NATIONAL SURVEY ON LGBTQ YOUTH MENTAL HEALTH 2020 INTRODUCTION
Experts are just beginning to understand Among some of the key findings of the report This year’s survey exemplifies our the mental health impacts of the multiple from LGBTQ youth in the survey: organization’s commitment to using crises in 2020 that have deeply impacted • 40% of LGBTQ respondents seriously research and data to prevent LGBTQ youth so many. But we know that suicide is still a suicide. public health crisis, consistently the second considered attempting suicide in the past twelve months, with more than half of leading cause of death among young people, We will continue to leverage new research and continues to disproportionately impact transgender and nonbinary youth having seriously considered suicide to help inform our life-saving services for LGBTQ youth. The need for robust research, LGBTQ youth, as well as expand the • 68% of LGBTQ youth systematic data collection, and comprehen- reported knowledge base for organizations around sive mental health support has never been symptoms of generalized anxiety dis- the globe. Our partner organizations also greater. order in the past two weeks, including conduct critical research, and we more than 3 in 4 transgender and nonbi- acknowledge that our life-saving programs The Trevor Project’s 2020 National Survey nary youth and research build on their important work. on LGBTQ Youth Mental Health is our • 48% of LGBTQ youth reported engaging second annual release of new insights in self-harm in the past twelve months, Given the lack of LGBTQ-inclusive data into the unique challenges that LGBTQ including over 60% of transgender and nationwide, we hope this report will provide youth face every day. nonbinary youth valuable insights that can be used by • 46% of LGBTQ youth report they researchers, policymakers, and the many Building on the findings of our inaugural wanted psychological or emotional coun- organizations working alongside The Trevor survey, it provides critical insights around seling from a mental health professional Project to support LGBTQ young people LGBTQ youth mental health disparities, but were unable to receive it in the past everywhere. discrimination, housing instability, 12 months barriers to affirming health care, subjection The Trevor Project’s research, advocacy, • 10% of LGBTQ youth reported under- education, and direct service programs will to conversion therapy, and suicide. The going conversion therapy, with 78% survey also highlights how safe spaces and continue to elevate the voices and reporting it occurred when they were experiences of LGBTQ youth. Our hope social support positively impact the well- under age 18 being of LGBTQ youth. is that by publicly sharing our resources • 29% of LGBTQ youth have experienced and our support for them, LGBTQ youth Representing the experiences of over homelessness, been kicked out, or run will hear us loud and clear: that they are 40,000 LGBTQ youth ages 13-24 across away beautiful the way they are, that their lives are valuable, and that they are never alone. the United States, it is the largest survey of • 1 in 3 LGBTQ youth reported that If you are an LGBTQ young person, please LGBTQ youth mental health ever conduct- they had been physically threatened ed. This wealth of data highlights the resil- know that The Trevor Project is here to or harmed in their lifetime due to their support you 24/7. iency and diversity of LGBTQ young people LGBTQ identity and demonstrates how important affirming • 61% of transgender and nonbinary one’s identity is to their health and wellness. youth Findings from this cross-sectional survey reported being prevented or also point to best practices for how to discouraged from using a bathroom that support LGBTQ young people and corresponds with their gender identity contribute positively to their mental health. • 86% of LGBTQ youth said that recent politics have negatively impacted their well-being • Transgender and nonbinary youth who reported having pronouns respected by all or most people in their lives attempted suicide at half the rate of those who did not have their pronouns respected Amit Paley CEO & Executive Director The Trevor Project
p.1 SUICIDE & MENTAL HEALTH 40% of LGBTQ respondents seriously considered attempting suicide in the past twelve months.
More than half of transgender and nonbinary youth have seriously considered suicide.
