LGBTQ+ youth’s mental health struggles are getting worse, according to a new survey

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.

These realities come into sharper focus in the first release of findings from an ongoing study by the Trevor Project to follow the mental health of nearly 1,700 youth in the United States over a long period of time.

Researchers at a West Hollywood-based nonprofit found a significant increase in psychological distress among participants. Over the course of one year, the proportion of participants who reported anxiety symptoms increased from 57% to 68%.

As political rhetoric has heated up over the past few years on the issues of teaching about LGBTQ+ identity in schools, playing transgender students on sports teams and whether to allow gender-affirming care, the share of young people who said they experienced symptoms of depression rose from 48% to 54%. Those reporting suicidal thoughts increased from 41% to 47%.

Transgender and non-binary youth were nearly twice as likely to say they would struggle with anxiety and suicidal thoughts than their cisgender peers—a pattern that was consistent in the first year of data collection on participants in this group.

“This allows us to clearly and unequivocally document what we know to be true: The treatment of LGBTQ+ youth in this country is harming their health and putting their lives at risk, and it’s getting worse,” James Black, executive director of The Trevor Project, said in a statement.

Even in California, a state considered a haven for trans people, the climate is changing. In a surprising move for an elected official who has declared support for the trans community, Governor Gavin Newsom recently vetoed a bill that would have required 12 months of hormone therapy coverage for transgender patients in California, citing cost concerns.

Another interesting finding in the study: an increase in the proportion of young people who said they had been pressured into “conversion therapy,” a controversial and scientifically dubious counseling process that advocates claim can suppress or eliminate same-sex desire, change the gender identity of young people who identify as transgender and question it.

The National Alliance on Mental Illness calls conversion therapy “stigmatizing, discriminatory, and harmful” and supports a ban on the practice that it says can harm the mental health of those who do not thrive. California became the first state to ban the practice in 2012.

But in the first year of follow-up, reports of threats to conversion therapy doubled, with 22% of respondents saying they had experienced this fear, up from 11% at the start of the study. The percentage of those who said they had experienced some form of conversion therapy rose 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 Challis v. Salazar, a Christian counselor argued that Colorado’s ban on conversion therapy for LGBTQ+ youth violated her free speech rights in voluntary therapy sessions with minors in question. Members of the court’s conservative majority, which prevailed earlier this year in a decision upholding Tennessee’s ban on gender-affirming care for minors, openly expressed skepticism about Colorado’s ban in hearings this week. The court is expected to decide on the case at the end of its session in June.

“Many people believe that this is a thing of the past, but the data shows that these dangerous practices are still happening,” said Dr. Ronita Nath, research assistant at the Trevor Project. She 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 a mental health survey every six months after joining the study.

This is the first time the Trevor Project has monitored changes in young people’s mental health over such a long period of time. Nath said such a complex, longitudinal study is important to public health providers and policymakers alike because it provides fresh evidence of a cause-and-effect relationship between social risk factors — such as the pressure to exchange treatment and lack of access to affordable mental health services — and future crises.

“Social and structural conditions drive these mental health outcomes, not just correspond to them,” Nath said.

The study found some positives: the percentage of LGBTQ+ youth who reported feeling supported at school increased from 53% to 58% during the first year. Also, 73% of participants said they asked friends for help, up from 45% at the start of the first year.

Most of those who participated in the study, however, said they had avoided seeking care because they couldn’t afford it or because they were worried they would suffer a mental health crisis.

Only 60% of respondents said they had access to mental health services at the end of their first year at the start of the study, down from 80% at the start of their follow-up.

On the other hand, 75% of those who received counseling in the first year of the study said they benefited from it, up from 61% at baseline.

The proportion of youth who said they sought help during suicidal episodes doubled to 64% during that period, Nath said, however, indicating an increase in youth suffering during this period.