Two in five. That’s the estimated ratio of young LGBTQ+ people who have “seriously considered” suicide in the past year (in the US alone). It comes from the National Survey on LGBTQ Youth Mental Health 2020 by the Trevor Project–the world’s largest suicide prevention and crisis intervention organization for lesbian, gay, bisexual, transgender, queer, and questioning youth.1

While the stats in the report—which reveal the unique challenges of over 40,000 LGBTQ+ youth aged 13-24—are staggering and tough to swallow, this new data will help researchers, policymakers, allies, and other organizations figure out steps for change. And it highlights something very crucial for anyone in the community who has experienced increased suicidal ideation: You are not alone.

Especially in 2020, a year that will go down in history for dealing blow after blow, there are people out there who feel the same way, and there are people out there who want to help you. So in this article, we’ll get really clear about what that help can look like. (If you’re in a crisis or simply interested in finding a safe space to talk, reach out to the TrevorLifeline, which is available 24/7 at 1-866-488-7386).

LGBTQ+ Suicide: Why It’s Happening

Let’s zoom out for a moment. After accidents, suicide is the second leading cause of death for people aged 15-24 in the US, according to data from the Centers for Disease Control and Prevention (CDC). No matter what your orientation, identity, or experience, all young people share one thing in common: a still-developing brain that’s particularly vulnerable to mood disorders like anxiety and depression, substance abuse, and yes, suicide.2,3

Neurologists know that the brain doesn’t quite reach total maturity until after age 25. In fact, the prefrontal cortex—which is the part of your brain that handles impulse control, complex decision-making, and rational reasoning and planning—is the last to fully develop.4

In the teenage brain, the hippocampus and amygdala—which are all about feeling and acting on emotions—are in the driver’s seat calling the shots. And that can be a lot to handle without the much more rational part of your brain helping to navigate life’s ups and downs. It’s why high school breakups really do feel like the end of the world, why bullying can easily cause depression, and why young people can make some pretty astonishing choices (there’s actually an entire podcast series, “What Were You Thinking” that explores how the adolescent brain is behind some of the riskiest decisions and behaviors).

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“Teens deal with a lot,” says Kathryn Van Eck, PhD, an assistant professor in the Division of Child and Adolescent Psychiatry at Johns Hopkins University and a psychologist at Kennedy Krieger Institute specializing in affirmative care for LGBTQ+ youth. “You’re trying to figure out who you are as a person and who your friends are. On top of that, you’re dealing with embarrassing parents and school and thinking about what you’re going to do with your life! There’s a lot of pressure on teens,” she says, “they’re a very stressed group of people.”

And then you have the LGBTQ+ experience.

“Being teenagers, a lot of interactions with the world are awkward and uncomfortable, but there’s this heightened sensitivity to that when you’re LGBTQ+,” say Van Eck. “It’s hard to know: Does this person just not know how to handle this part about me, or are they not accepting of me, or am I just being awkward with the situation? It’s not clear all the time.”

When you’re facing everyday microaggressions, societal and systemic discrimination, and—on the extreme end—conversion therapy, it’s easy to start internalizing that discomfort, explains Deborah Cohan, PhD, an associate professor of sociology in the Department of Social Sciences at the University of South Carolina-Beaufort who teaches classes on gender, sexuality, and society. “Internalized oppression is a form of self-loathing,” she says. “Sexual minority youth typically endure long periods of self-blame and shame, and it can be difficult to overcome.”

In the throes of intense pain, teens will try to solve problems with impaired problem-solving skills, making young LGBTQ people three times more likely to consider suicide—and five times more likely to have attempted suicide—than their heterosexual peers.

Who’s Most at Risk for LGBTQ+ Suicide?

Girls, transgender boys, and gender non-binary youth are the most vulnerable. Here’s why:

  • Girls tend to be more at risk for depression and report attempting suicide more than boys. “In general, we see a spike between 14-15 years of age in which adolescent girls show four times the rate of boys in having depression,” says Van Eck.5
  • Transgender boys and gender non-binary youth report higher rates of self-harm and have the highest rate of attempted suicide. 5“This is the group that has the most vulnerability and greatest burden of mental health,” says Van Eck. “Gender-diverse youth have two times the risk of depression, anxiety, and suicidal behavior compared to LGB, and four times the risk of depression compared to the general population of youths.”

[Click to Read:The Gender Identity Terms You Need to Know]

When teens get really irritable, withdraw substantially from social interactions, and stop enjoying the things that they like, “those are big signs that something isn’t right,” advises Van Eck. While girls might sometimes show more sadness or crying than boys, and boys might show more irritability or physical aggression than girls, the signs of depression are the same regardless of whether a child is LGBTQ+, cisgender, or otherwise.