LGBTQ youth who Youth who attempted suicide among considered and attempted suicide: those who considered:
By Gender Identity: Cisgender
34%
11%
Transgender and nonbinary 41% Transgender and Cisgender 33% nonbinary 52%
21% Gender Identity
By Age: 13–17
48%
21%
18–24 13–17 year 44% olds 29% 34% 18–24 year olds
10% Age
p.2 SUICIDE & MENTAL HEALTH
68% of LGBTQ youth reported symptoms • 55% of LGBTQ youth reported symptoms of major depressive disorder in the past two weeks, including of generalized anxiety disorder in the more than 2 in 3 transgender and nonbinary youth past two weeks, including more than 3 in • 86% of LGBTQ youth said that recent politics have negatively 4 transgender and nonbinary youth. impacted their well-being • Nearly 15% of LGBTQ respondents attempted suicide in the past twelve months, including more than 1 in 5 transgender and nonbinary youth • 48% of LGBTQ youth reported engaging in self-harm in the past twelve months, including over 60% of transgender and nonbinary youth
46% of LGBTQ youth respondents report that they wanted psychological or emotional counseling from a mental health professional but were unable to receive it in the past 12 months.
In the past 12 months, have you wanted counseling from a Over 40% of LGBTQ youth mental health professional? reported they were unable to receive care due to concerns with parental permission.
No 16% Ability to afford care was the strongest barrier to receiving mental health care. Yes, but I didn’t get it 46% Yes, and I got it 38%
p.3 SUICIDE & MENTAL HEALTH Nearly half of transgender and nonbinary youth didn’t receive wanted mental health care due to concerns related to the LGBTQ competence of providers.
LGBTQ youth who wanted mental health care but were unable to get it cited the following reasons for cisgender and transgender and nonbinary respondents:
Inability to afford care 50%
58%
Concerns about getting parent/caregiver permissions 44%
46%
Concerns about finding an LGBTQ competent provider 23%
46%
Transportation difficulties 21%
31%
Fears of being outed 20%
26%
Previous negative experience 20%
26%
Lack of providers who were LGBTQ 7%
17%
p.4 CONVERSION THERAPY & CHANGE ATTEMPTS 6 out of 10 LGBTQ youth said that someone attempted to convince them to change their sexual orientation or gender identity.
LGBTQ youth who reported someone Youth who attempted suicide, comparison attempted to convince them to change their of those who experienced attempts to sexual orientation or gender identity: change their sexual orientation or gender identity to those who had not:
19% Attempt to convince to change No attempt to convince to change 42% No attempt to 8% Attempt to convince to change convince to change 58% Youth who attempted suicide
Who attempted to convince you to change your sexual orientation or gender identity?
Parent or caregiver 35%
Friend 28% Other relative 22%
Religious leader 14% Teacher or school counselor 6%
Healthcare provider 5%
p.5 CONVERSION THERAPY & CHANGE ATTEMPTS 10% of LGBTQ youth reported receiving conversion therapy from someone who tried to change their sexual orientation or gender identity to straight or cisgender.
LGBTQ youth who reported Youth who attempted suicide, Types of formal conversion undergoing conversion comparison of those who efforts reported by LGBTQ therapy: experienced conversion youth who underwent therapy with those who conversion therapy: had not: Not sure 28% Conversion 4% therapy Conversion Gender therapy identity 10% 8%
No conversion No 12% Both sexual therapy conversion orientation and 90% therapy gender identity 27% Sexual Youth who orientation attempted suicide 61%
LGBTQ youth underwent conversion therapy 3% of youth reported undergoing led by the following individuals: conversion therapy by a health- care professional. Personal pastor or priest Outside 6% religious leader 5% Healthcare 78% of youth who underwent professional conversion therapy reported that 3% it was when they were under the age of 18.
All respondents
p.6 DISCRIMINATION & PHYSICAL HARM 1 in 3 LGBTQ youth report that they have been physically threatened or harmed in their lifetime due to their sexual orientation and/or gender identity.
