problematic for youth in marginalized social positions.

Mental Health Disparities Across Social and Cultural 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.

According to The Trevor Project’s analysis of CDC data, almost half 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 non-binary Youth

• Transgender and non-binary 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.

• Trevor Project’s researchers found that transgender and non-binary 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

LGBTQ youth of color reported higher rates suicide than their white peers in the past year. Among the nearly 34,000 LGBTQ youth surveyed, 12% of white youth attempted suicide compared to 21% of Native/Indigenous youth, 20% of Middle Eastern/Northern African youth, 19% of Black youth, 17% of multiracial youth, 16% of Latinx youth, and 12% of Asian/Pacific Islander youth.

In particular, Black transgender and non-binary youth report disproportionate rates of suicide risk — with 59% seriously considering suicide and more than 1 in 4 (26%) attempting suicide in the past year. 

These disparities highlight the devastating impacts of historical and ongoing oppression and trauma inflicted on Black, Indigenous, and people of color.

Bullying & Discrimination

36% of LGBTQ youth reported that they have been physically threatened or harmed, and those who did attempted suicide at nearly triple the rate of those who did not in the past year.

52% of  in middle or high school LGTB youth reported being bullied either in person or electronically in the past year, and those who did had three times greater odds of attempting suicide in the past year, while  73% reported experiencing discrimination based on their sexual orientation or gender identity at least leading to twice the rate of suicide attempt compared to those who were not 

Conversion Therapy

A 2020 peer-reviewed study found that youth who underwent 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.

How May Coming out Help?

To start, their health and lives depend on it. Greater visibility and role models of public figures, including artists, offer a sense of hoping and belonging. 

Until the last decade or so, gay, bisexual, and transgender individuals were invisible in most aspects of life, making their need for comprehensive and specialized health often ignored or denied. LGTBQ youth have unique medical concerns that need to be addressed by a specialized, non-judgmental healthcare professional. Transgender individuals, more specifically,  may need medication on hormone replacement therapy that many can get through illegal means. 

Even today, about seven out of 10 LGBTQ youth report experiencing negative care leading them to avoid health care settings, leading to poorer health outcomes. Coming out may help these patients connect with a competent provider who can compassionately address vital health care issues and concerns while providing the youth with routine care, free of the worries about violence, discrimination, or harassment.

Better Medical Care:

There is hope!  Although it has taken the medical community way too long to acknowledge the unique medical needs of LGBTQ youth, as I did my research for this article, I was both proud and hopeful to see that the medical community has finally embraced that it is OUR RESPONSIBILITY to provide quality care to all, regardless of sexual orientation or gender identity.

For example, the EQUALITY study is focused on changing how medical practitioner providers in emergency rooms ask for and store information about sexual orientation and gender identity. The project's foundation benefit is that with better data, health care professionals will more easily identify the unmet needs of LGBTQ patients and offer more effective solutions.

Another project that is dear to my heart is geared at giving medical students the needed knowledge to provide appropriate care for These right risk youth. For example, an updated medical curriculum from the Johns Hopkins University School of Medicine enables trainees to connect with — and care for — the diverse patient populations they'll serve.

How to Help Our LGBTQ Youth:

Creating safe spaces at school is of extreme importance. 

Research has shown that LGBTQ youth who found their school and home to be LGBTQ-affirming reported lower rates of attempting suicide. Furthermore, LGBTQ youth who reported the presence of trusted adults in their school showed  higher self-esteem and decreased levels of anxiety and depression, especially among those among those who lacked support from their family,  which decreased the risk of a suicide attempt among by 40 percent.

A safe for all school setting also offers youth the ability to participate in extracurricular activities and clubs, leading to positive youth development. For example, the presence of Gender and Sexualities Alliances (GSAs) was found to significantly reduce the risk for depression and increase well-being among LGBTQ youth and young adults.

Also, 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.

References: 

Cyrus, K. (2017). Multiple minorities as multiply marginalized: Applying the minority stress theory to LGBTQ people of color. Journal of Gay & Lesbian Mental Health, 21(3), 194–202.

Green, A. E., DeChants, J. P., Price, M. N., & Davis, C. K. (2021). Association of gender-affirming hormone therapy with depression, thoughts of suicide, and attempted suicide among transgender and nonbinary youth. Journal of Adolescent Health, 1–7.

Green, A. E., Price-Feeney, M., & Dorison, S.H. (2019). National Estimate of LGBTQ Youth Seriously Considering Suicide. New York, New York: The Trevor Project.

Green, A. E., Price-Feeney, M., & Dorison, S. H. (2021). Association of sexual orientation acceptance with reduced suicide attempts among lesbian, gay, bisexual, transgender, queer, and questioning youth. LGBT health, 8(1), 26–31..

Johns, M. M., Lowry, R., Andrzejewski, J., Barrios, L. C., Zewditu, D., McManus, T., et al. (2019). Transgender identity and experiences of violence victimization, substance use, suicide risk, and sexual risk behaviors among high school student–19 states and large urban school districts, 2017. Morbidity and Mortality Weekly Report, 68(3), 65-71.

Parra, L. A., Bell, T. S., Benibgui, M., Helm, J. L., & Hastings, P. D. (2018). The buffering effect of peer support on the links between family rejection and psychosocial adjustment in LGB emerging adults. Journal of Social and Personal Relationships, 35(6), 854-871.

Price-Feeney, M., Green, A. E., & Dorison, S. (2020). Understanding the mental health of transgender and nonbinary youth. Journal of Adolescent Health, 66(6), 684–690. .

Ryan, C., Huebner, D., Diaz, R. M., & Sanchez, J. (2009). Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics, 123(1), 346-352.

The Trevor Project. (2019). Research Brief: Accepting Adults Reduce Suicide Attempts Among LGBTQ Youth. https://www.thetrevorproject.org/research-briefs/accepting-adults-reduce-suicide-attempts-among-lgbtq-youth/

The Trevor Project. (2020). 2020 National Survey on LGBTQ Youth Mental Health. https://www.thetrevorproject.org/wp-content/uploads/2020/07/The-Trevor-Project-National-Survey-Results-2020.pdf

The Trevor Project. (2020). Research Brief: LGBTQ & Gender-Affirming Spaces. https://www.thetrevorproject.org/research-briefs/lgbtq-gender-affirming-spaces/

The Trevor Project. (2021). Estimate of How Often LGBTQ Youth Attempt Suicide in the U.S. https://www.thetrevorproject.org/research-briefs/estimate-of-how-often-lgbtq-youth-attempt-suicide-in-the-u-s/

The Trevor Project. (2021). 2021 National Survey on LGBTQ Youth Mental Health. https://www.thetrevorproject.org/survey-2022/assets/static/trevor01_2022survey_final.pdf

Learn more about LGBTQ-specific health concerns:

• Lesbian and bisexual women
• Gay and bisexual men
• Transgender persons
• https://suicidepreventionlifeline.org/help-yourself/lgbtq/

About the author:

Dr. Edison de Mello is the Founder and Chief Medical Officer of the Akasha center of Integrative medicine in Santa, CA. He is both a board-certified Integrative Physician and a licensed Ph.D. psychotherapist. He and his husband, Drew, have co-parented 3 children, now ages 25-14. In his new book, BLOATED?, Dr. de Mello explains the connection between our gut, brain, and emotional wellbeing. Dr. De Mello is passionate about addressing how we as a system have failed our vulnerable youth.