Additionally, to help cope with that emotional distress and anxiety, “research shows that LGBTQ+ youth are using alcohol and other drugs at much higher rates (up to four times higher) than their heterosexual and cisgender peers,” says Joe Kort, PhD, psychotherapist, and clinical director and founder of the Center for Relationship and Sexual Health.6

“Parents, pay attention to your kids’ behavior and mood. If you’re noticing this, get a professional involved to help protect your child,” advises Van Eck. “We want to assess how we can help them so that they can move towards thriving.”

When Worrisome Behaviors Start

Experts say that issues like depression, anxiety, and self-harming behaviors can start to appear during early adolescence—regardless of sexual orientation or gender identity. But there’s an important context for LGBTQ+ and gender-diverse kids.

“Usually it’s during those early middle-school years when you start to go through puberty and begin to build more awareness of who you are as a person and how you may be similar and different to the people around you,” says Van Eck. “Your attraction to other people becomes clearer as you develop, and you might start to realize: I have all this diversity in my interests, or my gender identity isn’t aligned with my sex at birth.”

“That creates a lot of discomfort,” she continues. “Kids don’t know how the people in their life and their parents are going to react to that. So that discomfort and uncertainty can create a lot of anxiety, and often that’s the context for developing self-harm behavior or suicidal behavior.”

So when is the risk highest? According to Van Eck, “It’s that time between self-awareness of LGBTQ+ identity and that process of coming out.”

How Family Acceptance Protects LGBTQ+ Youth at Risk of Suicide

The process of coming out is an extraordinarily stressful and scary time. The Trevor Project report reveals that six out of 10 participants said someone close to them has tried to convince them to change their sexual orientation or gender identity (in other words, to stick with their birth gender). And 35% of kids who have experienced this say it came from a parent or caregiver.

Parental acceptance is absolutely huge,” says Cohan. It’s one of the most powerful protective factors. Kids who are accepted by their parents are “less likely to engage in dangerous behavior and destructive decisions, and they have improved physical and mental health, and less suicidal ideation and behaviors,” she explains.

And it’s especially true for gender-expansive youth (gender non-binary and transgender). Research tells us that “when parents allow their child to present themselves and identify the way that feels congruent for their child, their risk for depression, anxiety, and suicidal behavior looks the same as youth who are not gender diverse,” says Van Eck. “We can really see where that risk lies: Family relationships are critical.”

FAQs and Expert Tips for Parents of LGBTQ+ Youth

It’s really important that parents work to cultivate close relationships with their child and teen. It can be hard and frustrating, especially during those early teen years, but it’s extremely protective. Below are a few expert tips to common questions:

  1. How can I show acceptance to my child? “Do a lot of listening and asking questions,” says Van Eck, “and over-communicate acceptance and openness. It’s really important to demonstrate that connectedness with your child.” To open up conversation and keep a dialogue going, “remain curious,” says Kort. “Tell your child that you want to learn all about their identity and experience and what it means to and for them.”
  2. What if I’m not totally comfortable with what they’re telling me? “There are so many resources available for parents (see our list, below) designed to help you accept the way that your child is identifying and learn how to deal with that for yourselves as well,” says Van Eck. “But it’s important that the parents work on that themselves and not bring that to the relationship with their child. That puts a lot of pressure on LGBTQ+ youth, and ‘parentification’ is real. They start to feel like, ‘I need to take care of my parent; they’re having such a tough time with this, and I can’t talk to them about this part of me.’ That’s a huge risk factor, too.”
  3. Should I get a professional involved? “If you’re a parent who suspects that your child is going through this process and you’re noticing significant depression or anxiety symptoms, that’s when you want a mental health provider involved,” advises Van Eck. “And then just after your child has disclosed to you that they’re gender diverse or LGB is another vulnerable time and not a bad idea to connect them with a therapist. They might be great with their mental health already! I just like to err on the side of generous assessment and engagement in mental health as a protective measure because they still face more challenges than our heterosexual teens.”
  4. What should I do if I suspect self-harm or suicidal behaviors? In case of emergencies, always have suicide prevention hotlines handy (call the Trevor Project’s 24-hour crisis hotline for youth at 1-866-488-7386). When it comes to bringing it up in conversation, “whatever we do, we have to be gentle,” says Cohan. “People benefit from a compassionate response and one where they can come to see for themselves how their patterns of behaviors are not serving them well. We can’t simply tell someone in this situation that they have to stop, but by remaining open to listening, they’re less likely to shut down or hide things in the future.”

The Healing Power of Acceptance

Social acceptance is another big one. According to the Trevor Project report, only 13% of youth who reported high levels of support from family, friends, or a special person reported attempting suicide in the past year compared to 22% of those with lower levels of support.