40% of transgender and LGBTQ youth who Youth who attempted suicide, nonbinary youth reported being experienced physical harm comparison of those who physically threatened or harmed due to either their sexual experienced physical harm in their lifetime due to their orientation or gender identity: with those who had not: gender identity, and 30% of LGBTQ youth reported being physically 31% Physical threatened or harmed in their harm lifetime due to their sexual orientation. Physical harm 33% No physical 11% No physical harm harm 67%
Youth who attempted suicide
LGBTQ youth who Youth who attempted suicide, 61% of transgender and experienced discrimination comparison of those who nonbinary youth reported being due to either their sexual experienced discrimination prevented or discouraged from orientation or gender identity: with those who had not: using a bathroom that corresponds with their gender identity, with school being the 22% Discrimination most frequent place where bathroom discrimination occurs. No discrimination 40%
No 8% Discrimination discrimination 60%
Youth who attempted suicide
p.7 HOUSING INSTABILITY 29% of LGBTQ youth have experienced homelessness, been kicked out, or run away.
LGBTQ youth who have Youth who have experienced Youth who attempted suicide experienced housing housing instability, among those who experienced instability: comparison by gender housing instability: identity:
38% Transgender 34% Transgender and nonbinary and nonbinary Experienced housing instability Cisgender 25% Cisgender 23% 29%
No housing instability 71% Youth who experienced Youth who housing instability attempted suicide
Percentage of cisgender or transgender and nonbinary 28% of LGBTQ youth who LGBTQ youth who reported that they were kicked out or ran experienced housing instability away due to their LGBTQ identity: reported a suicide attempt in the past year.
Among kicked out 33%
50%
Among ran away 35%
56%
p.8 SUPPORTING TRANSGENDER & NONBINARY YOUTH Affirming gender identityamong transgender and nonbinary youth is consistently associated with lower rates of suicide attempts.
Transgender and nonbinary youth Youth who attempted suicide, Transgender and nonbinary who report having their pronouns comparison of number of youth with access to binders, respected by all or most of the people who respected their shapewear, and gender- people in their lives attempted pronouns: affirming clothing reported suicide at half the rate of those None lower rates of attempting suicide A few who did not have their pronouns 28% Some in the past year compared to respected. 25% transgender and nonbinary 24% A lot youth without access.* Only 1 in 5 transgender and 19% All or nonbinary youth reported having most their pronouns respected by all 12% or most of the people in their lives, including less than one in ten among those who primarily Youth who identified as nonbinary. attempted suicide
Amount of people in transgender and nonbinary youth’s lives Youth who attempted suicide, who respect their pronouns: comparison of those who had access to binders, shapewear, and gender-affirming clothing All or most None to those who had not: 20% 7% 26% No access
A few 35% A lot Access to 14% 17% most
Some 21% Youth who attempted suicide
*Binders and shapewear refer to undergarments, such as tank tops or bodysuits, that help youth who are experiencing gender dysphoria align the appearance of their body with their gender identity. p.9 FINDING SUPPORT 78% of LGBTQ youth report having access to at least one in-person LGBTQ-affirming space.
86% of LGBTQ youth report having high levels of support from at least one person.
Youth who attempted suicide in the past year, 12% of those who reported at least one in-person comparison of whether spaces are LGBTQ-affirming space attempted suicide in the not LGBTQ-affirming or LGBTQ-affirming: past year compared to 20% of LGBTQ youth without in-person LGBTQ-affirming spaces. School (if enrolled) 20% • Over 80% of youth said that celebrities who are LGBTQ positively impact how they feel 11% about being LGBTQ Home • More than half of youth said brands who 16% support the LGBTQ community positively impact how they feel about being LGBTQ 12%
Community events
15% Youth who attempted suicide in the past year, comparison on whether they received low or 12% moderate support or high support from the following individuals: Work (if employed) Friend 12% 20%
9% 12%
13% of youth who reported high levels of support Special Person from family, friends, or a special person reported 18% attempting suicide in the past year compared to 22% of those with lower levels of support. 12%
Family 18%
7%
p.10 DIVERSITY OF GENDER IDENTITY & SEXUAL ORIENTATION LGBTQ youth identify themselves in an incredibly wide range of ways.
