No one is immune to mental health struggles, including anxiety, depression or even then thoughts of self-harm or suicide. Young people and teenagers are just as susceptible as adults. Research published in JAMA Pediatrics last year found that 5.6 million kids (9.2%) had been diagnosed with anxiety, and 2.4 million (4%) had been diagnosed with depression. And the disparity of mental health struggles between queer teens and their straight and cisgender is impossible to ignore.
The Centers for Disease Control and Prevention (CDC) notes that LGB youth are five times more likely than their straight peers to attempt suicide. The CDC also reports that transgender youth, in particular, are more likely to be victimized, abuse drugs and be at risk for suicide ideation and attempts.
But there is hope. “If we work together to create safe environments and support systems for LGBTQ young people, we can save young lives,” says Ronita Nath (she/her), who holds her doctorate in health research methodology and is VP of Research at The Trevor Project.
Here, the latest findings on LGBTQIA teens’ mental health and what Nath and other experts say parents and caregivers can do to offer support.
Why LGBTQIA+ kids are at higher risk for mental health struggles
The Trevor Project’s 2023 U.S. National Survey on the Mental Health of LGBTQ Young People, which the organization explains “amplifies the experiences of more than 28,000 LGBTQ young people ages 13 to 24,” not only confirms the dire need to protect the mental health of queer youth, but dives into the specifics of why they are struggling.
The key findings:
- 41% of queer youth have considered suicide.
- 56% of LGBTQ youth who wanted mental health care couldn’t get it.
- 38% of queer youth reported their home to be affirming, yet those who were living with people and going to schools where their identity was respected experienced lower rates of suicide attempts.
The connection between supporting a LGBTQIA+ teens and their mental health is clear. However, parents and caregivers often struggle with knowing how to support their queer teen, either in understanding their identity or how to get them the professional help they need. The good news is that it’s not as complicated as it seems, and education, as well as unconditional acceptance and love goes a long way.
A teen who identifies as LGBTQIA+ is not automatically at risk for mental health struggles because of their queerness. Joni Ogle, licensed clinical social worker and certified sex addiction therapist, says LGBTQIA+ teens are at higher risk for mental health issues due to ongoing stigma and lack of acceptance. Lack of queer-competent teachers, coaches and doctors put teens at risk too. While a queer teen may struggle with internalized homophobia or dysphoria based on their gender identity and/or their body, most of what impacts the mental health of a LGBTQIA+ teen comes from external people and environments.
These include:
- An unsupportive parent
- Anti-LGBTQIA+ legislation, both directly and indirectly
- Banned books
- Unsupportive school setting
- Social media that portrays negative comments about the LGBTQIA+ community
A queer teen’s risk is also higher if they also face cultural, religious or race-related discrimination. “Under the minority stress model, experiences of discrimination and violence are compounded and can lead to negative mental health outcomes for LGBTQ young people who hold multiple marginalized identities,” says Nath. “When these nuances are overlooked — or erased altogether — it becomes impossible to understand this community or the public health interventions that would more effectively meet their needs,”
More intersectional data needs to be collected in order to address the “very real and urgent health crisis of suicide,” she adds.
When the needs of queer teens are met, they are more likely to thrive, and what they need is access to affirming homes, education and health care.
“The number one concern of LGBTQIA+ teens is, ‘Will I be loved if I am different?’”
— ADAM D. BLUM (HE/HIM), LICENSED PSYCHOTHERAPIST AND FOUNDER OF THE GAY THERAPY CENTER
How parents and adults can be proactive and reactive when supporting their teen
“The number one concern of LGBTQIA+ teens is, ‘Will I be loved if I am different?’” points out Adam D. Blum (he/him), marriage and family therapist, licensed psychotherapist and the founder of the Gay Therapy Center. “One of the best ways you can help your teen is by letting them know how much they are loved.”
Even if you don’t have a child who is out to you or may never come out, it’s important to make sure your home is a safe and affirming environment for all kids, no matter how they identify.
Educate yourself
Doug Ziegler (he/him), a parent in New York who has a gay child, transgender child and nonbinary child, wishes he would have started educating himself earlier. “I’ve always been pretty progressive in my acceptance of people, but I didn’t really understand the challenges they face,” he notes. “I have a better grasp of that now, but I’m still learning. I would advise parents to start learning sooner rather than later. It makes empathy far easier.”
Gretchen Bates (she/her), Vermont, has a transgender son, and says the same. “I wish, as a new parent, I had been provided or seeked ways to educate myself to recognize the possibility that my children may not be the gender they were assigned,” she explains. “I wish I had picked up on these cues and given them the language they needed at an earlier age.”
Bates says that her son talks about not having the language to describe what he was feeling until months before he came out. Had she and her husband had been better educated, Bates believes they would have been better equipped to support her son and understand him and that would have lessened — if not prevented — the depression he experienced before coming out.
Use supportive language and embrace queer media
The language you use as a parent when referring to the LGBTQIA+ community goes a long way to providing an affirming home, says Rae McDaniel (they/them), licensed clinical professional counselor, certified sex therapist, CST, Transgender Diversity and Inclusion educator.
“Queering up” the media shown in your home by watching shows with “positive representations of queer characters, finding and sharing books with queer characters and listening to queer and transgender creators,” shows your support of the queer community, adds McDaniel. They also say that telling kids they are loved and supported no matter their sexual orientation or gender identity is something parents often miss.
Listen
You likely won’t have most of the answers or solutions for your teen, but that’s OK. They don’t always want you to fix something — they want you to listen.
“Spend time validating their emotions, offer support and give them space to open up about what they’re really thinking and feeling,” advises Lana Lipe, (she/they), a licensed clinical social worker. “Offering a listening ear lets them know that you care and that they are not alone.”
