The Trevor Project — the world’s largest suicide prevention and crisis intervention organization for LGBTQ young people — has the results of its third annual national survey on LGBTQ youth mental health. The results show the consequences of the ongoing pandemic and call for urgent political solutions to contain a mental health crisis.
The discrimination that LGBTQIA+ people routinely face based on their sexual gender orientations and gender identities remains an alarming reality in 2021.
Being young can increase a certain degree of uncertainty and difficulty for people who are exposed to this discrimination. Discovering and possessing one’s own identity in adolescence is already a challenging process — and doing so while constantly questioning or denying that identity can endanger the mental health and well-being of a young person.
same time, intersectional identities present additional, unique challenges for young LGBTQIA+ people of color, people who come from historically marginalized groups, and people whose families do not have high incomes, and so on. All of these factors have an impact on the psychological well-being of a young person.
LGBTQIA+ youth are much more likely to have mental health problems than the general population, and the last year has increased the pressure of the pandemic on an already worrying landscape.
What is the mental health of LGBTQIA+ youth now and how are young LGBTQIA+ people doing during this phase of the pandemic? To find out, The Trevor Project collected and analyzed responses from nearly 35,000 LGBTQ participants aged 13 to 24 in the US. The survey was conducted between October 12 and December 31, 2020.
The survey used the term “LGBTQ” to refer to “lesbian, gay, bisexual, transgender, queer, and questioning” people, and the survey results report uses the term “transgender and nonbinary” as an umbrella term for a wide range of non-cisgender identities.
According to Amit Paley, CEO and Executive Director of The Trevor Project, the survey sample was the “most diverse so far compared to previous years, with 45% being LGBTQ youth of color and 38% being transgender or non-binary youth.”
In this function, we review the results of the survey. We also talk to two experts who helped us work out the wider socio-political implications of the survey, particularly for LGBTQ youth of color: Dr. Myeshia Price, senior research scientist at The Trevor Project, and Dr. Kia Darling-Hammond, author, mentor and director of education programs, and Research at the National Black Justice Coalition.
42% have “seriously considered” a suicide attempt
The new survey found that an alarming number of respondents, 42%, had “seriously considered” a suicide attempt last year. This included more than half of transgender and non-binary respondents.
Crucially, the survey revealed further differences in mental health across race. Twelve percent of white respondents said they had attempted suicide last year, while black and multiracial youth were both almost twice as likely to attempt suicide — 21%.
In addition, 31% of “indigenous” survey participants said they had attempted suicide last year. Finally, 18% of Latin American youth and 12% of “Asian/Pacific Islander” youth said they had attempted suicide during the same period.
“Strengthened identity can lead to aggravated difficulties”
Being a young LGBTQ person of color brings additional discrimination, as the survey shows. Fifty percent of LGBTQ youth of color said they had been discriminated against based on their race or ethnicity. This included 67% of black LGBTQ youth and 60% of LGBTQ youth among Asia/Pacific Islanders.
People who were discriminated against based on their sexual orientation, gender identity, race, or ethnicity reported a much higher rate of suicide attempts: 36% of those who were discriminated against said they had attempted suicide compared to just 7% of those who did not come forward had discrimination.
Overall, more than half of respondents to LGBTQ youth last year reported discrimination based on their sexual orientation or gender identity, and 75% said it had happened at least once in their lives.
“Intersectionality goes beyond the idea that identities are additive, such as Latinx and nonbinary,” Dr. Darling-Hammond told Medical News Today. “It recognizes that being a non-binary Latinx person is a unique phenomenon and is shaped by socio-political forces such as cultural norms relating to gender and ethnic identity, xenophobia, racism, misogyny, and so on.”
“If you add a young age to this list, the extent of potential disempowerment increases. Against this backdrop, the numerous people who are expansive both “of color” and gender and/or sexuality are being bombarded by powerful oppression.”
“A heightened identity can lead to aggravated difficulties,” Dr. Darling-Hammond emphasized, noting that black LGBTQ+ youth are also less likely to receive professional help.
“Even if indigenous, black and Latin American LGBTQ+/SGL people [same gender-loving] people get access to mental health care, they must deal with a predominantly white, cis-straight and wealthy corps of providers that is not just a product of a bigoted society, but has receives little to no corrective training and is generally unable to provide responsive support.”
— Dr. Kia Darling-Hammond
Although representation is critical, Dr. Darling-Hammond further explained: “A certain affinity for identity, like a black therapist,” does not guarantee that a “black LGBTQ+/SGL client receives the empathy and guidance they need.”
Queer and Trans People of Color face unique challenges
Dr. Myeshia Price from the Trevor Project echoed similar feelings and spoke to us about the unique challenges Queer and Trans People of Color (QtPoC) in particular faced in the past year.
“[QTPoC] had to endure an incredibly hostile political climate and almost constant news images of racist and transphobic violence, which can have a negative impact on mental health and self-confidence.”
“We also know that communities of color were disproportionately affected by COVID-19 and that QTPoC may be particularly vulnerable to negative mental health effects associated with the pandemic, as they were already at significantly increased risk of suicide attempts, primarily due to of an increased experience with victimization.”