LGBTQ youth in the survey identified with LGBTQ youth in the survey identified with more than 100 different combinations of more than 100 different combinations of terms to describe their gender identity: terms to describe their sexual orientation:
Agender Androgynous Asexual/Ace Spectrum Androsexual
Bigender Butch Cisgender Achillean Biromantic
Boy or man Genderflux Bisexual Demiromantic Demisexual
Demigirl Demiboy Genderfluid Gay/Lesbian Greysexual
Femme Gender non-conforming Gynosexual Monosexual Queer
Genderqueer Girl or woman Omnisexual Polyamorous
Omnigender Queer Nonbinary Polysexual Pansexual Sapphic
Neutrois Transfeminine Prefer no labels Panromantic
Questioning Transmasculine Questioning
Sexually fluid Transgender
p.11 RESEARCH The mission of The Trevor Project’s Research Department is to produce and use innovative research that brings new knowledge and clinical implications to the field of suicidology and LGBTQ youth mental health.
To address this mission we:
Advance Scientific Inquiry Support The Trevor Project’s Inform Public Knowledge Providing empirical data to better Life-Saving Work Ensuring our research and evaluation understand the lives of LGBTQ youth Using internal and external data and findings are applicable and widely and suicidality including risk factors, research findings to advance The Trevor communicated to the broader public protective factors, and outcomes. Project’s crisis services and peer support including LGBTQ youth-serving agencies programs as well as advocacy and and mental health organizations. • The Trevor Project will be a leading education initiatives. source of scientific information on the • The Trevor Project will serve as a needs and strengths of LGBTQ youth • The Trevor Project’s advocacy and training national model on how to integrate the • The Trevor Project will collaborate activities will be supported by data best research evidence into its practices, with key national and international collected directly by The Trevor Project programs, and policies research teams and agencies to as well as evidence gathered from the • The Trevor Project will be a leading improve the lives of LGBTQ youth broader research literature resource on terminology related • The Trevor Project will embody an to LGBTQ youth evidence-informed culture in which all staff are supported and recognized in the use of research evidence
Recommended Citation The Trevor Project. (2020). 2020 National Survey on LGBTQ Youth Mental Health. New York, New York: The Trevor Project. For additional information please contact: [email protected]
p.12 METHODOLOGY The content and methodology for The Trevor Project’s 2020 National Survey on LGBTQ Youth Mental Health were approved by an independent Institutional Review Board.
The content and methodology for The suicide in the past 12 months were taken sample, a filter was applied to remove youth Trevor Project’s 2020 National Survey on from the Centers for Disease Control and who did not reach the midpoint of the LGBTQ Youth Mental Health were approved Prevention’s Youth Risk Behavior Surveillance survey, which included questions on suicide by an independent Institutional Review Survey to allow for direct comparisons to (n=13,343). Youth who were not LGBTQ Board. their nationally representative sample. (n=205) were excluded from the analytic sample. A quantitative cross-sectional design Each question related to mental health and was used to collect data using an online suicidality was preceded by a message Additionally, a mischievous responders survey platform between December 2, stating: analysis identified and removed 73 youth 2019 and March 31, 2020. A sample of who provided obvious hate speech about individuals ages 13–24 who resided in the “If at any time you need to talk LGBTQ populations in the free response United States was recruited via targeted options or who reported answering ads on social media. No recruitment was to someone about your mental dishonestly. conducted via The Trevor Project website or health or thoughts of suicide, any of The Trevor Project social media sites. please call The Trevor Project The final analytic sample was Respondents were defined as being LGBTQ if they identified with a sexual orientation at 1-866-488-7386.” comprised of 40,001 LGBTQ youth other than straight/heterosexual, a gender ages 13–24 in the United States. identity other than cisgender, or both. In Participation was voluntary, and informed order to ensure the representativeness consent was obtained. No names or Preliminary analyses were conducted to of the