What’s more, “a lot of LGBTQ+ youth report that they don’t have a single friend,” says Van Eck. “Just think about how that leads them to feel vulnerable in a social peer setting and creates actual vulnerability for other kinds of harassment and bullying.”

Some of the most impactful things we can do to show acceptance, support, and help provide a protective environment that’s fair to LGBTQ+ people include:

  • Respecting and using their pronouns (this help reduce the risk of suicide attempts by half!)
  • Not calling attention to sexual orientation or personal presentation.
  • Being aware of microaggressions (saying things like, “you don’t sound gay,” “you don’t look trans,” “how do you know if you’re queer if you’ve never had sex?”).
  • Being more active bystanders and calling out bullying and cyberbullying.

“The more we can respect and honor each other’s humanity and cultivate this approach in interacting with people in our family, school systems, and society, the more we can help this population,” says Van Eck.

Reasons for Hope

The good news in all of this is that “acceptance by non-LGBTQ+ peers is huge, and more and more families are accepting,” says Kort. “Many teens, after coming out, find that things do get a whole lot better.”

Cohan agrees, adding, “This is a generation that, despite its struggles with mental health and other deep issues, is indeed more accepting than ever before of issues related to gender nonconformity. They are more curious, open, and sympathetic

Through research, advocacy, education, and dynamic changes within our culture, school systems, and beyond, there are plenty of reasons for this community and their loved ones to feel hopeful about driving down the LGBTQ+ suicide rates—including:

Access to more mental health and affirmative care.

“We’ve gotten more comfortable with people being lesbian, gay, bisexual, and identifying as queer with sexual orientation, and now we’re getting more comfortable with gender diversity,” says Dr. Van Eck.

The team of pediatricians and nurse practitioners at Emerge Clinic at Johns Hopkins School of Medicine, for example, is part of the institution’s Center for Transgender Health that provides gender-affirmative care. And while there’s still a huge need for healthcare providers, especially for mental health, that have training, competence, and comfort in working with gender-diverse youth, specialists like Van Eck are helping to move the needle.

“I do a lot of training with different groups of people in schools and clinics so that pediatricians, social workers, therapists, and psychologists all feel comfortable providing affirming mental health care to gender-diverse youth,” she says. “I’ve found that pediatricians and mental health providers are very interested in partnering with me to create different services that meet kids’ needs when they’re gender diverse—it’s really exciting to see those programs blossom and grow.”

Advancements in technology for suicide prevention.

The Trevor Project, for example, is now using AI to prevent LGBTQ suicides, thanks to a $1.5 million grant awarded by Google to incorporate machine learning into its services—and that recognition from one of the most powerful companies in tech is key.

“When youth in crisis reach out to us via chat and text, they’re often connected to a counselor in five minutes or less,” the organization’s Director of Technology John Callery said in an interview with Fast Company. “We wanted to find a way to connect to LGBTQ youth at highest risk of suicide to counselors as quickly as possible, sometimes when every minute counts.”

The more data we have, the better-equipped advocates and leaders are to roadmap policies and programs that improve the mental well-being of LGBTQ+ youth, ultimately saving more lives. Instead of letting the worrisome stats paralyze us, let’s use it to make progress happen. As Cohan puts it, “One of the most gratifying things is witnessing the transformation of someone going from palpable self-hatred to becoming comfortable in their own skin. That’s a beautiful thing.”

Resources for LGBTQ+ Youth, Friends, and Supporters

  • If you’re a young LGBTQ person and need to talk to someone, call The Trevor Project’s 24-hour crisis hotline for youth at 1-866-488-7386.
  • If you are a transgender person of any age, call the Trans Lifeline at 877-565-8860.
  • TrevorSpace is a safe social networking site from the Trevor Project specifically made for the LGBTQ+ community.
  • PFLAG offers social activities for families with LGBTQ+ youth and also parent groups that help families stay connected and educated with series and toolkits, covering everything from gender basics to protecting kids from conversion therapy to keeping siblings seen and supported.
  • Human Rights Campaign (HRC) does survey research on LGBTQ+ topics and offers helpful information in the form of white papers and infographics—a great way to stay informed on the current issues.
  • Gay, Lesbian, Straight Education Network (GLSEN) has resources for parents, teachers, and students who want to implement non-discriminatory school policy, host local LGBTQ-affirming events, or learn more about the proper use of pronouns.
  • Gender Sexualities Alliance Network (GSA) (Gender Sexualities Alliance Network) lets you search student-run organizations that unite LGBTQ+ and allied youth to build community and organize around issues.
  • Campus Pride Index is a tool that helps students search and find LGBTQ+ friendly colleges and universities.
  • Check out these tips for parents of LGBTQ+ who are newly out about opening up the conversation and tangible ways to support them.

[Click to Read: The Tragedy of Child Suicide]

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Last Updated: Sep 30, 2020