These increased risks are in addition to already disproportionate rates of unemployment, homelessness, and lack of access to mental health care, according to Dr. Price.
Dr. Darling-Hammond also noted: “While only about 10% of the youth population identify as LGBTQ+/SGL, they make up between 40 and 50% of the unsheltered youth population.”
“The main reasons for their expulsion are: family rejection (and being kicked out) and fleeing from family abuse,” she added.
LGBTQ acceptance cuts suicide rates in half
The new Trevor Project survey also highlights the importance of LGBTQ-affirming practices and living environments, as well as the importance of having a support network and being surrounded by people who respect one’s identity.
For example, only one in three LGBTQ youth said their homes were LGBTQ affirmative, and 49% of transgender and non-binary respondents said that no one they lived with respected their pronouns.
Young people whose households fully respected their pronouns (29%) reported that they attempted suicide, half as likely as those whose pronouns were not respected at all.
In addition, young people who could change their name, gender, or both in legal documents had a much lower rate of suicide attempts.
“Respect and use pronouns and preferred names—this indicates respect for people’s humanity and authority over their own identity. It validates young people that they are being seen and it also helps them develop a strong sense of self-confidence, self-love, and confidence.”
— Dr. Kia Darling-Hammond
In contrast, discriminatory and abusive practices such as conversion therapy were associated with much higher suicide rates, according to the survey.
Transgender and non-binary youth were twice as likely as cisgender LGBTQ youth to undergo conversion therapy, and were twice as likely to attempt suicide as those who were not subjected to practice.
Reaffirming action: What each of us can do to help
“We can all help make the world a better place for LGBTQ youth,” said Dr. Price. “Educate yourself first and raise awareness among your friends and family about LGBTQ issues to relieve LGBTQ people who constantly need to explain themselves to others.”
“Actively encourage the creation of LGBTQ-affirming environments in your daily life, whether at home, at school, or online, where LGBTQ youth feel accepted and can thrive. And practices as simple as asking for someone’s pronouns and listening without judgment when they need support can have a profound effect on a young LGBTQ person.”
Dr. Darling-Hammond also spoke about steps each of us can take to support the mental health of LGBTQ youth in general and that of QTPoC in particular.
“Confirm, confirm, confirm! “she said. “Be vocal and don’t apologize when you support members of the QtNB-PoC community as whole people who are experts on their (evolving) self and needs.”
“Learn about QTPoC stories and cultures,” she added. “We’ve always been here.”
“Work on your prejudices — take on the life-long challenge of unlearning beliefs that oppress and disadvantage others, and act to remove structural and interpersonal prejudices, stigma, and discrimination.”
— Dr. Kia Darling-Hammond
The impact of COVID-19 on LGBTQ youth
The 2021 Trevor Project survey also looked more deeply at the impact of the pandemic on the mental health of LGBTQ youth. It is not surprising that the pandemic had negative economic consequences and put a strain on respondents’ financial security, which in turn has had an impact on their mental health and well-being.
Almost half of respondents said that COVID-19 has affected their ability to express their sexual orientations, and more than 80% of LGBTQ youth said it has made their living situation more stressful.
In addition, almost 60% of non-binary and transsexual youth said it had affected their ability to express their gender identity.
The pandemic has also contributed to food insecurity, which in turn is a risk factor for suicide. LGBTQ youth who reported food insecurity last month, 30% of respondents, were twice as likely to have suicide attempts as teens who did not report it.
Racial differences were strong here too. Fifty percent of all local/indigenous LGBTQ youth and more than one in three black and Latin American LGBTQ youth said they had experienced food insecurity in the past month.
“The past year was incredibly difficult for so many young LGBTQ people due to multiple crises, from the COVID-19 pandemic to the hostile political climate and repeated acts of racist and transphobic violence,” says Amit Paley. “This data makes it clear that LGBTQ youth face unique mental health issues and continue to have differences in access to affirmative care, family rejection, and discrimination.”
Proposed intersectional policy solutions
Paley gibt den politischen Entscheidungsträgern angesichts der Ergebnisse der Umfrage klare Leitlinien. „Die Bestätigung eines jungen Menschen in seiner Geschlechtsidentität ist stark mit einem geringeren Selbstmordrisiko verbunden“, sagt er. „Deshalb sollten wir die Unterstützungssysteme erweitern und integrativere Maßnahmen umsetzen, ohne Trans-Jugendlichen den Zugang zu bestätigenden Räumen und Pflege zu verweigern.“
„An alle Gesetzgeber, die Anti-Transgender-Gesetzesvorlagen im gesamten Landkreis in Betracht ziehen – wir bitten Sie dringend, sich diese Beweise genau anzusehen und sich Zeit zu nehmen, um sich tatsächlich mit den Transgender- und nicht-binären Jugendlichen zu treffen, die durch Ihre fehlgeleitete Vorschläge.“
— Amit Paley, CEO und Geschäftsführer von The Trevor Project
MNT befragte seine Experten nach intersektionalen politischen Lösungen für die in der Umfrage hervorgehobenen Probleme.