sample, targeted recruitment was personal details were included to ensure identify any potential problems with conducted to ensure adequate sample sizes anonymity. A total of 60,795 youth from redundancy (e.g., multicollinearity) among with respect to geography, gender identity, unique IP addresses consented to complete similar variables such as experiences of and race/ethnicity. Qualified respondents the online survey. Youth who indicated that discrimination and victimization. All completed a secure online questionnaire they lived outside of the U.S. (n=210), were variables contributed uniquely to indicators that included a maximum of 150 questions. outside the 13–24 age range (n=551) or related to suicide attempts. Questions on sexual orientation and gender who did not meet predefined demographic identity (SOGI) were aligned with the best characteristics during the targeted practices identified in SOGI measurement. recruitment phase (n=6,412) were directed Questions on considering and attempting out of the survey. To create the analytic
p.13 METHODOLOGY Our analytic sample has representation from over PARTICIPANTS 4,000 Hispanic/Latinx LGBTQ youth, over 1,500 Black/ Youth participants in the survey were recruited broadly and African American LGBTQ youth, over 1,500 Asian/ represented a wide range of the LGBTQ community. Pacific Islander LGBTQ youth, and over 500 American Straight or heterosexual Indian/Alaskan Native LGBTQ youth. Bisexual 2% 35% Not sure 3% COMPARABILITY Queer In order to better understand how our sample compares to a national 10% probabilistic sample, we included questions regarding considering and attempting suicide that were identical to those used by the Pansexual Gay or 17% Centers for Disease Control and Prevention (CDC) in their Youth Risk lesbian Behavior Surveillance System (YRBS). 33%
Analyses were conducted to compare rates of seriously considering suicide and attempting suicide in the past 12 months among youth By Sexual Orientation ages 13–18 in our sample to the 2017 YRBS sample of lesbian, gay, and bisexual (LGB) high school students.
YRBS prevalence rates among LGB youth for seriously Ages 13–16 Ages 17–20 considering suicide (48%) were comparable to 36% 32% rates among the same age range in our sample (47%).
Additionally, 23% of LGB youth in the 2017 YRBS reported a suicide attempt in the past 12 months compared to 20% in our sample of Ages 21–24 youth ages 13–18. 32%
By Age Comparability metrics: Trevor Project Survey and YRBS Survey Questioning gender Girl or 5% woman Nonbinary, 51% genderfluid, or gender non-conforming 15% 2020 Trevor 47% 48% Most recent Project Survey CDC YRBS Boy or man (13–18) Survey 29% By Gender Identity
Considering suicide
Cisgender Transgender or 66% nonbinary 34%
2020 Trevor 23% Most recent Project Survey 20% CDC YRBS (13–18) Survey By Transgender and Attempting suicide Nonbinary Identity
p.14 The Trevor Project is the world’s largest suicide prevention and crisis intervention organization for lesbian, gay, bisexual, transgender, queer & questioning young people.
Need Help? We are here for you 24/7 For over 20 years, we have worked to TrevorLifeline TrevorText TrevorChat TrevorSpace save young lives by providing support The only nationwide, A free, confidential, A free, confidential, The world’s largest through our free and confidential crisis 24/7 crisis and 24/7, secure 24/7, secure safe space social services programs, including TrevorLifeline, suicide prevention service for LGBTQ instant messaging networking TrevorChat, and TrevorText. We also run lifeline offering free youth to text a service that pro- community for TrevorSpace, the world’s largest safe space and confidential trained Trevor vides live help for LGBTQ youth, their social networking site for LGBTQ youth, counseling for counselor for LGBTQ youth by friends, and allies. and operate innovative advocacy, research, LGBTQ youth. support and crisis trained counselors. and education programs across the country. intervention.
www.TheTrevorProject.org @TrevorProject @TheTrevorProject @TrevorProject
Trevor Research Trevor Advocacy Trevor Education Our programmatic Our advocacy work Our online education evaluations ensure at the federal, state, programs include we significantly and local levels information about reduce suicidality includes publicly school policies and with our services, advocating for/ training programs for and we also publish against particular teachers and guidance external research to bills and filing/ counselors. help peers support joining amicus LGBTQ youth. briefs in major cases.