Mental Health Issues in LGBTQ Youth

The LGBTQ community is composed of individuals who have a different sexual orientation or gender identity than most of the population. While many people who identify as LGBTQ experience mental health issues, identifying as LGBTQ is not a mental illness itself. ¹

Within the LGBTQ community, those who are bisexual and transgender have the highest rates of mental health issues, and LGBTQ youth experience the most mental health issues compared to the rest of the age groups in the community. ¹

Members of the LGBTQ community are more likely to have mental health issues because they are at high risk for experiencing shame, discrimination, and adverse and traumatic events. There are several negative stereotypes associated with identifying as LGBTQ community, which can cause members to feel uncomfortable being honest about their identity. Hiding their true identity can increase feelings of loneliness. ¹

Fortunately, many people within the LGBTQ community have supportive friends, families, and communities that help them walk through adverse experiences and remain resilient. LGBTQ individuals also use mental health services 2.5 times more than individuals who do not identify as LGBTQ. ¹

Risk Factors

There are plenty of risk factors that go into the mental health issues in the LGBTQ in youth today.

Coming Out

There have been positive changes in the social attitude towards the LGBTQ community. This shift has led to an increase in the number of LGBTQ youth who “come out” or share their sexual orientation or gender identity. Coming out at a young age can impact social and relational experiences and negatively affect mental health, especially when these young people do not have a healthy support system. ²

Lack of Community

Coming out as a member of the LGBTQ community can sometimes be a difficult or traumatic experience. Coming out is especially challenging if it is met with rejection from a close friend, family member, coworker, or fellow member of a religious community. In 2019, 86% of LGBTQ youth were harassed or assaulted at school, which significantly impacted their mental health. ²

Violence

LGBTQ youth in the LGBTQ community have a higher risk of experiencing violence compared to other young people. Violence includes behaviors such as bullying, teasing, harassment, and physical assault. In 2015, a survey found the following regarding LGBTQ students: ³

10% were threatened or injured on school property
34% were bullied on school property
28% were subject to cyberbullying
23% of those who had dated in the past year experienced sexual dating violence that year
18% had experienced physical dating violence
18% had been subject to forced sexual intercourse at some point in their lives

Trauma

Members of the LGBTQ community may experience homophobia, biphobia, transphobia, bullying, and other forms of identity-based shame. This community is one of the most targeted communities by those who engage in hate crimes in the United States. The harassment and discrimination they face are often traumatizing. ²

Other forms of discrimination that the LGBTQ community experiences include labeling, stereotyping, denial of opportunities, and verbal, mental, and physical abuse. This discrimination can lead to a significantly heightened risk of PTSD in the LGBTQ community. ²

Inadequate Mental Health Care

Mental health treatment for LGBTQ individuals often groups together all individuals within the community. This approach can create a lack of proper mental health care, as each sub-community has its own set of experiences, challenges, and rates of mental illness. ²

Within the LGBTQ community, various individuals experience separate and overlapping mental health challenges. Other aspects of an individual’s identity, like race or economic status, can also affect their mental health status and their ability to access treatment. ²

Within the mental health field, people who identify as LGBTQ may face discrimination, harassment, or a lack of cultural knowledge from potential health care providers. This type of treatment can cause LGBTQ individuals to hide their sexual orientation or gender identity when seeking help, making it even more challenging for them to receive proper care. ²

Mental Health Issues

Young people in the LGBTQ community experience mental health issues at a higher rate than other young people and are also more likely to experience abuse.

A study conducted with LGBTQ youth found that: ⁴
Two-thirds of the participants reported that someone in their life had tried to convince them to change their sexual orientation
76% of participants said that the political climate affected their mental health
Less than half of the participants had come out to an adult at their school
58% of transgender and nonbinary participants reported that others had discouraged them from using a bathroom that wasn’t specific to their birth gender

Another study found that of the LGBTQ youth population: ⁴
34% experienced bullying at their school
18% experienced physical violence or dating violence at some point in their life
18% experienced some form of sexual assault
10% were threatened or injured with a weapon at school

Schools can sometimes provide unsafe learning environments for LGBTQ youth. They may expose these young individuals to discriminatory behaviors and practices. LGBTQ youth might experience several mental health issues as a result of this discrimination and other risk factors. Some of these mental health issues include anxiety and depression, stress, low self-esteem, disordered eating, substance abuse, and even suicide. ⁴

Anxiety and Depression

Young members of the LGBTQ community experience higher rates of anxiety and depression than their heterosexual and cisgender peers. As of 2020, LGBTQ youth are 1.75 times more likely to experience anxiety and depression than their peers, and trans and nonbinary youth are 2.4 times more likely to experience anxiety and depression. ⁴

Additionally, while the COVID-19 pandemic has been challenging for all individuals, it may have been particularly challenging for self-identified LGBTQ youth. Lockdown procedures caused many young members to experience increased exposure to stigma, especially when quarantining with unsupportive family members, which caused even greater anxiety. ⁴

One-third of LGBTQ youth reported that they could not be themselves at home, and 16% said that they felt unsafe at home. Additionally, 25% of LGBTQ reported that they did not have access to proper mental health care during the pandemic. ⁴

Stress

LGBTQ youth encounter similar stressors compared to other young people, including going through puberty, fitting in at school, conflicts at home, school work, and planning for the future. Unfortunately, young LGBTQ members also experience rejection and discrimination based on their identity. ⁴

Because of this additional, impactful stressor, stress rates among LGBTQ youth are much higher than other young individuals. A 2018 survey found that 98% of the LGBTQ respondents experienced trouble sleeping, 77% had felt depressed in the past week, and only 26% said they felt safe at their schools. ⁴