„Schulen, Beamte des öffentlichen Gesundheitswesens und alle jugenddienenden Organisationen für psychische Gesundheit müssen einen umfassenden, intersektionalen Ansatz für psychische Gesundheit und Suizidprävention verfolgen“, sagte Dr. Price vom Trevor Project.
„Das bedeutet, Programme und Dienstleistungen auf die spezifischen Bedürfnisse verschiedener Gemeinschaften zuzuschneiden, um effektiver zu sein – denn ein einheitlicher Ansatz reicht nicht aus.“
„Und bei der Entwicklung von Programmen für psychische Gesundheit für QTPoC sollten Sie immer Beiträge von Interessengruppen der Gemeinde einbeziehen, die es am besten wissen, bevor Sie externe Reaktionsstrategien anbieten, die darauf abzielen, ihren Gemeinden zugute zu kommen.“
Die Bedeutung kultureller Kompetenz, Repräsentation und Erschwinglichkeit
„Mangelnde kulturelle Kompetenz und Erschwinglichkeit sind große Hindernisse für die Versorgung von QTPoC“, sagte Dr. Price gegenüber MNT. „Daher brauchen wir politische Entscheidungsträger, die in öffentlich finanzierte Programme investieren und Anreize für die Einstellung vielfältigerer Arbeitskräfte im Bereich der psychischen Gesundheit schaffen.“
Die Vertretung schwarzer LGBTQ+-Personen als Therapeuten und in anderen psychiatrischen Diensten spielt ebenfalls eine Schlüsselrolle. „Es ist wichtig, dass Anbieter psychischer Gesundheit die gelebten Erfahrungen der Jugendlichen, denen sie dienen, verstehen oder teilen können“, betonte der leitende Forscher.
„In früheren Untersuchungen haben farbige LGBTQ-Jugendliche Bedenken im Zusammenhang mit dem Stigma der psychischen Gesundheit in ihrer Kultur sowie Bedenken hinsichtlich der Fähigkeit überwiegend weißer Anbieter, ihre Identität zu verstehen, und die Auswirkungen von Rassismus auf ihre psychische Gesundheit gemeldet.“
„Es ist notwendig, durch verstärkte Rekrutierungs- und integrative Schulungsprogramme eine vielfältigere Belegschaft im Bereich der psychischen Gesundheit zu entwickeln, sowie dass sich die bestehende Belegschaft kontinuierlich beruflich im Bereich Antirassismus weiterentwickeln und LGBTQ-Identitäten.“
— Dr. Myeshia Price, Senior Research Scientist bei The Trevor Project
„Wenn sich junge Menschen in ihrem Therapeuten oder Berater sehen, sind sie möglicherweise eher bereit, sich zu öffnen und das Gefühl zu haben, verstanden zu werden.“
Wirtschaftliche Entlastung „kritischster Ausgangspunkt“
Dr. Darling-Hammond bezeichnete umfassendere Bundesprogramme zur wirtschaftlichen Entlastung als „den kritischsten Ausgangspunkt“.
„Die Beseitigung existenzieller Stressfaktoren wie Wohnraum und Ernährungsunsicherheit kann erhebliche psychische und physische Energie freisetzen, die Teil dessen ist, was für den Aufbau einer einfühlsameren Gesellschaft erforderlich ist“, sagte sie. „Zu diesem Zweck wird eine vom Bund erzwungene Vermögensumverteilung von entscheidender Bedeutung sein.“
Furthermore, “federal laws such as the [Pursuing Equity in Mental Health Act] could enshrine both development and repair efforts, as they would introduce some long-needed civil rights protection measures and modernize others.”
Dr. Darling-Hammond weist auch auf positive und hoffnungsvolle Beispiele in bestehenden gesetzgeberischen Bemühungen hin, die ein gutes Modell bieten könnten, dem man folgen kann.
„Es gibt einen Gesetzentwurf, der [Pursuing Equity in Mental Health Act], der Investitionen in Höhe von 805 Millionen US-Dollar in Forschung, Entwicklung und Schulung von Anbieterpipelines sowie Programme zur Reduzierung der Stigmatisierung genehmigt. Der Schwerpunkt liegt auf schwarzen Kindern und Jugendlichen, mit einem gewissen Augenmerk auf schwarze LGBTQ+/SGL-Jugendliche. Diese Art von Gesetzgebung ist unerlässlich und schafft eine solide Grundlage für zusätzliche politische Infrastrukturen.“
“In education, we’ve seen progress toward an inclusive curriculum from California (ethnic studies) to Illinois (LGBTQ curriculum), so there’s hope,” she added.
Wenn Sie oder jemand, den Sie kennen, Hilfe oder Unterstützung benötigen,
stehen die ausgebildeten Krisenberater von The Trevor Project rund um die Uhr unter 1-866-488-7386, per Chat unter TheTrevorproject.org/help oder per SMS START an 678678 zur Verfügung.