New research takes a look at a mental health crisis that’s facing American young people who identify as lesbian, gay, bisexual, or questioning (LGBQ).
LGBQ youth report experiencing earlier onset of suicidality. This includes a faster progression from suicidal ideation to planning than heterosexual (straight) peers.
What do these findings say about support systems in place for LGBQ youth, and what more needs to be done to give these young people the help they need?
What the new research shows
The researchers looked at 1,771 adolescents who were part of the NEXT Generation Health Study. They followed young people who were in the 10th grade of high school in 2009 over the next 7 years, to 2016.
The results? LGBQ adolescents reported having a higher risk of suicidal ideation over their lifetime compared to their heterosexual peers — 26.1 percent to 13 percent, respectively.
Additionally, 16.6 percent of LGBQ youth had a higher risk of suicidal planning than 5.4 percent of straight adolescents. They also found that 12 percent of LGBQ young people had a higher risk of suicide attempts compared to 5.4 percent of heterosexual teens in the study.
The younger the respondents, the greater the concerns.
The researchers found that suicidal thoughts, planning, attempts, and suicide itself were more likely to be reported by LGBQ young people at younger ages — those younger than age 15 had riskier suicidal behaviors than people 15 years and older.
“What our results reinforce from the existing literature is that having those thoughts and acting on them might be different things — and in our study, LGBQ youth were more likely to act on them,” Luk said.
Luk began this research when he was a post-doctoral fellow at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). This research was finished once he came to the NIAAA. Both the NICHD and NIAAA are part of the National Institutes of Health (NIH).
“This highlights the need for timely suicide prevention to address reasons underlying suicide ideation among LGBQ youth so that they do not progress to acting on their suicide ideation,” Luk added.
Looking forward in future research, Luk said he and his colleagues will be examining the reasons why LGBQ youth may be more likely than their heterosexual peers to engage in risk-taking behaviors like high-risk drinking.
What other data shows
When asked what might account for these high rates of suicidal ideation, planning, and attempts among LGBQ young people, Luk said it’s known that LGBQ youth are “more likely than heterosexual peers to be depressed because they are, on average, less satisfied in their family and tend to experience more bullying at school and in social media.”
“LGBQ youth younger than age 15 do not only need to navigate developmental challenges that are common to teenagers, but they also need to explore their sexual identity and manage stress related [to] being a minority, which may potentially trigger thoughts of suicide,” he added.
Amy Green, PhD, vice president of research for The Trevor Project, the world’s largest suicide prevention and crisis intervention organization for LGBTQ+ youth, echoed Luk in saying that this research falls into the wider understanding of the higher rates of suicidal ideation LGBTQ young people face due to “how they are treated.”
“Compared to their straight, cisgender peers, LGBTQ youth are significantly more likely to experience discrimination, rejection, bullying, violence, and harassment — which can compound and produce negative mental health outcomes,” said Green, who’s not affiliated with the new study in Pediatrics.
“It’s important to emphasize that LGBTQ youth face stressors that their peers simply never have to worry about, such as anxiety around coming out and fears around being rejected or discriminated against on the basis of their LGBTQ identity,” Green explained.
Green cited results from The Trevor Project’s National Survey on LGBTQ Youth Mental Health 2021 that found 94 percent of LGBTQ young people reported politics negatively affecting their mental health, while 80 percent of these young respondents said the COVID-19 pandemic “made their living situation more stressful.”
She noted that just 1 in 3 LGBTQ youth reported that their home was “LGBTQ- affirming.”
Additionally, The Trevor Project’s survey found 75 percent of LGBTQ youth reported they “had experienced discrimination based on their sexual orientation or gender identity at least once in their lifetime and more than half said they experienced this discrimination in the past year,” Green said.
“Those who experienced discrimination in the past year attempted suicide at more than twice the rate of those who did not,” she added.
When placed in conversation with the new study, these statistics paint a worrying picture about the way LGBTQ+ young people are responding to stress, discrimination, and lack of social supports in the United States.
The experience of transgender and nonbinary youth
One thing the new study does not delve into is the full scope of the larger LGBTQIA+ community. It specifically looks at sexuality rather than gender identity.
When asked if rates of suicidal ideation, planning, and attempts were similarly high among young members of the greater transgender community, as well as people who identify as nonbinary, Green said “transgender and nonbinary youth face unique challenges and increased risk for suicidal thoughts and behaviors compared to their cisgender peers — including within the LGBTQ community.”
Green again pointed to The Trevor Project’s 2021 national survey that found 52 percent of transgender and nonbinary youth “seriously considered suicide in the past year and 1 in 5 reported attempting suicide.”
By comparison, 32 percent of cisgender LGBQ youth reported seriously considering suicide, while 1 in 10 attempted suicide in the past year.
“Further, our new journal article, ‘Cumulative minority stress and suicide risk among LGBTQ youth,’ underscores how these mental health disparities relate to cumulative minority stress, or the reality that the more marginalized an LGBTQ young person is, the more they experience stress related to their marginalized identities, and the greater their odds are for attempting suicide,” Green said.
“The study found that transgender and nonbinary youth had significantly greater odds of experiencing three or more minority stress risk factors, such as physical harm, discrimination, and/or housing instability due to their LGBTQ identity. And these disparities are most pronounced among youth who hold multiple marginalized identities, like transgender youth of color,” she added.
Providing better support
When asked what more can be done to improve suicide interventions and support, not just for LGBQ young people, but young people who fall within the greater LGBTQIA+ community, Luk said that working directly with schools and parents can go a long way in increasing acceptance and providing support.
He also said pediatric healthcare professionals can play a crucial role in “creating a safe and supportive environment” for these young people “to discuss mental health-related issues in the pediatric healthcare setting.”
Green stressed that “suicide is preventable.”
She echoed Luk that all of us working together to “create affirming spaces and support systems for LGBTQ young people” can save lives.
“Our research consistently shows that LGBTQ youth who have access to LGBTQ- affirming spaces like at home, school, or online report lower rates of attempting suicide,” she said.
“Further, transgender and nonbinary youth attempt suicide less when respect is given to their pronouns, when they are allowed to officially change their legal documents, and when their gender identity is affirmed,” Green added.
“Our research has also found that having at least one accepting adult in a young LGBTQ person’s life can reduce the risk of a suicide attempt by 40 percent. So, we all have a role to play in fostering the creation of a safer, more accepting world for LGBTQ young people,” she said.