“Spend time validating their emotions, offer support and give them space to open up about what they’re really thinking and feeling.”
— LANA LIPE (SHE/THEY), A LICENSED CLINICAL SOCIAL WORKER
Connect to community
Providing spaces and people who support your teen is incredibly important to their mental health. Lipe says to familiarize yourself with local services that specialize in LGBTQIA+ youth support and advocacy and encourage your kids to seek support from LGBTQIA+ organizations, school clubs, counselors and trusted online groups like Q Chat Space or TrevorSpace.
Bates’ son thrives on the support of his own friends and family, she explains. “His mental health is improved through these relationships and really his own telling of his story to family who ask to understand in a supportive way has deepened his relationship with his aunts and uncles,” she says, adding that he also has a close relationship with family friends who are also transgender men.
Bates knows her son won’t feel comfortable sharing everything with her, and she is OK with that, because he has others he can reach out to. “My feeling is [that] the stronger community [he has] that is authentic and supportive, the more likely they will be to seek support or tell someone something at a time when they may not want to confide in their parents,” she says. “My husband feels the exact same way.”
How to talk about emotional pain and suicidal thoughts
“It’s impossible to know 100% of the time if your teen is struggling,” acknowledges McDaniel. “That said, there are ways to create an environment where your child feels more comfortable talking to you about their struggles.”
Talk early and often about mental health
Talking about mental health early and often, including ways you have struggled or ways you support your own health, make it clear you are a safe and nonjudgmental place to talk about their challenges.
“When we begin to accept that life includes pain for people of all ages, our children will be more likely to share their secrets with us,” says Blum. “They may start to believe that you won’t judge them or reject them for their depressed thoughts.”
Explore your relationship with mental health
Blum also reminds adults and parents that it gets easier to talk to children about mental health when we have explored our own relationship to difficult emotions like sadness or hopelessness.
Acknowledge that not being happy all of the time is “normal”
Blum says, “Are we willing to acknowledge to ourselves that we’ve also struggled during particularly painful times in our lives? It is not easy being a human. There’s a lot of pressure to be happy all the time, and yet, no one is. So why do we expect our children to be happy?”
Respond without shame or judgment
Talking about suicide does not increase the likelihood that someone will commit suicide. It does take away some of the shame and stigma though.
“We regularly ask people if they have thought about how they would kill themselves,” says Blum. “If you ask these questions calmly, bluntly, and without a critical or anxious tone, you are more likely to get an honest answer.”
Seek help if your child has suicidal thoughts or a plan
Blum says that if your child says they have thought about suicide or have a plan, you need to seek help for your child. Often a therapist will take your child off of a waiting list if they know the situation is urgent.
When to seek professional help
While parents and adults who love and work with teens can do a lot to support and improve the mental health of a LGBTQIA+ teenager, there may be a time when therapy is necessary. Even if a teen is in a supportive home, they may want an outside person to talk to. This can be because they know a therapist would be a good addition to their toolbox of support or because they have more serious emotions and thoughts to process and see the toolbox as a lifesaver. In this case, a clinical expert is a necessary part of getting a teen the help they need and deserve.
Before you get to this point though, especially if your child hasn’t asked you to see a therapist, you will need to nurture the conversation and look for both yellow and red flags that indicate your teen needs to see a therapist.
Ogle, says that the following are things parents should take seriously:
- Sudden withdrawal from peers and family
- Self-isolation
- Changes in mood or behavior, such as rapid mood swings or intense irritation over small things.
- Talking about self-harm
Additionally a lack of interest in things they usually enjoy and wearing clothing that is inappropriate for the weather (long sleeves on a hot day), are signs your child may be struggling or self-harming, says McDaniel.
Don’t ignore these signs. Instead start or continue conversations about mental health and the importance of therapy.
“If your child is resistant to seeing a therapist, it can be helpful to communicate that you are not suggesting they go to therapy because there is anything wrong with them, but because you want them to have a safe space to talk about their feelings and get support navigating a world that isn’t always friendly for the LGBTQIA+ community,” notes McDaniel.
Where to find an LGBTQIA+ affirming therapist
Ideally, you will find a LGBTQIA+ competent therapist for your teen. However, waitlists can be long and, depending on where you live, an in-person therapist may not be an option. As you start your search consider the following:
- Look for therapists who have had LGBTQIA+ training or mention their work with queer youth.
- Review the American Psychological Association’s practice guidelines.
- Ask a therapist if they meet the list of core competencies provided by the Society for Sexual, Affectional, Intersex, and Gender Expansive Identities (SAIGE).
- Search the CDC for a state-by-state guide on where to find LGBTQIA+ health care services, including affirming mental health providers.
- National Queer and Trans Therapist of Color Network has a state-by-state directory that helps QTPoC get the mental health they need.
If your teen prefers telehealth or it’s the only option, there are LGBTQIA+ providers who can offer phone or video appointments. Pride Counseling, Talkspace and Gay Therapy Center offer telehealth therapy sessions for LGBTQIA+ individuals.
The bottom line
A LGBTQIA+ teen is at higher risk for anxiety, depression and suicide ideation because they often lack the acceptance and affirming care they need and deserve. “It can be challenging for queer youth to navigate their identities and find support from those closest to them,” says Lipe. “As an adult in their life, it is essential to provide a safe and understanding environment.”
And even when parents and adults do everything “right” when it comes to supporting their LGBTQIA+ teen’s mental health, there are people and lawmakers who don’t; it’s important to be mindful of your child’s mental health in the face of both.
From providing your teen with LGBTQIA+ resources and community support and advocating for their rights and more, there are many ways in which you can support your child unconditionally and contribute to the wider effort to improve the conditions in which queer teens are living and learning so that they can thrive.