Low Self-Esteem

The self-esteem of young LGBTQ members can be significantly affected by potential discrimination, rejection from family members, and fear of being treated differently. In 2018, 91% of LGBTQ youth said they felt pride in their identity, and still, 70% felt worthless or hopeless in the past week. ⁴

Among LGBTQ youth, 67% reported that they had heard family members make negative statements about the LGBTQ community. LGBTQ youth of color had the highest feelings of rejection, and only 11% of this group said that their racial or ethnic group was viewed positively by others. ⁴

Disordered Eating

LGBTQ youth may be more likely to develop eating disorders to cope with the emotional pain they feel as a result of discrimination. Eating disorders can also develop out of a necessity to gain control when life feels out of control like it might for a young member of the LGBTQ community. ⁴

In 2020, 54% of LGBTQ individuals reported that they were diagnosed with at least one eating disorder at some point in their life. Additionally, in 2020, 21% of the LGBTQ community suspected they might have an active eating disorder. ⁴

Substance Abuse

Young individuals in the LGBTQ community might also be more likely than their peers to use substances as a coping mechanism. According to multiple studies, young lesbian, gay, and bisexual individuals use tobacco, alcohol, and illicit drugs at higher rates than their heterosexual counterparts. Additionally, lesbian and bisexual girls are 9.7 times more likely to smoke cigarettes than heterosexual girls, and 25% of gay boys are regular binge drinkers. ⁵

Any family rejection that LGBTQ youth might face can also affect their use of illegal substances. According to a study, young people who experience a moderate level of family rejection are 1.5 times more likely to use illicit substances than those who experience little or no rejection. Youth who experience high levels of family rejection are 3.5 times more likely to use these substances. ⁵

Young transgender individuals are at high risk of developing issues with substance dependency. Transgender people use certain drugs like methamphetamine, injectable drugs, and tobacco at higher rates than other individuals. ⁵

Unfortunately, transgender youth may experience more barriers to accessing behavioral health care than the rest of the LGBTQ community. These barriers include physical and verbal abuse from other clients and staff, clothing requirements based on biological sex instead of their identified gender, and sleep requirements with other individuals based on biological sex. ⁵

Suicide

Suicide rates have continued to rise for most groups over the years, and LGBTQ youth have continued to have higher rates of suicidal thoughts and actions than cisgender, straight youth. ⁴ LGBTQ youth are two times as likely to have suicidal thoughts than their peers. Additionally, suicide is the third leading cause of death among youth ages 15 to 24, and LGBTQ youth are more likely than their peers to attempt suicide. ⁵

In the past year, more than half of transgender and non-binary youth considered suicide. ⁶ In 2016, young people who identified as gay, lesbian, and bisexual considered suicide at three times the rate of their heterosexual counterparts. In 2019, 39% of the LGBTQ youth community had seriously considered suicide in the prior year, and 71% felt sad or hopeless. ⁴ Additionally, LGBTQ high school students engage in suicide attempts at a rate that is two to seven times higher than the rate at which heterosexual high schoolers do. ⁵

A 2009 survey found that of the students who seriously considered suicide in the year prior, 9.9% to 13.2% identified as heterosexual, and 18.8% to 43.4% identified as lesbian or gay. The survey also found that of the students who engaged in suicide attempts in the year prior, 3.8% to 9.6% identified as heterosexual, and 15.1% to 34.3% identified as lesbian or gay. ⁵

Supporting the Youth LGTBQ Community

Young members of the LGBTQ community thrive when they have healthy support systems at home and school. Strong bonds within the family, safety at school, and support from adults can help LGBTQ youth avoid depression and thoughts of suicide. Young LGBTQ members with supportive families have higher levels of self-esteem and better health overall. Additionally, transgender children who grow up in families that affirm their gender identity are just as psychologically healthy as their cisgender peers. ⁷

Support systems are such an essential aspect of the mental health and well-being of LGBTQ youth, these young people must have allies within their communities.

General Population

Members of the general population who are allies to LGBTQ youth should: ⁸
Not make assumptions about another individual’s sexual orientation or gender identity
Take a stand against homophobia, transphobia, and harassment and discrimination towards the LGBTQ community
Speak out against the use of slurs directed towards members of the LGBTQ community
Support LGBTQ individuals who choose to come out
Attend LGBTQ events
Learn about and discuss the rights of young LGBTQ people
Display LGBTQ buttons, stickers, posters, or clothing

Classmates

Classmates who are allies to LGBTQ can show their support by: ⁸
Reporting any LGBTQ harassment or discrimination they witness to the school principal in writing
Standing up for the respect and acceptance of LGBTQ friends and voicing support for them
Supporting a friend’s decision to bring a same-sex date to school-related social events
Advocating for a nondiscriminatory policy that includes sexual orientation and gender identity
Checking out books by LGBTQ authors about LGBTQ individuals and issues from the school library

School Faculty and Staff

School faculty and staff who are allies to LGBTQ youth can show their support by: ⁸
Making the classroom a safe space by refusing to tolerate any discrimination or harassment
Advocating for the adoption and enforcement of a nondiscrimination policy that includes sexual orientation and gender identity
Checking out books from the school library that LGBTQ authors have written about LGBTQ individuals and issues
Encouraging inclusivity at school events
Creating a curriculum that includes contributions of LGBTQ people
Teaching lesson plans about LGBTQ history month

Parents & Families

Parents and family members of LGBTQ youth should: ⁸
Support their children who might question their sexuality or gender identity or who identify as LGBTQ
Meet with school faculty and staff regarding any LGBTQ issues
Help their LGBTQ children file complaints when they experience any discrimination or harassment
Assist in the organization of events that celebrate LGBTQ history month
Hold their child’s school accountable to the school district’s nondiscrimination policy or state laws

By creating supportive environments for LGBTQ youth, these young people have the opportunity to embrace who they are and thrive within their communities.