There are many stresses that come with being an LGBTQ+ youth: fear, isolation, bullying, feeling like the world hates you, loved ones pressuring you to change.
Those realities become clearer in the first release of findings from an ongoing study conducted by the Trevor Project to track the mental health of about 1,700 young people in the U.S. over an extended period.
Researchers at the West Hollywood-based nonprofit observed a sharp increase in mental distress among participants. Over the course of a year, the proportion of participants reporting anxiety symptoms increased from 57% to 68%.
As political rhetoric in recent years has spilled over into issues such as teaching about LGBTQ+ identity in schools, transgender students playing on sports teams, and whether gender-affirming care should be allowed, the share of young people who said they have experienced symptoms of depression rose from 48% to 54%. Those who reported having suicidal thoughts went from 41% to 47%.
Transgender and nonbinary youth were almost twice as likely to say they had struggled with anxiety and suicidal thoughts than their cisgender peers, a pattern that remained stable during the first year of collecting data on participants in this group.
“This allows us to clearly and unequivocally document what we know to be true: the way LGBTQ+ youth are treated in this country harms their health and risks their lives, and it's only getting worse,” Trevor Project executive director Jaymes Black said in a statement.
Even in California, a state considered a haven for trans people, the climate appears to be changing. In a surprising move for an elected official who has proclaimed his support for the trans community, Gov. Gavin Newsom recently vetoed a bill that would have required 12 months of hormone therapy coverage for transgender patients in California, citing concerns about costs.
Another surprising finding in the study: an increase in the proportion of young people who said they faced pressure to undergo “conversion therapy,” a controversial and scientifically dubious counseling process that advocates say can suppress or erase same-sex desire, change the gender identity of young people who identify as trans, and discourage those who question it.
The National Alliance on Mental Illness calls conversion therapy “discredited, discriminatory and harmful” and supports banning a practice it says can harm, not improve, the mental health of those who undergo it. California became the first state to ban the practice in 2012.
But reports of being threatened with conversion therapy doubled in the first year of follow-up, with 22% of respondents saying they had experienced this intimidation, up from 11% at the start of the study. The percentage of those who said they had been exposed to conversion therapy in some way increased from 9% to 15%.
The findings come as the Supreme Court hears arguments in one of the most closely watched cases of its current term. In Chiles vs. Salazar, a Christian counselor, has argued that Colorado's ban on conversion therapy for LGBTQ+ youth violates her right to free speech in voluntary therapy sessions with interrogated minors. Members of the court's conservative majority, who prevailed earlier this year in a decision upholding a Tennessee ban on gender-affirming child care, openly expressed their skepticism about Colorado's ban in hearings this week. The court's decision is expected to be handed down at the end of its session in June.
“Many people believe it is a relic of the past, but the data indicates that these dangerous practices still occur,” said Dr. Ronita Nath, vice president of research for the Trevor Project. He added that threats and exposure to conversion therapy contributed to future depression and suicidal thoughts among study participants.
Researchers began recruiting in September 2023. Each participant completed mental health surveys every six months after joining the study.
This is the first time the Trevor Project has monitored changes in the mental health of queer youth over such a long period. Nath said this type of sophisticated, far-reaching study is important for both public health providers and policymakers because it provides new evidence of a cause-and-effect link between social risk factors (such as pressure to undergo conversion therapy and lack of access to affordable mental health services) and future crises.
“Social and structural conditions are driving these mental health outcomes, not simply coinciding with them,” Nath said.
The study identified some positives: The percentage of LGBTQ+ youth who reported feeling supported at school increased from 53% to 58% over the course of the first year. Additionally, 73% of participants said they sought help from friends, up from 45% at the beginning of the first year.
However, many of those in the study said they avoided seeking care because they couldn't afford it or because they feared being stigmatized for having a mental health crisis.
Only 60% of respondents said they had access to mental health services at the end of the first year in the study, compared to 80% at the beginning of follow-up.
On the other hand, 75% of those who received counseling during the first year of the study said they benefited from it, up from 61% at the beginning.
However, the proportion of youth who said they sought help during suicidal episodes doubled to 64 percent in that period, pointing to the higher level of distress youth experienced during that time, Nath said.
